1
|
Stojcevski M, Cheung A, Agwu V, Fan X. Exploring Zentangle as a virtual mindfulness-based art intervention for people with serious mental illness. Front Psychiatry 2023; 14:1260937. [PMID: 38098622 PMCID: PMC10720359 DOI: 10.3389/fpsyt.2023.1260937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/13/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction Zentangle is an emerging art intervention that incorporates mindfulness into creative drawing. This pilot study explored Zentangle as a novel adjunct treatment for people with serious mental illness (SMI). Methods Six participants with SMI completed an 8-week Zentangle program. Psychiatric outcomes were evaluated using the Brief Psychiatric Rating Scale (BPRS), Mindful Attention Awareness Scale (MAAS), Perceived Stress Scale (PSS), and Quality of Life Enjoyment and Satisfaction Scale (Q-LES-Q-SF). A focus group was conducted to better understand the experiences of the participants. Results A significant reduction in psychiatric symptoms was observed as measured by the total score on the BPRS between baseline and 5-week post-intervention (40.7 ± 9.1 vs. 33.7 ± 8.9, mean ± SD, p = 0.02). Participants also showed a significant increase in mindful attention using the average score on the MAAS between 1- and 5-week post-intervention (3.5 ± 0.4 vs. 4.2 ± 0.7, mean ± SD, p = 0.04). Four themes were generated from the focus group: (1) approaching mindfulness through Zentangle; (2) power of uncomplicated art creation; (3) understanding the value of self-appreciation; and (4) fostering a positive environment. Discussion Our preliminary data suggest that the use of Zentangle for participants with SMI may have a positive impact on overall psychiatric symptoms and mindfulness. Moreover, the Zentangle Method encourages positive emotions like gratitude and self-accomplishment to counteract negative feelings of self-criticism and failure in participants.
Collapse
Affiliation(s)
| | | | | | - Xiaoduo Fan
- Department of Psychiatry, University of Massachusetts Chan Medical School/UMass Memorial Health, Worcester, MA, United States
| |
Collapse
|
2
|
Tredget G, Williams J, McGrath R, Sadler E, Gaughran F, Ang K, Stepan N, Cross S, Tweed J, Orlando L, Sevdalis N. How is physical healthcare experienced by staff, service users, and carers in adult community mental health services in a south London mental health trust? A service evaluation. Front Health Serv 2023; 3:1125790. [PMID: 37441436 PMCID: PMC10335794 DOI: 10.3389/frhs.2023.1125790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/31/2023] [Indexed: 07/15/2023]
Abstract
Background Adults with a serious mental illness (SMI) are at greater risk of physical health morbidity and premature death than the general population, largely as a result of preventable physical health issues. Staff working in mental health services have a role to play in addressing these inequalities, but little is known about how they perceive their role and how this impacts on their practice. Understanding this better would enable services to improve their approach and support better health outcomes for SMI patients. A service evaluation was undertaken to investigate how physical healthcare is approached within adult community mental health teams (CMHTs) at a South London (UK) Mental Health Trust. Methods This was a prospective, cross-sectional evaluation design. Interviews and focus groups were conducted with clinical staff, service users and carers (non-professional caregivers e.g., family or friends, of adults living with an SMI), to understand their experiences and to identify key barriers and facilitators to supporting physical healthcare support for adults with SMI. Thematic analysis was conducted to identify key themes which were classified into five main categories. Results 50 participants took part in the study, 38 were clinical staff, eight were service users and four were carers. We found staff widely recognised the importance of supporting physical healthcare. However, there was variability in how staff approached physical healthcare in routine practice, and differences in how physical healthcare is experienced by service users and carers. Staff were keen to engage in changes to the way physical healthcare is delivered in CMHTs. However, they sought clearer guidance on their roles and responsibilities, and wanted to better understand the rationale for changes in community mental health practice, such as increased screening for physical healthcare. Service users and carers felt equally that the role of CMHTs in physical healthcare was unclear, which limited their ability to access it and understand the benefit for their overall care. Staff articulated gaps in leadership and training that impacted on their ability to implement the overall vision for physical healthcare within the Trust. Conclusion Mental health staff recognise the role they play in supporting the physical health of adults living with SMI. This evaluation provides insight into common barriers and facilitators faced by staff, service users and carers when providing or accessing physical healthcare within adult CMHTs. These findings indicate a more comprehensive and better articulated approach to physical healthcare in mental health Trusts is needed to ensure service users and their carers understand what support is available and how to access it and to equip staff to provide and sustain that care in routine practice.
Collapse
Affiliation(s)
- Gracie Tredget
- Integrating our Mental and Physical Healthcare Systems, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Centre for Implementation Science, King's College London, London, United Kingdom
| | - Julie Williams
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Ray McGrath
- Integrating our Mental and Physical Healthcare Systems, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Centre for Implementation Science, King's College London, London, United Kingdom
| | - Euan Sadler
- Psychosis Studies, King's College London, London, United Kingdom
| | - Fiona Gaughran
- Integrating our Mental and Physical Healthcare Systems, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Mind & Body Programme, King's Health Partners, Guy's Hospital, London, United Kingdom
| | - Karen Ang
- Integrating our Mental and Physical Healthcare Systems, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Centre for Implementation Science, King's College London, London, United Kingdom
| | - Natalia Stepan
- Centre for Implementation Science, King's College London, London, United Kingdom
| | - Sean Cross
- Integrating our Mental and Physical Healthcare Systems, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Centre for Implementation Science, King's College London, London, United Kingdom
| | - John Tweed
- Integrating our Mental and Physical Healthcare Systems, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Lia Orlando
- Integrating our Mental and Physical Healthcare Systems, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Nick Sevdalis
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | | |
Collapse
|
3
|
Delman J, Arntz D, Whitman A, Skiest H, Kritikos K, Alves P, Chambers V, Markley R, Martinez J, Piltch C, Whitney-Sarles S, London J, Shtasel D, Cather C. Using Community-Based Participatory Research to Conduct a Collaborative Needs Assessment of Mental Health Service Users: Identifying Research Questions and Building Academic-Community Trust. Health Promot Pract 2023:15248399231171144. [PMID: 37177791 DOI: 10.1177/15248399231171144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Attempts to meaningfully engage people with serious mental illnesses (SMI) as allies in conducting research have often failed because researchers tend to decide on the research topic without including community members. Academic researchers can avoid this pitfall by collaborating with community members to conduct a needs assessment to identify relevant research topics and build trust. Here, we report on the results of a psychosocial needs assessment for adult mental health service users in Massachusetts conducted by an academic-peer research team. The project was initiated as part of an academic mental health center's efforts to conduct community-based participatory research (CBPR) with a group of people with SMI. People with SMI were hired and trained to co-lead research projects and the development of the listening group guide, and they conducted 18 listening groups with 159 adults with mental health conditions. The data were transcribed, and rapid analysis employing qualitative and matrix classification methods was used to identify service need themes. Six themes emerged from qualitative analysis: reduce community and provider stigma, improve access to services, focus on the whole person, include peers in recovery care, have respectful and understanding clinicians, and recruit diverse staff. The policy and practice implications of these findings include creating a stronger culture of innovation within provider organizations, developing specific plans for improving recruitment and retention of peer workers and a multicultural workforce, enhancing training and supervision in cultural humility, communicating respectfully with clients, and including peers in quality improvement activities.
Collapse
Affiliation(s)
| | - Diana Arntz
- Massachusetts General Hospital, Boston, MA, USA
| | | | | | | | - Paul Alves
- Massachusetts General Hospital, Boston, MA, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Demler TL, O’Donnell C. Exploring the Impact of COVID-19 Vaccination on Patients Taking Clozapine. Innov Clin Neurosci 2023; 20:32-38. [PMID: 37122573 PMCID: PMC10132275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Objective Individuals with serious mental illness (SMI) are recognized to be among the highest risk patients to experience more severe symptoms of COVID-19, not only due to poor baseline health and associated disparity, but also due to medications prescribed to manage their illness that are known to compromise immunity even further. Clozapine, a gold standard antipsychotic used in the treatment for refractory schizophrenia, is considered to be the antipsychotic with the greatest risk of compromising immunity due to its potential to cause blood dyscrasia, including leukopenia and rarely, but potentially, agranulocytosis. The objective of this study is to determine if there is any potential hematological consequence for the use of COVID-19 messenger ribonucleic acid (mRNA) vaccines or the impact of active severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients receiving clozapine therapy. Since there is controversy over the rate of vaccine hesitancy in patients with SMI, we also examined the rate of vaccine acceptance in our subject population. Design This study was a retrospective chart review conducted at a 160-bed state psychiatric inpatient hospital in upstate New York evaluating the impact of COVID-19 vaccination, SARS-CoV-2 infection, and vaccine acceptance in patients prescribed clozapine. Results Both the administration of COVID-19 mRNA vaccines and SARS-CoV-2 infection did not appear to significantly influence the hematologic values that are monitored by the United States (US) Food and Drug Administration (FDA) to ensure safe use of clozapine. When offered vaccination, most patients hospitalized for SMI were willing to accept it. Conclusion With the likelihood of COVID-19 mRNA vaccinations becoming a recommended routine vaccination, requiring periodic boosters, patients receiving clozapine therapy have been observed to not be at higher risk of adverse hematological consequences when the mRNA vaccine is administered. Furthermore, inpatient psychiatry settings should be considered an optimal site of vaccination to improve vaccination efforts in our communities.
Collapse
Affiliation(s)
- Tammie Lee Demler
- Drs. Demler and O’Donnell are with the New York State Office of Mental Health at Buffalo Psychiatric Center and State University of New York at Buffalo School of Pharmacy and Pharmaceutical Sciences, Department of Pharmacy Practice in Buffalo, New York
- Dr. Demler is with the State University of New York at Buffalo School of Medicine, Department of Psychiatry in Buffalo, New York
| | - Carolyn O’Donnell
- Drs. Demler and O’Donnell are with the New York State Office of Mental Health at Buffalo Psychiatric Center and State University of New York at Buffalo School of Pharmacy and Pharmaceutical Sciences, Department of Pharmacy Practice in Buffalo, New York
| |
Collapse
|
5
|
Smith MJ, Burke-Miller JK, Bornheimer LA, Ross B, Bell MD, McGurk SR, Mueser KT, Brown A, Prestipino J, Borghani N, Nelson K, Lieberman T, Pashka NJ, Razzano LA, Kallen MA. Psychometric properties of the mock interview rating scale for schizophrenia and other serious mental illnesses. Front Psychiatry 2023; 14:1150307. [PMID: 37181877 PMCID: PMC10172658 DOI: 10.3389/fpsyt.2023.1150307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/06/2023] [Indexed: 05/16/2023] Open
Abstract
Background Over the past 10 years, job interview training has emerged as an area of study among adults with schizophrenia and other serious mental illnesses who face significant challenges when navigating job interviews. The field of mental health services research has limited access to assessments of job interview skills with rigorously evaluated psychometric properties. Objective We sought to evaluate the initial psychometric properties of a measure assessing job interview skills via role-play performance. Methods As part of a randomized controlled trial, 90 adults with schizophrenia or other serious mental illnesses completed a job interview role-play assessment with eight items (and scored using anchors) called the mock interview rating scale (MIRS). A classical test theory analysis was conducted including confirmatory factor analyses, Rasch model analysis and calibration, and differential item functioning; along with inter-rater, internal consistency, and test-retest reliabilities. Pearson correlations were used to evaluate construct, convergent, divergent, criterion, and predictive validity by correlating the MIRS with demographic, clinical, cognitive, work history measures, and employment outcomes. Results Our analyses resulted in the removal of a single item (sounding honest) and yielded a unidimensional total score measurement with support for its inter-rater reliability, internal consistency, and test-retest reliability. There was initial support for the construct, convergent, criterion, and predictive validities of the MIRS, as it correlated with measures of social competence, neurocognition, valuing job interview training, and employment outcomes. Meanwhile, the lack of correlations with race, physical health, and substance abuse lent support for divergent validity. Conclusion This study presents initial evidence that the seven-item version of the MIRS has acceptable psychometric properties supporting its use to assess job interview skills reliably and validly among adults with schizophrenia and other serious mental illnesses. Clinical Trial Registration NCT03049813.
Collapse
Affiliation(s)
- Matthew J. Smith
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
- *Correspondence: Matthew J. Smith,
| | - Jane K. Burke-Miller
- Department of Psychiatry, University of Illinois-Chicago, Chicago, IL, United States
| | | | - Brittany Ross
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | - Morris D. Bell
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, United States
| | - Susan R. McGurk
- Boston University Center for Psychiatric Rehabilitation, Boston, MA, United States
| | - Kim T. Mueser
- Boston University Center for Psychiatric Rehabilitation, Boston, MA, United States
| | | | | | | | | | | | | | - Lisa A. Razzano
- Department of Psychiatry, University of Illinois-Chicago, Chicago, IL, United States
- Thresholds, Chicago, IL, United States
| | - Michael A. Kallen
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| |
Collapse
|
6
|
Woodberry KA, Johnson KA, Shrier LA. Screening for Early Emerging Mental Experiences (SEE ME): A Model to Improve Early Detection of Psychosis in Integrated Primary Care. Front Pediatr 2022; 10:899653. [PMID: 35757126 PMCID: PMC9226538 DOI: 10.3389/fped.2022.899653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/13/2022] [Indexed: 11/13/2022] Open
Abstract
Early intervention in serious mental health conditions relies on the accurate identification of adolescents and young adults at high risk or with very recent onset of psychosis. Current early detection strategies have had limited success, identifying only a fraction of these individuals within the recommended 3- to 6-month window. Broader public health strategies such as population screening are hampered by low base rates and poor self-report screen specificity. Screening for Early Emerging Mental Experiences (SEE ME) is a three-stage "SCREEN-TRIAGE-ENGAGE" model for the early detection of psychosis in integrated primary care adolescent and young adult patients during the period of peak onset. It builds on the KNOW THE SIGNS-FIND THE WORDS-MAKE THE CONNECTION framework outlined on psychosisscreening.org and developed with input from community collaborators. Systematic screening aims to expand the reach of early detection and reduce reliance on provider knowledge. Triage and engagement by trained mental health clinicians aims to improve the specificity of screen responses, enhance engagement in appropriate care, and reduce provider burden. Leveraging the low stigma of primary care, its reach to non-help-seeking adolescents and young adults, and the mental health training of clinicians within integrated care practices, SEE ME has potential to improve the benefit/risk ratio of early detection of psychosis by improving both the sensitivity and specificity of screening and clinical response. We review the rationale and design of this promising model.
Collapse
Affiliation(s)
- Kristen A Woodberry
- Center for Psychiatric Research, MaineHealth, Portland, ME, United States.,Department of Psychiatry, Tufts School of Medicine, Boston, MA, United States
| | - Kelsey A Johnson
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, United States.,Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Lydia A Shrier
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States.,Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| |
Collapse
|
7
|
Abstract
We examined expressed emotion (EE) and attributions in parents with schizophrenia and compared them to parents without serious mental illness (SMI) in order to better understand the emotional climate of families in which a parent has schizophrenia. Parenting practices and parental reports of child behavior were also compared between the two groups. The relationship of EE to attributions was examined in each group separately. Relationships between parental mental health, EE, and attributions were explored in the parents with schizophrenia only. The Camberwell Family Interview was used to determine both EE and attributions in 20 parents with schizophrenia and 20 parents without SMI. We found that more parents with schizophrenia were rated as high EE than those without (60 and 35%, respectively) although this was not a statistically significant difference. Parents with schizophrenia demonstrated significantly more hostility and criticism toward their children than those without SMI and made more child-blaming attributions. Blame was associated with increased hostility, less warmth, and fewer positive remarks. Parental warmth was related to greater parenting self-efficacy, less harsh parenting practices, better child behavior, and a more positive parent-child relationship. We conclude that EE and attributions are potential explanatory variables to be considered in the development of preventative and early intervention strategies for families with a parent with schizophrenia or other psychotic disorder. Blame and warmth are modifiable factors that could be targeted within family and parenting interventions.
Collapse
Affiliation(s)
- Lynsey Gregg
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Rachel Calam
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Richard J. Drake
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, The University of Manchester, Manchester, United Kingdom
| | - Lauren Wolfenden
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| |
Collapse
|
8
|
Lupton-Smith C, Stuart EA, McGinty EE, Dalcin AT, Jerome GJ, Wang NY, Daumit GL. Determining Predictors of Weight Loss in a Behavioral Intervention: A Case Study in the Use of Lasso Regression. Front Psychiatry 2021; 12:707707. [PMID: 35185628 PMCID: PMC8850776 DOI: 10.3389/fpsyt.2021.707707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 12/29/2021] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE This study investigates predictors of weight loss among individuals with serious mental illness participating in an 18-month behavioral weight loss intervention, using Lasso regression to select the most powerful predictors. METHODS Data were analyzed from the intervention group of the ACHIEVE trial, an 18-month behavioral weight loss intervention in adults with serious mental illness. Lasso regression was employed to identify predictors of at least five-pound weight loss across the intervention time span. Once predictors were identified, classification trees were created to show examples of how to classify participants into having likely outcomes based on characteristics at baseline and during the intervention. RESULTS The analyzed sample contained 137 participants. Seventy-one (51.8%) individuals had a net weight loss of at least five pounds from baseline to 18 months. The Lasso regression selected weight loss from baseline to 6 months as a primary predictor of at least five pound 18-month weight loss, with a standardized coefficient of 0.51 (95% CI: -0.37, 1.40). Three other variables were also selected in the regression but added minimal predictive ability. CONCLUSIONS The analyses in this paper demonstrate the importance of tracking weight loss incrementally during an intervention as an indicator for overall weight loss, as well as the challenges in predicting long-term weight loss with other variables commonly available in clinical trials. The methods used in this paper also exemplify how to effectively analyze a clinical trial dataset containing many variables and identify factors related to desired outcomes.
Collapse
Affiliation(s)
- Carly Lupton-Smith
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Elizabeth A Stuart
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Emma E McGinty
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Arlene T Dalcin
- Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Gerald J Jerome
- Department of Kinesiology, Towson University, Towson, MD, United States
| | - Nae-Yuh Wang
- Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Gail L Daumit
- Johns Hopkins School of Medicine, Baltimore, MD, United States
| |
Collapse
|
9
|
Lu W, Yanos PT, Waynor WR, Gao CE, Bazan C, Giacobbe G, Gill K, Bullock D, Prigerson HG. Trauma Exposure and Prolonged Grief Disorder Among Persons Receiving Community Mental Health Services: Rates and Correlates. Front Psychiatry 2021; 12:760837. [PMID: 35185633 PMCID: PMC8854856 DOI: 10.3389/fpsyt.2021.760837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/06/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Persons with serious mental illnesses (SMIs) are at increased risk for exposure to trauma and posttraumatic stress disorder (PTSD). Prolonged Grief Disorder (PGD) may also impact this population but has been seldom studied. AIMS The present study investigated the rate of both PTSD and PGD among clients receiving community mental health services, and the clinical correlates of co-occurring PTSD/PGD. METHODS Trauma history, PTSD and PGD were assessed among 536 individuals receiving community mental health services (Study 1). A subsample of 127 individuals from Study 1 who met DSM-5 criteria for PTSD based on diagnostic interview completed measures of psychiatric symptoms (Study 2). RESULTS In Study 1, 92.4% of participants receiving community mental health services had experienced a traumatic event, 49.6% met criteria for probable and provisional PTSD, 14.7% scored positive for probable PGD, and 11.9% met criteria for probable and provisional PTSD as well as probable PGD. In Study 2, participants meeting diagnostic DSM-5 criteria for PTSD and probable PGD had more self-reported PTSD symptoms, but did not differ on other outcomes. CONCLUSIONS Findings highlight the need for trauma informed services including grief counseling for persons with SMI.
Collapse
Affiliation(s)
- Weili Lu
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, New Brunswick, NJ, United States
| | - Philip T Yanos
- John Jay College, City University of New York, New York City, NY, United States
| | - William R Waynor
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, New Brunswick, NJ, United States
| | - Carol E Gao
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, New Brunswick, NJ, United States
| | - Carolyn Bazan
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, New Brunswick, NJ, United States
| | - Giovanna Giacobbe
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, New Brunswick, NJ, United States
| | - Kenneth Gill
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, New Brunswick, NJ, United States
| | - Deanna Bullock
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, New Brunswick, NJ, United States
| | - Holly G Prigerson
- Department of Medicine, Center for Research on End of Life Care, Cornell University, White Plains, NY, United States
| |
Collapse
|
10
|
Zomer LJC, Voskes Y, van Weeghel J, Widdershoven GAM, van Mierlo TFMM, Berkvens BS, Stavenuiter B, van der Meer L. The Active Recovery Triad Model: A New Approach in Dutch Long-Term Mental Health Care. Front Psychiatry 2020; 11:592228. [PMID: 33250796 PMCID: PMC7674651 DOI: 10.3389/fpsyt.2020.592228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 10/07/2020] [Indexed: 11/13/2022] Open
Abstract
Unlike developments in short-term clinical and community care, the recovery movement has not yet gained foothold in long-term mental health services. In the Netherlands, approximately 21,000 people are dependent on long-term mental health care and support. To date, these people have benefited little from recovery-oriented care, rather traditional problem-oriented care has remained the dominant approach. Based on the view that recovery is within reach, also for people with complex needs, a new care model for long-term mental health care was developed, the active recovery triad (ART) model. In a period of 2.5 years, several meetings with a large group of stakeholders in the field of Dutch long-term mental health care took place in order to develop the ART model. Stakeholders involved in the development process were mental health workers, policy advisors, managers, directors, researchers, peer workers, and family representatives. The ART model combines an active role for professionals, service users, and significant others, with focus on recovery and cooperation between service users, family, and professionals in the triad. The principles of ART are translated into seven crucial steps in care and a model fidelity scale in order to provide practical guidelines for teams implementing the ART model in practice. The ART model provides guidance for tailored recovery-oriented care and support to this "low-volume high-need" group of service users in long-term mental health care, aiming to alter their perspective and take steps in the recovery process. Further research should investigate the effects of the ART model on quality of care, recovery, and autonomy of service users and cooperation in the triad.
Collapse
Affiliation(s)
- Lieke J C Zomer
- Department of Ethics, Law and Humanities, Amsterdam UMC, Amsterdam, Netherlands
| | - Yolande Voskes
- Department of Ethics, Law and Humanities, Amsterdam UMC, Amsterdam, Netherlands.,Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands.,Impact Care Group, GGz Breburg, Tilburg, Netherlands
| | - Jaap van Weeghel
- Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands.,Phrenos Center of Expertise on Severe Mental Illness, Utrecht, Netherlands.,Parnassia Mental Health Center, The Hague, Netherlands
| | | | | | | | | | - Lisette van der Meer
- Department of Clinical & Developmental Neuropsychology, University of Groningen, Groningen, Netherlands.,Department of Rehabilitation, Lentis Psychiatric Institute, Zuidlaren, Netherlands
| |
Collapse
|
11
|
Ghebrehiwet S, Baul T, Restivo JL, Kelkile TS, Stevenson A, Gelaye B, Fekadu A, Hailemariam M, Girma E, Teferra S, Canelos V, Henderson DC, Borba CPC. Gender-specific experiences of serious mental illness in rural Ethiopia: A qualitative study. Glob Public Health 2019; 15:185-199. [PMID: 31630624 DOI: 10.1080/17441692.2019.1680723] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Considerable variation in the gender-specific prevalence of serious mental illness (SMI) has been reported in low- and middle-income countries (LMICs). In the rural setting of Butajira, Ethiopia, the male-to-female prevalence ratio of schizophrenia was reported to be 5:1. This qualitative study explores gender-specific experiences of SMI and the extent to which sociocultural factors may explain the observed difference in prevalence estimates. Using purposive sampling, 39 in-depth interviews were conducted with community members from Butajira, a rural district in South Central Ethiopia. Transcripts were analysed using thematic analysis to elicit community perspectives on cultural explanatory models of SMI and experiences in this region. Gender-specific experiences were reported to differ due to visibility of symptoms, community responses, and varying levels of family support towards individuals with SMI. Overall, respondents described how various sociocultural factors subject women with SMI to higher levels of physical and social isolation compared to men, greatly affecting community health workers' ability to identify and provide care to women with mental illness. Future case detection methods should involve family members as they interact with women with SMI early on in the development of their symptoms and play an essential role in their path to mental health care.
Collapse
Affiliation(s)
| | - Tithi Baul
- Department of Psychiatry, Boston Medical Center, Boston, USA
| | - Juliana L Restivo
- Department of Global Health, Boston University School of Public Health, Boston, USA
| | | | - Anne Stevenson
- Broad Institute, Stanley Center for Psychiatric Research, Cambridge, USA.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Abebaw Fekadu
- Department of Psychiatry, College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.,Global Health & Infection Department, Brighton and Sussex Medical School, Brighton, UK.,Department of Psychological Medicine, Centre for Affective Disorders, King's College London, Institute of Psychiatry, London, UK
| | - Maji Hailemariam
- College of Human Medicine, Division of Public Health, Michigan State University, Flint, USA
| | - Eshetu Girma
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Solomon Teferra
- Department of Psychiatry, College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - David C Henderson
- Department of Psychiatry, Boston Medical Center, Boston, USA.,Boston University School of Medicine, Boston, USA
| | - Christina P C Borba
- Department of Psychiatry, Boston Medical Center, Boston, USA.,Boston University School of Medicine, Boston, USA
| |
Collapse
|
12
|
Lawental M, Surratt HL, Buttram ME, Kurtz SP. Serious mental illness among young adult women who use drugs in the club scene: co-occurring biopsychosocial factors. PSYCHOL HEALTH MED 2017; 23:82-88. [PMID: 28508675 DOI: 10.1080/13548506.2017.1330545] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Young women who regularly attend nightclubs are at risk for numerous health and social consequences, including mental distress, sexual and physical victimization and substance dependence. This paper uses a biopsychosocial framework to examine co-occurring mental health problems, victimization, substance dependence, sexual risk and physical pain among a sample of young women who use drugs (N = 222) in Miami's club scene. The majority of women were under 24 years old, Hispanic, and identified as heterosexual. Almost all the women reported past 90-day use of alcohol, ecstasy/MDMA, marijuana, cocaine and prescription opioids and benzodiazepines; 32% of women reported being in a monogamous relationship while 41.9% reported having three or more sexual partners in the past 90 days; 65.3% met DSM-IV criteria for substance dependence; 60.4% met DSM-IV criteria for serious mental illness (SMI) and 59.9% were victimized as minors. Women who had SMI had higher odds of substance dependence, concurrent physical pain, three or more sexual partners in the past 90 days, childhood victimization and severe abuse-related trauma. The high levels of interconnected mental health, victimization, trauma, physical pain, substance dependence and sexual risk factors observed are underreported in the literature, as young women club scene participants appear to be more similar to other marginalized drug-involved populations than previously considered. While further research is needed, it appears these young women are in great need of outreach for primary health, mental health, HIV prevention, increased social support and substance abuse treatment services.
Collapse
Affiliation(s)
- Maayan Lawental
- a School of Social Work, College of Behavioral and Community Sciences, University of South Florida , Tampa , FL , USA.,b School of Social Work, University of Haifa , Haifa , Israel
| | - Hilary L Surratt
- c Center for Health Services Research, University of Kentucky , Lexington , KY , USA
| | - Mance E Buttram
- d Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University , Miami , FL , USA
| | - Steven P Kurtz
- d Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University , Miami , FL , USA
| |
Collapse
|
13
|
White J, Hemingway S, Stephenson J. Training mental health nurses to assess the physical health needs of mental health service users: a pre- and post-test analysis. Perspect Psychiatr Care 2014; 50:243-50. [PMID: 25324028 DOI: 10.1111/ppc.12048] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 08/29/2013] [Accepted: 10/10/2013] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of this project was to develop, deliver, and evaluate a brief evidenced-based education package to enhance physical health literacy in mental health nurses. DESIGN AND METHODS Pre- and post-test survey of knowledge of physical health in serious mental illness, satisfaction with the workshop, and applicability to practice. FINDINGS Participants were motivated to attend and complete the questions. There was statistically significant knowledge gain immediately post workshop and participants described satisfaction with the content and a willingness to apply learning from the session to their practice. PRACTICE IMPLICATIONS If such workshops are provided as a collaborative and relatively inexpensive way of education, they can contribute to building the capacity of mental health nurses to be literate in physical health interventions.
Collapse
|
14
|
Topor DR, Grosso D, Burt J, Falcon T. Skills for Recovery: A Recovery-Oriented Dual Diagnosis Group for Veterans with Serious Mental Illness and Substance Abuse. Soc Work Groups 2013; 36:222-235. [PMID: 31543556 DOI: 10.1080/01609513.2012.762489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Individuals with serious mental illness (SMI) are at a high risk for abusing alcohol and illicit substances relative to the general population. This use, even in small quantities, can negatively affect mental and physical health. Group therapy is an evidence-based treatment for individuals dually diagnosed with SMI and a substance abuse disorder. The Skills for Recovery group used a recovery-oriented therapy manual for dual diagnoses and was informed by the International Association for Social Work with Groups' Standards for Social Work Practice with Groups throughout the development and implementation of the group.
Collapse
Affiliation(s)
- David R Topor
- VA Boston Healthcare System and Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Darryl Grosso
- VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Joshua Burt
- VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Thalia Falcon
- VA Boston Healthcare System, Boston, Massachusetts, USA
| |
Collapse
|