1
|
Um YJ, Choi YJ. The effect of employment status on people with a mental disability and on daily life satisfaction: The mediating effect of acceptance of disability. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-01123-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
2
|
Prat Vigué G, Cano Prieto I, Del Río Sáez R, Vilanova Masana R, Simó Algado S. Training Peer Support Workers in Mental Health Care: A Mixed Methods Study in Central Catalonia. Front Psychiatry 2022; 13:791724. [PMID: 35463525 PMCID: PMC9023875 DOI: 10.3389/fpsyt.2022.791724] [Citation(s) in RCA: 4] [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] [Received: 10/08/2021] [Accepted: 02/25/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION A mental health peer support program was implemented at two reference institutions in Central Catalonia. The program culturally and contextually adapted successful international projects by training people with experience of mental health problems and ensuring their employment in multidisciplinary health care teams. This study explores the influence of peer interventions in mental health on the three groups of participants: peer support workers, service users, and mental health professionals. METHODS A mixed observational method design included pre-, inter-, and post-experimental components and a qualitative description of the impact. The triangulation of the qualitative and quantitative findings showed its coherence and facilitated the understanding of the results. Outcomes and measures were as follows: self-stigma (Self-Stigma Questionnaire); life satisfaction (Scale of Satisfaction with Life); participation in relevant activities (Engagement in Meaningful Activities Survey); personal recovery (Scale-revised Recovery Assessment); occupational performance (Canadian Occupational Performance Measure); and attitudes toward mental illness (Community Attitudes toward Mental Illness). RESULTS The program showed beneficial effects on peer support workers' (PSW) perceptions of occupational performance, specifically on the ability to find work (p = 0.038), work as a peer support worker (p = 0.016), give to the community (p = 0.011), and satisfaction in the ability to find work (p = 0.031). The assessment made by the three groups of participants was very positive: the PSWs showed an increase in self-esteem and a feeling of usefulness; users of the service described the experience as a source of hope and optimism in their recovery process; and professionals described the program as a positive step in their professional growth. DISCUSSION The peer-to-peer strategy is a source of hope in the personal recovery process, providing meaning to life for the PSWs while providing an extra source of support to service users in their process of personal recovery. The results offer us lines of improvement for future implementations. PSW's final emphasis has us reflecting on improvements to enhance their own wellness in mental health care services. The findings show the importance of working on life projects and their impact on the recovery process.
Collapse
Affiliation(s)
- Gemma Prat Vigué
- Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain
| | - Ivan Cano Prieto
- Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain
| | | | | | | |
Collapse
|
3
|
Fukuura Y, Shigematsu Y. The Work Ability of People with Mental Illnesses: A Conceptual Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910172. [PMID: 34639474 PMCID: PMC8508570 DOI: 10.3390/ijerph181910172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 11/16/2022]
Abstract
Continuous employment is an important goal for many people with mental illnesses. However, job retention and absenteeism remain significant problems that deter their attempts at gaining financial independence, expanding interpersonal relationships, and developing self-esteem. Although there is consensus on the necessity of their proactive treatment and social participation, such support is currently underwhelming. Therefore, this study analyzes the conceptual framework for work ability of people with mental illnesses. We performed our investigations using Rodgers' evolutionary conceptual analysis, targeting literature published from 1978 to 2020. Our search yielded 1420 articles in the Scopus inventory and 199 in PubMed. After exclusions, 13 articles remained. Using the same keywords in Google Scholar, we included 31 articles in our analysis. The attributes of work ability included the ability to self-manage, adaptability, the ability to dedicate oneself to work, and the ability to formulate plans. These were developed through a reiterative process. This study notes the importance of adjusting the work environment according to the patients' condition. Therefore, the ability to cope with stress and workload, as well as active self-adjustment, are crucial skills that nurses can help develop after assessing the patient's daily life. Furthermore, they can foster multidisciplinary collaboration and follow-up systems after employment.
Collapse
Affiliation(s)
- Yoshitomo Fukuura
- Department of Nursing, Graduate School of Medicine, Kurume University, Kurume 830-0003, Fukuoka-ken, Japan
- Correspondence:
| | - Yukako Shigematsu
- Department of Nursing, School of Nursing, Kurume University, Kurume 830-0003, Fukuoka-ken, Japan;
| |
Collapse
|
4
|
Ottewell N. Working in disability employment: An interpretative phenomenological study of experiences of people with a diagnosis of schizophrenia. Br J Occup Ther 2021. [DOI: 10.1177/03080226211039429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim To understand how employees with schizophrenia in disability employment interpret their work experience. Method Nine people with schizophrenia were interviewed. Data were analysed with the interpretative phenomenological analysis. Results All participants regarded themselves as ‘persons with mental illness’. Some participants developed their mental illness identity by realising that working without accommodations is difficult. Although participants found working in the current company comfortable because the supervisors provided appropriate accommodations, they were dissatisfied with low salary. A proportion of the participants felt dissatisfaction with the menial work, which led to low levels of self-esteem as they viewed non-disability employment of higher value. In addition, the present study noted a difference between self-labelling and labelling by others; although participants regarded themselves as ‘persons with mental illness’, they felt reluctant to be viewed as such by others. Most of the participants wanted to work in non-disability employment in future for financial and personal reasons, such as to increase self-esteem. Conclusion It is imperative that benefits and other issues in disability employment for people with psychosocial disability relating to mental illness are explored more broadly in future research. Further, employers must create healthy workplaces, for all employees regardless of disability can benefit from it.
Collapse
|
5
|
Stevenson BJ, Millner UC, Satgunam SA, Love R. Hope, adaptability, and job-search intensity among individuals living with serious mental illness. JOURNAL OF VOCATIONAL REHABILITATION 2021. [DOI: 10.3233/jvr-211147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Increased intensity in job-search behavior is associated with important employment outcomes like job attainment. There is evidence that work hope, and career adaptability are important antecedents of higher job-search intensity. However, there is no evidence that these relationships exist among individuals living with serious mental illness. OBJECTIVE: This study seeks to improve our understanding of factors that contribute to job-search intensity among individuals living with serious mental illness. METHODS: Eighty-five individuals living with serious mental illness completed surveys of demographics, work hope, career adaptability, and job-search intensity. Correlational and regression analysis was used to examine the primary relationships in this study. RESULTS: Education level, employment status, and use of vocational rehabilitation services were background factors related to job-search intensity. Controlling for background factors, regression analysis found that work hope positively predicted job-search intensity, and career adaptability negatively predicted job-search intensity. Our model explained 35%of the variance in job-search intensity. Additionally, individuals who were employed had significantly higher career adaptability than individuals who were unemployed. CONCLUSIONS: Work hope and career adaptability are related to important vocational outcomes among individuals living with serious mental illness.
Collapse
Affiliation(s)
- Brian J. Stevenson
- Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts, USA
| | - Uma Chandrika Millner
- Division of Psychology & Applied Therapies, Lesley University, Cambridge, Massachusetts, USA
| | - Sarah A. Satgunam
- Division of Psychology & Applied Therapies, Lesley University, Cambridge, Massachusetts, USA
| | - Richard Love
- Division of Psychology & Applied Therapies, Lesley University, Cambridge, Massachusetts, USA
| |
Collapse
|
6
|
Vlachou A, Roka O, Stavroussi P. Experiences of workers with disabilities receiving supported employment services in Greece. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2021; 25:151-167. [PMID: 31476953 DOI: 10.1177/1744629519871172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
People with disabilities (PwDs) are under-represented in the workforce, especially during times of economic recession. Supported employment is recognized as an effective practice for promoting work inclusion of PwDs, including people with intellectual disabilities (IDs). This study aimed at exploring the experiences of workers with ID or mental health conditions who received supported employment services in Greece. Semi-structured interviews were conducted with nine workers with ID and five with mental health conditions. The thematic analysis revealed that emotional pressure was experienced by the participants with mental health conditions and those with ID during the job search and the adaptation period, respectively. On-the-job training was available for the participants with ID and assistance in finding suitable job opportunities was given to those with mental health conditions. All participants highlighted the importance of maintaining employment. The findings can inform efforts on developing employment services targeting social and work inclusion for PwDs.
Collapse
|
7
|
Testing Kumpfer’s Resilience Model Among Adults With Serious Mental Illness. REHABILITATION COUNSELING BULLETIN 2021. [DOI: 10.1177/00343552211006770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Having a serious mental illness (SMI) is often associated with significant adversities, and people respond differently to adversities. The existing research supports that people with SMI can achieve and maintain positive life outcomes despite experiencing adversities. Resilience, the ability to cope with (or bounce back quickly from) crisis, can help buffer the negative effects of various types of adversities, including chronic illness and disability, and facilitate the psychosocial adaptation process to SMI. Kumpfer’s resilience model, a person-process-context framework, has been widely used to conceptualize, and assess for, resilience in various populations, including people with chronic illnesses and disabilities. However, the research in resilience among people with SMI is very limited. The purpose of this study was to empirically assess the utility of Kumpfer’s resilience model and its proposed predictive components for conceptualizing the adaptation process to SMI. One hundred forty-four participants completed a Qualtrics survey containing demographic questions and a series of validated instruments representing the major components of Kumpfer’s resilience model. Hierarchical regression analysis was used to analyze the data, and the final model explained 71% of the variance of the dependent variable—adaptation to disability. Avoidance coping, internalized stigma, and optimism were significant independent predictors of adaptation to disability. This study supports the utilization of Kumpfer’s resilience model to conceptualize the adaptation to disability process among people with SMI. Implications for rehabilitation counseling practices are discussed.
Collapse
|
8
|
Cervello S, Dubreucq J, Trichanh M, Dubrulle A, Amado I, Bralet MC, Chirio-Espitalier M, Delille S, Fakra E, Francq C, Guillard-Bouhet N, Graux J, Lançon C, Zakoian JM, Gauthier E, Demily C, Franck N. Cognitive remediation and professional insertion of people with schizophrenia: RemedRehab, a randomized controlled trial. Eur Psychiatry 2021; 64:e31. [PMID: 33853701 PMCID: PMC8135109 DOI: 10.1192/j.eurpsy.2021.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background People suffering from schizophrenia cannot easily access employment in European countries. Different types of vocational programs coexist in France: supported employment, sheltered employment (ShE), and hybrid vocational programs. It is now acknowledged that the frequent cognitive impairments constitute a major obstacle to employment for people with schizophrenia. However, cognitive remediation (CR) is an evidence-based nonpharmacological treatment for these neurocognitive deficits. Methods RemedRehab was a multicentric randomized comparative open trial in parallel groups conducted in eight centers in France between 2013 and 2018. Participants were recruited into ShE firms before their insertion in employment (preparation phase). They were randomly assigned to cognitive training Cognitive Remediation for Schizophrenia (RECOS) or Treatment As Usual (TAU). The aim of the study was to compare with the benefits of the RECOS program on access to employment and work attendance for people with schizophrenia, measured by the ratio: number of hours worked on number of hours stipulated in the contract. Results Seventy-nine patients were included in the study between October 2018 and September 2019. Fifty-three patients completed the study. Hours worked / planned hours equal to 1 or greater than 1 were significantly higher in the RECOS group than in the TAU group. Conclusions Participants benefited from a RECOS individualized CR program allows a better rate of work attendance in ShE, compared to the ones benefited from TAU. Traditional vocational rehabilitation enhanced with individualized CR in a population of patients with schizophrenia is efficient on work attendance during the first months of work integration.
Collapse
Affiliation(s)
- S Cervello
- Psychosocial Rehabilitation Resource Center (CRR) and Reference Center (SUR-CL3R), Le Vinatier Hospital, Lyon, France
| | - J Dubreucq
- Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - M Trichanh
- Psychosocial Rehabilitation Resource Center (CRR) and Reference Center (SUR-CL3R), Le Vinatier Hospital, Lyon, France
| | - A Dubrulle
- Psychosocial Rehabilitation Resource Center (CRR) and Reference Center (SUR-CL3R), Le Vinatier Hospital, Lyon, France
| | - I Amado
- Service hospitalo-universitaire, CJAAD, centre hospitalier Sainte-Anne, 75014Paris, France.,Faculté de médecine, université Paris Descartes, Sorbonne Paris Cité, 75006Paris, France.,Inserm, laboratoire de physiopathologie des maladies psychiatriques, centre de psychiatrie et neurosciences, U894, institut de psychiatrie (GDR3557), 75014Paris, France.,Service hospitalo-universitaire, C3RP, centre hospitalier Sainte-Anne, 75014Paris, France
| | - M C Bralet
- Crisalid Unit (FJ5), CHI Clermont de l'Oise, 2 rue des Finets, 60607Clermont, France
| | - M Chirio-Espitalier
- Pôle de psychiatrie et santé mentale, Centre de référence en soins d'éducation thérapeutique et remédiation cognitive (CReSERC), centre hospitalier universitaire, 85, rue Saint-Jacques, 44093Nantes cedex, France
| | - S Delille
- Département de Réhabilitation Psychosociale et de remédiation cognitive, Lille, France
| | - E Fakra
- University Department of Psychiatry, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne, France.,INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center (CRNL), PSYR2 Team, Université de Lyon, Lyon, France
| | - C Francq
- Center of Research in Economics and Statistics (CREST), UMR 9194, Palaiseau, France
| | - N Guillard-Bouhet
- CREATIV & URC Pierre Deniker, Centre Hospitalier Laborit, Poitiers, France
| | - J Graux
- Se rétablir 37, CHRU de Tours, UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - C Lançon
- CEReSS, Université de la mediteranée, Marseille, France
| | - J M Zakoian
- Center of Research in Economics and Statistics (CREST), UMR 9194, Palaiseau, France
| | - E Gauthier
- Psychosocial Rehabilitation Resource Center (CRR) and Reference Center (SUR-CL3R), Le Vinatier Hospital, Lyon, France
| | - C Demily
- GénoPsy, Reference Center for Diagnosis and Management of Genetic Psychiatric Disorders, Centre Hospitalier le Vinatier and EDR-Psy Q19 Team (Centre National de la Recherche Scientifique & Lyon 1 Claude Bernard University), 69678Bron, France
| | - N Franck
- Psychosocial Rehabilitation Resource Center (CRR) and Reference Center (SUR-CL3R), Le Vinatier Hospital, Lyon, France.,UMR 5229, CNRS & Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| |
Collapse
|
9
|
Brooks JM, Iwanaga K, Chan F, Lee B, Chen X, Wu JR, Walker R, Fortuna KL. Psychometric validation of the Job Satisfaction of Persons with Disabilities Scale in a sample of peer support specialists. Psychiatr Rehabil J 2021; 44:93-98. [PMID: 32191104 PMCID: PMC8034488 DOI: 10.1037/prj0000411] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The primary purpose of the study was to evaluate the psychometric properties of the Job Satisfaction of Persons with Disabilities Scale in a sample of peer support specialists. METHOD A total of 121 employed peer support specialists with lived experience of a serious mental health condition were recruited for this study from statewide peer certification training programs and the International Association of Peer Supporters. Respondents completed an online survey on job satisfaction and related constructs. A principal components analysis was used to explore and identify the instrument subscales. RESULTS The findings identified 2 factors: (a) the 9-item job satisfaction with intangible benefits factor and (b) the 5-item job satisfaction with tangible benefits factor. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The Job Satisfaction of Persons with Disabilities Scale demonstrates good-to-excellent psychometrics. The use of this scale among peer support specialists within training and supervision practices in psychiatric rehabilitation settings is warranted. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
| | - Kanako Iwanaga
- Department of Rehabilitation Counseling, College of Health Professions, Virginia Commonwealth University
| | - Fong Chan
- Department of Rehabilitation Psychology and Special Education, School of Education, University of Wisconsin-Madison
| | - Beatrice Lee
- Department of Rehabilitation Psychology and Special Education, School of Education, University of Wisconsin-Madison
| | - Xiangli Chen
- Department of Rehabilitation Psychology and Special Education, School of Education, University of Wisconsin-Madison
| | - Jia-Rung Wu
- Department of Counselor Education, Daniel L. Goodwin College of Education, Northeastern Illinois University
| | | | - Karen L Fortuna
- Geisel School of Medicine, Department of Mental Health, Dartmouth College
| |
Collapse
|
10
|
Lambert M, Sanchez P, Bergmans P, Gopal S, Mathews M, Wooller A, Pungor K. Effect of Paliperidone Palmitate 3-Month Formulation on Goal Attainment and Disability After 52 Weeks' Treatment in Patients with Clinically Stable Schizophrenia. Neuropsychiatr Dis Treat 2020; 16:3197-3208. [PMID: 33380797 PMCID: PMC7767727 DOI: 10.2147/ndt.s286654] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/08/2020] [Indexed: 01/09/2023] Open
Abstract
PURPOSE This pragmatic clinical study aimed to assess goal attainment among patients with schizophrenia treated with paliperidone palmitate 3-monthly (PP3M) and its relation to their level of disability, and whether patients achieved symptomatic remission at the study endpoint. PATIENTS AND METHODS Goal attainment was assessed as a secondary endpoint using Goal Attainment Scaling (GAS) within a 52-week, prospective, single-arm, non-randomized, open-label, international, multicenter study evaluating the impact of transitioning stable patients with schizophrenia from paliperidone palmitate 1-monthly (PP1M) to PP3M. Additional exploratory analyses were performed to investigate the relationship between disability and functioning as measured by the World Health Organization Disability Assessment Schedule (WHODAS), Version 2.0, symptomatic remission, and goal attainment. RESULTS Overall, 305 patients were enrolled, of whom 281 (92.1%) provided GAS data at baseline. Of these, 160 achieved symptomatic remission at the last observation carried forward (LOCF) endpoint. The most common category of goals was "self" related, of which work-related was most frequent. Two-thirds of patients (67.7%) achieved at least one goal at the LOCF endpoint. Goal achievement was positively associated with lower baseline symptoms and symptomatic remission at LOCF endpoint, and with lower WHODAS scores at baseline and LOCF endpoint and greater WHODAS score improvements from baseline. Age, duration of disease, and duration of PP1M treatment before the switch did not impact goal setting and goal attainment. The proportion of patients with remunerated work status increased by 11.3% at LOCF endpoint. CONCLUSION The results of this secondary endpoint analysis indicate that continued treatment of patients with schizophrenia with PP3M following stabilization with PP1M may facilitate attainment of patients' personal goals and reduce disability, especially, but not exclusively, in patients with symptomatic remission achieved at LOCF.
Collapse
Affiliation(s)
- Martin Lambert
- Centre for Psychosis and Integrated Care, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Pedro Sanchez
- Treatment Resistant Psychosis Unit, Hospital Psiquiatrico De Álava, Osakidetza, Vitoria, Spain
- School of Medicine, University of Deusto, Bilbao, Spain
| | - Paul Bergmans
- Janssen-Cilag B.V., Biostatistics, Breda, Netherlands
| | | | - Maju Mathews
- Janssen Pharma, Global Medical Affairs, New York City, NY, USA
| | | | - Katalin Pungor
- Janssen Medical Affairs EMEA, Janssen-Cilag GmbH. Johnson and Johnson Platz 1, 41470 Neuss, Germany
| |
Collapse
|
11
|
Yazdani K, Nikoo M, Sayre EC, Choi F, Jang K, Krausz RM. The impact of employment on recovery among individuals who are homeless with severe mental illness in the Vancouver At Home/Chez Soi trial. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1619-1627. [PMID: 32476057 DOI: 10.1007/s00127-020-01887-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 05/15/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To assess impact of employment on recovery in a sample of adults from Vancouver At Home (VAH) study, who were homeless and were diagnosed with severe mental disorders. METHODS The VAH included two randomized controlled trials investigating the effect of housing first with support intervention in vulnerable population. Employment was assessed at baseline and during the follow-up using Demographics, Housing, Vocational, and Service Use History (DSHH), and Vocational Timeline Follow-Back (VTLFB) self-report questionnaires, respectively. Recovery was examined using Recovery Assessment Scale (RAS) at baseline and at 24-month follow-up visit. Multivariable regression models were built to examine: (1) the effect of current employment at baseline on RAS score at baseline, and RAS score at 24-month follow-up visit; and (2) and to examine the cumulative effect of recent employment over 8 follow-up visits on RAS score at 24-month visit. Cumulative effect of employment over the follow-up visits was weighted by recency using a pre-specified weighting function. RESULTS Employment at baseline was associated with an increase in recovery score at baseline [8.06 (95% CI 1.21, 14.91); p = 0.02], but not with recovery score at 24-month follow-up visit [3.78 (-4.67, 12.24); p = 0.37]. Weighted cumulative effect of employment over 8 follow-up visits was associated with increase in RAS score at 24-month follow-up visit [8.33 (1.68, 14.99) p = 0.01]. CONCLUSION Employment is associated with an increase in recovery. Our result suggests a dual effect of employment on recovery, an immediate effect through current employment, and a long-term effect of cumulative employment.
Collapse
Affiliation(s)
- Kiana Yazdani
- Addiction and Concurrent Disorders Group, Department of Psychiatry, Faculty of Medicine, Institute of Mental Health, University of British Columbia, Vancouver, Canada. .,Arthritis Research Canada, Richmond, BC, Canada. .,Experimental Medicine Program, Department of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada.
| | - Mohammadali Nikoo
- Addiction and Concurrent Disorders Group, Centre for Health Evaluation Outcome Sciences, Department of Psychiatry, Faculty of Medicine, Institute of Mental Health, University of British Columbia, Vancouver, Canada
| | | | - Fiona Choi
- Addiction and Concurrent Disorders Group, Centre for Health Evaluation Outcome Sciences, Department of Psychiatry, Faculty of Medicine, Institute of Mental Health, University of British Columbia, Vancouver, Canada
| | - Kerry Jang
- Department of Psychiatry, Faculty of Medicine, Institute of Mental Health, University of British Columbia, Vancouver, Canada
| | - Reinhard Michael Krausz
- Addiction and Concurrent Disorders Group, Centre for Health Evaluation Outcome Sciences, Department of Psychiatry, Faculty of Medicine, Institute of Mental Health, University of British Columbia, Vancouver, Canada
| |
Collapse
|
12
|
Liljeholm U, Argentzell E, Bejerholm U. An integrated mental health and vocational intervention: A longitudinal study on mental health changes among young adults. Nurs Open 2020; 7:1755-1765. [PMID: 33072359 PMCID: PMC7544838 DOI: 10.1002/nop2.560] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 05/26/2020] [Accepted: 06/16/2020] [Indexed: 01/17/2023] Open
Abstract
Aim This study aimed to investigate changes in mental health among young adults participating in an integrated mental health and vocational support intervention according to the Södertälje Supported Employment and Education model. Design A prospective longitudinal pre–post intervention study of 12 months. Methods Instruments on depressive symptoms, quality of life, empowerment, engagement in activities and sociodemographic characteristics were administered to 42 young adults aged 19–28 years with mood disorders. Wilcoxon signed rank tests were used to assess changes in mental health. Results Statistically significant positive changes between baseline and 12 months were noted for quality of life and engagement in activities. Difference in empowerment scores neared significance and a statistical trend towards lower depression scores was seen, corresponding to moderate depression at baseline and less severe depression at 12 months. Conclusions Integrated mental health and vocational services may support young adults' mental health and is suggested to be linked to their personal recovery and clinical recovery.
Collapse
Affiliation(s)
- Ulrika Liljeholm
- Department of Health Sciences/Mental Health, Activity and Participation Lund University Lund Sweden.,Centre for Evidence-based Psychosocial Interventions Lund University Lund Sweden
| | - Elisabeth Argentzell
- Department of Health Sciences/Mental Health, Activity and Participation Lund University Lund Sweden.,Centre for Evidence-based Psychosocial Interventions Lund University Lund Sweden
| | - Ulrika Bejerholm
- Department of Health Sciences/Mental Health, Activity and Participation Lund University Lund Sweden.,Centre for Evidence-based Psychosocial Interventions Lund University Lund Sweden
| |
Collapse
|
13
|
Tiderington E, Henwood BF, Padgett DK, Tran Smith B. Employment experiences of formerly homeless adults with serious mental illness in Housing First versus treatment first supportive housing programs. Psychiatr Rehabil J 2020; 43:253-260. [PMID: 31621352 PMCID: PMC7162698 DOI: 10.1037/prj0000391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This paper examines how formerly homeless adults with serious mental illness living in Housing First (HF) and "treatment first" (TF) supportive housing programs experience employment. Research questions include: How do these individuals experience employment in the context of their mental health recovery? What do they perceive as the benefits of and obstacles to attaining employment? Are there programmatic differences in their employment experiences? METHOD Case study analyses of data from a federally funded qualitative study were conducted of 40 individuals purposively sampled from HF and TF programs. Data were independently analyzed and consensually discussed to develop cross-case themes. RESULTS Three themes emerged: (a) the meaning of work, (b) working within the system, and (c) balancing treatment requirements and work. While none of the study participants had full-time jobs, more HF program clients had part-time employment than their TF counterparts. Of the 12 employed participants, all but 2 worked within their respective programs. Participants in both groups described similar benefits of obtaining employment, but TF program requirements inhibited job-seeking. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE These findings provide insight into the challenges of obtaining employment for formerly homeless individuals with serious mental illness residing in supportive housing. Despite the motivation to work, individual, structural, and organizational factors impeded employment. To address this problem, factors at each of these levels will need to be considered. Interventions such as supported employment offer promise to supportive housing programs committed to employment as a contributor to recovery. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
Affiliation(s)
- Emmy Tiderington
- School of Social Work, Rutgers, The State University of New Jersey
| | - Benjamin F Henwood
- Suzanne Dworak-Peck School of Social Work, University of Southern California
| | | | | |
Collapse
|
14
|
Gibbons BJ, Salkever DS. Working with a Severe Mental Illness: Estimating the Causal Effects of Employment on Mental Health Status and Total Mental Health Costs. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 46:474-487. [PMID: 30815767 DOI: 10.1007/s10488-019-00926-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Employment is an important goal for persons who have a severe mental illness (SMI). The current literature finds some evidence for a positive relationship between employment and measures of mental health (MH) status, however study design issues have prevented a causal interpretation. This study aims to measure the causal effect of employment on MH status and total MH costs for persons with SMI. In a quasi-experimental prospective design, self-reported data measured at baseline, 6-months, and 12-months, on MH status and employment are paired with Public Mental Health System (PMHS) claims data. The study population (N = 5162) is composed of persons with a SMI who received PMHS services for a year or more. Outcome variables are MH status symptom scores from the BASIS-24 instrument and total MH costs. The estimation method is full information maximum likelihood, which allows for tests of employment endogeneity. Outcomes with an insignificant test of endogeneity are estimated using tobit or ordinary least square (OLS). Employment has modest but meaningful effects on MH status (including overall MH status, functioning, and relationships) and reduces total mental health costs on average by $538 in a 6-month period. Tests of endogeneity were largely insignificant, except for the depression score that tested marginally statistically significant. Interaction terms between baseline MH scores and employment indicated larger employment effects for individuals with worse baseline scores. This study demonstrates the non-vocational benefits of employment for individuals with SMI. Results have high generalizability and should be of interest to federal and state governments in setting appropriate disability policy and funding vocational programs. From a methodological perspective, future research should still be concerned with potential endogeneity problems, especially if employment status and MH outcomes are simultaneously measured and/or baseline measures of MH are not adequately controlled for future research should continue to examine the multi-dimensional nature of MH status and costs. Our analyses also demonstrate the practical use of a state-wide outcomes measurement program in assessing the factors that influence the recovery trajectories of individuals with SMI.
Collapse
Affiliation(s)
- Brent J Gibbons
- The National University of Singapore, School of Public Health, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore.
| | - David S Salkever
- The University of Maryland, Baltimore County (UMBC), Baltimore, USA
| |
Collapse
|
15
|
Riedl L, Blank D, Kohl M, Lang A, Kehl V, Brieger P, Hamann J. Return-to-work-experts for inpatient treatment of patients with mental illnesses- a proof-of-concept-study (RETURN): the study protocol. BMC Psychiatry 2020; 20:177. [PMID: 32306925 PMCID: PMC7168961 DOI: 10.1186/s12888-020-02504-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 02/17/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Patients with mental illnesses often have massive difficulties returning to work after inpatient treatment at a psychiatric clinic and are often at risk of losing their jobs. The psychosocial support for this patient group at the interface of clinic/outpatient care is often insufficient. METHODS/DESIGN The RETURN-study prospectively assesses and surveys 200 patients with mental disorders in a cluster randomized intervention study, i.e. treatment teams and patients from intervention wards receive a return-to-work (RTW) intervention. Patients in control wards obtain treatment as usual (TAU). Pairs of comparable wards (similar patient population, similar staff density) have been identified and then randomized for control and intervention (n = 14 for each condition). On intervention wards return-to-work experts (RTW experts) who focus treatment on the workplace-related needs of patients with mental illnesses have been established. These RTW experts ensure the use of available resources within the framework of work-related discharge management and should lead to a more successful return to the workplace. The days at work in the year after release will be evaluated in a mixed methods approach as well as the return rate in the year after release, disability days in the year after return, relapse rate after 12 months, cost-benefit ratio of the intervention, analysis of the predictors / barriers for a successful return to the workplace (e.g. psychopathology, cognition, stigma, social-psychiatric support, company support, etc.), possibilities to implement the concept of RTW experts in standard psychiatric care (TAU - treatment as usual), the impact of the RTW experts' approach on the treatment process in standard psychiatric care. DISCUSSION This approach is already internationally established in the field of somatic rehabilitation and supported employment [Am J Psychiatry 171:1183-90, 2014; Lancet 370:1146-52, 2007; Cochrane Database Syst Rev, doi:10.1002/14651858.CD006237.pub3, 2014]; the innovative aspect of this project is to implement and evaluate it in standard psychiatric care in Germany. This project requires no new interventions to be developed and tested, as the techniques of the case manager/job coach is applied to the field of return to work. TRIAL REGISTRATION The study was registered in Deutsches Register Klinische Studien searchable via its Meta-registry (http://apps.who.int/trialsearch/), Trial registration number: DRKS00016037, Date of registration: 21/12/2018, URL of trial registry record.
Collapse
Affiliation(s)
- Lina Riedl
- Department of Psychiatry and Psychotherapy of Technische Universität München, School of Medicine, Ismaninger Str.22, 81675, Munich, Germany.
| | - Daniela Blank
- kbo-Isar-Amper-Klinikum, Academic Teaching Hospital LMU Munich, Munich-Haar, Germany
- Academic Teaching Hospital LMU, Munich, Germany
| | - Monika Kohl
- Department of Psychiatry and Psychotherapy of Technische Universität München, School of Medicine, Ismaninger Str.22, 81675, Munich, Germany
| | - Anne Lang
- kbo-Isar-Amper-Klinikum, Academic Teaching Hospital LMU Munich, Munich-Haar, Germany
- Academic Teaching Hospital LMU, Munich, Germany
| | - Victoria Kehl
- Department of Psychiatry and Psychotherapie, Technische Universität München, School of Medicine, Munich, Germany
| | - Peter Brieger
- kbo-Isar-Amper-Klinikum, Academic Teaching Hospital LMU Munich, Munich-Haar, Germany
- Academic Teaching Hospital LMU, Munich, Germany
| | - Johannes Hamann
- Department of Psychiatry and Psychotherapy of Technische Universität München, School of Medicine, Ismaninger Str.22, 81675, Munich, Germany
| |
Collapse
|
16
|
Chen R, Liou TH, Miao NF, Chang KH, Yen CF, Liao HF, Chi WC, Chou KR. Using World Health Organization Disability Assessment Schedule 2.0 in people with schizophrenia: a 4-year follow-up. Eur Arch Psychiatry Clin Neurosci 2020; 270:301-310. [PMID: 31011812 DOI: 10.1007/s00406-019-01000-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 03/21/2019] [Indexed: 11/30/2022]
Abstract
Little is known about the changes of people with schizophrenia disability in Taiwan who receive routine treatments under the current mental healthcare system. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was used to assess and track changes in the degree of disability in people with schizophrenia before and after 4 years of follow-up. Data on 4497 people with schizophrenia were acquired from the Taiwan Data Bank of Persons with Disability. The WHODAS 2.0 was used for disability assessment, and the chi-square test, logistic regression and generalised estimating equations were adopted for statistical analysis. People with schizophrenia exhibited improvement in cognition, mobility and participation among the six domains as well as in the overall score. The degree of disability in all domains remained mild to moderate among people aged 18-64 years; the degree of disability in cognition declined from moderate to severe among patients aged ≥65 years. The degree of disability in all domains remained mild to moderate among people with mild to moderate impairment; among those with severe impairment, the degree of disability in the domains of cognition and life activities declined from moderate to severe and the degree of disability in the domain of mobility declined from mild to moderate. Community-dwelling patients exhibited less degree of disability in all domains than their institutionalised peers. Early detection and treatment and an emphasis on communication and social problem-solving skills in rehabilitation programmes are recommended for people with schizophrenia.
Collapse
Affiliation(s)
- Ruey Chen
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan, ROC.,School of Nursing, College of Nursing, Taipei Medical University, No. 250, Wu-Hsing Street, 110, Taipei, Taiwan, ROC
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, ROC.,Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
| | - Nae-Fang Miao
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, ROC
| | - Kwang-Hwa Chang
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC.,Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan, ROC.,Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, ROC
| | - Chia-Feng Yen
- Department of Public Health, Tzu Chi University, Hualien, Taiwan, ROC
| | - Hua-Fang Liao
- Taiwan Society of International Classification of Functioning, Disability and Health, Taipei, Taiwan, ROC.,School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC
| | - Wen-Chou Chi
- Department of Occupational Therapy, Chung Shan Medical University, Taichung, Taiwan, ROC. .,Occupational Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan, ROC.
| | - Kuei-Ru Chou
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan, ROC. .,School of Nursing, College of Nursing, Taipei Medical University, No. 250, Wu-Hsing Street, 110, Taipei, Taiwan, ROC. .,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan, ROC.
| |
Collapse
|
17
|
Wright AC, Mueser KT, McGurk SR, Fowler D, Greenwood KE. Cognitive and metacognitive factors predict engagement in employment in individuals with first episode psychosis. Schizophr Res Cogn 2020; 19:100141. [PMID: 31828018 PMCID: PMC6889423 DOI: 10.1016/j.scog.2019.100141] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 02/10/2019] [Accepted: 03/25/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Research has demonstrated that cognitive abilities predict work outcomes in people with psychosis. Cognitive Remediation Programs go some way in improving work outcomes, but individuals still experience difficulty maintaining employment. Metacognition has been demonstrated to predict work performance in individuals with schizophrenia, but this has not yet been applied to First Episode Psychosis (FEP). This study assessed whether metacognition, intellectual aptitude and functional capacity can predict engagement in work and number of hours of work within FEP. METHODS Fifty-two individuals with psychosis, from an Early Intervention in Psychosis service, completed measures of IQ, metacognition (Metacognitive Assessment Interview), functional capacity (UPSA), and functional outcome (hours spent in structured activity per week, including employment). RESULTS Twenty-six participants (22 males, 4 females) were employed and twenty-six (22 males, 4 females) were not employed. IQ and metacognition were significantly associated with whether the individual was engaged in employment [IQ (p = .02) and metacognition (p = 006)]. When controlling for IQ, metacognition (differentiation subscale) remained significant (p = .04). Next, including only those employed, no cognitive nor metacognitive factors predicted number of hours in employment. DISCUSSION This is the first study to directly assess metacognition as a predictor of work hours for individuals with FEP. This study highlights the importance of enhancing metacognitive ability in order to improve likelihood of, and engagement in, employment for those with FEP.
Collapse
Affiliation(s)
- Abigail C. Wright
- University of Sussex, School of Psychology, Brighton, East Sussex, United Kingdom
- Sussex Partnership NHS Foundation Trust, Swandean, West Sussex, United Kingdom
- Center of Excellence for Psychosocial & Systemic Research, Massachusetts General Hospital, USA
| | - Kim T. Mueser
- Center for Psychiatric Rehabilitation, Boston University, Boston, MA, USA
| | - Susan R. McGurk
- Center for Psychiatric Rehabilitation, Boston University, Boston, MA, USA
| | - David Fowler
- University of Sussex, School of Psychology, Brighton, East Sussex, United Kingdom
- Sussex Partnership NHS Foundation Trust, Swandean, West Sussex, United Kingdom
| | - Kathryn E. Greenwood
- University of Sussex, School of Psychology, Brighton, East Sussex, United Kingdom
- Sussex Partnership NHS Foundation Trust, Swandean, West Sussex, United Kingdom
| |
Collapse
|
18
|
Wright A, Fowler D, Greenwood K. Influences on functional outcome and subjective recovery in individuals with and without First Episode Psychosis: A metacognitive model. Psychiatry Res 2020; 284:112643. [PMID: 31718807 DOI: 10.1016/j.psychres.2019.112643] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/22/2019] [Accepted: 10/24/2019] [Indexed: 11/28/2022]
Abstract
Models of functional and subjective recovery in psychosis suggest that the path between neurocognition and functioning is mediated by cognitive processes, which may include metacognition, considered 'thinking about thinking'. Metacognition has several components: metacognitive ability, experience and efficiency, connected by metacognitive monitoring and metacognitive control processes; akin to executive control processes. This study aimed to explore whether metacognitive components are fragmented, how individuals with FEP perform on the metacognitive scores compared to healthy control participants, and whether metacognitive components are associated with functioning and, for FEP only, subjective recovery. 62 individuals with FEP and 73 matched healthy controls completed measures of metacognition, functional capacity, functional outcome, and subjective recovery; covariates: IQ and symptoms. Factor analysis, to assess loading of metacognitive items onto separate factors, demonstrated that metacognitive ability, experience, efficiency and monitoring were separate components, with limited association. Metacognitive ability and metacognitive control process were reduced in FEP sample, but metacognitive experience and monitoring process were higher in FEP. Metacognitive ability predicted functional capacity, functional outcome and subjective recovery. Metacognitive experience predicted functional capacity. This is the first study to assess key metacognitive components within a large model and consider the distinct contributions to both functional and subjective recovery.
Collapse
Affiliation(s)
- Abigail Wright
- Center of Excellence for Psychosocial & Systemic Research, Massachusetts General Hospital; University of Sussex, School of Psychology.
| | - David Fowler
- University of Sussex, School of Psychology; Sussex Partnership NHS Foundation Trust
| | - Kathryn Greenwood
- University of Sussex, School of Psychology; Sussex Partnership NHS Foundation Trust
| |
Collapse
|
19
|
Ang MS, Rekhi G, Lee J. Vocational Profile and Correlates of Employment in People With Schizophrenia: The Role of Avolition. Front Psychiatry 2020; 11:856. [PMID: 33192630 PMCID: PMC7481460 DOI: 10.3389/fpsyt.2020.00856] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/06/2020] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE Employment was associated with recovery in individuals with schizophrenia. Our study aimed to delineate the vocational profile and investigate factors associated with likelihood of employment in individuals with schizophrenia. MATERIALS AND METHODS 276 community dwelling outpatients with schizophrenia were recruited; 274 completed the Positive and Negative Syndrome Scale (PANSS) and Brief Negative Symptom Scale (BNSS). Information on employment status, work outcomes and demographics were collected. Occupation was coded in accordance with the Singapore standard occupational classification. Either BNSS Motivation and Pleasure (MAP) and Emotional Expressivity (EE) or BNSS five-factor (Anhedonia, Asociality, Avolition, Blunted Affect, Alogia) were examined with PANSS factors and demographics in logistic regression with employment status and working full-time as outcome variables. RESULTS One-hundred and twenty-seven (46.01%) participants were employed; 65 (51.18%) worked full-time. In the model with BNSS MAP-EE, MAP (OR=0.897, CI=0.854-0.941) and presence of physical comorbidity (OR=0.533, CI=0.304-0.937) were associated with reduced likelihood of employment; female sex (OR=0.286, CI=0.128 - 0.637) was associated with working part-time. In the model with BNSS five-factor, Avolition (OR=0.541, CI=0.440-0.666), and PANSS Positive (OR=0.924, CI=0.855-0.997) were associated with reduced likelihood of employment; female sex (OR=0.289, CI=0.126 - 0.662) and Avolition (OR=0.644, CI=0.475 - 0.872) were associated with working part-time. DISCUSSION Our study described the vocational profile and correlates of employment in a developed urban Asian country. Negative symptoms, particularly MAP and Avolition, positive symptoms, and physical comorbidity reduced an individual's likelihood of employment, while female sex and Avolition were associated with working part-time. Efforts to identify and address these factors are necessary to encourage employment in individuals with schizophrenia.
Collapse
Affiliation(s)
- Mei San Ang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Gurpreet Rekhi
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Jimmy Lee
- Research Division, Institute of Mental Health, Singapore, Singapore.,North Region & Department of Psychosis, Institute of Mental Health, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| |
Collapse
|
20
|
Identifying social participation subgroups of individuals with severe mental illnesses: a latent class analysis. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1067-1077. [PMID: 31127349 DOI: 10.1007/s00127-019-01704-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 03/26/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To investigate factors that influence participation in and needs for work and other daytime activities among individuals with severe mental illnesses (SMI). METHODS A latent class analysis using routine outcome monitoring data from 1069 patients was conducted to investigate whether subgroups of individuals with SMI can be distinguished based on participation in work or other daytime activities, needs for care in these areas, and the differences between these subgroups. RESULTS Four subgroups could be distinguished: (1) an inactive group without daytime activities or paid employment and many needs for care in these areas; (2) a moderately active group with some daytime activities, no paid employment, and few needs for care; (3) an active group with more daytime activities, no paid employment, and mainly met needs for care; and (4) a group engaged in paid employment without needs for care in this area. Groups differed significantly from each other in age, duration in MHC, living situation, educational level, having a life partner or not, needs for care regarding social contacts, quality of life, psychosocial functioning, and psychiatric symptoms. Differences were not found for clinical diagnosis or gender. CONCLUSIONS Among individuals with SMI, different subgroups can be distinguished based on employment situation, daytime activities, and needs for care in these areas. Subgroups differ from each other on patient characteristics and each subgroup poses specific challenges, underlining the need for tailored rehabilitation interventions. Special attention is needed for individuals who are involuntarily inactive, with severe psychiatric symptoms and problems in psychosocial functioning.
Collapse
|
21
|
Liljeholm U, Bejerholm U. Work identity development in young adults with mental health problems. Scand J Occup Ther 2019; 27:431-440. [DOI: 10.1080/11038128.2019.1609084] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Ulrika Liljeholm
- Department of Health Sciences/Mental Health, Activity and Participation, Lund University, Lund, Sweden
| | - Ulrika Bejerholm
- Department of Health Sciences/Mental Health, Activity and Participation, Lund University, Lund, Sweden
| |
Collapse
|
22
|
Naslund JA, Aschbrenner KA. Risks to Privacy With Use of Social Media: Understanding the Views of Social Media Users With Serious Mental Illness. Psychiatr Serv 2019; 70:561-568. [PMID: 30947635 PMCID: PMC6602849 DOI: 10.1176/appi.ps.201800520] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Social media may afford new opportunities to enhance mental health services; however, privacy risks have received less attention. This study explored privacy risks of using social media for reasons related to mental health from the perspectives of social media users with serious mental illness. METHODS Twitter users who self-identified in their profile as having a serious mental illness participated in an online survey inquiring whether they were ever concerned about risks to their privacy when using social media for anything related to their mental illness. User characteristics were compared between those who were concerned about risks and those who were not. Participants' responses to an open-ended question about privacy risks were analyzed thematically. RESULTS Among 90 respondents who self-identified as having schizophrenia spectrum disorders (40%), bipolar disorder (37%), or major depressive disorder (23%), more than one-third (36%) expressed concerns about privacy risks with using social media. Risks were more frequently reported among respondents with a college degree, compared with those without a college degree, and among respondents who were currently working or in school, compared with those who were not currently working. Thematic analysis of participants' responses to the open-ended question yielded four categories of risk: threats to employment, fear of stigma and being judged, impact on personal relationships, and facing hostility or being hurt. CONCLUSIONS These findings offer preliminary insights about the types of privacy risks that individuals with serious mental illness are concerned about when using social media for their mental health. The findings can inform the safety of future social media interventions.
Collapse
Affiliation(s)
- John A Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, Boston (Naslund); Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire (Aschbrenner)
| | - Kelly A Aschbrenner
- Department of Global Health and Social Medicine, Harvard Medical School, Boston (Naslund); Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire (Aschbrenner)
| |
Collapse
|
23
|
Ellison ML, Belanger LK, Niles BL, Evans LC, Bauer MS. Explication and Definition of Mental Health Recovery: A Systematic Review. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2019; 45:91-102. [PMID: 27709376 DOI: 10.1007/s10488-016-0767-9] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This review assessed the concordance of the literature on recovery with the definition and components of recovery developed by the Substance Abuse and Mental Health Services Administration (SAMHSA). Each SAMHSA identified recovery component was first explicated with synonyms and keywords and made mutually exclusive by authors. Inter-rater reliability was established on the coding of the presence of 17 recovery components and dimensions in 67 literature reviews on the recovery concept in mental health. The review indicated that concordance varied across SAMHSA components. The components of recovery with greatest concordance were: individualized/person centered, empowerment, purpose, and hope.
Collapse
Affiliation(s)
- Marsha Langer Ellison
- Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, 200 Springs Rd, Bedford, MA, 01730-0012, USA. .,Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA.
| | - Lindsay K Belanger
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA
| | - Barbara L Niles
- National Center for PTSD Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA
| | - Leigh C Evans
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA.,School of Public Health, Boston University, Boston, MA, USA
| | - Mark S Bauer
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
24
|
Sangeorzan I, Andriopoulou P, Livanou M. Exploring the experiences of people vlogging about severe mental illness on YouTube: An interpretative phenomenological analysis. J Affect Disord 2019; 246:422-428. [PMID: 30599364 DOI: 10.1016/j.jad.2018.12.119] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 11/23/2018] [Accepted: 12/24/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Evidence suggests that, compared to the general population, individuals with severe mental illness (SMI) are more likely to engage in online social networking and share personal experiences through blogging. However, little is known about the impact of creating and publicly sharing mental health videos (vlogging) on individuals with self-identified SMIs. AIMS The present study aims to investigate the experiences of individuals with self-identified SMIs who vlog about their SMI on YouTube. METHODS YouTube was systematically searched using four key search items ("schizophrenia", "bipolar disorder", "major depressive disorder" and "schizoaffective disorder"). After manually screening approximately 50 channels, a set of 30 videos by individuals with self-identified SMIs discussing their experience of vlogging was selected and transcribed verbatim. An interpretative phenomenological analysis (IPA) was employed for the analysis of the data. RESULTS The analysis produced three global themes: Minimising Isolation; Vlogging as Therapy; and Fighting stigma. LIMITATIONS The data collected was limited as regards depth of content by the inability to ask follow-up questions. CONCLUSIONS The findings suggest that engaging in the act of vlogging about mental illness may benefit and encourage recovery in individuals with SMIs by providing them with peer support, enhancing self-efficacy, and reducing self-stigma. Future research should employ interviews to produce more robust data for analysis.
Collapse
Affiliation(s)
- Irina Sangeorzan
- Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, Manchester M15 6GX, UK
| | - Panoraia Andriopoulou
- Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, Manchester M15 6GX, UK.
| | - Maria Livanou
- Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, Manchester M15 6GX, UK
| |
Collapse
|
25
|
Willner T, Lipshits-Braziler Y, Gati I. Construction and Initial Validation of the Work Orientation Questionnaire. JOURNAL OF CAREER ASSESSMENT 2019. [DOI: 10.1177/1069072719830293] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The goal of the present research was to develop a model of work meaning, consisting of five orientations: job (financial compensation), career (advancement and influence), calling (prosocial duty), social embeddedness (belongingness), and busyness (filling idle time with activities). Two versions of the Work Orientation Questionnaire (WOQ), which measures these five orientations, were developed—for young adults and for working adults. Study 1 describes the development of the WOQ and psychometric properties for young adults. Exploratory ( N = 200) and confirmatory ( N = 447) factor analyses supported a five-factor solution, and the five scales, which correspond to the five orientations, had adequate internal consistency reliabilities (median = .81). The divergent validity of the WOQ was supported, as shown by the negligible associations of the five orientations with the 12 scales of the Career Decision-Making Profiles questionnaire. In Study 2, the analyses of the responses of 506 employed adults also supported the five-dimensional structure, and four of the WOQ scales were associated with work satisfaction ( R 2 = .33). Implications for research and practice are discussed along with future research directions.
Collapse
Affiliation(s)
- Tirza Willner
- The Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Itamar Gati
- The Hebrew University of Jerusalem, Jerusalem, Israel
| |
Collapse
|
26
|
Employment Rates in Flexible Assertive Community Treatment Teams in The Netherlands: An Observational Study. Community Ment Health J 2019; 55:350-359. [PMID: 29344834 DOI: 10.1007/s10597-018-0233-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 01/06/2018] [Indexed: 10/18/2022]
Abstract
We determined the proportions of clients treated in Flexible Assertive Community Treatment teams who were unemployed and gained employment and who were employed and lost employment. Secondly, we explored the demographical and clinical factors associated with employment. Data were collected during routine outcome monitoring. We calculated differences in employment rates over a year and explored differences in demographic characteristics at baseline between patient groups. Logistic regression analysis was used to estimate the role of clinical predictor variables on employment status. Over time, 10% remained employed, 5% lost their employment, 3% gained employment and 82% remained unemployed. Clients who found employment were younger, more often male, and had significantly fewer psychosocial problems and a higher subjective quality of life during follow-up than those who remained unemployed. Problems with motivation for treatment at baseline were related to losing employment or remaining unemployed. Better implementation of vocational services is very important for increasing the number of clients gaining employment.
Collapse
|
27
|
Wright AC, Fowler D, Greenwood KE. Developing a dynamic model of anomalous experiences and function in young people with or without psychosis: a cross-sectional and longitudinal study protocol. BMJ Open 2018; 8:e022546. [PMID: 30391913 PMCID: PMC6231554 DOI: 10.1136/bmjopen-2018-022546] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 07/06/2018] [Accepted: 09/21/2018] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION Anomalous experiences are common within the general population, but the frequency and intensity is increased in young people with psychosis. Studies have demonstrated that perceptual biases towards noticing these phenomena plays a role, but the way one thinks about one's experience (metacognition) may also be relevant. While poor metacognitive function has been theoretically associated with anomalous experiences, this relationship is currently unclear. However, metacognition may work along a continuum with various metacognitive levels, many of which have been demonstrated as impaired in psychosis. These metacognitive components may interact via processes that maintain poor metacognition across levels, and that potentially impact both what people do in their everyday lives (functional outcome) and how people feel about their everyday lives (subjective recovery outcome) in young people with psychosis compared with healthy control participants. METHODS AND ANALYSIS This study will investigate the association and contribution of metacognition to anomalous experiences and outcome measures cross-sectionally and longitudinally in a 36-month follow-up. First, young people with psychosis will be compared with healthy control participants on selected measures of anomalous experience, metacognition, and function, using analysis of covariance to identify group differences. Next, the relationship between metacognitive components and processes will be explored, including processes connecting the different components, using regression analyses. Finally, mediation analyses will be used to assess the predictive value of metacognitive measures on outcome measures, both cross-sectionally and longitudinally at 36 months, while controlling for symptoms and cognition. ETHICS AND DISSEMINATION Ethical and Health Research Authority approval has been obtained through Camberwell St. Giles Research Ethics Committee (reference number: 17/LO/0055). This research project will be reported within a PhD thesis and submitted for journal publication. Once key predictive components of poor outcome in psychosis are identified, this study will develop a series of dynamic models to understand influences on outcome for young people with psychosis.
Collapse
Affiliation(s)
- Abigail C Wright
- School of Psychology, University of Sussex, Brighton, UK
- Research & Development, Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - David Fowler
- School of Psychology, University of Sussex, Brighton, UK
- Research & Development, Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - Kathryn E Greenwood
- School of Psychology, University of Sussex, Brighton, UK
- Research & Development, Sussex Partnership NHS Foundation Trust, Worthing, UK
| |
Collapse
|
28
|
Fitzgerald S, Kimmel K, Locust A, Miller S. Uncovering the early vocational recovery phases for persons with psychiatric disabilities participating in a supported employment program. JOURNAL OF VOCATIONAL REHABILITATION 2018. [DOI: 10.3233/jvr-170913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Sandra Fitzgerald
- Department of Counseling, San Francisco State University, San Francisco, CA, USA
| | - Kaitlin Kimmel
- Department of Counseling, San Francisco State University, San Francisco, CA, USA
| | - Alexander Locust
- Department of Counseling, San Francisco State University, San Francisco, CA, USA
| | - Susan Miller
- Center on Disability Studies, University of Hawaii at Manoa, Honolulu, HI, USA
| |
Collapse
|
29
|
Pachoud B. Activité professionnelle et processus de rétablissement. SANTE MENTALE AU QUEBEC 2017. [DOI: 10.7202/1041914ar] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Il est largement reconnu que l’exercice d’une activité professionnelle est un des facteurs contribuant le plus efficacement au rétablissement des personnes vivant avec des troubles mentaux sévères. En nous fondant sur une synthèse de la littérature pertinente dans ce domaine, nous nous attachons dans cet article à montrer que le lien étroit entre travail et rétablissement mérite d’être envisagé non seulement en partant du travail pour souligner ses apports au processus de rétablissement, mais également en partant d’une conception approfondie du rétablissement et de ce qu’il implique, pour contextualiser dans ce cadre les pratiques de soutien à l’emploi. Il est intéressant de remarquer la convergence entre les principes des pratiques axées sur le rétablissement et ceux qui orientent les pratiques de référence en matière de soutien à l’emploi. La spécification d’un changement de posture individuelle dans l’accompagnement pour promouvoir le rétablissement importe pour faire évoluer les pratiques d’accompagnement « vers » puis « dans » l’emploi. Nombre de travaux se sont attachés à identifier les façons par lesquelles le travail contribue au processus de rétablissement. Ces bénéfices du travail s’avèrent nombreux et de natures diverses. Ils ont fait l’objet d’études de synthèse qui identifient les principales dimensions en fonction desquelles nous présentons ces facteurs contribuant au rétablissement.
Collapse
Affiliation(s)
- Bernard Pachoud
- Professeur de psychopathologie à l’Université Paris Diderot, chercheur au CRPMS (Centre de Recherche Psychanalyse, Médecine et Société)
| |
Collapse
|
30
|
Villotti P, Corbière M, Dewa CS, Fraccaroli F, Sultan-Taïeb H, Zaniboni S, Lecomte T. A serial mediation model of workplace social support on work productivity: the role of self-stigma and job tenure self-efficacy in people with severe mental disorders. Disabil Rehabil 2017; 40:3113-3119. [DOI: 10.1080/09638288.2017.1377294] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Patrizia Villotti
- Centre de Recherche de l’Hôpital Charles LeMoyne, Université de Sherbrooke, Longueuil, Canada
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, Canada
| | - Marc Corbière
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, Canada
- Department of Education – Career Counselling, Université du Québec à Montréal, Montréal, Canada
| | - Carolyn S. Dewa
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - Franco Fraccaroli
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Hélène Sultan-Taïeb
- Département d'organisation et ressources humaines, École des Sciences de la Gestion, Université du Québec à Montréal, Montréal, Canada
| | - Sara Zaniboni
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Tania Lecomte
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, Canada
- Department de Psychologie, Université de Montréal, Montréal, Canada
| |
Collapse
|
31
|
Cartwright KA, Lecomte T, Corbière M, Lysaker P. Narrative development and supported employment of persons with severe mental illness. J Ment Health 2017. [PMID: 28644705 DOI: 10.1080/09638237.2017.1340606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: While the relationship between objective recovery and work among persons with severe mental illness (SMI) is well-established, few studies have examined the link between subjective recovery and employment.Aims: The study investigated the prospective relationship between narrative development at the start of supported employment (SE) and positive work outcomes.Methods: The authors employed a time-limited, mixed-method longitudinal design to examine the relationship between the baseline narrative development of 38 SE participants with SMI and employment outcomes eight months later, as well as whether narratives evolved over the course of the study.Results: While narrative development was unrelated to work for the 59% of participants who were employed at the end of the study, unemployed individuals showed more developed baseline narratives overall, as well as enriched baseline emotional connectedness and social worth. Higher emotional connectedness at the start of SE programs was predictive of fewer hours worked eight months later, controlling for executive functioning, negative symptoms and self-esteem. Although workers showed no narrative changes over time, those without work demonstrated increased agency over the eight months of the study.Conclusion: Further research is warranted to clarify the relationship between richer personal narratives and unemployment.
Collapse
Affiliation(s)
| | | | | | - Paul Lysaker
- Roudebush VA Medical Centre, Indiana University School of Medicine, Indianapolis, IN, USA
| |
Collapse
|
32
|
Eklund M, Bäckström M, Bejerholm U. How do Swedish day center attendees with psychiatric disabilities view their worker role? A structural equation modeling study. Scand J Occup Ther 2017; 25:203-212. [PMID: 28562142 DOI: 10.1080/11038128.2017.1335776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIM To investigate how day center attendees with psychiatric disabilities perceived their worker role and the importance of current work situation and personal factors in that respect. METHODS Two-hundred attendees completed the Worker Role Self-assessment and questionnaires addressing possible predictors of the worker role: current employment situation, satisfaction with that situation, and a personal factor (encompassing self-esteem, self-mastery and engagement). Structural equation modeling was used. RESULTS A model indicated two worker role factors; belief in a future worker role (WR1) and current capacities and routines (WR2). WR1 was positively influenced by having a job, younger age and the personal factor. Satisfaction with current work situation (usually unemployment) was negatively associated with WR1. The personal factor was single predictor of WR2. The attendees rated WR2 more positively than WR1. CONCLUSIONS The personal factor was crucial for both WR1 and WR2. Work-related factors were only important for WR1. The more negative rating of belief in a future worker role may be interpreted as mistrust in the services. The attendees' positive ratings of capacities indicate, however, that they had a rehabilitation potential to develop. Enhancing self-esteem, mastery and engagement may be an avenue for staff in efforts to support the attendee's worker role.
Collapse
Affiliation(s)
- Mona Eklund
- a Department of Health Sciences/Mental Health, Activity and Participation , Lund University , Lund , Sweden
| | | | - Ulrika Bejerholm
- c Department of Health Sciences/Mental Health, Activity and Participation , Lund University , Lund , Sweden
| |
Collapse
|
33
|
Eklund M, Bejerholm U. Staff ratings of occupational engagement among people with severe mental illness - psychometric properties of a screening tool in the day center context. BMC Health Serv Res 2017; 17:338. [PMID: 28482841 PMCID: PMC5422941 DOI: 10.1186/s12913-017-2283-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 05/02/2017] [Indexed: 11/10/2022] Open
Abstract
Background Staff who plan and organize day center activities may need to observe the attendees’ performance and progression. This led us to develop a tool for that purpose, termed General Occupational Engagement in people with Severe mental illness (GOES). The aim was to investigate its psychometric properties in terms of factor structure, internal consistency, corrected item-total correlations (CITC), convergent and discriminant validity, and test-retest stability. Methods Ninety-three day center attendees were assessed by the GOES and instruments addressing constructs hypothesized to be either similar to (activity level, motivation for day center attendance, perceptions of the worker role, hours spent in the day center) or divergent from the GOES (attendees’ ratings of engagement in specified occupations, self-rated health, psychosocial functioning, psychiatric symptoms). A second sample of 41 attendees were included for the test-retest analysis. Exploratory factor analysis, Cronbach’s alpha analysis, Pearson correlations and paired-samples t-tests were performed. Results Exploratory factor analysis indicated one factor, which was in line with the intentions of the scale. The alpha value was 0.85 and all CITC were above 0.30. The tests for convergent validity resulted in correlations ranging between 0.23 and 0.47, most of which were moderately strong and mainly confirmed the hypotheses. Discriminant validity was clearly indicated, since all correlations with the selected constructs were <0.20. GOES also showed preliminary test-retest stability (r = 0.32). Conclusions The GOES is ready for use in rehabilitation services and research where productive and other types of activities are of interest. It may serve as an important supplement to attendees’ self-reported occupational engagement.
Collapse
Affiliation(s)
- Mona Eklund
- Department of Health Sciences/ Mental Health, Activity and Participation, Lund University, Box 157, SE 221 00, Lund, Sweden.
| | - Ulrika Bejerholm
- Department of Health Sciences/ Mental Health, Activity and Participation, Lund University, Box 157, SE 221 00, Lund, Sweden
| |
Collapse
|
34
|
Latimer E. Extending the Quality and Reach of IPS. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2017; 44:374-377. [PMID: 28361473 DOI: 10.1007/s10488-017-0801-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Eric Latimer
- Mental Health and Society Research Program, Douglas Hospital Research Centre, Perry 3C, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada.
- Department of Psychiatry, McGill University, Montreal, Canada.
| |
Collapse
|
35
|
Brusilovskiy E, Townley G, Snethen G, Salzer MS. Social media use, community participation and psychological well-being among individuals with serious mental illnesses. COMPUTERS IN HUMAN BEHAVIOR 2016. [DOI: 10.1016/j.chb.2016.08.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
36
|
Abstract
This study explored the recovery experiences from being on a vocational rehabilitation scheme for service users with severe and enduring mental health problems. This was the first phase of a vocational rehabilitation service review and development. Two associate researchers/service users were integral to the study and increased its validity. A qualitative research method was taken, using a semi-structured interview. Two main themes emerged: moving on and being on the scheme. The findings were that transitional vocational rehabilitation schemes could have a positive effect on the vocational status, quality of life and mental health of service users with severe and enduring mental health problems given the right environment. It was recommended that the vocational rehabilitation scheme should continue, whilst the support for service users and interagency working alongside the scheme warranted further investigation. Following the study, the scheme expanded to become an employment service that extends from the public to the independent sector and offers a wider range of vocational rehabilitation schemes within it.
Collapse
|
37
|
Lloyd C, Waghorn G. The Importance of Vocation in Recovery for Young People with Psychiatric Disabilities. Br J Occup Ther 2016. [DOI: 10.1177/030802260707000202] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Young people with psychiatric disabilities are particularly disadvantaged when it comes to participating in vocational training or higher education or to seeking and maintaining employment. A review of the literature reveals that this is due to a number of factors, including low expectations by health professionals, stigma and discrimination, symptomatology and the lack of a clear responsibility for promoting vocational and social outcomes. A useful approach for occupational therapists to use is a recovery framework combining evidence-based employment and educational assistance with mental health care, provided in parallel with brief vocational counselling, illness management skills, training in stigma countering and disclosure strategies, context-specific social skills and skills in social network development. It is concluded that there is an urgent need to link evidence-based vocational practices with quality mental health care, in order to restore hope among young people of ever realising their vocational goals and once again feeling included as valued members of society.
Collapse
|
38
|
Jorge-Monteiro MF, Ornelas JH. "What's Wrong with the Seed?" A Comparative Examination of an Empowering Community-Centered Approach to Recovery in Community Mental Health. Community Ment Health J 2016; 52:821-33. [PMID: 27072950 DOI: 10.1007/s10597-016-0004-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 04/07/2016] [Indexed: 10/22/2022]
Abstract
This cross-sectional group comparison aimed to examine whether personal empowerment, recovery and community integration were associated with the individual's participation in an empowering community-centered model of intervention. Ninety-three participants from an empowering community-centered community mental health organization were compared with a matched group of individuals from standard interventions of four equivalent organizations. Results showed that participants taking advantage of the empowering community-centered approach were more involved in high recovery-oriented programs; and attained higher levels of personal goals and hope, empowerment, and of community integration. An involvement in high recovery-oriented programs (supported employment or independent housing) revealed improved outcomes for the individual. In conclusion, the findings suggested a transformative impact of the empowering community-centered model both at the individual and the program level by altering the resource accessibility and social conditions for people who experience mental illness. The implications of findings for transforming community mental health practice are discussed in detail.
Collapse
Affiliation(s)
- Maria F Jorge-Monteiro
- ISPA - Instituto Universitário, Rua Jardim do Tabaco, No. 34, 1149-041, Lisbon, Portugal.
| | - José H Ornelas
- Department of Clinical and Health Psychology, ISPA - Instituto Universitário, Lisbon, Portugal
| |
Collapse
|
39
|
Cognitive and Social Functioning Correlates of Employment Among People with Severe Mental Illness. Community Ment Health J 2016; 52:851-8. [PMID: 25895854 DOI: 10.1007/s10597-015-9874-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 04/09/2015] [Indexed: 10/23/2022]
Abstract
We assess how social and cognitive functioning is associated to gaining employment for 213 people diagnosed with severe mental illness taking part in employment programs in Andalusia (Spain). We used the Repeatable Battery for the Assessment of Neuropsychological Status and the Social Functioning Scale and conducted two binary logistical regression analyses. Response variables were: having a job or not, in ordinary companies (OCs) and social enterprises, and working in an OC or not. There were two variables with significant adjusted odds ratios for having a job: "attention" and "Educational level". There were five variables with significant odds ratios for having a job in an OC: "Sex", "Educational level", "Attention", "Communication", and "Independence-competence". The study looks at the possible benefits of combining employment with support and social enterprises in employment programs for these people and underlines how both social and cognitive functioning are central to developing employment models.
Collapse
|
40
|
Coombes K, Haracz K, Robson E, James C. Pushing through: Mental health consumers' experiences of an individual placement and support employment programme. Br J Occup Ther 2016. [DOI: 10.1177/0308022616658297] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Individual placement and support is recognized as current best practice vocational rehabilitation for people living with a severe mental illness. This study aimed to provide insight into the consumer perspective of factors that impact the success of an individual placement and support programme in Australia. Method A qualitative study was conducted using semi-structured interviews with five participants. Participants were diagnosed with a severe mental illness and were engaged with an individual placement supported employment programme in one area health service in New South Wales, Australia. Data analysis was conducted using grounded theory methods. Results Analysis revealed the core category of pushing through, a three-step process that involved experiencing discomfort, learning to adapt, and getting into a groove. Pushing through described the participants' direct experience of individual placement and support, as well as their management of their health and ability to cope with everyday practicalities and relationships while engaged in the programme. Conclusions The participants in this study described their experiences of being involved in an individual placement and support programme as being characterized by a process of pushing through. The participants' actions and experiences at each stage of this process provide cues for more tailored support within individual placement and support to meet changing needs.
Collapse
Affiliation(s)
- Kate Coombes
- Occupational Therapist, Konekt, Newcastle, NSW, Australia
| | - Kirsti Haracz
- Lecturer, School of Health Sciences, University of Newcastle, NSW, Australia
| | - Emma Robson
- Accessibility Advisor, Student Care and Equity, University of Newcastle, NSW, Australia
| | - Carole James
- Associate Professor, School of Health Sciences, University of Newcastle, NSW, Australia
| |
Collapse
|
41
|
Eklund M, Eklund L. Gender in relation to work motivation, satisfaction and use of day center services among people with psychiatric disabilities. Scand J Occup Ther 2016; 24:214-221. [DOI: 10.1080/11038128.2016.1220619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
42
|
Castle D, Crosse C, Morgain D, McDowell C, Rossell S, Thomas N, Phillipou A, Gilbert M, Moore G, Fossey E, Harvey C. Helping people with a mental illness obtain work: the Health Optimisation Program for Employment. Australas Psychiatry 2016; 24:337-41. [PMID: 27307449 DOI: 10.1177/1039856216654400] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Inclusion in work and education remains problematic for many people with a mental illness. We describe a structured programme - the Health Optimisation Program for Employment - that supported people with a mental illness to gain employment or commence studies. METHOD Twenty hours of the Health Optimisation Program for Employment were delivered to 600 individuals. Participants were asked to complete an evaluation survey encompassing vocational status and ratings of self-efficacy. RESULTS Of the 364 participants who completed the baseline assessment, 168 responded to the evaluation survey 6 months after the delivery of the Health Optimisation Program for Employment. Of these, 21.5% had started a new job, while a further 42.8% were either volunteering or studying. Satisfaction with the programme was high and self-efficacy ratings improved significantly over the short term only. CONCLUSIONS The Health Optimisation Program for Employment requires further evaluation using rigorous scientific methodology but these initial results are encouraging in terms of vocational attainment for people with a mental illness, in the Australian context.
Collapse
Affiliation(s)
- David Castle
- Department of Psychiatry, University of Melbourne, St Vincent's Hospital, Fitzroy, VIC, Australia
| | | | - Dea Morgain
- Social Firms Australia, Melbourne, VIC, Australia
| | - Caitlin McDowell
- La Trobe University Melbourne, VIC, and: Social Firms Australia, Melbourne, VIC, Australia
| | - Susan Rossell
- Brain and Psychological Sciences Research Centre, Swinburne University, Melbourne, VIC, and; Monash Alfred Psychiatry Research Centre, Alfred Hospital and Monash University Central Clinical School, Clayton, VIC, Australia
| | - Neil Thomas
- Brain and Psychological Sciences Research Centre, Swinburne University, Melbourne, VIC, and; Monash Alfred Psychiatry Research Centre, Alfred Hospital and Monash University Central Clinical School, Clayton, VIC, Australia
| | - Andrea Phillipou
- Department of Psychiatry, St Vincent's Hospital, Fitzroy, VIC, Australia
| | | | - Gaye Moore
- Department of Psychiatry, St Vincent's Hospital, Fitzroy, VIC, Australia
| | - Ellie Fossey
- Department of Occupational Therapy, School of Primary Health Care, Monash University, Clayton, VIC, Australia
| | - Carol Harvey
- Psychosocial Research Centre, Department of Psychiatry, University of Melbourne & North Western Mental Health, Melbourne, VIC, Australia
| |
Collapse
|
43
|
Wienert J, Schwarz B, Bethge M. Effectiveness of work-related medical rehabilitation in cancer patients: study protocol of a cluster-randomized multicenter trial. BMC Cancer 2016; 16:544. [PMID: 27465148 PMCID: PMC4964285 DOI: 10.1186/s12885-016-2563-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 07/14/2016] [Indexed: 11/21/2022] Open
Abstract
Background Work is a central resource for cancer survivors as it not only provides income but also impacts health and quality of life. Additionally, work helps survivors to cope with the perceived critical life event. The German Pension Insurance provides medical rehabilitation for working-age patients with chronic diseases to improve and restore their work ability, and support returning to or staying at work, and thus tries to sustainably avoid health-related early retirement. Past research showed that conventional medical rehabilitation programs do not support returning to work sufficiently and that work-related medical rehabilitation programs report higher return-to-work rates across several health conditions, when compared to medical rehabilitation. Therefore, the current study protocol outlines an effectiveness study of such a program for cancer survivors. Methods To evaluate the effectiveness of work-related medical rehabilitation in cancer patients we conduct a cluster-randomized multicenter trial. In total, 504 rehabilitation patients between 18 and 60 years with a Karnofsky Performance Status of ≥70 %, a preliminary positive social-medical prognosis of employability for at least 3 h/day within the next 6 months and an elevated risk of not returning to work will be recruited in four inpatient rehabilitation centers. Patients are randomized to the work-related medical rehabilitation program or the conventional medical rehabilitation program based on their week of arrival at each rehabilitation center. The work-related medical rehabilitation program comprises additional work-related diagnostics, multi-professional team meetings, an introductory session as well as work-related functional capacity training, work-related psychological groups, and social counseling. All additional components are aimed at the adjustment of the patients’ capacity in relation to their individual job demands. Role functioning defines the main study outcome and will be assessed with the EORTC-QLQ30. Secondary outcome measures are the remaining scales of the EORTC-QLQ30, fatigue, self-rated work ability, disease coping, participation in working life, realization of work-related goals and therapies during rehabilitation, and treatment satisfaction. Discussion A positive evaluation of work-related medical rehabilitation in cancer patients is expected due to the promising findings on the effectiveness of such programs for patients with other health conditions. Results may support the dissemination of work-related medical rehabilitation programs in German cancer rehabilitation. Trial registration German Clinical Trials Register DRKS00007770. Registered 13 May 2015. Electronic supplementary material The online version of this article (doi:10.1186/s12885-016-2563-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Julian Wienert
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
| | - Betje Schwarz
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Matthias Bethge
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| |
Collapse
|
44
|
Gunnarsson AB, Eklund M. Young people with psychiatric disabilities and their views of day centres. Scand J Occup Ther 2016; 24:167-177. [PMID: 27141968 DOI: 10.1080/11038128.2016.1178327] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Young people with psychiatric disabilities may require support in structuring their everyday life. To learn more about the relevance of day centres in this respect, this study aimed to examine the experiences of young people with psychiatric disabilities. A particular focus was on the perceptions of meaningful occupation when visiting day centres, their reasons for not choosing this option when given it and what they desired instead. A qualitative design based on individual interviews was used. Twelve women and eight men between 18 and 35 years, with a need for organized daily occupations, participated as informants. Qualitative content analysis revealed three categories: 'Being in a context', 'Balancing between developing and stagnating', and 'Longing for something more'. The findings indicated that the occupations were inherently age neutral, as were the possibilities for socializing. There was a desire for more activities in the community and more support for engaging in occupations that other young people did. A major issue in the accomplishment of this was the need to earn money, and the lack of opportunities for doing that in the day centre context was a considerable drawback. The findings highlight the importance of identifying young people's views when designing day centres.
Collapse
Affiliation(s)
- A Birgitta Gunnarsson
- a Department of Research and Development , Region Kronoberg , Växjö , Sweden.,b Department of Clinical Neuroscience and Rehabilitation , The Sahlgrenska Academy at University of Gothenburg , Gothenburg , Sweden
| | - Mona Eklund
- c Department of Health Sciences , Lund University , Lund , Sweden
| |
Collapse
|
45
|
Pedersen I, Dalskau LH, Ihleb C, Patil G. Content and key components of vocational rehabilitation on care farms for unemployed people with mental health problems: A case study report. Work 2015; 53:21-30. [PMID: 26684701 DOI: 10.3233/wor-152212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Mental health problems are a major cause for new disability grants in Norway. A variety of approaches in vocational rehabilitation is needed for this group. Green work is one such program that has been implemented at Norwegian care farms, which aims to promote health and support the transition from unemployment to working life. OBJECTIVE To describe care farms in Norway and identify the presence of key components of such vocational programs. METHODS In this case study, we used The Norwegian National Register of Care Farms to gain an overview of farms with vocational rehabilitation programs. Data consisted of written information from five farms' own web-site together with answers from a cross sectional questionnaire. Content about programs was systematically extracted by using national green work guidelines. RESULTS Descriptions of care farm programs showed that key components outlined by the national guidelines for green work were present. These components were; (1) variety of work activities, (2) adaptation of work tasks, (3) the farmers' support and supervision, (4) experiencing nature, (5) enhanced structure in everyday life. CONCLUSION The description of vocational programs on care farms in relation to these key components, gives a thorough understanding of the content and organization of such programs.
Collapse
Affiliation(s)
- Ingeborg Pedersen
- Section for Public Health Science, Department of Landscape Architecture and Spatial Planning, Norwegian University of Life Sciences, Ås, Norway
| | - Lina Harvold Dalskau
- Section for Public Health Science, Department of Landscape Architecture and Spatial Planning, Norwegian University of Life Sciences, Ås, Norway
| | - Camilla Ihleb
- Section for Public Health Science, Department of Landscape Architecture and Spatial Planning, Norwegian University of Life Sciences, Ås, Norway.,Faculty of Health and Social Work Studies, Østfold University College, Fredrikstad, Norway
| | - Grete Patil
- Section for Public Health Science, Department of Landscape Architecture and Spatial Planning, Norwegian University of Life Sciences, Ås, Norway
| |
Collapse
|
46
|
Ellingsen-Dalskau LH, Morken M, Berget B, Pedersen I. Autonomy support and need satisfaction in prevocational programs on care farms: The self-determination theory perspective. Work 2015; 53:73-85. [DOI: 10.3233/wor-152217] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Lina H. Ellingsen-Dalskau
- Section for Public Health Sciences, Department of Landscape Architecture and Spatial Planning, Norwegian University of Life Sciences, s, Norway
| | - Margrete Morken
- Department of Animal and Aquacultural Sciences, Norwegian University of Life Sciences, s, Norway
| | - Bente Berget
- Department of Animal and Aquacultural Sciences, Norwegian University of Life Sciences, s, Norway
| | - Ingeborg Pedersen
- Section for Public Health Sciences, Department of Landscape Architecture and Spatial Planning, Norwegian University of Life Sciences, s, Norway
| |
Collapse
|
47
|
Reupert A, Maybery D, Cox M, Scott Stokes E. Place of family in recovery models for those with a mental illness. Int J Ment Health Nurs 2015; 24:495-506. [PMID: 26279272 DOI: 10.1111/inm.12146] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Within the context of mental illness, there is an acknowledgement that the social environment is critical to recovery. Nonetheless, how family roles and interactions are presented in recovery frameworks is unclear. This systematic review sought to: (i) identify how family is defined in recovery models, and (ii) synthesize how family relationships and roles are incorporated into recovery models for those with a mental illness. A systematic search of electronic databases was conducted for peer reviewed, English language papers published between 1980 to April 2013, from Ovid MEDLINE, PsycINFO, Proquest, CINAHL plus and Web of Knowledge. Studies were included if they presented a recovery framework and include primary data from people with a mental illness where family was incorporated. A narrative thematic analysis was conducted on the eligible 31 studies, using inductive, open coding techniques. Eight studies did not define what was meant by 'family' while 10 studies focused exclusively on an individual's relationships with parents; six papers collected parenting demographics. Family roles included being a (adult) child, parent, spouse and being part of a 'family'. Family interactions involved being passive recipients of family support, caring for elderly parents and children and reciprocal, give and take relationships. Family interactions and roles offer the opportunity to both facilitate and impede recovery.
Collapse
Affiliation(s)
- Andrea Reupert
- Faculty of Education, Monash University, Clayton, Northern Territory, Australia
| | - Darryl Maybery
- Department of Rural and Indigenous Health, School of Rural Health, Monash University, Moe, Northern Territory, Australia
| | - Merrilee Cox
- Department of Health, Darwin, Northern Territory, Australia
| | - Eileen Scott Stokes
- Faculty of Education, Monash University, Clayton, Northern Territory, Australia
| |
Collapse
|
48
|
Larivière N, Couture É, Blackburn C, Carbonneau M, Lacombe C, Schinck SA, David P, St-Cyr-Tribble D. Recovery, as Experienced by Women with Borderline Personality Disorder. Psychiatr Q 2015; 86:555-68. [PMID: 25736797 DOI: 10.1007/s11126-015-9350-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Studies examining recovery through the service users' perspectives have mainly included persons with schizophrenia or bipolar disorder. Giving voice to those with borderline personality disorder (BPD) would enrich our understanding of recovery, as their specific experiences may bring new dimensions, obstacles and facilitators. The objective of this study was to qualitatively capture the experience of recovery in women with BPD. Participants were women between 18 and 65 years old who had a diagnosis of BPD and completed at least 2 years in a program for persons with BPD. During the first meeting, they produced a picture collage, followed by an interview on their experience of recovery. The second meeting was a phone interview to discuss new thoughts. In addition, their medical records were reviewed. A thematic analysis of the interviews was conducted and organized with the Person-Environment-Occupation model. Although recovery was not the best term to name their experience, they all talked about a process towards stability and wellbeing (n = 12). Dimensions of recovery included, for example, letting go of the past (person), being involved in meaningful activities (occupation) and having healthy relationships (environment). Facilitators included social support and participation in a specialized therapy program. The main obstacle was unstable family relationships. The findings from this study showed similar dimensions to previous recovery studies, new perspectives on certain dimensions, as well as new ones. They also reinforced the importance to incorporate intervention outcomes that target the person with BPD, their social environment and meaningful occupations.
Collapse
Affiliation(s)
- Nadine Larivière
- School of Rehabilitation, Université de Sherbrooke, 3001, 12e avenue Nord, Sherbrooke, QC, J1H 5N4, Canada.
| | - Élise Couture
- School of Rehabilitation, Université de Sherbrooke, 3001, 12e avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Catherine Blackburn
- School of Rehabilitation, Université de Sherbrooke, 3001, 12e avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
| | - Manon Carbonneau
- School of Rehabilitation, Université de Sherbrooke, 3001, 12e avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
| | - Christophe Lacombe
- School of Rehabilitation, Université de Sherbrooke, 3001, 12e avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
| | - Shella-Ann Schinck
- School of Rehabilitation, Université de Sherbrooke, 3001, 12e avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
| | - Pierre David
- Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada
| | | |
Collapse
|
49
|
Doroud N, Fossey E, Fortune T. Recovery as an occupational journey: A scoping review exploring the links between occupational engagement and recovery for people with enduring mental health issues. Aust Occup Ther J 2015; 62:378-92. [DOI: 10.1111/1440-1630.12238] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Nastaran Doroud
- Department of Community and Clinical Allied Health; School of Allied Health; La Trobe University; Bundoora Victoria Australia
| | - Ellie Fossey
- Living with Disability Research Centre; School of Allied Health; La Trobe University; Bundoora Victoria Australia
| | - Tracy Fortune
- Department of Community and Clinical Allied Health; School of Allied Health; La Trobe University; Bundoora Victoria Australia
| |
Collapse
|
50
|
Pachoud B, Llorca PM, Azorin JM, Dubertret C, de Pierrefeu I, Gaillard R, Franck N. [How to improve practices and interventions for work integration of people with schizophrenia in France?]. Encephale 2015; 41:507-14. [PMID: 26520189 DOI: 10.1016/j.encep.2015.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 09/25/2015] [Indexed: 11/27/2022]
Abstract
Getting and keeping a job are not only one of the criteria of recovery from schizophrenia, but are also one of its main means. Indeed, recovery is partly defined by the ability to work. Despite the lack of data in France about employment of people with schizophrenia, it is widely acknowledged that the employment rate of people with schizophrenia remains quite low, and frequently it is only an employment in sheltered workshops, not on the regular work market. International research data show that it is possible to improve significantly this employment rate, with an appropriate support, that is precisely defined by the current researches, and that is quickly spreading in most developed countries. The aim of this paper is to present, on the basis of a broad current literature review, the key predictive factors of the return to work for people with schizophrenia, and the strategies to optimize vocational services. It will appear that there are several ways to improve practices and interventions in France to support work integration. To begin with individual factors of work integration, dependant on each person, the clinical state and the cognitive skills (in a broad sense, including social cognition and metacognition) are to be taken into account, and optimized by means of the association of a finely tuned pharmacological treatment and psychosocial interventions such as cognitive remediation adjusted to the person's specific needs. The other main kind of factors is environmental factors, particularly the kind of vocational support, which turns out to have a major impact not only on job acquisition, but importantly also on job tenure. The most effective vocational services are based on the "Place and train" model, and even more precisely on the Individual Placement and Support (IPS) model, that allows to the majority of people with a severe mental illness (more than 50%) to obtain a competitive employment after 6 to 18 months of individualized support. This approach is now widely recommended as "an evidence-based practice" of rehabilitation. It is important to promote in France the development of this kind of practice, already implemented as an experiment by few militant and involved associations. This development remains in France slow and delayed (compared to the practices in the other European countries) because of the lack of public funding. It implies an evolution of the social and medico-social practices, taking into account current research data, and assessing the outcomes of their practices in order to improve them. The employment specialist (sometimes called also the "job coach") turns out to play a key role, emphasized by current research, implying, among many other tasks, to coordinate the net of people supporting the work integration, including the clinical team, the employer and the colleagues of the workplace.
Collapse
Affiliation(s)
- B Pachoud
- Université Paris-Diderot, Sorbonne Paris Cité, CRPMS, 5, rue Thomas-Mann, 75013 Paris, France.
| | - P M Llorca
- Université Paris-Diderot, Sorbonne Paris Cité, CRPMS, 5, rue Thomas-Mann, 75013 Paris, France
| | - J M Azorin
- Université Paris-Diderot, Sorbonne Paris Cité, CRPMS, 5, rue Thomas-Mann, 75013 Paris, France
| | - C Dubertret
- Université Paris-Diderot, Sorbonne Paris Cité, CRPMS, 5, rue Thomas-Mann, 75013 Paris, France
| | - I de Pierrefeu
- Université Paris-Diderot, Sorbonne Paris Cité, CRPMS, 5, rue Thomas-Mann, 75013 Paris, France
| | - R Gaillard
- Université Paris-Diderot, Sorbonne Paris Cité, CRPMS, 5, rue Thomas-Mann, 75013 Paris, France
| | - N Franck
- Université Paris-Diderot, Sorbonne Paris Cité, CRPMS, 5, rue Thomas-Mann, 75013 Paris, France
| |
Collapse
|