Serious Mental Illness (serious + mental_illness)

Distribution by Scientific Domains
Distribution within Medical Sciences


Selected Abstracts


A Qualitative Investigation of Individual and Contextual Factors Associated With Vocational Recovery Among People With Serious Mental Illness

AMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 2 2010
Erin C. Dunn
Most people with serious mental illness (SMI) experience difficulty in fulfilling a vocational role, with many being unemployed or underemployed. Given the profound social and economic costs of this level of work impairment, researchers have investigated ways to enhance "vocational recovery," or the processes through which people with SMI regain their role as workers and reintegrate into the workforce. Using data collected from a larger qualitative study of 23 individuals who had progressed to an advanced stage of recovery from SMI, this study explored respondents' perspectives on employment and its relationship to their vocational recovery. Text passages describing employment were analyzed inductively by a diverse team of researchers. Seven themes were identified as being important in helping participants return to work or remain employed following the onset of a serious psychiatric disability: having the confidence to work, having the motivation to work, possessing work-related skills, assessing person,job fit, creating work opportunities, receiving social support, and having access to consumer-oriented programs and services. Implications of these findings on the development of interventions and policies to improve the vocational outcomes of people with SMI are discussed. [source]


Another Breed of "Service" Animals: STARS Study Findings About Pet Ownership and Recovery From Serious Mental Illness

AMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 3 2009
Jennifer P. Wisdom PhD
This study elucidates the role of pets in recovery processes among adults with serious mental illness. Data derive from interviews with 177 HMO members with serious mental illness (52.2% women, average age 48.8 years) in the Study of Transitions and Recovery Strategies (STARS). Interviews and questionnaires addressed factors affecting recovery processes and included questions about pet ownership. Data were analyzed using a modified grounded theory method to identify the roles pets play in the recovery process. Primary themes indicate pets assist individuals in recovery from serious mental illness by (a) providing empathy and "therapy"; (b) providing connections that can assist in redeveloping social avenues; (c) serving as "family" in the absence of or in addition to human family members; and (d) supporting self-efficacy and strengthening a sense of empowerment. Pets appear to provide more benefits than merely companionship. Participants' reports of pet-related contributions to their well-being provide impetus to conduct more formal research on the mechanisms by which pets contribute to recovery and to develop pet-based interventions. [source]


Which comes first: atypical antipsychotic treatment or cardiometabolic risk?

ACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2009
S. M. Stahl
Objective:, To provide an overview for practicing clinicians on the pharmacological basis of cardiometabolic risk induced by antipsychotic drugs in patients with serious mental illness, to propose hypotheses to explain these risks and to give tips for managing cardiometabolic risk during antipsychotic treatment. Method:, A MEDLINE search using terms for atypical antipsychotics (including individual drug names), metabolic, cardiovascular, weight gain and insulin resistance, cross-referenced with schizophrenia was performed on articles published between 1990 and May 2008. Results:, Strong evidence exists for significant cardiometabolic risk differences among several antipsychotic agents. Histamine H1 and serotonin 5HT2C antagonism are associated with risk of weight gain, but receptor targets for dyslipidemia and insulin resistance have not yet been identified. Convincing data indicate that hypertriglyceridemia and insulin resistance may occur in the absence of weight gain with certain antipsychotics. Conclusion:, Although lifestyle and genetics may contribute independent risks of cardiometabolic dysfunction in schizophrenia and other serious mental illness, antipsychotic treatment also represents an important contributor to risk of cardiometabolic dysfunction, particularly for certain drugs and for vulnerable patients. Mental health professionals must learn to recognize the clinical signposts indicating antipsychotic-related cardiometabolic problems to forestall progression to type II diabetes, cardiovascular events and premature death. [source]


Obesity, serious mental illness and antipsychotic drugs

DIABETES OBESITY & METABOLISM, Issue 7 2009
Richard I. G. Holt
The prevalence of overweight and obesity is higher in people with mental illness than in the general population. Body weight is tightly regulated by a complex system involving the cortex and limbic system, the hypothalamus and the gastrointestinal tract. While there are justifiable concerns about the weight gain associated with antipsychotic medication, it is too simplistic to ascribe all obesity in people with serious mental illness (SMI) to their drug treatment. The development of obesity in SMI results from the complex interaction of the genotype and environment of the person with mental illness, the mental illness itself and antipsychotic medication. There are dysfunctional reward mechanisms in SMI that may contribute to poor food choices and overeating. While it is clear that antipsychotics have profound effects to stimulate appetite, no one receptor interaction provides an adequate explanation for this effect, and many mechanisms are likely to be involved. The complexity of the system regulating body weight allows us to start to understand why some individuals appear much more prone to weight gain and obesity than others. [source]


Healthy babies for mothers with serious mental illness: A case management framework for mental health clinicians

INTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 6 2008
Yvonne Hauck
ABSTRACT Women with a serious mental illness (SMI), notably schizophrenia, bipolar disorder, and personality disorders are considered high risk for adverse pregnancy and birth outcomes, which in turn, are associated with poor neurodevelopment in the child. Failure to access antenatal care, poor adherence with folate supplementation, an unhealthy lifestyle, and inappropriate health decisions can contribute to poor outcomes. Many women with SMI continue contact with mental health services while pregnant. This primary prevention project aimed to develop a framework for community mental health clinicians to improve the reproductive health outcomes for women with SMI. The consultation process involved discussions with key stakeholders, an environmental scan to determine current service delivery issues, a literature review, and individual and group interviews with community mental health clinicians, consumers, general practitioners, and midwives. Three key elements underpin the framework: early detection and monitoring of pregnancy, providing reproductive choices, and implementing a ,small known team approach' in the management of the pregnant client. Specific modules within the framework focus upon establishing a professional support network, assessing the risk of pregnancy, the early detection of pregnancy, monitoring during pregnancy, preparing for birth, and planning for the postnatal period. Implementation of the framework has the potential to significantly improve obstetric and neonatal outcomes for this high-risk group. [source]


Critical evaluation of the use of research tools in evaluating quality of life for people with schizophrenia

INTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 1 2007
Jeanette Hewitt
ABSTRACT:, Schizophrenia may lead to impairments in many aspects of life, including physical, cognitive, and role functioning. The subjective quality of life of people with schizophrenia has been shown to be lower than in the general population and appropriate patient-assessed health outcome measures are necessary to capture the distress and disability experienced by people living with a serious mental illness. Although psychiatry has been slow to become involved in quality of life measurement, the use of quality of life instruments has now been recognized as a means of evaluating the outcome of care interventions, in terms of symptoms and functioning. This paper evaluates the effectiveness of two widely used instruments: The Medical Outcomes Study Short Form Health Survey (SF-36) and The Lancashire Quality of Life Profile (LQoLP) in terms of reliability and validity in measuring the quality of life of people with schizophrenia. The LQoLP appeared to be best suited for evaluation of care programmes, whereas the SF-36 was more appropriate for medical trials, comparisons between patient groups, and assessment of the direct consequences of treatment on health and function. Subjective quality of life should, however, be considered to be distinct from clinical status and quality of life assessment should include the broadest range of indicators, to reflect the holistic ethos of mental health nursing. [source]


Screening for serious mental illness in the general population with the K6 screening scale: results from the WHO World Mental Health (WMH) survey initiative

INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue S1 2010
Ronald C. Kessler
Abstract Data are reported on the background and performance of the K6 screening scale for serious mental illness (SMI) in the World Health Organization (WHO) World Mental Health (WMH) surveys. The K6 is a six-item scale developed to provide a brief valid screen for Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) SMI based on the criteria in the US ADAMHA Reorganization Act. Although methodological studies have documented good K6 validity in a number of countries, optimal scoring rules have never been proposed. Such rules are presented here based on analysis of K6 data in nationally or regionally representative WMH surveys in 14 countries (combined N = 41,770 respondents). Twelve-month prevalence of DSM-IV SMI was assessed with the fully-structured WHO Composite International Diagnostic Interview. Nested logistic regression analysis was used to generate estimates of the predicted probability of SMI for each respondent from K6 scores, taking into consideration the possibility of variable concordance as a function of respondent age, gender, education, and country. Concordance, assessed by calculating the area under the receiver operating characteristic curve, was generally substantial (median 0.83; range 0.76,0.89; inter-quartile range 0.81,0.85). Based on this result, optimal scaling rules are presented for use by investigators working with the K6 scale in the countries studied. Copyright 2010 John Wiley & Sons, Ltd. [source]


Improving the K6 short scale to predict serious emotional disturbance in adolescents in the USA

INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue S1 2010
Jennifer Greif Green
Abstract Effective screening for emotional and behavioral disorders among youth requires brief screening scales with good validity to identify youth requiring further evaluation and to estimate prevalence of target disorders in populations of interest such as schools or neighborhoods. This paper examines the psychometric properties of a very short (six-item) screening scale, the K6, to assess serious emotional disturbance (SED) among youth. The K6, which is made up of symptoms of depression and anxiety, has been shown in previous research to be a strong predictor of serious mental illness (SMI) in adults, but no information is available on the ability of the scale to screen for SED among youth. The current report examines the K6 as a screen for SED in a national survey of US adolescents, the National Comorbidity Survey Replication Adolescent Supplement (NCS-A). The K6 is shown to provide fairly good prediction of SED [area under curve (AUC) = 0.74] that is somewhat higher for internalizing (AUC = 0.80) than behavior (AUC = 0.75) disorders. Based on this result, we augmented the K6 with questions about symptoms of behavior disorders. This improved prediction of SED (from AUC = 0.74 to AUC = 0.83) as well as of SED associated with pure behavior disorders (from AUC = 0.53 to AUC = 0.78). These results show that although the symptoms of depression and anxiety in the K6 are sufficient to detect SMI among adults, high rates of behavior disorders among adolescents require indicators of behavior disorders to be added to the K6 to screen adequately for adolescent SED. Copyright 2010 John Wiley & Sons, Ltd. [source]


The construct validity of the client questionnaire of the Wisconsin Quality of Life Index , a cross-validation study

INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2003
Jean Caron
Abstract The Wisconsin Quality of Life Index (W-QLI, Becker, Diamond and Sainfort, 1993) consists of eight scales: satisfaction with life domains, occupational activities, symptoms, physical health, social relations/support, finances, psychological wellbeing, and activities of daily living. The W-QLI has been modified to fit the characteristics of the Canadian population, the universal Canadian health system, and community and social services in Canada and the modified form was named CaW-QLI (Diaz, Mercier, Hachey, Caron, and Boyer, 1999). This study will verify the empirical basis of these theoretical dimensions by applying a cross-validation procedure on two samples, most of whose subjects have a serious mental illness. Confirmatory factor analyses and exploratory factor analyses using the principal component extraction technique with varimax rotation were applied. With the exception of the occupational activities domain, the remaining scales were correctly identified by the factor analyses on each sample. The occupational activities scale should be developed by additional items for representing this scale, which is too brief, and two other items should be revised in order to improve the quality of the instrument. Copyright 2003 Whurr Publishers Ltd. [source]


HIV prevention for people with serious mental illness: a survey of mental health workers' attitudes, knowledge and practice

JOURNAL OF CLINICAL NURSING, Issue 4 2009
Elizabeth Hughes
Aim., The aim of this survey was to investigate the attitudes, knowledge and reported practice (capabilities) of mental health workers concerning humanimmunodeficiency virus (HIV) and other sexually transmitted diseases in people with serious mental illness. Background., People with serious mental illness are at increased risk of HIV and other sexually transmitted infections. Mental health workers have a key role to play in promoting sexual health in this population, but it is unclear how they perceive their role in this work and whether they have the capabilities to deliver sexual health promotion. Design., Cross sectional survey. Methods., A questionnaire was devised and distributed to 650 mental health workers working in a London (UK) NHS mental health service. Results., A response rate of 44% was achieved. Overall, workers reported positive attitudes to sexual health promotion and were knowledgeable about risk behaviours and risk factors for HIV infection. Adherence to glove wearing was good. However, participants' knowledge about HIV/AIDS in people with schizophrenia was poor and most reported they were not engaged in sexual health promotion activities with people with serious mental illness. Glove wearing was predicted by those who had drug and alcohol training and clinical experience and knowledge of risk factors was predicted by previous health promotion training. No other demographic factors predicted any of the other subscales. Conclusion., Mental health workers require training to provide skills for health promotion regarding sexual health and HIV in people with serious mental health problems. In addition, there needs to be more research on risk behaviours. Relevance to clinical practice., The development of effective interventions to reduce this behaviour. [source]


God's will, God's punishment, or God's limitations?

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 6 2007
Religious coping strategies reported by young adults living with serious mental illness
Qualitative research has demonstrated that religious meaning-making coping, defined as attributions of a stressful life event that involve the sacred, is particularly relevant to persons with serious mental illness. However, recent research advances in the study of religious coping have yet to be employed in clinical samples. This longitudinal study examines religious meaning-making coping in a sample of 48 young adults diagnosed with schizophrenia or bipolar disorder over a one-year period. Young adults with mental illness generally reported using religious meaning-making coping in levels comparable to nonpsychiatric samples. Reports of benevolent religious reappraisals were associated with perceptions of positive mental health, whereas punishing God reappraisals and reappraisals of God's power were associated with self-reported distress and personal loss. Religious coping variables accounted for variation in adults' reports of psychiatric symptoms and personal loss one year later over and above demographic and global religious variables. Implications of findings for clinical practice are discussed. 2007 Wiley Periodicals, Inc. J Clin Psychol. [source]


Development of a measure of sense of community for individuals with serious mental illness residing in community settings

JOURNAL OF COMMUNITY PSYCHOLOGY, Issue 3 2009
Greg Townley
The psychological sense of community is one of the most commonly investigated constructs in community psychology. Sense of community may be particularly important for individuals with serious mental illness (SMI) because they often face societal barriers to participation in community living, including stigma and discrimination. To date, no published studies have investigated the psychometric qualities of sense of community measures among individuals with SMI. The current study tested a series of confirmatory factor analyses using the Brief Sense of Community Index (Long & Perkins, 2003) in a sample of 416 persons with SMI living in community settings to suggest a model of sense of community for individuals with SMI and other disabilities. The resulting scale, the Brief Sense of Community Index-Disability, demonstrated good model fit and construct validity. Implications are discussed for how this scale may be used in research investigating community integration and adaptive functioning in community settings. 2009 Wiley Periodicals, Inc. [source]


Housing satisfaction for persons with psychiatric disabilities

JOURNAL OF COMMUNITY PSYCHOLOGY, Issue 6 2003
Sam Tsemberis
Provision of residential services to people with mental illness has assumed increasing importance since deinstitutionalization and as community- based services have increased. This large-scale multisite study of housing programs specifically for persons with mental illness examines one of the factors that lead to successful residential tenure for persons with serious mental illness. To date, the Lehman Quality of Life Scale has been used primarily to assess satisfaction with housing in studies of residential services. This article reports on a new measure of housing satisfaction. This new 25-item instrument was developed, field tested in a variety of housing settings across the country, and analyzed for reliability and validity by a group of housing researchers and clinicians. The implications of using this instrument for future evaluation and research on housing for persons with mental illness are examined. 2003 Wiley Periodicals, Inc. J Comm Psychol 31: 581,590, 2003. [source]


Women, serious mental illness and recidivism: A gender-based analysis of recidivism risk for women with SMI released from prison

JOURNAL OF FORENSIC NURSING, Issue 1 2010
Kristin G. Cloyes PhD
Abstract Two groups now constitute the fastest growing segment of the U.S. prison population: women and persons with mental illness. Few large-scale studies have explored associations among serious mental illness (SMI), gender, and recidivism, or compared factors such as illness severity and clinical history as these construct notably different situations for incarcerated women and men. We report on our recent study comparing prison recidivism rates, severity of mental illness, and clinical history for women and men released from Utah State Prison 1998,2002. Implications: While women generally have better recidivism outcomes than men, we find that SMI related factors have a greater negative effect on the trajectories of women in this sample as compared with the men. This suggests that programs and policies focused on the SMI-specific risks and needs of women could significantly reduce prison recidivism and increase community tenure for this group, with far-reaching effects for families and communities. [source]


Family Network Support and Mental Health Recovery

JOURNAL OF MARITAL AND FAMILY THERAPY, Issue 1 2010
Francesca Pernice-Duca
Family members often provide critical support to persons living with a serious mental illness. The focus of this study was to determine which dimensions of the family support network were most important to the recovery process from the perspective of the recovering person. Consumers of a community mental health program completed in-depth structured interviews that included separate measures of social network support and recovery. Consumers named an average of 2.6 family members on the social network, interacted with family on a weekly basis, and were quite satisfied with their contact. This study revealed that support and reciprocity with family members are important dimensions of a personal support network that relates to the recovery process. [source]


Relatives of persons with recently discovered serious mental illness: in need of support to become resource persons in treatment and recovery

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 4 2010
K. NORDBY cand. polit. rpn
Accessible summary ,,Relatives want the health workers to regard the patient not only as sick but also regard him/her as a person. Parents want to get involved at an early stage and find it important that their opinions and experiences are heard. The staff also express that relatives possess knowledge that should be important for them to receive. ,,The relatives underline the importance of an opening for hope to be present at all time, else you do not have the strength to cope with the situation. No matter how pessimistic the staff are, hope must be expressed. ,,The relatives want to know what happens after discharge. They do not always know what questions to ask before discharge as challenges are discovered gradually. They want to know how to behave and what to say to their family member with a psychiatric illness. When parents can impart their concerns and receive adjusted counselling their level of stress is reduced. ,,It is important to consider relatives as resource persons. The staff consider themselves as experts on psychosis and the parents as experts on their own children. Abstract A considerable amount of research on the treatment of young people suffering from serious mental illnesses states that good collaboration with relatives is essential for reducing relapse, improving recovery and enhancing quality of life for patients and relatives. The aim of this study was to explore and describe what facilitates active involvement for relatives in the treatment and rehabilitation of their family member. The present study is a part of a larger cooperative inquiry project carried out in a mental hospital in southern Norway focusing on improving practices for collaboration with relatives. This sub-study presents results from eight focus group interviews with relatives and staff members. Data were analysed by means of qualitative content analysis. The results showed that the relatives had mostly positive experiences from their encounters with the staff, although some negative experiences were articulated. Both relatives and staff underlined the importance of developing a good encounter characterized by sharing information, giving guidance and support according to the relatives' needs as well as addressing existential issues. This was perceived as a necessary basis for the relatives to become active participants in the treatment and rehabilitation process. To activate this basis, the relatives are dependent on the staff members' ability to convey and nurture hope related to the patient's recovery and quality of life. [source]


The development of the serious mental illness physical Health Improvement Profile

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 5 2009
J. WHITE rn bsc (hons) pgcert
People with serious mental illness (SMI), such as schizophrenia and bipolar disorder, are more likely to suffer from a range of long-term physical conditions including diabetes and cardiovascular disease. Consequently they will die 10,15 years earlier than the general population. Health services have failed to address this major health inequality because of a lack of consensus about the type and frequency of monitoring people with SMI require and a lack of knowledge and skills in the mental health workforce. We developed the SMI physical Health Improvement Profile to help mental health nurses profile the physical health of the SMI patients they work with and direct them towards the evidence base interventions available to address identified health problems. [source]


Training in cognitive behavioural interventions on acute psychiatric inpatient wards

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2005
E. McCANN phd msc rmn dip psi pgdip (academic practice)
There has been a drive towards addressing the types of care and therapeutic interventions available to people with serious mental illness, which is reflected in the latest government mental health policy initiatives. Recent evidence strongly supports the implementation of psychological and social interventions for people with psychosis, and in particular the use of cognitive behavioural techniques. Until now, the main focus has been on people living in the community. This study examines the delivery of psychosocial interventions training to qualified psychiatric nurses and unqualified staff on seven acute psychiatric admission wards in London, UK. The approach had the strength of on-site delivery, follow-up role modelling of the interventions and clinical supervision. Despite this, in some cases the training was less successful, mainly because of staffing and leadership weaknesses. The impact of training in these methods and the implications for mental health education and practice development are discussed. [source]


Assertive community treatment: development of the team, selection of clients, and impact on length of hospital stay

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2002
A. Jones bn(hons) rmn rn(adult)
Mental health services have been criticized for the lack of focus and response to people suffering from a serious mental illness (SMI). Assertive community treatment (ACT) offers the potential for greater partnership working between the user and provider of mental health services. The author describes one approach in developing ACT in the UK. Four criteria were developed to identify the most appropriate service users for ACT: those with SMI, illness instability, illness disability and risk to self or others. Fifty-five clients were identified using these criteria and tracked for their length of hospital stay and frequency of admission 2 years before acceptance to an ACT team and for 12 months after. Duration of hospital stay was unchanged although both the frequency and total numbers of bed days were reduced. [source]


Reduction in Recidivism in a Juvenile Mental Health Court: A Pre- and Post-Treatment Outcome Study

JUVENILE AND FAMILY COURT JOURNAL, Issue 3 2009
Monic P. Behnken
ABSTRACT A review of an evaluation of the Court for the Individualized Treatment of Adolescents (a prototype Juvenile Mental Health Court in Santa Clara, California) is presented along with admission criteria. Participant demographics are described. McNemar Test and Paired T Test results show that study participants committed violent, aggressive, and property crimes in significantly lower numbers in the 23 months following court admission than in the 18 months preceding court admission, despite escalating patterns of antisocial behavior prior to court involvement. The importance of developing multidisciplinary models to address moderately severe offenders with serious mental illness is discussed. [source]


A Qualitative Investigation of Individual and Contextual Factors Associated With Vocational Recovery Among People With Serious Mental Illness

AMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 2 2010
Erin C. Dunn
Most people with serious mental illness (SMI) experience difficulty in fulfilling a vocational role, with many being unemployed or underemployed. Given the profound social and economic costs of this level of work impairment, researchers have investigated ways to enhance "vocational recovery," or the processes through which people with SMI regain their role as workers and reintegrate into the workforce. Using data collected from a larger qualitative study of 23 individuals who had progressed to an advanced stage of recovery from SMI, this study explored respondents' perspectives on employment and its relationship to their vocational recovery. Text passages describing employment were analyzed inductively by a diverse team of researchers. Seven themes were identified as being important in helping participants return to work or remain employed following the onset of a serious psychiatric disability: having the confidence to work, having the motivation to work, possessing work-related skills, assessing person,job fit, creating work opportunities, receiving social support, and having access to consumer-oriented programs and services. Implications of these findings on the development of interventions and policies to improve the vocational outcomes of people with SMI are discussed. [source]


The Impact of Hurricane Katrina on the Mental and Physical Health of Low-Income Parents in New Orleans

AMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 2 2010
Jean Rhodes
The purpose of this study was to document changes in mental and physical health among 392 low-income parents exposed to Hurricane Katrina and to explore how hurricane-related stressors and loss relate to post-Katrina well-being. The prevalence of probable serious mental illness doubled, and nearly half of the respondents exhibited probable posttraumatic stress disorder. Higher levels of hurricane-related loss and stressors were generally associated with worse health outcomes, controlling for baseline sociodemographic and health measures. Higher baseline resources predicted fewer hurricane-associated stressors, but the consequences of stressors and loss were similar regardless of baseline resources. Adverse health consequences of Hurricane Katrina persisted for a year or more and were most severe for those experiencing the most stressors and loss. Long-term health and mental health services are needed for low-income disaster survivors, especially those who experience disaster-related stressors and loss. [source]


Another Breed of "Service" Animals: STARS Study Findings About Pet Ownership and Recovery From Serious Mental Illness

AMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 3 2009
Jennifer P. Wisdom PhD
This study elucidates the role of pets in recovery processes among adults with serious mental illness. Data derive from interviews with 177 HMO members with serious mental illness (52.2% women, average age 48.8 years) in the Study of Transitions and Recovery Strategies (STARS). Interviews and questionnaires addressed factors affecting recovery processes and included questions about pet ownership. Data were analyzed using a modified grounded theory method to identify the roles pets play in the recovery process. Primary themes indicate pets assist individuals in recovery from serious mental illness by (a) providing empathy and "therapy"; (b) providing connections that can assist in redeveloping social avenues; (c) serving as "family" in the absence of or in addition to human family members; and (d) supporting self-efficacy and strengthening a sense of empowerment. Pets appear to provide more benefits than merely companionship. Participants' reports of pet-related contributions to their well-being provide impetus to conduct more formal research on the mechanisms by which pets contribute to recovery and to develop pet-based interventions. [source]


Coming In: An Examination of People With Co-Occurring Substance Use and Serious Mental Illness Exiting Chronic Homelessness

AMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 2 2009
Alisa K. Lincoln PhD
Despite national efforts, the number of people who are chronically homeless in our cities remains high. People with serious mental illness and substance abuse problems continue to represent the majority of those experiencing long-term homelessness. Traditional shelters have difficulty engaging and addressing the needs of this group; however, there are an increasing number of alternative models, including the Safe Haven shelter program, developed to better meet their needs. In this article, the authors examine responses from 28 qualitative interviews conducted with 16 residents of a Safe Haven shelter serving chronically homeless people, at 3 and 9 months after entry. All had a severe mental illness and were actively substance abusing. The importance of a model that respects personhood, a place that feels like home, and challenges faced by residents as they "come in" are emphasized. [source]


An analysis of post-booking jail diversion programming for persons with co-occurring disorders,

BEHAVIORAL SCIENCES & THE LAW, Issue 6 2004
Dr Michael S. Shafer Ph.D.
For persons with co-occurring disorders, interaction with criminal justice systems is a frequent occurrence. As a result, a variety of diversionary programs have been developed nationwide. In this study, a total of 248 individuals with co-occurring disorders of serious mental illness and substance use disorders who had been arrested and booked on misdemeanor charges participated in a post-booking jail diversion program in two urban communities. A quasi-experimental design was used with individuals assigned to diversion or non-diversion status based upon the decision processes of the mental health,criminal justice systems. The effectiveness of the jail diversion program was evaluated from a variety of sources, including structured interviews, behavioral health service utilization patterns, and criminal justice recidivism patterns. Analyses revealed general main effects for time on many of the outcome variables, with few main effects or interaction effects detected on the basis of diversion status (diverted versus non-diverted). Across all measures assessing mental health and substance abuse, study participants displayed improvements over time, irrespective of their diversion status or program location. Participants generally displayed no significant changes in their rates of accessibility to, or frequency of use of, the various mental health, substance abuse, and other services, and few changes for diversion status were detected with regard to service utilization. Although a number of indicators of criminality and violence were reduced over time, these reductions were statistically insignificant, with changes for diversionary status or time identified at follow-up. These results are discussed in light of their implications for jail diversion programming and future research in this area. Copyright 2004 John Wiley & Sons, Ltd. [source]


Evaluation of a mental health treatment court with assertive community treatment,

BEHAVIORAL SCIENCES & THE LAW, Issue 4 2003
Merith Cosden Ph.D.
Without active engagement, many adults with serious mental illnesses remain untreated in the community and commit criminal offenses, resulting in their placement in the jails rather than mental health facilities. A mental health treatment court (MHTC) with an assertive community treatment (ACT) model of case management was developed through the cooperative efforts of the criminal justice and mental health systems. Participants were 235 adults with a serious mental illness who were booked into the county jail, and who volunteered for the study. An experimental design was used, with participants randomly assigned to MHTC or treatment as usual (TAU), consisting of adversarial criminal processing and less intensive mental health treatment. Results were reported for 6 and 12 month follow-up periods. Clients in both conditions improved in life satisfaction, distress, and independent living, while participants in the MHTC also showed reductions in substance abuse and new criminal activity. Outcomes are interpreted within the context of changes brought about in the community subsequent to implementation of the MHTC. Copyright 2003 John Wiley & Sons, Ltd. [source]


Accounting for unemployment among people with mental illness

BEHAVIORAL SCIENCES & THE LAW, Issue 6 2002
Richard C. Baron M.A.
Persons diagnosed with a serious mental illness experience significantly high rates of unemployment compared with the general population. The explanations for this situation have included a focus on the symptoms associated with these disorders, a focus on the lack of effective vocational rehabilitation programs for this population, and, most recently, a focus on employer discrimination and the financial disincentives to employment in various public policies. The authors of this manuscript review the evolution in thought pertaining to the labor market experiences of persons with a serious mental illness and propose as an additional set of factors that should be considered, those labor market liabilities that this population shares with others without disabilities who experience similar employment histories. The authors conclude that the inclusion of these factors in our understanding of issues that persons with serious mental illness face in the competitive labor market will likely lead to a further evolution in program and policy development. Copyright 2002 John Wiley & Sons, Ltd. [source]


Nutrition and exercise behavior among patients with bipolar disorder,

BIPOLAR DISORDERS, Issue 5 2007
Amy M Kilbourne
Objectives:, There have been few comprehensive studies of nutrition and exercise behaviors among patients with bipolar disorder (BPD). Based on a national sample of patients receiving care in the Veterans Affairs (VA) health care system, we compared nutrition and exercise behaviors among individuals diagnosed with BPD, others diagnosed with schizophrenia, and others who did not receive diagnoses of serious mental illness (SMI). Methods:, We conducted a cross-sectional study of patients who completed the VA's Large Health Survey of Veteran Enrollees section on health and nutrition in fiscal year (FY) 1999 and who either received a diagnosis of BPD (n = 2,032) or schizophrenia (n = 1,895), or were included in a random sample of non-SMI VA patients (n = 3,065). We compared nutrition and exercise behaviors using multivariable logistic regression, controlling for patient socio-economic and clinical factors, and adjusting for patients clustered by site using generalized estimating equations. Results:, Patients with BPD were more likely to report poor exercise habits, including infrequent walking (odds ratio, OR = 1.33, p < 0.001) or strength exercises (OR = 1.28, p < 0.001) than those with no SMI. They were also more likely to self-report suboptimal eating behaviors, including having fewer than two daily meals (OR = 1.32, p < 0.001) and having difficulty obtaining or cooking food (OR = 1.48, p < 0.001). Patients with BPD were also more likely to report having gained ,10 pounds in the past 6 months (OR = 1.59, p < 0.001) and were the least likely to report that their health care provider discussed their eating habits (OR = 0.84, p < 0.05) or physical activity (OR = 0.81, p < 0.01). Conclusions:, Greater efforts are needed to reduce the risk of poor nutrition and exercise habits among patients diagnosed with BPD. [source]