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McDonald A, Still M, Sommer J, Coniglio F. Riding the tides: Directions in mental health rehabilitation in NSW. Australas Psychiatry 2023; 31:791-794. [PMID: 37907834 DOI: 10.1177/10398562231205129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
OBJECTIVE This paper outlines the evolution of mental health rehabilitation in NSW, where allocation of health resources has repeatedly contradicted the policy intention to reorient services from inpatient to community-based services, leaving community rehabilitation the poor and disconnected cousin of inpatient services. The expanding role of community-managed organisations (CMOs) in psychosocial rehabilitation, the introduction of the National Disability Insurance Scheme (NDIS), and emerging service models have helped foster a maturing housing and social care environment, but present reality and the integration of health and social care services remains at a distance from best evidence practice. CONCLUSION The challenge of the next decade of mental health reform is to embrace and consolidate greater service diversity and complexity. Understanding what factors influenced present reality is important in providing guardrails for the future, enabling the current wave of renewal and reinvestment in NSW to build on the strengths of past developments and steer a course around their weaknesses.
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Affiliation(s)
- Andrew McDonald
- Mental Health Services, Sydney Local Health District, Concord, NSW, Australia
| | - Megan Still
- Mental Health Services, Sydney Local Health District, Concord, NSW, Australia
| | - Joanne Sommer
- New South Wales Ministry of Health, Sydney, NSW, Australia
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Dol M, Varatharajan S, Neiterman E, McKnight E, Crouch M, McDonald E, Malachowski C, Dali N, Giau E, MacEachen E. Systematic Review of the Impact on Return to Work of Return-to-Work Coordinators. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:675-698. [PMID: 33881671 DOI: 10.1007/s10926-021-09975-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/01/2021] [Indexed: 05/26/2023]
Abstract
Purpose We conducted a systematic review to understand the impact that return-to-work coordinators (RTWCs) have on return to work (RTW) outcomes for sick/injured workers. Methods MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, and ABI Inform were searched from January 1, 2000 to September 16, 2020. Of 2,927 retrieved and screened citations, 14 quantitative articles fulfilled the eligibility and quality criteria. Quality assessment, data extraction, and evidence synthesis followed article screening. Results We focused on the impact of RTWCs for outcomes of work absence, RTW rates, quality of life, and cost-benefit. Our final synthesis included 14 articles. We found strong evidence that work absence duration was reduced when workers had face-to-face contact with a RTWC. As well, there was strong evidence linking face-to-face RTWC interventions with higher RTW rates and moderate evidence that this reduced intervention costs. RTWC interventions involving the identification of barriers and facilitators to RTW also showed promising results. However, only limited evidence was found that RTWCs improved quality of life for workers. Conclusions Our synthesis identifies key features of RTW interventions that improve RTW outcomes. Future high-quality research should measure long-term outcomes of RTWC interventions to evaluate sustainability and consider the nature of work. They should also focus on RTWC impact on worker quality of life assessments and for older workers and workers with chronic health conditions.
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Affiliation(s)
- M Dol
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - S Varatharajan
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - E Neiterman
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - E McKnight
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - M Crouch
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - E McDonald
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - C Malachowski
- University of Ontario Institute of Technology, 2000 Simcoe St N, Oshawa, ON, L1G 0C5, Canada
| | - N Dali
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - E Giau
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - E MacEachen
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
- University of Ontario Institute of Technology, 2000 Simcoe St N, Oshawa, ON, L1G 0C5, Canada.
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Costa M, Baker M, Davidson L, Giard J, Guillorn L, Ibáñez AG, Weitz D, O'Connell M. Provider perspectives on employment for people with serious mental illness. Int J Soc Psychiatry 2017; 63:632-640. [PMID: 28797214 DOI: 10.1177/0020764017725769] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Persons with serious mental illnesses (SMI) can lead productive lives, and the majority want to work. Mental health providers can play an important role in helping their clients gain and maintain employment. AIMS The Provider Survey was developed to shed additional light on providers' views toward employment and recovery, and the utilization of Individual Placement and Support (IPS) supported employment (SE) services for people with SMI. METHODS A total of 1,306 providers of the State of Connecticut participated in the survey. Four main questions were addressed in the survey: what do providers do, what do they view as most important regarding employment, what are their views when it comes to what promotes recovery and what barriers do providers face in attempting to refer their clients to IPS services. RESULTS Referring clients to additional supports was rated as the most important aspect of what providers do; encouragement was rated as the most important component to enable clients in gaining and maintaining employment; agency, belonging and medical care were rated as most important in promoting recovery; and expectations that clients would be discriminated against at work was the most important barrier to referring clients for SE. Also, employment and finances were seen as the least important factors in promoting the recovery of people with SMI. CONCLUSION This survey suggests that one reason that more clients may not be referred to IPS programs is that clinicians do not view employment or financial self-sufficiency as important factors in recovery, further compounding the historical view that these persons are unable to, and uninterested in, working. Such findings call for a provider education and training campaign to highlight the fact that most persons with SMI - like most persons in general - do want to work and, with supports, most are capable of doing so.
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Affiliation(s)
- Mark Costa
- 1 Yale Program for Recovery and Community Health (PRCH), Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Michaella Baker
- 2 Department of Social & Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Larry Davidson
- 1 Yale Program for Recovery and Community Health (PRCH), Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.,3 Institution for Social and Policy Studies, Yale University, New Haven, CT, USA.,4 Connecticut Department of Mental Health and Addiction Services, Hartford, CT, USA
| | - Julienne Giard
- 4 Connecticut Department of Mental Health and Addiction Services, Hartford, CT, USA
| | - Linda Guillorn
- 4 Connecticut Department of Mental Health and Addiction Services, Hartford, CT, USA
| | - Angels González Ibáñez
- 1 Yale Program for Recovery and Community Health (PRCH), Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - Maria O'Connell
- 1 Yale Program for Recovery and Community Health (PRCH), Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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