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Brophy L, Fletcher J, Dawadi S, Reece J, Edan V, Enticott J, Farhall J, Fossey E, Hamilton B, Harvey C, Meadows G, Mihalopoulos C, Morrisroe E, Newton R, Palmer V, Vine R, Waks S, Pirkis J. A longitudinal study of the impacts of a stay in a Prevention and Recovery Care service in Victoria, Australia. Aust N Z J Psychiatry 2024; 58:615-626. [PMID: 38679852 PMCID: PMC11193319 DOI: 10.1177/00048674241242943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
BACKGROUND Prevention and Recovery Care services are residential sub-acute services in Victoria, Australia, guided by a commitment to recovery-oriented practice. The evidence regarding the effectiveness of this service model is limited, largely relying on small, localised evaluations. This study involved a state-wide investigation into the personal recovery, perceived needs for care, well-being and quality-of-life outcomes experienced by Prevention and Recovery Care services' consumers. METHODS A longitudinal cohort design examined the trajectory of self-reported personal recovery and other outcomes for consumers in 19 Victorian Prevention and Recovery Care services over 4 time points (T1 - 1 week after admission; T2 - within 1 week of discharge; T3 - 6 months after discharge; T4 - 12 months after discharge). T2-T4 time frames were extended by approximately 3 weeks due to recruitment challenges. The Questionnaire about the Process of Recovery was the primary outcome measure. RESULTS At T1, 298 consumers were recruited. By T4, 114 remained in the study. Participants scored higher on the Questionnaire about the Process of Recovery at all three time points after T1. There were also sustained improvements on all secondary outcome measures. Improvements were then sustained at each subsequent post-intervention time point. Community inclusion and having needs for care met also improved. CONCLUSION The findings provide a consistent picture of benefits for consumers using Prevention and Recovery Care services, with significant improvement in personal recovery, quality of life, mental health and well-being following an admission to a Prevention and Recovery Care service. Further attention needs to be given to how to sustain the gains made through a Prevention and Recovery Care service admission in the long term.
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Affiliation(s)
- Lisa Brophy
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, Australia
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- The ALIVE National Centre for Mental Health Research Translation, The University of Melbourne, Melbourne, VIC, Australia
| | - Justine Fletcher
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- The ALIVE National Centre for Mental Health Research Translation, The University of Melbourne, Melbourne, VIC, Australia
| | - Shrinkhala Dawadi
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, VIC, Australia
| | - John Reece
- Discipline of Psychological Sciences, Australian College of Applied Professions, Melbourne, VIC, Australia
| | - Vrinda Edan
- Centre for Mental Health Nursing, Department of Nursing, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Joanne Enticott
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, VIC, Australia
| | - John Farhall
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
| | - Ellie Fossey
- Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia
| | - Bridget Hamilton
- Centre for Mental Health Nursing, Department of Nursing, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Carol Harvey
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
- North West Area Mental Health, Division of Mental Health, Northern Health, Melbourne, VIC, Australia
| | - Graham Meadows
- School of Psychology, Psychiatry and Psychological Medicine, Monash University, Melbourne, VIC, Australia
| | - Cathrine Mihalopoulos
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
- School of Health and Social Development, Faculty of Health, Deakin University, Melbourne, VIC, Australia
| | - Emma Morrisroe
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Richard Newton
- Peninsula Mental Health Service, Melbourne, VIC, Australia
- Department of Psychiatry, Monash University, Melbourne, VIC, Australia
| | - Victoria Palmer
- The ALIVE National Centre for Mental Health Research Translation, The University of Melbourne, Melbourne, VIC, Australia
- Department of General Practice and Primary Care, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Ruth Vine
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - Shifra Waks
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Chippendale, NSW, Australia
| | - Jane Pirkis
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- The ALIVE National Centre for Mental Health Research Translation, The University of Melbourne, Melbourne, VIC, Australia
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Armoon B, Grenier G, Fleury MJ. Perceived Higher Unmet Care Needs among Adults in Permanent Supportive Housing. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024:10.1007/s10488-024-01390-2. [PMID: 38819494 DOI: 10.1007/s10488-024-01390-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2024] [Indexed: 06/01/2024]
Abstract
This study is original in that it assesses various types of care needs, barriers to care, and factors associated with higher unmet needs among 308 permanent supportive housing (PSH) residents in Quebec (Canada). Data from structured interviews that featured the Perceived Need for Care Questionnaire were collected from 2020 to 2022, controlling for the COVID-19 pandemic period. Eight types of care (e.g., information, counseling) were accounted for. Based on the Behavioral Model for Vulnerable Populations, predisposing, need, and enabling factors associated with higher unmet care needs were assessed using a negative binomial regression model. The study found that 56% of adult PSH residents, even those who had lived in PSH for 5 + years, had unmet care needs. Twice as many unmet needs were due to structural (e.g., care access) rather than motivational barriers. Living in single-site PSH, in healthier neighborhoods, having better quality of life and self-esteem, and being more satisfied with housing and outpatient care were associated with fewer unmet care needs. PSH residents with co-occurring mental disorders (MD) and substance use disorders (SUD), and with moderate or severe psychological distress were likely to have more unmet needs. Better access to care, counseling and integrated treatment for co-occurring MD-SUD might be improved, as well as access to information on user rights, health and available support. Welfare benefits could be increased, with more peer support and meaningful activities, especially in single-site PSH. The quality of the neighborhoods where PSH are located might also be better monitored.
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Affiliation(s)
- Bahram Armoon
- Douglas Hospital Research Centre, Montréal, Québec, Canada
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Guy Grenier
- Douglas Hospital Research Centre, Montréal, Québec, Canada
| | - Marie-Josée Fleury
- Douglas Hospital Research Centre, Montréal, Québec, Canada.
- Department of Psychiatry, McGill University, Montréal, Québec, Canada.
- Douglas Mental Health University Institute, Research Centre, 6875 LaSalle Boulevard, Montréal, QC, H4H 1R3, Canada.
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Stewart K, Hancock N, Chapparo C, Stancliffe ERJ. Supports that help me to live well in the community: experiences of people living with schizophrenia. Aust Occup Ther J 2024; 71:340-351. [PMID: 38151285 DOI: 10.1111/1440-1630.12919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 10/05/2023] [Accepted: 11/12/2023] [Indexed: 12/29/2023]
Abstract
INTRODUCTION People with schizophrenia are more likely to be hospitalised than any other psychiatric diagnosis. Occupational therapists working in mental health are often required to assess and recommend supports that will assist people with schizophrenia to live successfully in the community. There is little research exploring consumer perspectives regarding the support they find useful to stay out of the hospital. The aim of this study was to explore what supports people living with schizophrenia identify as helping them to live in the community and stay out of the hospital. METHOD Qualitative data were collected via semi-structured interviews with adult consumers (N = 18) diagnosed with schizophrenia. Data were thematically analysed using constant comparative analysis methods. Inductive analysis was followed by a deductive phase of analysis. FINDINGS Participants highlighted personal-, occupational- and environmental-focused supports. Person-focused supports addressed cognitive and psychological needs. Occupation-focused supports included assisting people to manage daily life with a mental illness; engage in social activities; and engage in meaningful activities. Environment-focused supports included access to financial security; accommodation security; and community of choice. In addition to types of support, participants highlighted the importance of quality of support including the need for flexible; timely; and non-judgemental support. CONCLUSION These results emphasise the multifaceted nature of support required by people living with schizophrenia to stay out of the hospital. Both type and quality of support are important. People in this study were able to clearly articulate the types and qualities of support that were important to them. Occupational therapists may benefit from greater collaboration with consumers during assessments of support needs and the development of recommendations. Further exploration of how occupational therapists identify people's multifaceted support needs is required.
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Affiliation(s)
- Kylie Stewart
- The University of Sydney, Faculty of Health Sciences, Centre for Disability Research and Policy, Sydney, Australia
- South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Nicola Hancock
- The University of Sydney, Faculty of Health Sciences, Centre for Disability Research and Policy, Sydney, Australia
| | - Christine Chapparo
- The University of Sydney, Faculty of Health Sciences, Centre for Disability Research and Policy, Sydney, Australia
| | - Emeritus Roger J Stancliffe
- The University of Sydney, Faculty of Health Sciences, Centre for Disability Research and Policy, Sydney, Australia
- University of Minnesota, Institute of Community Integration, Minneapolis, Minnesota, USA
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