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Kernot J, Goh J, Aguilar A, Muller J, Dawson S. Individual placement and support: A qualitative investigation of carers' experiences supporting someone experiencing mental illness into employment. Aust Occup Ther J 2024; 71:240-250. [PMID: 38110830 DOI: 10.1111/1440-1630.12922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 11/18/2023] [Accepted: 11/25/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Unemployment rates for people living with mental illness remain persistently high. Individual Placement Support (IPS) is an evidence-based employment model that supports people with severe mental illness to gain employment. Although carers provide emotional and instrumental support for people with mental illness, there is limited research exploring carers' perspectives of IPS. AIMS To explore carers' perspectives of their experience as caregivers of individuals living with mental illness who have participated in IPS. METHODS This qualitative descriptive study gained carers' perspectives through semi-structured interviews. A convenience sample of eight carers was recruited via a community mental health service in Adelaide. Data were analysed thematically. FINDINGS Three main themes were identified: (1) employment benefits, (2) factors that may impact on employment, and (3) knowledge and opinions of IPS. Within each theme, four sub-themes emerged. CONCLUSIONS This study addresses a gap in research and provides insights into carers' experiences of IPS. Increased communication and involvement of carers in IPS may benefit IPS participants and staff as carers provide invaluable additional insight into supporting individuals through their employment journey.
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Affiliation(s)
- Jocelyn Kernot
- Allied Health & Human Performance Academic Unit, University of South Australia, Adelaide, South Australia
| | - Jiin Goh
- Allied Health & Human Performance Academic Unit, University of South Australia, Adelaide, South Australia
| | - Alejandra Aguilar
- Allied Health & Human Performance Academic Unit, University of South Australia, Adelaide, South Australia
| | - Jess Muller
- Allied Health & Human Performance Academic Unit, University of South Australia, Adelaide, South Australia
| | - Suzanne Dawson
- Caring Futures Institute, Flinders University, Adelaide, South Australia
- Southern Adelaide Local Health Network, Adelaide, South Australia
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Salomon-Gimmon M, Orkibi H, Elefant C. The Contribution of a Music and Arts Rehabilitation Program to the Creative Identity, Well-Being, and Community Integration of People With Mental Health Conditions. JOURNAL OF HUMANISTIC PSYCHOLOGY 2022. [DOI: 10.1177/00221678221105719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The United Nations highlighted the importance of promoting the rights of people with mental health conditions (MHC) to education, employment, and citizenship. One related initiative in Israel is the Garage pre-academic music and arts school for individuals with musical and artistic abilities coping with MHC. This process–outcome study examined whether and how the Garage contributes to participants’ creative self-concept, mental health, alleviates loneliness, and promotes postsecondary education and work integration. It also probed the participants’ initial expectations and the extent to which these were fulfilled. Using a single-group pretest–posttest design, quantitative data on the outcome variables were collected, along with mid-test data on process variables from the Garage students ( N = 44). Supplementary qualitative data were collected at pretest on the students’ expectations. The results suggest a significant increase in creative personal identity and mental health, a decrease in loneliness, and promotion of postsecondary education and work integration. These findings were associated with persistent attendance, basic psychological needs satisfaction, and expectation fulfillment. A merged analysis indicated that the students’ qualitative expectations were generally congruent with the quantitative results. Overall, the findings show how the program corresponds to humanistic values, targets service users’ needs and rights, and promotes personal recovery and community integration.
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Affiliation(s)
- Maayan Salomon-Gimmon
- School of Creative Arts Therapies, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Hod Orkibi
- School of Creative Arts Therapies, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Cochavit Elefant
- School of Creative Arts Therapies, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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Yan H, Ding Y, Guo W. Clubhouse Model of Psychiatric Rehabilitation in China to Promote Recovery of People With Schizophrenia: A Systematic Review and Meta-Analysis. Front Psychiatry 2021; 12:730552. [PMID: 34589010 PMCID: PMC8473690 DOI: 10.3389/fpsyt.2021.730552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/16/2021] [Indexed: 01/08/2023] Open
Abstract
Background: Whether the clubhouse model of psychiatric rehabilitation is well-implemented in China and whether patients with schizophrenia successfully achieve symptom remission and functional recovery through engaging in the clubhouse remain unclear. Methods: Seven electronic databases were searched for relevant articles from inception to April 21, 2021. Quality assessment, data synthesis, and subgroup analysis were performed on the included studies. Results: Seven randomized controlled studies with 682 participants were included in the present meta-analysis. The clubhouse model of psychiatric rehabilitation has a significant effect on promoting the remission of psychiatric symptoms, especially negative symptoms. However, it does not show a definite effect on promoting recovery of positive symptoms. The clubhouse model of psychiatric rehabilitation has a significant effect on promoting social functioning recovery, reducing the family burden, improving the quality of life, and promoting the remission of depressive and anxiety symptoms of patients with schizophrenia in China. Conclusions: Our findings suggest that the clubhouse model of psychiatric rehabilitation can promote the remission of symptoms and functional recovery of Chinese with schizophrenia. It may be suitable to address the urgent need for better mental health services in China.
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Affiliation(s)
- Haohao Yan
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yudan Ding
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Wenbin Guo
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, China
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Jennings C, Lhuede K, Bradley G, Pepin G, Hitch D. Activity participation patterns of community mental health consumers. Br J Occup Ther 2020. [DOI: 10.1177/0308022620945166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Previous international research indicates that people with severe mental illness often experience lower levels of activity participation and may therefore be marginalized from occupational opportunities that support recovery. This study aimed to describe activity and participation patterns of consumers of mental health services living in the community and identify significant relationships with demographic characteristics. Method A cross-sectional observational study design was utilized, via data mining of the Activity and Participation Questionnaires completed while receiving services from an area mental health service. Data for 282 consumers, who submitted 333 questionnaires, were included. Results Consumers were mostly engaged in home-based and unpaid work, and their participation in these tasks significantly increased over time. Significant relationships were found between activity participation and age, gender and primary language. Consumers who were older were less likely to participate in employment, education and physical activity, while female and culturally and linguistically diverse consumers were less likely to engage in activities in the community. Conclusion Demographic factors may have a significant impact on the ability of consumers to participate in activities. This may require targeted approaches to activity and participation interventions for specific groups of consumers.
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Affiliation(s)
- Courtney Jennings
- Formerly of Occupational Therapy, Deakin University, Geelong, Australia. Currently LaTrobe Regional Hospital, Traralgon, Australia
| | - Kate Lhuede
- North Western Mental Health, Coburg, Australia
| | | | | | - Danielle Hitch
- North Western Mental Health, Coburg, Australia
- Occupational Therapy, Deakin University, Geelong Australia
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Pelizza L, Ficarelli ML, Vignali E, Artoni S, Franzini MC, Montanaro S, Andreoli MV, Marangoni S, Ciampà E, Erlicher D, Troisi E, Pupo S. Individual placement and support in Italian young adults with mental disorder: Findings from the Reggio Emilia experience. Early Interv Psychiatry 2020; 14:577-586. [PMID: 31642590 DOI: 10.1111/eip.12883] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 08/26/2019] [Accepted: 09/24/2019] [Indexed: 01/26/2023]
Abstract
AIM Individual placement and support (IPS) has a considerable body of evidence for its effectiveness in helping people with mental disorder to achieve and maintain competitive jobs. However, little data in young adult populations are currently available, especially in Europe. Aim of this study was to assess the effect of IPS in Italian young adults with moderate-to-severe mental illness, examining the main competitive employment outcomes and drop out rates during a 3-year follow-up period. METHODS Participants (n = 54) were recruited from patients receiving psychiatric treatment in one of the seven adult Community Mental Health Centers of the Reggio Emilia Department of Mental Health. Together with drop out rates, we investigated job duration (total number of days worked), job acquisition (employment in the labour market for at least 1 day during the follow-up), total hours per week worked, and job tenure (weeks worked on the longest-held competitive job). RESULTS A crude competitive employment rate of 40.7% and a crude drop out rate of 22.2% over the 3-year follow-up period were found. However, 66% of 42 clients who remained in the program over 3 years gained competitive employment at some time during the 3-year period. CONCLUSIONS This research shows the feasibility of an IPS intervention model in the public mental health care system in Italy, especially for a young adult target population.
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Affiliation(s)
- Lorenzo Pelizza
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Maria L Ficarelli
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elisabetta Vignali
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Simona Artoni
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maria C Franzini
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Serenella Montanaro
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maria V Andreoli
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | | | | | - Elisa Troisi
- School of Psychiatric Rehabilitation Techniques, University of Modena and Reggio Emilia, Modena, Italy
| | - Simona Pupo
- Intensive Care Unit, Guastalla Civil Hospital, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Anesthesia and Resuscitation Service, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
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Hart A, Psyllou A, Eryigit-Madzwamuse S, Heaver B, Rathbone A, Duncan S, Wigglesworth P. Transitions into work for young people with complex needs: a systematic review of UK and Ireland studies to improve employability. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2020. [DOI: 10.1080/03069885.2020.1786007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Angie Hart
- Centre of Resilience for Social Justice/Community University Partnership Programme, University of Brighton, Brighton, UK
| | - Agoritsa Psyllou
- Centre of Resilience for Social Justice, University of Brighton, Brighton, UK
| | | | - Becky Heaver
- Centre of Resilience for Social Justice, University of Brighton, Brighton, UK
| | - Anne Rathbone
- Centre of Resilience for Social Justice, University of Brighton, Brighton, UK
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Chanen AM, Nicol K, Betts JK, Bond GR, Mihalopoulos C, Jackson HJ, Thompson KN, Jovev M, Yuen HP, Chinnery G, Ring J, Allott K, McCutcheon L, Salmon AP, Killackey E. INdividual Vocational and Educational Support Trial (INVEST) for young people with borderline personality disorder: study protocol for a randomised controlled trial. Trials 2020; 21:583. [PMID: 32591007 PMCID: PMC7320570 DOI: 10.1186/s13063-020-04471-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 05/30/2020] [Indexed: 12/14/2022] Open
Abstract
Background The clinical onset of borderline personality disorder (BPD) usually occurs in young people (aged 12–25 years) and commonly leads to difficulty achieving and maintaining vocational (education and/or employment) engagement. While current psychosocial interventions lead to improvements in psychopathology, they have little effect upon functioning. Individual Placement and Support (IPS) is a client-driven model that assists individuals with severe mental illness to engage with education and/or employment appropriate to their personal goals, and that provides ongoing support to maintain this engagement. The objective of the INdividual Vocational and Educational Support Trial (INVEST) is to evaluate the effectiveness of adding IPS to an evidence-based early intervention programme for BPD, with the aim of improving vocational outcomes. Methods/design INVEST is a single-blind, parallel-groups, randomised controlled trial (RCT). The randomisation is stratified by gender and age and uses random permuted blocks. The interventions are 39 weeks of either IPS, or ‘usual vocational services’ (UVS). Participants will comprise 108 help-seeking young people (aged 15–25 years) with three or more DSM-5 BPD features and a desire to study or work, recruited from the Helping Young People Early (HYPE) early intervention programme for BPD at Orygen, in Melbourne, Australia. All participants will receive the HYPE intervention. After baseline assessment, staff who are blind to the intervention group allocation will conduct assessments at 13, 26, 39 and 52 weeks. At the 52-week primary endpoint, the primary outcome is the number of days in mainstream education/employment since baseline. Secondary outcomes include the cost-effectiveness of the intervention, quality of life, and BPD severity. Discussion Current treatments for BPD have little impact on vocational outcomes and enduring functional impairment is prevalent among this patient group. IPS is a targeted functional intervention, which has proven effective in improving vocational outcomes for adults and young people with psychotic disorders. This trial will investigate whether IPS is effective for improving vocational (employment and educational) outcomes among young people with subthreshold or full-syndrome BPD. Trial registration Australian New Zealand Clinical Trials Registry, ID: ACTRN12619001220156. 13 September 2019.
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Affiliation(s)
- Andrew M Chanen
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia. .,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia.
| | - Katie Nicol
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
| | - Jennifer K Betts
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
| | - Gary R Bond
- IPS Employment Center, Rockville Institute and Westat Inc., 85 Mechanic Street, Suite C3-1, Box 4A, Lebanon, NH, 03766, USA
| | - Cathrine Mihalopoulos
- Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, VIC, 3220, Australia
| | - Henry J Jackson
- Melbourne School of Psychological Sciences, Redmond Barry Building, The University of Melbourne, Parkville, Melbourne, VIC, 3010, Australia
| | - Katherine N Thompson
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
| | - Martina Jovev
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
| | - Hok Pan Yuen
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
| | - Gina Chinnery
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
| | - Judith Ring
- Travancore School, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
| | - Kelly Allott
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
| | - Louise McCutcheon
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
| | - Ashleigh P Salmon
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
| | - Eoin Killackey
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
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Moe C, Brinchmann B, McDaid D, Killackey E, Rinaldi M, Mykletun A. Approaches to implementing individual placement and support in the health and welfare sectors: a scoping review protocol. JBI Evid Synth 2019; 18:170-177. [PMID: 31503087 DOI: 10.11124/jbisrir-d-19-00035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review is to identify and map existing knowledge on the methods and approaches used to implement Individual Placement and Support at scale in the health and welfare sectors, as well as the frameworks and methodological approaches used in implementation studies, and to identify knowledge gaps that are important for further research. INTRODUCTION Individual Placement and Support is an evidence-based, standardized approach designed to support people with mental health conditions to gain and maintain competitive jobs in the labor market. Translating scientific knowledge into mainstream practice is challenging, and there is insufficient knowledge of the approaches used to implement Individual Placement and Support at scale in the health and welfare sectors. INCLUSION CRITERIA This review will include studies reporting on the implementation of Individual Placement and Support for people with mental health conditions within a health and welfare context, from 1993 to the present. Studies that have abstracts in English, German or Scandinavian languages will be considered. Randomized controlled trials will be excluded. METHODS The review will be conducted in accordance with the JBI methodology for scoping reviews. We will follow a three-step search strategy to trace published studies. Search strategies are developed to fit with the databases MEDLINE, Cochrane Central Register of Controlled Trials, Embase, PsycINFO, Base, OpenGrey and CINAHL. Data will be extracted from papers included in the review using data extraction tables developed by the reviewers. A qualitative content analysis will be used to facilitate the mapping of the results.
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Affiliation(s)
- Cathrine Moe
- Nord University, Faculty of Nursing and Health Sciences, Bodø, Norway.,Nordland Hospital Trust, Centre for Work and Mental Health, Bodø, Norway
| | - Beate Brinchmann
- Nordland Hospital Trust, Centre for Work and Mental Health, Bodø, Norway
| | - David McDaid
- London School of Economics and Political Science, Personal Social Services Research Unit, Department of Health Policy, London, UK
| | - Eoin Killackey
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Miles Rinaldi
- South West London and St George's Mental Health NHS Trust, London, UK
| | - Arnstein Mykletun
- Nordland Hospital Trust, Centre for Work and Mental Health, Bodø, Norway
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Salomon-Gimmon M, Orkibi H, Elefant C. Process and outcomes evaluation of a pre-academic arts program for individuals with mental health conditions: a mixed methods study protocol. BMJ Open 2019; 9:e025604. [PMID: 31324678 PMCID: PMC6661563 DOI: 10.1136/bmjopen-2018-025604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 06/06/2019] [Accepted: 06/21/2019] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION The Garage is a multidisciplinary pre-academic arts school for people with artistic abilities who are coping with mental health conditions (MHC). The programme, supported by the National Insurance Institute and the Ministry of Health in Israel, is an innovative rehabilitation service designed to impart and enhance artistic-professional skills and socioemotional abilities to ultimately facilitate participants' integration into higher education and the job market. METHODS AND ANALYSIS This mixed methods longitudinal study will include an embedded design in which the qualitative data are primary and the quantitative data are secondary, thus providing complementary information. The study will examine the contribution of the Garage to changes in participants' personal recovery, well-being, creative self-concept and community integration as well as possible mechanisms that may account for these changes. Qualitative data will be collected using focus groups with graduates and students (a total of ~60 participants). Quantitative data will be collected by self-report questionnaires only from students attending the programme (before, during and at the end of the academic year). Data on the graduates' integration into higher education and the job market after completing the programme will also be collected from the management team. The qualitative data will be analysed following the grounded theory approach and the quantitative data will be analysed with correlations, paired tests to examine pre-post changes and regression analyses. A merged data analysis will be conducted for data integration. ETHICS AND DISSEMINATION The University's Human Research Ethics Committee approved the design and procedures of the study (approval #357-16). All participants will sign an informed consent form where it is clarified that participation in the study is on a voluntary basis, and anonymity and confidentiality are guaranteed. The results will be submitted for peer-reviewed journal publications, presented at conferences and disseminated to the funder and the programme's management team.
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Affiliation(s)
| | - Hod Orkibi
- School of Creative Arts Therapies, University of Haifa, Haifa, Israel
| | - Cochavit Elefant
- School of Creative Arts Therapies, University of Haifa, Haifa, Israel
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Experiences of hospitalised homeless adults and their health care providers in OECD nations: A literature review. Collegian 2019. [DOI: 10.1016/j.colegn.2018.04.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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11
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Heinz AJ, Meffert BN, Halvorson MA, Blonigen D, Timko C, Cronkite R. Employment characteristics, work environment, and the course of depression over 23 years: Does employment help foster resilience? Depress Anxiety 2018; 35:861-867. [PMID: 29878482 PMCID: PMC6123281 DOI: 10.1002/da.22782] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 03/22/2018] [Accepted: 05/12/2018] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Depression is the leading cause of disability and represents a significant challenge to stable employment and professional success. Importantly, employment may also operate as a protective factor against more chronic courses of depression as it can function as a form of behavioral activation and scaffold recovery by facilitating community integration. The current study examined work-related characteristics as protective or risk factors for subsequent long-term depression trajectories. METHODS Relations between employment characteristics and lifetime course of depression were examined among 424 adults in the community who entered treatment for depression. The sample was followed for 23 years with assessments at 1, 4, 10, and 23 years post baseline. At baseline, participants were asked about employment history and status along with work-related events and aspects of their work environments. Depression was measured at each assessment, and three different life course trajectories of depression were identified. RESULTS Employment at baseline was associated with lower levels of depression at baseline and less severe life courses of depression. Among employed participants, higher occupational prestige, a more supportive work environment (greater involvement, cohesion, and perceived support), and lower work stress (less pressure and more control, role clarity, and autonomy) may protect against more severe, intractable depression over time and may have bolstered functioning. CONCLUSIONS Findings have potential to be harnessed for clinical translation to better inform vocational rehabilitation counseling and human resources programs. Specifically, clinician assessment of work setting can guide patient decision making about how to reduce vulnerability to depression and foster resilience via employment.
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Affiliation(s)
- Adrienne J. Heinz
- National Center for PTSD, Dissemination and Training Division, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, USA,Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, USA
| | - Brienna N. Meffert
- National Center for PTSD, Dissemination and Training Division, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, USA
| | - Max A. Halvorson
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Daniel Blonigen
- Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, USA,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Christine Timko
- Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, USA,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Ruth Cronkite
- Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, USA,Department of Sociology, Stanford University, Stanford, CA, USA,Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, CA, USA
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Stratton E, Lampit A, Choi I, Calvo RA, Harvey SB, Glozier N. Effectiveness of eHealth interventions for reducing mental health conditions in employees: A systematic review and meta-analysis. PLoS One 2017; 12:e0189904. [PMID: 29267334 PMCID: PMC5739441 DOI: 10.1371/journal.pone.0189904] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 12/04/2017] [Indexed: 02/03/2023] Open
Abstract
Background Many organisations promote eHealth applications as a feasible, low-cost method of addressing mental ill-health and stress amongst their employees. However, there are good reasons why the efficacy identified in clinical or other samples may not generalize to employees, and many Apps are being developed specifically for this group. The aim of this paper is to conduct the first comprehensive systematic review and meta-analysis evaluating the evidence for the effectiveness and examine the relative efficacy of different types of eHealth interventions for employees. Methods Systematic searches were conducted for relevant articles published from 1975 until November 17, 2016, of trials of eHealth mental health interventions (App or web-based) focused on the mental health of employees. The quality and bias of all identified studies was assessed. We extracted means and standard deviations from published reports, comparing the difference in effect sizes (Hedge’s g) in standardized mental health outcomes. We meta-analysed these using a random effects model, stratified by length of follow up, intervention type, and whether the intervention was universal (unselected) or targeted to selected groups e.g. “stressed”. Results 23 controlled trials of eHealth interventions were identified which overall suggested a small positive effect at both post intervention (g = 0.24, 95% CI 0.13 to 0.35) and follow up (g = 0.23, 95% CI 0.03 to 0.42). There were differential short term effects seen between the intervention types whereby Mindfulness based interventions (g = 0.60, 95% CI 0.34 to 0.85, n = 6) showed larger effects than the Cognitive Behaviour Therapy (CBT) based (g = 0.15, 95% CI 0.02 to 0.29, n = 11) and Stress Management based (g = 0.17, 95%CI -0.01 to 0.34, n = 6) interventions. The Stress Management interventions however differed by whether delivered to universal or targeted groups with a moderately large effect size at both post-intervention (g = 0.64, 95% CI 0.54 to 0.85) and follow-up (g = 0.69, 95% CI 0.06 to 1.33) in targeted groups, but no effect in unselected groups. Interpretation There is reasonable evidence that eHealth interventions delivered to employees may reduce mental health and stress symptoms post intervention and still have a benefit, although reduced at follow-up. Despite the enthusiasm in the corporate world for such approaches, employers and other organisations should be aware not all such interventions are equal, many lack evidence, and achieving the best outcomes depends upon providing the right type of intervention to the correct population.
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Affiliation(s)
- Elizabeth Stratton
- Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney, Australia
- * E-mail:
| | - Amit Lampit
- School of Psychiatry, University of Sydney, Sydney, Australia
| | - Isabella Choi
- Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Rafael A. Calvo
- School of Electrical and Information Engineering, University of Sydney, Sydney, Australia
| | - Samuel B. Harvey
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Black Dog Institute, Sydney, Australia
- St George Hospital, Sydney, Australia
| | - Nicholas Glozier
- Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney, Australia
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13
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Harvey SB, Wang MJ, Dorrington S, Henderson M, Madan I, Hatch SL, Hotopf M. NIPSA: a new scale for measuring non-illness predictors of sickness absence. Occup Environ Med 2017; 75:98-104. [PMID: 28978718 DOI: 10.1136/oemed-2017-104382] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 07/23/2017] [Accepted: 07/26/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We describe the development and initial validation of a new scale for measuring non-illness factors that are important in predicting occupational outcomes, called the NIPSA (non-illness predictors of sickness absence) scale. METHODS Forty-two questions were developed which covered a broad range of potential non-illness-related risk factors for sickness absence. 682 participants in the South East London Community Health study answered these questions and a range of questions regarding both short-term and long-term sickness absence. Factor analysis was conducted prior to examining the links between each identified factor and sickness absence outcomes. RESULTS Exploratory factor analysis using the oblique rotation method suggested the questionnaire should contain 26 questions and extracted four factors with eigenvalues greater than 1: perception of psychosocial work environment (factor 1), perceived vulnerability (factor 2), rest-focused attitude towards recovery (factor 3) and attitudes towards work (factor 4). Three of these factors (factors 1, 2 and 3) showed significant associations with long-term sickness absence measures (p<0.05), meaning a final questionnaire that included 20 questions with three subscales. CONCLUSIONS The NIPSA is a new tool that will hopefully allow clinicians to quickly assess for the presence of non-illness factors that may be important in predicting occupational outcomes and tailor treatments and interventions to address the barriers identified. To the best of our knowledge, this is the first time that a scale focused on transdiagnostic, non-illness-related predictors of sickness absence has been developed.
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Affiliation(s)
- Samuel B Harvey
- King's College London, Institute of Psychiatry Psychology and Neuroscience, London, UK.,School of Psychiatry, University of New South Wales, Sydney, Australia.,Black Dog Institute, Sydney, Australia
| | - Min-Jung Wang
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Sarah Dorrington
- King's College London, Institute of Psychiatry Psychology and Neuroscience, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Max Henderson
- King's College London, Institute of Psychiatry Psychology and Neuroscience, London, UK.,Leeds and York Partnership NHSFT, Leeds, UK
| | - Ira Madan
- Guy's and St Thomas' NHS Trust and King's College London, London, UK
| | - Stephani L Hatch
- King's College London, Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Matthew Hotopf
- King's College London, Institute of Psychiatry Psychology and Neuroscience, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
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14
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Peterson D, Gordon S, Neale J. It can work: Open employment for people with experience of mental illness. Work 2017; 56:443-454. [PMID: 28269806 DOI: 10.3233/wor-172510] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Previous research has tended to focus on the barriers to employment for people with mental illness and the extra support they may need. This research contributes to the knowledge base pertaining to this population by looking at successful employment relationships in New Zealand. OBJECTIVE To describe factors enabling and/or sustaining the open employment of people with experience of mental illness. METHOD Fifteen pairs of employers and employees were interviewed individually but consecutively (using a semi-structured interview schedule) about their perceptions of the critical factors that enabled and sustained the employee's employment. Employee participants were recruited by advertisement, with employers approached through their employees. Transcripts were analysed using a thematic analysis. RESULTS Themes raised in the interviews included the meaning of work, disclosure of mental illness, the benefits of working, special arrangements or accommodations, the work environment and key things employers and employees do to sustain successful employment. CONCLUSION Four critical success factors were identified relating to disclosure, the employment relationship, freedom from discrimination and workplace flexibility.
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Affiliation(s)
- Debbie Peterson
- Suicide and Mental Health Research Group, University of Otago, Wellington, New Zealand
| | - Sarah Gordon
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Jenny Neale
- Health Services Research Centre, Victoria University of Wellington, New Zealand
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15
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Bowman S, McKinstry C, McGorry P. Youth mental ill health and secondary school completion in Australia: time to act. Early Interv Psychiatry 2017; 11:277-289. [PMID: 27381567 DOI: 10.1111/eip.12357] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 02/01/2016] [Indexed: 12/30/2022]
Abstract
AIM This paper reviews the evidence of youth mental ill health and its impact on secondary school educational attainment. METHODS This narrative review presents the current research related to the mental ill health of young people in urban and rural Australia, their educational attainment and the effectiveness of mental health strategies implemented in secondary schools. RESULTS The prevalence of mental ill health is high for Australian young people and the onset of depression, anxiety, substance-use disorders and first episode psychosis (FEP) commonly occurs when the individual is at school. The prevalence is reported to be higher for rural young people and barriers to treatment exist. Current evidence suggests that 40% of young people experiencing depression or anxiety disorders are not completing secondary school. Further evidence shows that over 50% of individuals who experience FEP do not finish secondary school. Current mental health promotion strategies employed in secondary schools have not been shown to reduce rates of depression or anxiety in adolescence nor identify prodromal or acute FEP. These strategies have not led to interventions that assist young people with mental ill health to finish school. CONCLUSIONS Not completing secondary school can limit employment options, lead to severe levels of disadvantage and increased burden on welfare and healthcare systems. All young people, including those in rural areas, have the right to education and should not be disadvantaged in their educational aspirations because they have an emerging or current mental illness.
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Affiliation(s)
- Siann Bowman
- Department of Occupational Therapy, Community and Clinical Allied Health & LaTrobe Rural Health School, College of Science, Health and Engineering, LaTrobe University, Melbourne, Victoria, Australia
| | - Carol McKinstry
- Occupational Therapy, LaTrobe Rural Health School, LaTrobe University, Bendigo, Victoria, Australia
| | - Patrick McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
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16
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Perlmutter AS, Conner SC, Savone M, Kim JH, Segura LE, Martins SS. Is employment status in adults over 25 years old associated with nonmedical prescription opioid and stimulant use? Soc Psychiatry Psychiatr Epidemiol 2017; 52:291-298. [PMID: 27858120 PMCID: PMC5673257 DOI: 10.1007/s00127-016-1312-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 11/11/2016] [Indexed: 11/25/2022]
Abstract
PURPOSE Nonmedical use of prescription opioid and stimulants (NMUPO and NMUPS, respectively) has declined in recent years, but remains an important public health problem. Evidence regarding their relationships with employment status remains unclear. We determined the relationship between employment status and NMUPO and NMUPS. METHODS We analyzed a cross-sectional, nationally representative, weighted sample of 58,486 adults, ages 26 years and older, using combined 2011-2013 data from the National Survey on Drug Use and Health (NSDUH). We fit two crude and two adjusted multivariable logistic regression models to assess the relationship between our two different outcomes of interest: (1) past-year NMUPO and (2) past-year NMUPS, and our exposure of interest: employment status, categorized as (1) full time, (2) part time, (3) unemployed, and (4) not in the workforce. Our adjusted models featured the following covariates: sex, race, age, marital status, and psychological distress, and other nonmedical use. RESULTS Prevalence of NMUPO was higher than NMUPS (3.48 vs. 0.72%). Unemployed participants had the highest odds of NMUPO [aOR 1.45, 95% CI (1.15-1.82)], while those not in the workforce had the highest odds of NMUPS [aOR 1.71, 95% CI (1.22-2.37)]. Additionally, part-time and unemployed individuals had increased odds of NMUPS [aORs, 95% CI 1.59 (1.09-2.31) and 1.67 (1.11-2.37) respectively], while those not in the workforce had decreased odds of NMUPO [aOR 0.82, 95% CI (0.68-0.99)] relative to full-time participants. CONCLUSIONS There is a need for adult prevention and deterrence programs that target nonmedical prescription drug use, especially among those unemployed or not in the workforce.
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Affiliation(s)
- Alexander S Perlmutter
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 168th St., Rm. 518, New York, NY, 10032, USA.
- Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité UMR1153, Université Paris Descartes, Hôpital Hôtel-Dieu, 1 place du Parvis Notre-Dame, 75004, Paris, France.
| | - Sarah C Conner
- Boston University School of Public Health, 715 Albany St, Boston, MA, 02118, USA
| | - Mirko Savone
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 168th St., Rm. 518, New York, NY, 10032, USA
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University Medical Center, 161 Ft. Washington Avenue IP7, New York, NY, 10032, USA
| | - June H Kim
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 168th St., Rm. 518, New York, NY, 10032, USA
| | - Luis E Segura
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 168th St., Rm. 518, New York, NY, 10032, USA
| | - Silvia S Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 168th St., Rm. 518, New York, NY, 10032, USA
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17
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Hitch D, Dun C, Vernon L. Work and beyond: Vocational participation for mental health service users. Aust N Z J Psychiatry 2017; 51:197. [PMID: 27289129 DOI: 10.1177/0004867416652738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Carolyn Dun
- 2 NorthWestern Mental Health, Melbourne, VIC, Australia
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18
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Bond GR, Drake RE, Campbell K. Effectiveness of individual placement and support supported employment for young adults. Early Interv Psychiatry 2016; 10:300-7. [PMID: 25138195 PMCID: PMC4417652 DOI: 10.1111/eip.12175] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 06/22/2014] [Indexed: 11/29/2022]
Abstract
AIM The individual placement and support (IPS) model of supported employment was first developed in community mental health centres for adults with severe mental illness. While IPS is an established evidence-based practice in this broad population, evidence on its effectiveness focused specifically on young adults has been limited. The current study aimed to address this gap. METHODS To investigate the effects of IPS on young adults, the authors conducted a secondary analysis on a pooled sample of 109 unemployed young adults (under age 30) from four randomized controlled trials employing a common research protocol that included a standardized measurement battery and rigorous fidelity monitoring. Researchers assessed these participants over 18 months on nine competitive employment outcome measures. RESULTS On all measures, the IPS group had significantly better employment outcomes. Overall, 40 (82%) of IPS participants obtained employment during follow-up compared with 25 (42%) of control participants, χ(2) = 17.9, P < .001. IPS participants averaged 25.0 weeks of employment, compared with 7.0 weeks for control participants, t = 4.50, P < .001. CONCLUSIONS The current analysis supports a small number of previous studies in showing that IPS is highly effective in helping young adults with severe mental illness to attain competitive employment. When young adults acquire competitive jobs and initiate a path towards normal adult roles, they may avoid the cycle of disability and psychiatric patient roles that are demeaning and demoralizing.
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Affiliation(s)
- Gary R. Bond
- Department of Psychiatry, Geisel Medical School at Dartmouth, Lebanon, NH, USA
| | - Robert E. Drake
- Department of Psychiatry, Geisel Medical School at Dartmouth, Lebanon, NH, USA
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19
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Modini M, Joyce S, Mykletun A, Christensen H, Bryant RA, Mitchell PB, Harvey SB. The mental health benefits of employment: Results of a systematic meta-review. Australas Psychiatry 2016; 24:331-6. [PMID: 26773063 DOI: 10.1177/1039856215618523] [Citation(s) in RCA: 172] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The literature on mental health in the workplace largely focuses on the negative impacts of work and how work may contribute to the development of mental disorders. The potential mental health benefits of employment have received less attention. METHOD A systematic search of reviews or meta-analyses that consider the benefits of work in regards to mental health was undertaken using academic databases. All relevant reviews were subjected to a quality appraisal. RESULTS Eleven reviews were identified as meeting the inclusion criteria, with four deemed to be of at least moderate quality. The available evidence supports the proposition that work can be beneficial for an employee's well-being, particularly if good-quality supervision is present and there are favourable workplace conditions. The benefits of work are most apparent when compared with the well-documented detrimental mental health effects of unemployment. CONCLUSIONS The potential positive effects of good work and the role work can play in facilitating recovery from an illness and enhancing mental well-being need to be highlighted and promoted more widely. Future research should aim to further investigate what constitutes a 'good' workplace or a 'good' job in terms of mental health outcomes.
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Affiliation(s)
- Matthew Modini
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Sadhbh Joyce
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Arnstein Mykletun
- Norwegian Institute of Public Health, Bergen, Norway; Nordland Hospital Trust, Bodø, Norway, and; The Arctic University of Norway, Tromsø; Norway, and; School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | | | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Sydney, NSW, and; Black Dog Institute, Randwick, NSW, Australia
| | - Samuel B Harvey
- School of Psychiatry, University of New South Wales, Sydney, NSW, and; Black Dog Institute, Randwick, NSW, and; St George Hospital, Kogarah, NSW, Australia
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20
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Chang L, Douglas N, Scanlan JN, Still M. Implementation of the enhanced intersectoral links approach to support increased employment outcomes for consumers of a large metropolitan mental health service. Br J Occup Ther 2016. [DOI: 10.1177/0308022616638673] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction The purpose of this article is to describe the outcomes of the enhanced intersectoral links (EIL) approach to supporting employment outcomes for individuals accessing a large mental health service. Method Based on individual placement and support (IPS) principles, features of EIL included: strong service-level relationships between mental health and local disability employment services; monthly joint meetings to share information; resources to assist mental health clinicians in supporting consumers to access employment services; and provision of training. Programme fidelity was evaluated against IPS principles. Outcome measures included: time from referral to commencement; time to first employment placement; employment placement rate; and duration of employment. Results Seventy-nine consumers were referred to the programme. At the close of data collection, 60 participants remained in the programme and 38 of these (63%) had gained at least one employment placement. Average duration of employment was 10.9 weeks. As expected, the EIL programme demonstrated ‘fair’ fidelity against IPS principles. The average time from referral to commencement was 47 days and from commencement to first placement was 81 days. Conclusion This project demonstrated how EIL can be implemented in a large mental health service. Further development is required to avoid delays in consumers’ commencement with employment services and support better job tenure.
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Affiliation(s)
- Lucy Chang
- Employment and Education Specialist, Mental Health Services, Sydney Local Health, Australia
| | - Nadine Douglas
- District Program Coordinator, Mental Health & Fit for the Job, The ORS Group, Australia
| | - Justin Newton Scanlan
- Professional Senior, Occupational Therapy, Mental Health Services, Sydney Local Health District, Australia; Senior Lecturer – Faculty of Health Sciences, University of Sydney, Australia
| | - Megan Still
- Service Planning and Innovation Manager, Mental Health Services, Sydney Local Health District, Australia
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21
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Modini M, Tan L, Brinchmann B, Wang MJ, Killackey E, Glozier N, Mykletun A, Harvey SB. Supported employment for people with severe mental illness: systematic review and meta-analysis of the international evidence. Br J Psychiatry 2016; 209:14-22. [PMID: 27103678 DOI: 10.1192/bjp.bp.115.165092] [Citation(s) in RCA: 202] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 07/13/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND Individual placement and support (IPS) is a vocational rehabilitation programme that was developed in the USA to improve employment outcomes for people with severe mental illness. Its ability to be generalised to other countries and its effectiveness in varying economic conditions remains to be ascertained. AIMS To investigate whether IPS is effective across international settings and in different economic conditions. METHOD A systematic review and meta-analysis of randomised controlled trials comparing IPS with traditional vocational services was undertaken; 17 studies, as well as 2 follow-up studies, were included. Meta-regressions were carried out to examine whether IPS effectiveness varied according to geographic location, unemployment rates or gross domestic product (GDP) growth. RESULTS The overall pooled risk ratio for competitive employment using IPS compared with traditional vocational rehabilitation was 2.40 (95% CI 1.99-2.90). Meta-regressions indicated that neither geographic area nor unemployment rates affected the overall effectiveness of IPS. Even when a country's GDP growth was less than 2% IPS was significantly more effective than traditional vocational training, and its benefits remained evident over 2 years. CONCLUSIONS Individual placement and support is an effective intervention across a variety of settings and economic conditions and is more than twice as likely to lead to competitive employment when compared with traditional vocational rehabilitation.
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Affiliation(s)
- Matthew Modini
- Matthew Modini, BPsych, Leona Tan, MPsych, School of Psychiatry, University of New South Wales, Sydney, Australia; Beate Brinchmann, MA PsyD, Nordland Hospital Trust, Bodø, and University of Tromsø - Arctic University of Norway, Tromsø, Norway; Min-Jung Wang, MSc, School of Psychiatry, University of New South Wales, Sydney; Eoin Killackey, DPsych, Centre for Youth Mental Health, University of Melbourne, and Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Nicholas Glozier, PhD, Brain and Mind Centre, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia; Arnstein Mykletun, PhD, Norwegian Institute of Public Health, Bergen and Oslo, and The Arctic University of Norway, Department of Community Medicine, Tromsø, in collaboration with Nordland Hospital Trust, Bodø, Norway; Samuel B. Harvey, PhD, School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, and St George Hospital, Kogarah, Australia
| | - Leona Tan
- Matthew Modini, BPsych, Leona Tan, MPsych, School of Psychiatry, University of New South Wales, Sydney, Australia; Beate Brinchmann, MA PsyD, Nordland Hospital Trust, Bodø, and University of Tromsø - Arctic University of Norway, Tromsø, Norway; Min-Jung Wang, MSc, School of Psychiatry, University of New South Wales, Sydney; Eoin Killackey, DPsych, Centre for Youth Mental Health, University of Melbourne, and Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Nicholas Glozier, PhD, Brain and Mind Centre, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia; Arnstein Mykletun, PhD, Norwegian Institute of Public Health, Bergen and Oslo, and The Arctic University of Norway, Department of Community Medicine, Tromsø, in collaboration with Nordland Hospital Trust, Bodø, Norway; Samuel B. Harvey, PhD, School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, and St George Hospital, Kogarah, Australia
| | - Beate Brinchmann
- Matthew Modini, BPsych, Leona Tan, MPsych, School of Psychiatry, University of New South Wales, Sydney, Australia; Beate Brinchmann, MA PsyD, Nordland Hospital Trust, Bodø, and University of Tromsø - Arctic University of Norway, Tromsø, Norway; Min-Jung Wang, MSc, School of Psychiatry, University of New South Wales, Sydney; Eoin Killackey, DPsych, Centre for Youth Mental Health, University of Melbourne, and Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Nicholas Glozier, PhD, Brain and Mind Centre, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia; Arnstein Mykletun, PhD, Norwegian Institute of Public Health, Bergen and Oslo, and The Arctic University of Norway, Department of Community Medicine, Tromsø, in collaboration with Nordland Hospital Trust, Bodø, Norway; Samuel B. Harvey, PhD, School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, and St George Hospital, Kogarah, Australia
| | - Min-Jung Wang
- Matthew Modini, BPsych, Leona Tan, MPsych, School of Psychiatry, University of New South Wales, Sydney, Australia; Beate Brinchmann, MA PsyD, Nordland Hospital Trust, Bodø, and University of Tromsø - Arctic University of Norway, Tromsø, Norway; Min-Jung Wang, MSc, School of Psychiatry, University of New South Wales, Sydney; Eoin Killackey, DPsych, Centre for Youth Mental Health, University of Melbourne, and Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Nicholas Glozier, PhD, Brain and Mind Centre, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia; Arnstein Mykletun, PhD, Norwegian Institute of Public Health, Bergen and Oslo, and The Arctic University of Norway, Department of Community Medicine, Tromsø, in collaboration with Nordland Hospital Trust, Bodø, Norway; Samuel B. Harvey, PhD, School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, and St George Hospital, Kogarah, Australia
| | - Eoin Killackey
- Matthew Modini, BPsych, Leona Tan, MPsych, School of Psychiatry, University of New South Wales, Sydney, Australia; Beate Brinchmann, MA PsyD, Nordland Hospital Trust, Bodø, and University of Tromsø - Arctic University of Norway, Tromsø, Norway; Min-Jung Wang, MSc, School of Psychiatry, University of New South Wales, Sydney; Eoin Killackey, DPsych, Centre for Youth Mental Health, University of Melbourne, and Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Nicholas Glozier, PhD, Brain and Mind Centre, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia; Arnstein Mykletun, PhD, Norwegian Institute of Public Health, Bergen and Oslo, and The Arctic University of Norway, Department of Community Medicine, Tromsø, in collaboration with Nordland Hospital Trust, Bodø, Norway; Samuel B. Harvey, PhD, School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, and St George Hospital, Kogarah, Australia
| | - Nicholas Glozier
- Matthew Modini, BPsych, Leona Tan, MPsych, School of Psychiatry, University of New South Wales, Sydney, Australia; Beate Brinchmann, MA PsyD, Nordland Hospital Trust, Bodø, and University of Tromsø - Arctic University of Norway, Tromsø, Norway; Min-Jung Wang, MSc, School of Psychiatry, University of New South Wales, Sydney; Eoin Killackey, DPsych, Centre for Youth Mental Health, University of Melbourne, and Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Nicholas Glozier, PhD, Brain and Mind Centre, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia; Arnstein Mykletun, PhD, Norwegian Institute of Public Health, Bergen and Oslo, and The Arctic University of Norway, Department of Community Medicine, Tromsø, in collaboration with Nordland Hospital Trust, Bodø, Norway; Samuel B. Harvey, PhD, School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, and St George Hospital, Kogarah, Australia
| | - Arnstein Mykletun
- Matthew Modini, BPsych, Leona Tan, MPsych, School of Psychiatry, University of New South Wales, Sydney, Australia; Beate Brinchmann, MA PsyD, Nordland Hospital Trust, Bodø, and University of Tromsø - Arctic University of Norway, Tromsø, Norway; Min-Jung Wang, MSc, School of Psychiatry, University of New South Wales, Sydney; Eoin Killackey, DPsych, Centre for Youth Mental Health, University of Melbourne, and Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Nicholas Glozier, PhD, Brain and Mind Centre, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia; Arnstein Mykletun, PhD, Norwegian Institute of Public Health, Bergen and Oslo, and The Arctic University of Norway, Department of Community Medicine, Tromsø, in collaboration with Nordland Hospital Trust, Bodø, Norway; Samuel B. Harvey, PhD, School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, and St George Hospital, Kogarah, Australia
| | - Samuel B Harvey
- Matthew Modini, BPsych, Leona Tan, MPsych, School of Psychiatry, University of New South Wales, Sydney, Australia; Beate Brinchmann, MA PsyD, Nordland Hospital Trust, Bodø, and University of Tromsø - Arctic University of Norway, Tromsø, Norway; Min-Jung Wang, MSc, School of Psychiatry, University of New South Wales, Sydney; Eoin Killackey, DPsych, Centre for Youth Mental Health, University of Melbourne, and Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Nicholas Glozier, PhD, Brain and Mind Centre, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia; Arnstein Mykletun, PhD, Norwegian Institute of Public Health, Bergen and Oslo, and The Arctic University of Norway, Department of Community Medicine, Tromsø, in collaboration with Nordland Hospital Trust, Bodø, Norway; Samuel B. Harvey, PhD, School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, and St George Hospital, Kogarah, Australia
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Joyce S, Modini M, Christensen H, Mykletun A, Bryant R, Mitchell PB, Harvey SB. Workplace interventions for common mental disorders: a systematic meta-review. Psychol Med 2016; 46:683-697. [PMID: 26620157 DOI: 10.1017/s0033291715002408] [Citation(s) in RCA: 254] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Depression and anxiety disorders are the leading cause of sickness absence and long-term work incapacity in most developed countries. The present study aimed to carry out a systematic meta-review examining the effectiveness of workplace mental health interventions, defined as any intervention that a workplace may either initiate or facilitate that aims to prevent, treat or rehabilitate a worker with a diagnosis of depression, anxiety or both. Relevant reviews were identified via a detailed systematic search of academic and grey literature databases. All articles were subjected to a rigorous quality appraisal using the AMSTAR assessment. Of the 5179 articles identified, 140 studies met the inclusion criteria, of which 20 were deemed to be of moderate or high quality. Together, these reviews analysed 481 primary research studies. Moderate evidence was identified for two primary prevention interventions; enhancing employee control and promoting physical activity. Stronger evidence was found for CBT-based stress management although less evidence was found for other secondary prevention interventions, such as counselling. Strong evidence was also found against the routine use of debriefing following trauma. Tertiary interventions with a specific focus on work, such as exposure therapy and CBT-based and problem-focused return-to-work programmes, had a strong evidence base for improving symptomology and a moderate evidence base for improving occupational outcomes. Overall, these findings demonstrate there are empirically supported interventions that workplaces can utilize to aid in the prevention of common mental illness as well as facilitating the recovery of employees diagnosed with depression and/or anxiety.
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Affiliation(s)
- S Joyce
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | - M Modini
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | | | - A Mykletun
- Norwegian Institute of Public Health,University of Bergen,Norway
| | - R Bryant
- School of Psychology,University of New South Wales,Sydney,NSW,Australia
| | - P B Mitchell
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | - S B Harvey
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
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23
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Raeburn T, Schmied V, Hungerford C, Cleary M. The use of social environment in a psychosocial clubhouse to facilitate recovery-oriented practice. BJPsych Open 2016; 2:173-178. [PMID: 27703771 PMCID: PMC4995550 DOI: 10.1192/bjpo.bp.115.002642] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 03/11/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Recovery-oriented language has been widely adopted in mental health policy; however, little is known about how recovery practices are implemented within individual services, such as psychosocial clubhouses. AIMS To explore how recovery practices are implemented in a psychosocial clubhouse. METHOD Qualitative case study design informed by self-determination theory was utilised. This included 120 h of participant observation, interviews with 12 clubhouse members and 6 staff members. Field notes and interview transcripts were subject to theoretical thematic analysis. RESULTS Two overarching themes were identified, each comprising three sub-themes. In this paper, the overarching theme of 'social environment' is discussed. It was characterised by the sub-themes, 'community and consistency', 'participation and opportunity' and 'respect and autonomy'. CONCLUSIONS Social environment was used to facilitate recovery-oriented practice within the clubhouse. Whether recovery is experienced by clubhouse members in wider society, may well depend on supports and opportunities outside the clubhouse. DECLARATION OF INTERESTS None. COPYRIGHT AND USAGE © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.
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Affiliation(s)
| | - Virginia Schmied
- , RN, RM, PhD, School of Nursing & Midwifery, Western Sydney University, Sydney, NSW, Australia
| | - Catherine Hungerford
- , RN, NP, PhD, FACMHN, School of Nursing, Midwifery, and Indigenous Health, Faculty of Science, Charles Sturt University, Bathurst, NSW, Australia
| | - Michelle Cleary
- , RN, PhD, School of Health Sciences, University of Tasmania, Sydney, NSW, Australia
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Tapfumaneyi A, Johnson S, Joyce J, Major B, Lawrence J, Mann F, Chisholm B, Rahaman N, Wooley J, Fisher HL. Predictors of vocational activity over the first year in inner-city early intervention in psychosis services. Early Interv Psychiatry 2015; 9:447-58. [PMID: 26104585 DOI: 10.1111/eip.12125] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 12/20/2013] [Indexed: 11/28/2022]
Abstract
AIM Work and educational activities are an important part of recovery for young people with psychosis, and improving vocational outcomes is a key target for early intervention services (EIS). This study evaluated predictors of vocational activity for first-episode psychosis (FEP) patients during the first year of EIS care. It was hypothesized that longer duration of untreated psychosis (DUP) and minority ethnic status would predict poorer vocational outcomes, whereas a history of good vocational functioning would predict better vocational functioning during follow up. METHODS FEP patients aged 14-35 years, who presented to seven EIS in London, UK, between 2003 and 2010, were followed for 1 year. Sociodemographic, clinical and vocational information (qualifications obtained and paid employment) were collected using the MiData audit tool at entry to EIS and 1 year later. RESULTS Approximately one-third of patients (n = 345/1013) were studying or employed at some point during the first year of EIS care. Baseline vocational activity was the strongest predictor of vocational functioning during 1 year of follow up. Moreover, employment prior to entry into EIS strongly predicted change in vocational activity during 1 year of follow up. Individuals with DUP <6 months or of Asian or black African origin were more likely to be studying than their white British counterparts. CONCLUSION This study confirms that a significant proportion of FEP patients are able to engage in meaningful vocational activities even within the first year of EIS care. However, services need to focus more resources on getting patients with poor educational or employment histories into training programmes to improve their vocational outcomes.
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Affiliation(s)
- Andrew Tapfumaneyi
- Lewisham Early Intervention Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Sonia Johnson
- Camden and Islington Early Intervention Service, Camden and Islington NHS Foundation Trust, London, UK.,Mental Health Sciences Unit, University College London, London, UK
| | - John Joyce
- Lewisham Early Intervention Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Barnaby Major
- EQUIP, Hackney, East London NHS Foundation Trust, London, UK
| | - Jo Lawrence
- STEP, Southwark, South London and Maudsley NHS Foundation Trust, London, UK
| | - Farhana Mann
- Mental Health Sciences Unit, University College London, London, UK
| | - Brock Chisholm
- Wandsworth Early Intervention Service, Southwest London & St Georges' Mental Health NHS Trust, London, UK
| | - Nikola Rahaman
- Kensington, Chelsea, Westminster and Brent Early Intervention Service, Central & North West London NHS Foundation Trust, London, UK
| | - James Wooley
- Wandsworth Early Intervention Service, Southwest London & St Georges' Mental Health NHS Trust, London, UK
| | - Helen L Fisher
- MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
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Conway P, Clatworthy J. Innovations in Practice: Grow2Grow - engaging hard-to-reach adolescents through combined mental health and vocational support outside the clinic setting. Child Adolesc Ment Health 2015; 20:112-115. [PMID: 32680394 DOI: 10.1111/camh.12079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/08/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Based on an organic farm and education centre, Grow2Grow offers young people with complex mental health needs both clinical mental health support and vocational opportunities. METHODS Change in functioning (CGAS), vocational outcomes and client satisfaction were assessed for all young people completing Grow2Grow placements between June 2010 and July 2014. RESULTS Twenty-one young people completed Grow2Grow placements, achieving increased CGAS scores (p < .001) and reporting high levels of satisfaction with the project. Eighty-one per cent achieved educational and/or employment outcomes. CONCLUSION This innovative approach to working with hard-to-reach young people is achieving high levels of engagement and positive vocational and mental health outcomes.
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Affiliation(s)
- Paula Conway
- Commonwork, Grow2Grow, Bore Place, Chiddingstone, Kent, UK
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Raeburn T, Schmied V, Hungerford C, Cleary M. Self-determination theory: a framework for clubhouse psychosocial rehabilitation research. Issues Ment Health Nurs 2015; 36:145-51. [PMID: 25325308 DOI: 10.3109/01612840.2014.927544] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The Clubhouse model is a widely used approach to psychosocial rehabilitation that has been a pioneer in supporting recovery-oriented programmes. Little consideration has been given however, to the theories that guide research of the recovery practices used by Clubhouses. In this paper, we provide a description of self-determination theory, including its philosophical background followed by explanation of its relevance to health care and Clubhouse contexts. We argue that self-determination theory provides a robust social constructionist theoretical framework that is well-suited to informing research related to psychosocial rehabilitation, recovery-oriented practices and the Clubhouse model.
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Affiliation(s)
- Toby Raeburn
- ROAM Communities Mental Health Nursing and PhD candidate School of Nursing & Midwifery, University of Western Sydney, Sydney, Australia
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Waghorn G, Dias S, Gladman B, Harris M, Saha S. A multi-site randomised controlled trial of evidence-based supported employment for adults with severe and persistent mental illness. Aust Occup Ther J 2014; 61:424-36. [DOI: 10.1111/1440-1630.12148] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Geoffrey Waghorn
- Queensland Centre for Mental Health Research (QCMHR); The Park Centre for Mental Health
- Behavioural Basis of Health; Griffith Health Institute; Griffith University
- The School of Medicine; The University of Queensland
| | - Shannon Dias
- Queensland Centre for Mental Health Research (QCMHR); The Park Centre for Mental Health
| | - Beverley Gladman
- Queensland Centre for Mental Health Research (QCMHR); The Park Centre for Mental Health
| | - Meredith Harris
- The School of Population Health; The University of Queensland; Brisbane Queensland Australia
| | - Sukanta Saha
- Queensland Centre for Mental Health Research (QCMHR); The Park Centre for Mental Health
- The School of Medicine; The University of Queensland
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Newton-Howes G. The impact of mental state disorder and personality on social functioning in patients engaged in community mental health care. Australas Psychiatry 2014; 22:19-22. [PMID: 23996666 DOI: 10.1177/1039856213500093] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to assess the degree to which mental state disorder and personality disorder impact on social functioning in patients engaged in secondary mental health care in New Zealand. METHOD Patients were interviewed using peer-reviewed instruments able to provide an indication of severity to assess their social functioning, personality status and diagnosis. Univariate correlations and linear regression was used to identify the association between social functioning, mental state disorder and personality. RESULTS Using simple correlations all diagnostic categories associated with declines in social functioning. In the regression analysis depression and personality dysfunction accounted for 48% of the variance in social functioning. CONCLUSIONS For patients engaged in secondary care, depression and personality dysfunction are significantly associated with poorer social functioning.
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Affiliation(s)
- Giles Newton-Howes
- Senior Lecturer, Department of Psychological Medicine, University of Otago, Wellington, New Zealand, and; Honorary Senior Lecturer, Imperial College, London, UK
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29
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Affiliation(s)
- Vaughan J Carr
- School of Psychiatry, University of New South Wales, Sydney, Australia.
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30
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Affiliation(s)
- Geoffrey Waghorn
- Queensland Centre for Mental Health Research (QCMHR), The Park Centre for Mental Health, Brisbane, Australia
- Behavioural Basis of Health, Griffith Health Institute, Griffith University, Mount Gravatt, Brisbane, Australia
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Morgan VA. Strategies for improving employment outcomes for people with psychosis. Commentary on: Severe mental illness and work--what can we do to maximise employment opportunities for individuals with psychosis? Aust N Z J Psychiatry 2013; 47:486-7. [PMID: 23653064 DOI: 10.1177/0004867413482494] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Vera A Morgan
- Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, Australia
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32
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Malhi GS. Buds of May. Aust N Z J Psychiatry 2013; 47:405-6. [PMID: 23653058 DOI: 10.1177/0004867413486555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Gin S Malhi
- Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, Australia
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