1
|
Kim B, Sullivan JL, Drummond KL, Connolly SL, Miller CJ, Weaver K, Bauer MS. Interdisciplinary behavioral health provider perceptions of implementing the Collaborative Chronic Care Model: an i-PARIHS-guided qualitative study. Implement Sci Commun 2023; 4:35. [PMID: 36998010 DOI: 10.1186/s43058-023-00407-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 03/04/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND The evidence-based Collaborative Chronic Care Model (CCM), developed to help structure care for chronic health conditions, comprises six elements: work role redesign, patient self-management support, provider decision support, clinical information systems, linkages to community resources, and organizational/leadership support. As the CCM is increasingly implemented in real-world settings, there is heightened interest in understanding specific influences upon implementation. Therefore, guided by the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework, we (i) identified innovation-, recipient-, context-, and facilitation-related influences on CCM implementation and (ii) assessed the influences' relationship to each CCM element's implementation. METHODS Using semi-structured interviews, we examined interdisciplinary behavioral health providers' experiences at nine VA medical centers that implemented the CCM. We used i-PARIHS constructs as a priori codes for directed content analysis, then analyzed the data for cross-coding by CCM element and i-PARIHS construct. RESULTS Participants (31 providers) perceived the CCM innovation as enabling comprehensive care but challenging to coordinate with existing structures/procedures. As recipients, participants recounted not always having the authority to design CCM-consistent care processes. They perceived local leadership support to be indispensable to implementation success and difficult to garner when CCM implementation distracted from other organizational priorities. They found implementation facilitation helpful for keeping implementation on track. We identified key themes at the intersection of i-PARIHS constructs and core CCM elements, including (i) the CCM being an innovation that offers a formal structure to stepping down care intensity for patients to encourage their self-management, (ii) recipients accessing their multidisciplinary colleagues' expertise for provider decision support, (iii) relationships with external services in the community (e.g., homelessness programs) being a helpful context for providing comprehensive care, and (iv) facilitators helping to redesign specific interdisciplinary team member roles. CONCLUSIONS Future CCM implementation would benefit from (i) facilitating strategic development of supportive maintenance plans for patients' self-management, (ii) collocating multidisciplinary staff (on-site or virtually) to enhance provider decision support, (iii) keeping information on available community resources up to date, and (iv) making clearer the explicit CCM-consistent care processes that work roles can be designed around. This work can inform concrete tailoring of implementation efforts to focus on the more challenging CCM elements, which is crucial to better account for multiple influences that vary across diverse care settings in which the CCM is being implemented.
Collapse
Affiliation(s)
- Bo Kim
- VA Boston Healthcare System, 150 South Huntington Avenue, Boston, MA, 02130, USA.
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.
| | - Jennifer L Sullivan
- VA Providence Healthcare System, 385 Niagara Street, Providence, RI, 02907, USA
- Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
| | - Karen L Drummond
- Central Arkansas Veterans Healthcare System, 4300 West 7th Street, Little Rock, AR, 72205, USA
- University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR, 72205, USA
| | - Samantha L Connolly
- VA Boston Healthcare System, 150 South Huntington Avenue, Boston, MA, 02130, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Christopher J Miller
- VA Boston Healthcare System, 150 South Huntington Avenue, Boston, MA, 02130, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Kendra Weaver
- VA Office of Mental Health and Suicide Prevention, 810 Vermont Avenue NW, Washington, DC, 20420, USA
| | - Mark S Bauer
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| |
Collapse
|
2
|
Sampietro HM, Rojo E, Gómez-Benito J. Recovery-oriented Care in Public Mental Health Policies in Spain: Opportunities and Barriers. CLÍNICA Y SALUD 2023. [DOI: 10.5093/clysa2023a4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
|
3
|
Sampietro HM, Barrios M, Guilera G, Rojo JE, Gómez-Benito J. Effectiveness of a recovery workshop implemented in community mental health services in Catalonia (Spain): study protocol for a non-randomized controlled trial. BMC Psychiatry 2022; 22:827. [PMID: 36575419 PMCID: PMC9793523 DOI: 10.1186/s12888-022-04350-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/29/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Many countries today are undergoing a paradigm shift in mental health policies towards a recovery-oriented and rights-based approach. From this perspective, self-determination and self-management are fundamental factors for recovery. Despite this shift, there is still a lack of evidence on the effectiveness of training programmes aimed at promoting self-determination and self-management in recovery processes implemented in southern European or Spanish-speaking countries. The aim of this paper is to present a study protocol that evaluates the effectiveness of a 12-session recovery workshop implemented in community mental health services in Catalonia (Spain). METHODS/DESIGN This is a 12-week follow-up multi-centre non-randomized controlled trial design. At least 160 users will be recruited from 13 Community Rehabilitation Services (CRS) in Catalonia. Eligible participants are adult (≥ 18 years old) users of a CRS, who sign a written consent to participate. The experimental group participates in a recovery workshop, in which people learn to develop and implement their own plan of personal recovery, which includes a Wellness Toolbox, a Maintenance Toolkit, a Personal Growth Plan, a Mirror of Relapses, a Crisis Plan, and a Learning Agenda. The control group participates in the usual activities of the CRS. Data is collected using a questionnaire of sociodemographic characteristics, personal recovery, empowerment, hope and perceived social support. The users' measurements are taken at the baseline and one week after the end of the workshop. The primary outcome measures include the Self-Identified Stage of Recovery and the Maryland Assessment of Recovery in Serious Mental Illness Scale (short version). The secondary outcome measures include the Netherlands Empowerment List, Dispositional Hope Scale, and Multidimensional Scale of Perceived Social Support. Descriptive statistics for characterizing the sample size will be performed. Multivariate analyses for repeated measures designs will be used to evaluate the primary and secondary outcomes. Between-group and within-subject comparisons will be conducted. DISCUSSION The results of the study will provide information on the usefulness of recovery workshops in a Mediterranean cultural context. Additionally, if this workshop is effective, it will be proposed for inclusion within the portfolio of community mental health services in Catalonia. TRIAL REGISTRATION ISRCTN11695542 (Registration date: 5 July 2022).
Collapse
Affiliation(s)
- Hernán María Sampietro
- ActivaMent Catalunya Associació, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Department of Social Psychology and Quantitative Psychology, University of Barcelona, Passeig de la Vall d’Hebron, 171, 08035 Barcelona, Spain
| | - Maite Barrios
- grid.5841.80000 0004 1937 0247Department of Social Psychology and Quantitative Psychology, University of Barcelona, Passeig de la Vall d’Hebron, 171, 08035 Barcelona, Spain ,grid.5841.80000 0004 1937 0247Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Georgina Guilera
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain. .,Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, University of Barcelona, Barcelona, Spain.
| | - J. Emilio Rojo
- grid.410675.10000 0001 2325 3084Department of Medicine, International University of Catalonia, Barcelona, Spain ,Hospital Benito Menni CASM, Sisters Hospitallers, Sant Boi de Llobregat, Spain
| | - Juana Gómez-Benito
- grid.5841.80000 0004 1937 0247Department of Social Psychology and Quantitative Psychology, University of Barcelona, Passeig de la Vall d’Hebron, 171, 08035 Barcelona, Spain ,grid.5841.80000 0004 1937 0247Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| |
Collapse
|
4
|
Gutierrez D, Goshorn JR, Dorais S. An exploration of thriving over time in recovery. J Subst Abuse Treat 2021; 132:108612. [PMID: 34489158 DOI: 10.1016/j.jsat.2021.108612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/02/2021] [Accepted: 08/17/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Emerging models of recovery have redirected the traditional focus on relapse prevention to an emphasis on wellness. According to this new framework of recovery, aspects of thriving can strengthen recovery and prevent relapse in substance use. However, the empirical support for these models is sparse. To fill the gap in the literature, the authors sought to predict the risk of relapse based on factors of thriving. METHOD Participants consisted of a stratified sample of 412 adults in early, middle, and late stages of recovery (based on length of time in recovery) who the study recruited via Qualtrics Online Panels. We utilized a sequential regression to examine the ability of factors of thriving, the influence of time in recovery and demographic variables to predict relapse risk. RESULTS Thriving, length of recovery, and demographics significantly predicted risk of relapse (p < .001, R2 = 65%), with Thriving accounting for 55% of the variance (ΔR2 = 55%). CONCLUSION These findings demonstrate that the natural developmental process that comes from the passage of time dedicated to recovery is significant but thriving or the quality of that time serves as a stronger protective factor preventing relapse. Addiction treatment and prevention specialists could benefit from including thriving in conceptual models and interventions for recovery. Further, these findings provide support for holistic models of addiction recovery.
Collapse
Affiliation(s)
- Daniel Gutierrez
- Department of School Psychology and Counselor Education, William & Mary, United States of America.
| | - Jeremy R Goshorn
- Department of Counseling, Wake Forest University, United States of America
| | - Stephanie Dorais
- Department of Counselor Education, Kean University, United States of America
| |
Collapse
|
5
|
Nemec PB, Swarbrick M, Spagnolo A, Brandow CL. Nudges to Support Health and Wellness for Individuals Served by Behavioral Health Programs. J Psychosoc Nurs Ment Health Serv 2020; 59:21-28. [PMID: 33095264 DOI: 10.3928/02793695-20201015-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/28/2020] [Indexed: 11/20/2022]
Abstract
Individuals served by behavioral health programs experience risk factors that threaten health and longevity. Health behavior changes may be supported through environmental modifications known as nudges. The current review (a) examines the potential value of nudges for helping individuals receiving services from behavioral health programs, and (b) offers physical and social environment strategies to support positive health behaviors. The authors discuss literature related to nudges and environmental influences on health behaviors. The research related to nudges supports the potential value of this framework for nurses in behavioral health settings, who are in a strong position to help address health and wellness concerns disproportionately experienced by individuals in behavioral health programs. [Journal of Psychosocial Nursing and Mental Health Services, 59(1), 21-28.].
Collapse
|
6
|
Montenegro CR, Cornish F. Historicising involvement: the visibility of user groups in the modernisation of the Chilean Mental Health System. CRITICAL PUBLIC HEALTH 2017. [DOI: 10.1080/09581596.2017.1400659] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Cristian R. Montenegro
- Department of Methodology, London School of Economics and Political Sciences, London, UK
| | - Flora Cornish
- Department of Methodology, London School of Economics and Political Sciences, London, UK
| |
Collapse
|
7
|
Mak WWS, Chan RCH, Pang IHY, Chung NYL, Yau SSW, Tang JPS. Effectiveness of Wellness Recovery Action Planning (WRAP) for Chinese in Hong Kong. AMERICAN JOURNAL OF PSYCHIATRIC REHABILITATION 2016. [DOI: 10.1080/15487768.2016.1197859] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
8
|
de Malmanche J, Robertson L. The Experience of KAI MAHI, an Employment Initiative for People with an Experience of Mental Illness, as Told by Zarna, Zeus, Lulu, Mary, Paul, and Hemi. Community Ment Health J 2015; 51:880-7. [PMID: 26173402 DOI: 10.1007/s10597-015-9909-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 06/10/2015] [Indexed: 11/30/2022]
Abstract
There is a growing body of evidence endorsing the use of supported employment models for people with an experience of mental illness. However current literature and research regarding the perspective of people with experience of mental illness, as well as alternate models of employment support, is sparse. This study has captured the stories of employment of people with experience of mental illness who participated in KAI MAHI, a group based employment program. Findings identified key components of KAI MAHI, consistent with their overall experiences of employment, which were influential in assisting them to find and sustain employment. These included the opportunity for self-determination, a sense of self-efficacy, and respectful relationships.
Collapse
Affiliation(s)
| | - Linda Robertson
- School of Occupational Therapy, Otago Polytechnic, PBag 1910, Dunedin, 9054, New Zealand.
| |
Collapse
|
9
|
Murphy AL, Gardner DM, Kisely S, Cooke C, Kutcher SP, Hughes J. A Qualitative Study of Antipsychotic Medication Experiences of Youth. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2015; 24:61-69. [PMID: 26336383 PMCID: PMC4357337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 08/20/2014] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To explore the lived experience of youth who are prescribed antipsychotics. METHODS We conducted an interpretive phenomenology study of young people with recent experience of taking antipsychotics. Youth were interviewed and a staged approach was used for data analysis of transcriptions. We collected approximately 13 hours of audio from 18 youth aged 13 to 26 years between January and August of 2010. RESULTS Ambivalence was significant and antipsychotic adverse effects frequently tempered benefits. Both illness and antipsychotics had significant impacts on physical and mental wellbeing with adverse effects on relationships and functioning in various contexts (e.g., school). Stigma related to both antipsychotics and illness was also prominent. Participants' limited knowledge about their antipsychotics and pressure to conform within their youth culture and context affected decisions on starting, adhering to, and persisting with treatment. CONCLUSIONS The lived experience of youth taking antipsychotics is complex and the benefits (e.g., symptom improvement) and consequences (e.g., adverse effects) associated with antipsychotics affect all facets of life. More research is needed to better understand youth priorities in treatment decisions and whether youth who demonstrate substantive gaps in their knowledge about antipsychotics are truly given the opportunity to be informed and engage in management decisions including whether to initiate, persist with, and discontinue treatments.
Collapse
Affiliation(s)
- Andrea L. Murphy
- College of Pharmacy, Dalhousie University, Halifax, Nova Scotia
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia
| | - David M. Gardner
- College of Pharmacy, Dalhousie University, Halifax, Nova Scotia
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia
| | - Steve Kisely
- School of Population Health, University of Queensland, Herston, Queensland, Australia
| | | | - Stan P. Kutcher
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia
- Sun Life Financial Chair in Adolescent Mental Health, Dalhousie University/IWK Health Centre, Halifax, Nova Scotia
| | - Jean Hughes
- School of Nursing, Dalhousie University, Halifax, Nova Scotia
| |
Collapse
|
10
|
Faigin DA, Stein CH. Community-based theater and adults with psychiatric disabilities: social activism, performance and community engagement. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2015; 55:148-163. [PMID: 25520209 DOI: 10.1007/s10464-014-9695-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The present study is an in-depth qualitative inquiry with an established theater troupe composed of adults living with psychiatric disabilities known as The Stars of Light. A grounded theory methodology is used to describe dimensions of social activism and characteristics of theater as a medium of engagement at the individual, setting/troupe, and community levels of analysis. Analysis of a broad scope of interview data, performance content, community contacts, and historical data from the troupe's 19-year history led to the identification of eight emergent theoretical concepts formulated from 17 supporting associated themes. The theoretical concepts characterize the impacts of community-based theater in the lives of participants, and theater troupe processes that contribute to community education and positive social change for adults living with psychiatric disabilities. Advantages, limitations, and future directions for research and action in community-based theater settings are discussed within the context of present research findings.
Collapse
Affiliation(s)
- David A Faigin
- VA Maine Heath Care System, U.S. Department of Veterans Affairs, Lewiston, ME, USA,
| | | |
Collapse
|
11
|
Carr ER, Bhagwat R, Miller R, Ponce AN. Training in Mental Health Recovery and Social Justice in the Public Sector. COUNSELING PSYCHOLOGIST 2014. [DOI: 10.1177/0011000014555200] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Individuals who experience serious mental illness (SMI) frequently encounter stigma and disenfranchisement. Attention to this concern necessitates a social justice focus within the mental health field. This article explores the significance and critical foundations of a psychology training experience grounded in a social justice and recovery-oriented perspective to answer the call for a focus on social justice and empowerment for individuals with SMI in mental health recovery. A specific training program is highlighted as an example of how social justice and recovery-oriented psychology training can be conducted. It includes theoretical foundations, trainee and supervision factors, a training model, and a description of didactic, clinical, consultation, interdisciplinary, and recovery-initiative training experiences. Last, specific successes and challenges of this type of training experience, as well as recommendations for future program development, are shared.
Collapse
Affiliation(s)
- Erika R. Carr
- Yale University School of Medicine, New Haven, CT, USA
| | | | | | | |
Collapse
|
12
|
Clifton A, Repper J, Banks D, Remnant J. Co-producing social inclusion: the structure/agency conundrum. J Psychiatr Ment Health Nurs 2013; 20:514-24. [PMID: 22882808 DOI: 10.1111/j.1365-2850.2012.01953.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
There is a raft of policy guidelines indicating that mental health nurses should be increasing the social inclusion of mental health service users. Despite this there is no universally accepted definition of social inclusion and there is a dearth of empirical evidence on the successful outcome of increasing inclusion for mental health service users. Recognizing the lack of clarity surrounding the concept we have a produced a social inclusion framework to assist mental health professionals and service users to co-produce social inclusive outcomes. Although we agree that social inclusion can be a positive aspect of recovery, we question the extent to which mental health nurses and service users in co-production can overcome the social, economic and political structures that have created the social exclusion in the first place. An understanding and appreciation of the structure/agency conundrum is required if mental health nurses are to engage with service users in an attempt to co-produce socially inclusive outcomes.
Collapse
Affiliation(s)
- A Clifton
- University of Northumbria, Newcastle upon Tyne, UK.
| | | | | | | |
Collapse
|
13
|
Ruggiano N. Consumer direction in long-term care policy: overcoming barriers to promoting older adults' opportunity for self-direction. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2012; 55:146-159. [PMID: 22324331 DOI: 10.1080/01634372.2011.638701] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
There has been a growing trend in long-term care policy to offer individuals with disabilities the option of consumer direction (CD), where responsibility of managing care and support services is transferred from agencies to care recipients, thus supporting clients' self-determination. Although CD has been accepted as an option for non-elderly individuals with disabilities, barriers persist to promoting older adults' autonomy through CD. This article reviews the incorporation of CD in long-term care policy, addresses the current barriers to providing older adults the right to self-direct, and makes recommendations for overcoming these barriers through social work practice, policy, and research.
Collapse
Affiliation(s)
- Nicole Ruggiano
- School of Social Work, Florida International University, Miami, Florida 33199, USA.
| |
Collapse
|
14
|
Hall-Lande J, Hewitt A, Bogenschutz M, LaLiberte T. County Administrator Perspectives on the Implementation of Self-Directed Supports. JOURNAL OF DISABILITY POLICY STUDIES 2011. [DOI: 10.1177/1044207311416595] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Self-directed supports are a program or service option in which individuals with Intellectual and Developmental Disabilities (IDD), their families, and their allies directly manage their supports. This study explores the perspectives of county-level administrators in the implementation of one state’s self-directed support option for people with IDD. Perspectives of local-level administrators are important as they have key leadership roles concerning policy, program implementation, and program accountability. As the prevalence of self-directed supports increases, it is important to understand both the successes and challenges faced by local administrators as they implement this service option. A qualitative research methodology was used for this study, following a grounded theory analytic approach. In-depth semi-structured telephone interviews were conducted with county directors of Developmental Disability Services as the primary source of data for this study. Analysis of the semi-structured interviews with the county-level administrators and staff revealed both successes and challenges with the self-directed waiver option. Many county administrators cited changes in professional philosophy, improved quality of life, higher staff quality, and lower costs as major sucof the self-directed waiver option. Challenges of the self-directed waiver option consisted of need for clear policy guidelines, program changes, and monitoring of outcomes. The results of this study illuminate both the successes and chalof self-directed service implementation for individuals with IDD from the perspectives of the local adminwho are responsible for the direct management of programs for individuals with IDD. This research presents important implications for the design, implementation, and modification of future self-directed initiatives.
Collapse
Affiliation(s)
| | - Amy Hewitt
- University of Minnesota, Minneapolis, USA
| | | | | |
Collapse
|
15
|
Marchinko S, Clarke D. The Wellness Planner: empowerment, quality of life, and continuity of care in mental illness. Arch Psychiatr Nurs 2011; 25:284-93. [PMID: 21784286 DOI: 10.1016/j.apnu.2010.10.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Revised: 10/05/2010] [Accepted: 10/16/2010] [Indexed: 11/25/2022]
Abstract
Coordination of mental health services has often been a challenge from the user's point of view. Resulting gaps in care can lead to increased use of crisis services, more frequent hospitalization, and impaired quality of life. This study examined an innovative approach to building an individual's self-care capacities by testing the use of a wellness intervention: an adaptation of a client-held medical record/crisis plan in booklet form. Fifty individuals using community mental health services were recruited. Using a pretest-posttest design, participants completed measures of empowerment, continuity of care, quality of life, and satisfaction with services at the start of and again following 3 months of using the booklet. The booklet, referred to as the Wellness Planner, included components that have been empirically demonstrated as effective, such as crisis planning, goal setting, and resource planning. For the 42 individuals who completed the study, statistically significant increases were seen in empowerment, continuity of care, and satisfaction with services after 3 months of using the Wellness Planner. Qualitative data further demonstrated positive acceptance of the booklet by the users. Findings of the study suggest that the use of such a booklet could not only have a positive impact on the recovery of individuals but could also have utility within the mental health system. Since the completion of this study, the Winnipeg Regional Health Authority has adopted the booklet for use within all its adult mental health programs. Future research will focus on the impact of the booklet on system-wide indicators such as service utilization and readmission rates.
Collapse
|
16
|
Slade M. Mental illness and well-being: the central importance of positive psychology and recovery approaches. BMC Health Serv Res 2010; 10:26. [PMID: 20102609 PMCID: PMC2835700 DOI: 10.1186/1472-6963-10-26] [Citation(s) in RCA: 270] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2009] [Accepted: 01/26/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A new evidence base is emerging, which focuses on well-being. This makes it possible for health services to orientate around promoting well-being as well as treating illness, and so to make a reality of the long-standing rhetoric that health is more than the absence of illness. The aim of this paper is to support the re-orientation of health services around promoting well-being. Mental health services are used as an example to illustrate the new knowledge skills which will be needed by health professionals. DISCUSSION New forms of evidence give a triangulated understanding about the promotion of well-being in mental health services. The academic discipline of positive psychology is developing evidence-based interventions to improve well-being. This complements the results emerging from synthesising narratives about recovery from mental illness, which provide ecologically valid insights into the processes by which people experiencing mental illness can develop a purposeful and meaningful life. The implications for health professionals are explored. In relation to working with individuals, more emphasis on the person's own goals and strengths will be needed, with integration of interventions which promote well-being into routine clinical practice. In addition, a more societally-focussed role for professionals is envisaged, in which a central part of the job is to influence local and national policies and practices that impact on well-being. SUMMARY If health services are to give primacy to increasing well-being, rather than to treating illness, then health workers need new approaches to working with individuals. For mental health services, this will involve the incorporation of emerging knowledge from recovery and from positive psychology into education and training for all mental health professionals, and changes to some long-established working practices.
Collapse
Affiliation(s)
- Mike Slade
- Health Service and Population Research Department (Box P029), Institute of Psychiatry, King's College London, Denmark Hill, London SE58AF, UK.
| |
Collapse
|
17
|
Early outcomes and lessons learned from a study of the Building Recovery of Individual Dreams and Goals through Education and Support (BRIDGES) program in Tennessee. Psychiatr Rehabil J 2010; 34:96-103. [PMID: 20952362 DOI: 10.2975/34.2.2010.96.103] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Peer-led education interventions have the potential to provide mental health consumers with the knowledge, skills and support they need to live successful and rewarding self-determined lives. However, few studies have explored whether and how these interventions enhance recovery. This study addresses this knowledge gap by examining changes among 160 participants in the Building Recovery of Individual Dreams and Goals (BRIDGES) education program. BRIDGES is a peer-led 8-week course taught by trained instructors who publicly disclose the fact that they are in recovery from mental illness. METHOD Structured interviews assessing recovery outcomes were conducted with participants in the month prior to their receipt of BRIDGES, and immediately after receipt of the intervention. Paired t-tests were conducted to examine changes in psychiatric symptoms, hopefulness, social support, self-advocacy, empowerment, adaptive coping, and recovery pre-receipt and post-receipt of BRIDGES. RESULTS Post-receipt of BRIDGES, participants reported significantly fewer psychiatric symptoms, decreased use of maladaptive coping behaviors, and increased feelings of hopefulness, self-advocacy, empowerment, and recovery. CONCLUSIONS These promising early results from our ongoing study of BRIDGES suggest that peer-led education interventions are a valuable resource. Additional research is needed to better understand the effectiveness of these interventions, including potential long-term post-program participation benefits.
Collapse
|
18
|
Cultural competency in peer-run programs: results of a web survey and implications for future practice. Psychiatr Rehabil J 2010; 34:121-9. [PMID: 20952365 DOI: 10.2975/34.2.2010.121.129] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The study explored perceptions of adults with psychiatric disabilities regarding cultural competency of peer-run mental health support groups and programs. METHODS Web survey respondents were recruited via mental health list-servs, web sites, newsletters, emails, and word of mouth. A total of 527 peers were surveyed about cultural competency barriers facing peer-run programs; common reasons for not using peer services; and strategies to engage diverse communities. RESULTS Both multicultural and Caucasian respondents agreed that lack of funding and staff education about diversity were barriers to cultural competency in peer programs. Multicultural respondents were more likely than whites to feel that both the recognition of the need for and interest in attending cultural competency training is lacking in peer programs, as well as information about the diverse composition of peer program memberships. Among those who had never participated in peer support, people of color were more likely than whites to endorse feeling they would not belong and believing their languages would not be spoken in peer programs. Whites, on the other hand, were more likely to cite a preference for professional over peer support, while nearly half of both groups indicated that the main reason for non-attendance is a lack of knowledge about peer programs. Qualitative results highlighted successful outreach and engagement strategies. CONCLUSIONS Study findings informed development of a cultural competency tool that was pilot-tested among peer-run programs. Given the importance of peer support in recovery, these findings suggest the need for additional research on cultural competency in peer programs.
Collapse
|
19
|
Townley G, Kloos B. Development of a measure of sense of community for individuals with serious mental illness residing in community settings. JOURNAL OF COMMUNITY PSYCHOLOGY 2009; 37:362-380. [PMID: 19305637 PMCID: PMC2658753 DOI: 10.1002/jcop.20301] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The psychological sense of community is one of the most commonly investigated constructs in community psychology. Sense of community may be particularly important for individuals with serious mental illness (SMI) because they often face societal barriers to participation in community living, including stigma and discrimination. To date, no published studies have investigated the psychometric qualities of sense of community measures among individuals with SMI. The current study tested a series of confirmatory factor analyses using the Brief Sense of Community Index (BSCI, Long & Perkins, 2003) in a sample of 416 persons with SMI living in community settings to suggest a model of sense of community for individuals with SMI and other disabilities. The resulting scale, the Brief Sense of Community Index- Disability (BSCI-D), demonstrated good model fit and construct validity. Implications are discussed for how this scale may be used in research investigating community integration and adaptive functioning in community settings.
Collapse
|
20
|
|
21
|
Onken SJ, Craig CM, Ridgway P, Ralph RO, Cook JA. An analysis of the definitions and elements of recovery: a review of the literature. Psychiatr Rehabil J 2007; 31:9-22. [PMID: 17694711 DOI: 10.2975/31.1.2007.9.22] [Citation(s) in RCA: 224] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
As mental health recovery gains traction, many people have put forward varying definitions. Few attempts have been made to create a dimensional analysis of the recovery literature that assesses the growing consensus about what recovery is or what its definition should entail. This paper incorporates an ecological framework to take the individual's life context into account while emphasizing both the reestablishment of one's mental health (i.e., first order change) and the mitigation of the oppressive nature of barriers imposed by the greater community (i.e., second order change) so that people may experience social integration and community inclusion.
Collapse
Affiliation(s)
- Steven J Onken
- University of Hawai'i at Mānoa, Mental Health Services Research, Evaluation and Training, Honolulu 96822, USA
| | | | | | | | | |
Collapse
|
22
|
Cook JA, Burke J. Public policy and employment of people with disabilities: exploring new paradigms. BEHAVIORAL SCIENCES & THE LAW 2002; 20:541-557. [PMID: 12465127 DOI: 10.1002/bsl.515] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
A "sea change" in public attitudes, legislation, and political power at the end of the 20th century in the United States has helped set the stage in the early 21st century for the entry of people with disabilities into the labor force. Major pieces of federal legislation have altered national policy with the intention of maximizing the work force participation of people with disabilities. At the same time, a new theoretical paradigm of disability has emerged, which emphasizes community inclusion, accommodation, and protection of civil rights. This "New Paradigm" of disability can be applied in concert with rigorous behavioral science methodologies to shed light on the outcomes of recent federal policy changes regarding the labor force participation of people with disabilities. In so doing, social science can be used in more meaningful ways to understand both the intended and unintended consequences of federal policy.
Collapse
Affiliation(s)
- Judith A Cook
- National Research and Training Center on Psychiatric Disability, Department of Psychiatry, University of Illinois at Chicago, 104 South Michigan Avenue, Suite 900, Chicago, IL 60603, USA.
| | | |
Collapse
|