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Occupational evaluation of community-based psychiatric rehabilitation outcomes in individuals with severe mental illnesses: A ten-year retrospective study. Asian J Psychiatr 2023; 81:103450. [PMID: 36630832 DOI: 10.1016/j.ajp.2023.103450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/20/2022] [Accepted: 01/05/2023] [Indexed: 01/07/2023]
Abstract
BACKGROUND There is a lack of research on the effect of community-based psychiatric rehabilitation programs (CBPRs) in individuals with severe mental illness. This research used data from a retrospective study to examine the effect of a CBPR in a community rehabilitation center. MATERIALS AND METHODS Clinical outcomes measures from a retrospective study were collected. Outcome measures were the Allen Cognitive Level Screen assessment, Purdue Pegboard Test, Chu's Attention Test, and Activities of Daily Living Rating Scale-III (ADLRS-III) before and immediately after 12 months of intervention. RESULTS The 141 participants with mental illness were an average age of 35.29 years (SD = 8.75). The retrospective review of medical records showed 46 people dropped out within 12 months, and 95 people continued to participate in the rehabilitation program for 1 year. After 1 year of community rehabilitation, there was a trend for the participants who completed the intervention to improve on the ADLRS-III, Purdue Pegboard Test, and Chu's Attention Test. Participants who performed better on the occupational assessment were more likely to transit to the employment status. CONCLUSION This study found the benefits of CBPR in work-related intervention for people with mental illness. Occupational assessments are relevant for studying changes in functional outcomes in people with mental illness receiving community-based rehabilitation.
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Korman N, Ng J, Gore-Jones V, Dark F, Parker S. Examining the outcomes of the first one hundred residents in a community based residential rehabilitation unit for people affected by severe and persistent mental illness. Australas Psychiatry 2023; 31:213-219. [PMID: 36857441 DOI: 10.1177/10398562231157599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
OBJECTIVE Community-based residential rehabilitation for people experiencing severe and persistent mental illness (SPMI) is increasingly available as an alternative to psychiatric inpatient care. Understanding who accesses these services and their outcomes will inform the optimal allocation of limited public mental health resources. METHOD This retrospective cohort study explored the outcomes of the first 100 consumers supported by a new Australian Community Care Unit (CCU). The primary outcome focus was acute mental health service use (emergency department presentations, acute mental health inpatient admission days), and secondary outcome foci were accommodation independence and substance use. RESULTS When the 365 days before and after CCU support were compared, significant reductions in acute mental health bed days were observed (22 days, W = 3.373, p = .001); greater reductions were noted for those staying >182 days (31 days, W = 3.373, p = .001). Additionally, significant improvements in accommodation independence were found, (W = 3.373, p = .001). CONCLUSION CCU consumers experienced reductions in acute mental health inpatient service use and improved accommodation independence. These observations are consistent with the intended functioning of the residential rehabilitation service.
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Affiliation(s)
- Nicole Korman
- Metro South Addiction and Mental Health Services, Brisbane, QLD, Australia; Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Joanna Ng
- Metro South Addiction and Mental Health Services, Brisbane, QLD, Australia
| | | | - Frances Dark
- Metro South Addiction and Mental Health Services, Brisbane, QLD, Australia; Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Stephen Parker
- Metro South Addiction and Mental Health Services, Brisbane, QLD, Australia; Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia; The Prince Charles Hospital, 157827Metro North Mental Health Services, Chermside, QLD, Australia
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Umucu E, Reyes A, Carrola P, Mangadu T, Lee B, Brooks JM, Fortuna KL, Villegas D, Chiu CY, Valencia C. Pain intensity and mental health quality of life in veterans with mental illnesses: the intermediary role of physical health and the ability to participate in activities. Qual Life Res 2020; 30:479-486. [PMID: 32974882 PMCID: PMC7515555 DOI: 10.1007/s11136-020-02642-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2020] [Indexed: 01/14/2023]
Abstract
Purpose The purpose of this study was to examine the intermediary role of physical health quality of life and ability to participate social roles and activities in the relationship between pain intensity and mental health quality of life in veterans with mental illnesses. Methods This is a cross-sectional correlational design study. Our participants are 156 veterans with self-reported mental illness (Mage = 37.85; SDage = 10.74). Descriptive, correlation, and mediation analyses were conducted for the current study. Results Pain intensity was negatively correlated with physical health QOL, ability to participate in social roles and activities, and mental health QOL. Physical health QOL and ability to participate in social roles and activities were positively associated with mental health QOL, respectively. Physical health QOL was positively correlated with a ability to participate in social roles and activities. Study results indicate that the effect of pain intensity on mental health QOL can be explained by physical health QOL and ability to participate. Conclusions Specific recommendations for practitioners include implementing treatment goals that simultaneously focus on physical health and ability to participate in social roles and activities for clients who present with both physical pain and low mental health QOL.
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Affiliation(s)
- Emre Umucu
- Department of Rehabilitation Sciences, The University of Texas at El Paso, 500 W University Ave, El Paso, TX, 79968, USA.
| | - Antonio Reyes
- Division of Special Education and Counseling, CA State University - Los Angeles, Los Angeles, CA, USA
| | - Paul Carrola
- Department of Educational Psychology and Special Services, The University of Texas at El Paso, El Paso, TX, USA
| | - Thenral Mangadu
- Department of Public Health Sciences, The University of Texas at El Paso, El Paso, TX, USA
| | - Beatrice Lee
- Department of Rehabilitation Sciences, The University of Texas at El Paso, 500 W University Ave, El Paso, TX, 79968, USA
| | - Jessica M Brooks
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA
| | - Karen L Fortuna
- The Geisel School of Medicine at Dartmouth, Dartmouth College, Concord, NH, USA
| | - Diana Villegas
- Department of Rehabilitation Sciences, The University of Texas at El Paso, 500 W University Ave, El Paso, TX, 79968, USA
| | - Chung-Yi Chiu
- Department of Kinesiology and Community Health, University of Illinois Urbana Champaign, Champaign, IL, USA
| | - Carolina Valencia
- Department of Rehabilitation Sciences, The University of Texas at El Paso, 500 W University Ave, El Paso, TX, 79968, USA
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Community-care unit model of residential mental health rehabilitation services in Queensland, Australia: predicting outcomes of consumers 1-year post discharge. Epidemiol Psychiatr Sci 2020; 29:e109. [PMID: 32157987 PMCID: PMC7214525 DOI: 10.1017/s2045796020000207] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AIMS Community care units (CCUs) are a model of residential psychiatric rehabilitation aiming to improve the independence and community functioning of people with severe and persistent mental illness. This study examined factors predicting improvement in outcomes among CCU consumers. METHODS Hierarchical regression using data from a retrospective cohort (N = 501) of all consumers admitted to five CCUs in Queensland, Australia between 2005 and 2014. The primary outcome was changed in mental health and social functioning (Health of the Nation Outcome Scale). Secondary outcomes were disability (Life Skills Profile-16), service use, accommodation instability, and involuntary treatment. Potential predictors covered service, consumer, and treatment characteristics. Group-level and individualised change were assessed between the year pre-admission and post-discharge. Where relevant and available, the reliable and clinically significant (RCS) change was assessed by comparison with a normative sample. RESULTS Group-level analyses showed statistically significant improvements in mental health and social functioning, and reductions in psychiatry-related bed-days, emergency department (ED) presentations and involuntary treatment. There were no significant changes in disability or accommodation instability. A total of 54.7% of consumers demonstrated reliable improvement in mental health and social functioning, and 43.0% showed RCS improvement. The majority (60.6%) showed a reliable improvement in psychiatry-related bed-use; a minority demonstrated reliable improvement in ED presentations (12.5%). Significant predictors of improvement included variables related to the CCU care (e.g. episode duration), consumer characteristics (e.g. primary diagnosis) and treatment variables (e.g. psychiatry-related bed-days pre-admission). Higher baseline impairment in mental health and social functioning (β = 1.12) and longer episodes of CCU care (β = 1.03) increased the likelihood of RCS improvement in mental health and social functioning. CONCLUSIONS CCU care was followed by reliable improvements in relevant outcomes for many consumers. Consumers with poorer mental health and social functioning, and a longer episode of CCU care were more likely to make RCS improvements in mental health and social functioning.
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Schmit MK, Watson JC, Fernandez MA. Examining the Effectiveness of Integrated Behavioral and Primary Health Care Treatment. JOURNAL OF COUNSELING AND DEVELOPMENT 2018. [DOI: 10.1002/jcad.12173] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Michael K. Schmit
- Department of Counseling and Educational Psychology; Texas A&M University-Corpus Christi
- Now at Department of Counseling and Higher Education, University of North Texas
| | - Joshua C. Watson
- Department of Counseling and Educational Psychology; Texas A&M University-Corpus Christi
| | - Mary A. Fernandez
- Department of Counseling and Educational Psychology; Texas A&M University-Corpus Christi
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Penkunas MJ, Hahn-Smith S. Risk Factors for Psychiatric Hospital Admission for Participants in California's Full-Service Partnership Program. Community Ment Health J 2016; 52:651-7. [PMID: 25527223 DOI: 10.1007/s10597-014-9789-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 12/05/2014] [Indexed: 10/24/2022]
Abstract
This study investigated the demographic and clinical predictors of psychiatric hospitalization during the first 2 years of treatment for adults participating in the full-service partnership (FSP) program, based on Assertive Community Treatment, in a large county in northern California. Clinical and demographic characteristics, data on prior hospitalizations, length of enrollment, and living situation for 328 FSP participants were collected from the county's internal billing system and the California Department of Health Care Services. In univariate models, the probability of hospitalization varied by diagnosis, age, and hospitalization history. In the multivariate model, younger age and frequent hospitalization prior to enrollment predicted hospitalization during enrollment. Findings support prior research on hospital recidivism and may be beneficial in refining future strategies for meeting the needs of adults with serious mental illness.
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Affiliation(s)
- Michael J Penkunas
- Research and Evaluation Unit, Contra Costa Behavioral Health Services, 1340 Arnold Drive, Suite 200, Martinez, CA, 94553, USA.
| | - Stephen Hahn-Smith
- Research and Evaluation Unit, Contra Costa Behavioral Health Services, 1340 Arnold Drive, Suite 200, Martinez, CA, 94553, USA
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Penkunas MJ, Friedman A, Hahn-Smith S. Characteristics of Older Adults With Serious Mental Illness Enrolled in a Publicly Funded In-Home Mental Health Treatment Program. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2015. [DOI: 10.1177/1084822315571531] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In-home mental health services for older adults will likely become increasingly utilized as the population ages. Little is known about older adults with serious mental illness who receive in-home services through the public mental health system. This study examined the demographic and clinical characteristics of this population. A total of 148 clients were included. Mood disorders were present in 75.7% and schizophrenia spectrum disorders were present in 23.6%. A history of problematic substance use was documented in 47.3% of clients and 31.8% reported suicidal ideation prior to enrollment. A total of 25% of clients utilized psychiatric emergency services during the year prior to enrollment and 15.5% of clients were hospitalized for psychiatric treatment. Older adults who receive in-home mental health services are vulnerable and have complex treatment needs.
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Affiliation(s)
| | - Anne Friedman
- Contra Costa Behavioral Health Services, Martinez, CA, USA
- University of California, Berkeley, USA
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Evaluating the impact of California's full service partnership program using a multidimensional measure of outcomes. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2013; 41:390-400. [PMID: 23456598 DOI: 10.1007/s10488-013-0476-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study evaluates the impact of California's full-service partnership (FSP) program using a multidimensional measure of outcomes. The FSP program is a key part of California's 2005 Mental Health Services Act. Secondary data were collected from the Consumer Perception Survey, the Client and Service Information System, and the Data Collection and Reporting System, all data systems which are maintained by the California Department of Mental Health. The analytic sample contained 39,681 observations of which 588 were FSP participants (seven repeated cross-sections from May 2005 to May 2008). We performed instrumental variables (IV) limited information maximum likelihood and IV Tobit analyses. The marginal monthly improvement in outcomes of services for FSP participants was approximately 3.5 % higher than those receiving usual care with the outcomes of the average individual in the program improving by 33.4 %. This shows that the FSP program is causally effective in improving outcomes among the seriously mentally ill.
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