Gaols or De Facto Mental Institutions? Why Individuals with a Mental Illness Are Over-Represented in the Criminal Justice System in New South Wales, Australia

ERIC Educational Resources Information Center

Henderson, Corinne

2007-01-01

The over-representation of people with mental illness in the criminal justice system highlights the need for legislative reform and the implementation of programs breaking the cycle of mental illness, poverty, unemployment and substance abuse across Australia. Whilst there is no inherent association between mental illness and crime, there is a…

Opening caregiver minds: National Alliance for the Mentally Ill's (NAMI) provider education program.

PubMed

Mohr, W K; Lafuze, J E; Mohr, B D

2000-10-01

The belief that poor parenting and dysfunctional families give rise to mental illness has been perpetuated by psychodynamic and family systems theories that lack supporting scientific evidence, and interventions based on these theories have failed to produce clinical improvements. Nevertheless the National Alliance for the Mentally III (NAMI) found that many clinical training programs continue to teach these outdated theories and interventions and that the mental health system is often destructive to family systems. This article describes a new 10-week program that is designed to educate service providers that will include families in the care of their chronically ill loved one. The program is based on a competence and adaptation rather than a pathology foundation and it shifts the discourse from causes to effects of illness.

Teaching children about mental health and illness: a school nurse health education program.

PubMed

Desocio, Janiece; Stember, Lisa; Schrinsky, Joanne

2006-04-01

A mental health education program designed by school nurses for children ages 10- 12 was developed in 2000-2001 and expanded with broader distribution in 2004-2005. Six classroom sessions, each 45 minutes in length, provided information and activities to increase children's awareness of mental health and illness. Education program content included facts about the brain's connection to mental health, information about healthy ways to manage stress, resources and activities to promote mental health, common mental health problems experienced by children, and how to seek help for mental health problems. Classes included a combination of didactic presentation and open discussion, encouraging students to ask questions and allowing the school nurse to correct misinformation. Analysis of pre- and posttests from 370 elementary and middle school students revealed statistically significant improvements in their knowledge of mental health and mental illness.

Homicidal maniacs and narcissistic parasites: stigmatization of mentally ill persons in the movies.

PubMed

Hyler, S E; Gabbard, G O; Schneider, I

1991-10-01

The portrayal of mentally ill persons in movies and television programs has an important and underestimated influence on public perceptions of their condition and care. Movie stereotypes that contribute to the stigmatization of mentally ill persons include the mental patient as rebellious free spirit, homicidal maniac, seductress, enlightened member of society, narcissistic parasite, and zoo specimen. The authors suggest that mental health professionals can fight this source of stigma by increasing their collaboration with patient advocacy groups in monitoring negative portrayals of mentally ill people, using public information campaigns such as Mental Illness Awareness Week to call attention to the process of stigmatization, and supporting accurate dramatic and documentary depictions of mental illness.

Teaching Children about Mental Health and Illness: A School Nurse Health Education Program

ERIC Educational Resources Information Center

DeSocio, Janiece; Stember, Lisa; Schrinsky, Joanne

2006-01-01

A mental health education program designed by school nurses for children ages 10-12 was developed in 2000-2001 and expanded with broader distribution in 2004-2005. Six classroom sessions, each 45 minutes in length, provided information and activities to increase children's awareness of mental health and illness. Education program content included…

The DoD Civilian Equal Employment Opportunity (EEO) Program

DTIC Science & Technology

1987-05-21

as mental retardation, organic brain syndrome , emotional or mental illness, and specific learning disabilities. b. Major Life Activities. Functions...mental or psychological disorder, such as mental retardation, organic brain syndrome , emotional or mental illness, and specific learning disabilities

Family Approaches to the Chronically Mentally Ill: Implications for Rural Areas.

ERIC Educational Resources Information Center

Kilpatrick, Allie C.; Kilpatrick, Ebb G.

The decade of the 1980s has witnessed a rebirth of concern regarding the chronically mentally ill. The way mental health professionals view families of the chronically mentally ill has changed dramatically, largely because of the emergence of the biological theories of causation for schizophrenia. Innovative programs for families have included…

The criminal justice outcomes of jail diversion programs for persons with mental illness: a review of the evidence.

PubMed

Sirotich, Frank

2009-01-01

Diversion programs are initiatives in which persons with serious mental illness who are involved with the criminal justice system are redirected from traditional criminal justice pathways to the mental health and substance abuse treatment systems. This article is a review of the research literature conducted to determine whether the current evidence supports the use of diversion initiatives to reduce recidivism and to reduce incarceration among adults with serious mental illness with justice involvement. A structured literature search identified 21 publications or research papers for review that examined the criminal justice outcomes of various diversion models. The review revealed little evidence of the effectiveness of jail diversion in reducing recidivism among persons with serious mental illness. However, evidence was found that jail diversion initiatives can reduce the amount of jail time that persons with mental illness serve. Implications for practice and research are discussed.

Implementing evidence-based physical activity interventions for people with mental illness: an Australian perspective.

PubMed

Rosenbaum, Simon; Tiedemann, Anne; Stanton, Robert; Parker, Alexandra; Waterreus, Anna; Curtis, Jackie; Ward, Philip B

2016-02-01

Physical activity (PA) and exercise is increasingly being recognised as an efficacious component of treatment for various mental disorders. The association between PA and cardiometabolic disease is well established, as is the strong link between mental illness, sedentary behaviour and poor cardiometabolic health. Examples of successful integration of clinical PA programs within mental health treatment facilities are increasing. The aim of this review was to summarise the evidence regarding PA and mental illness, and to present examples of clinical exercise programs within Australian mental health facilities. A narrative synthesis of systematic reviews and clinical trials was conducted. Evidence supporting the inclusion of PA programs as an adjunct to treatment for various conditions was presented; including depression, schizophrenia, anxiety disorders, post-traumatic stress disorder and substance abuse. In light of the available evidence, the inclusion of clinical PA programs within mental health treatment, facilitated by dedicated clinicians (exercise physiologists / physiotherapists) was justified. PA is a feasible, effective and acceptable adjunct to usual care for a variety of mental disorders. There is a clear need for greater investment in initiatives aiming to increase PA among people experiencing mental illness, given the benefits to both mental and physical health outcomes. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Mental illness stigma, help seeking, and public health programs.

PubMed

Henderson, Claire; Evans-Lacko, Sara; Thornicroft, Graham

2013-05-01

Globally, more than 70% of people with mental illness receive no treatment from health care staff. Evidence suggests that factors increasing the likelihood of treatment avoidance or delay before presenting for care include (1) lack of knowledge to identify features of mental illnesses, (2) ignorance about how to access treatment, (3) prejudice against people who have mental illness, and (4) expectation of discrimination against people diagnosed with mental illness. In this article, we reviewed the evidence on whether large-scale anti-stigma campaigns could lead to increased levels of help seeking.

Mental Illness Stigma, Help Seeking, and Public Health Programs

PubMed Central

Evans-Lacko, Sara; Thornicroft, Graham

2013-01-01

Globally, more than 70% of people with mental illness receive no treatment from health care staff. Evidence suggests that factors increasing the likelihood of treatment avoidance or delay before presenting for care include (1) lack of knowledge to identify features of mental illnesses, (2) ignorance about how to access treatment, (3) prejudice against people who have mental illness, and (4) expectation of discrimination against people diagnosed with mental illness. In this article, we reviewed the evidence on whether large-scale anti-stigma campaigns could lead to increased levels of help seeking. PMID:23488489

Review and analysis of the Mental Health Nurse Incentive Program.

PubMed

Happell, Brenda; Platania-Phung, Chris

2017-09-04

Objective The aim of the present study was to review and synthesise research on the Mental Health Nurse Incentive Program (MHNIP) to ascertain the benefits and limitations of this initiative for people with mental illness, general practitioners, mental health nurses and the wider community. Methods An electronic and manual search was made of the research literature for MHNIP in May 2017. Features of studies, including cohorts and findings, were tabulated and cross-study patterns in program processes and outcomes were closely compared. Results Seventeen reports of primary research data have been released. Triangulation of data from different cohorts, regions and design show that the program has been successful on the primary objectives of increased access to primary mental health care, and has received positive feedback from all major stakeholders. Although the program has been broadly beneficial to consumer health, there are inequities in access for people with mental illness. Conclusions The MHNIP greatly benefits the health of people with mental illness. Larger and more representative sampling of consumers is needed, as well as intensive case studies to provide a more comprehensive and effective understanding of the benefits and limitations of the program as it evolves with the establishment of primary health networks. What is known about the topic? The MHNIP is designed to increase access to mental health care in primary care settings such as general practice clinics. Studies have reported favourable views about the program. However, research is limited and further investigation is required to demonstrate the strengths and limitations of the program. What does this paper add? All studies reviewed reported that the MHNIP had positive implications for people with severe and persistent mental illness. Qualitative research has been most prevalent for mental health nurse views and research on Health of the Nation Outcome Scale scores for recipients of the program. There is more research on system dimensions than on person-centred care. Mental health consumers, carers and families have been neglected in the establishment, engagement and evaluation of the MHNIP. What are the implications for practitioners? A more systematic, national-level research program into the MHNIP is required that is centred more on the experiences of people with mental illness.

A recovery-based outreach program in rural Victoria.

PubMed

Prabhu, Radha; Browne, Mark Oakley

2007-04-01

A recovery-based outreach program for people with severe mental illness in regional Victoria is described. The paper covers a description of the program, the services provided and outcomes achieved. The program emphasized active collaboration between patients and clinicians as outlined in the collaborative recovery model and recognized that recovery from mental illness is an individual, personal process. The program provided service to 108 people over 3 years and had a positive impact on clinicians, patients and carers. The benefits of recovery orientation, multidisciplinary teams, collaborative relationships and carer involvement are discussed. The paper highlights the need for a focus on recovery and comprehensive care for people with severe mental illness.

Using the brain's fight-or-flight response for predicting mental illness on the human space flight program

NASA Astrophysics Data System (ADS)

Losik, L.

A predictive medicine program allows disease and illness including mental illness to be predicted using tools created to identify the presence of accelerated aging (a.k.a. disease) in electrical and mechanical equipment. When illness and disease can be predicted, actions can be taken so that the illness and disease can be prevented and eliminated. A predictive medicine program uses the same tools and practices from a prognostic and health management program to process biological and engineering diagnostic data provided in analog telemetry during prelaunch readiness and space exploration missions. The biological and engineering diagnostic data necessary to predict illness and disease is collected from the pre-launch spaceflight readiness activities and during space flight for the ground crew to perform a prognostic analysis on the results from a diagnostic analysis. The diagnostic, biological data provided in telemetry is converted to prognostic (predictive) data using the predictive algorithms. Predictive algorithms demodulate telemetry behavior. They illustrate the presence of accelerated aging/disease in normal appearing systems that function normally. Mental illness can predicted using biological diagnostic measurements provided in CCSDS telemetry from a spacecraft such as the ISS or from a manned spacecraft in deep space. The measurements used to predict mental illness include biological and engineering data from an astronaut's circadian and ultranian rhythms. This data originates deep in the brain that is also damaged from the long-term exposure to cortisol and adrenaline anytime the body's fight or flight response is activated. This paper defines the brain's FOFR; the diagnostic, biological and engineering measurements needed to predict mental illness, identifies the predictive algorithms necessary to process the behavior in CCSDS analog telemetry to predict and thus prevent mental illness from occurring on human spaceflight missions.

Analysis of a support group for children of parents with mental illnesses: managing stressful situations.

PubMed

Gladstone, Brenda M; McKeever, Patricia; Seeman, Mary; Boydell, Katherine M

2014-09-01

We report an ethnographic analysis of a psycho-education and peer-support program for school-aged children of parents with mental illnesses. We conducted a critical discourse analysis of the program manual and observed group interactions to understand whether children shared program goals predetermined by adults, and how, or if, the intervention was responsive to their needs. Children were expected to learn mental illness information because "knowledge is power," and to express difficult feelings about being a child of a mentally ill parent that was risky. Participants used humor to manage group expectations, revealing how they made sense of their parents' problems, as well as their own. Suggestions are made for determining good mental health literacy based on children's preferences for explaining circumstances in ways they find relevant, and for supporting children's competencies to manage relationships that are important to them. © The Author(s) 2014.

76 FR 9032 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-16

...: Protection and Advocacy for Individuals With Mental Illness (PAIMI) Annual Program Performance Report (OMB No. 0930-0169)-- Revision The Protection and Advocacy for Individuals with Mental Illness (PAIMI) Act at 42... individual and systemic advocacy services to individuals with significant (severe) mental illness (adults...

42 CFR 51.45 - Confidentiality of protection and advocacy system records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... GRANTS REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM... under the Act on serving individuals with mental illness. Officials that have access to such information... legal guardian, conservator, or other legal representative of an individual with mental illness, unless...

42 CFR 51.25 - Grievance procedure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Program Administration and... from: (1) Clients or prospective clients of the P&A system to assure that individuals with mental illness have full access to the services of the program; and (2) Individuals who have received or are...

42 CFR 51.7 - Eligibility for protection and advocacy services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Basic...) Individuals with mental illness as defined in 42 U.S.C. 10802(4) and 10805(a), including persons who report matters which occurred while they were individuals with mental illness; (2) Persons who were individuals...

42 CFR 51.6 - Use of allotments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Basic Requirements § 51.6 Use of... available in the State to protect and advocate the rights of individuals with mental illness. (b) Allotments... individuals with mental illness and when it appears on behalf of named plaintiffs or a class of plaintiffs for...

42 CFR 51.42 - Access to facilities and residents.

Code of Federal Regulations, 2013 CFR

2013-10-01

... REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Access to... or treatment for individuals with mental illness, and to all areas of the facility which are used by... of an individual with mental illness. (c) In addition to access as prescribed in paragraph (b) of...

42 CFR 51.42 - Access to facilities and residents.

Code of Federal Regulations, 2014 CFR

2014-10-01

... REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Access to... or treatment for individuals with mental illness, and to all areas of the facility which are used by... of an individual with mental illness. (c) In addition to access as prescribed in paragraph (b) of...

42 CFR 51.42 - Access to facilities and residents.

Code of Federal Regulations, 2012 CFR

2012-10-01

... REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Access to... or treatment for individuals with mental illness, and to all areas of the facility which are used by... of an individual with mental illness. (c) In addition to access as prescribed in paragraph (b) of...

42 CFR 51.42 - Access to facilities and residents.

Code of Federal Regulations, 2011 CFR

2011-10-01

... REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Access to... or treatment for individuals with mental illness, and to all areas of the facility which are used by... of an individual with mental illness. (c) In addition to access as prescribed in paragraph (b) of...

Mental Illness Discrimination in Mental Health Treatment Programs: Intersections of Race, Ethnicity, and Sexual Orientation.

PubMed

Holley, Lynn C; Tavassoli, Kyoko Y; Stromwall, Layne K

2016-04-01

People with mental illnesses (PWMI) who are of color and/or lesbian, gay, or bisexual (LGB) experience mental health disparities, including within mental health treatment programs (MHTPs). Informed by a critical framework with attention to intersectionality and microaggressions, this qualitative study asked 20 PWMI and family members who also are of color and/or LGB whether they had experienced mental illness discrimination in MHTPs, a possible factor in disparities. We also asked participants about aspects of MHTPs that supported recovery. Participants reported that they were ignored/not listened to, not viewed as complex individuals, experienced condescension/lack of respect and violations of privacy or other rights, and were presumed to lack intelligence. In addition, identifying mental illness discrimination was complex due to intersections of identities. Despite these perceptions of discrimination, participants described supportive aspects of MHTPs. Implications for practice and research are offered.

The Depiction of Mental Illnesses in Children's Television Programs

ERIC Educational Resources Information Center

Wahl, Otto; Hanrahan, Erin; Karl, Kelly; Lasher, Erin; Swaye, Janel

2007-01-01

Concern has been expressed that negative attitudes toward people with mental illnesses begin to develop early in childhood. This study examines one of the possible sources of learning of such negative attitudes--children's television programs. Two hundred sixty-nine (269) hours of children's television programming were videotaped, viewed, and…

[Development of Empowerment Program for Persons with Chronic Mental Illness and Evaluation of Impact].

PubMed

Kim, Mijung; Lee, Kyunghee

2015-12-01

This study was done to develop an empowerment program for people with chronic mental illness and to analyze effects of the program on level of empowerment. The research was conducted using a nonequivalent control group pretest-posttest design. Participants were 37 people with chronic mental illness (experimental group: 18, control group: 19). The empowerment program was provided for 8 weeks (15 sessions). Data were collected between July 21 and October 17, 2014. Data were analyzed using Chi-square, Fisher's exact test, Sapiro-Wilk test, and Repeated measure ANOVA with SPSS/WIN 18.0. Quantitative results show that self-efficacy, interpersonal relationships, attitudes in the workplace, occupational performance capacity, and levels of empowered execute were significantly better in the experimental group compared to the control group. Study findings indicate that this empowerment program for persons with chronic mental illness is effective for improving self efficacy, interpersonal skills, attitudes in the workplace, occupational performance capacity, levels of empowered execute.

[Practices and interventions related to the work integration of people with a severe mental illness: work outcomes and avenues of research].

PubMed

Pachoud, B; Corbière, M

2014-06-01

Sustained work integration for people with a severe mental illness or handicap psychique in French (e.g., schizophrenia) is an important issue in our society today. Indeed, work is not only an essential factor in people's social integration but is also a stepping-stone toward recovery for this clientele. Well-defined programs and services related to work integration were developed and studied over the last three decades. Although the work integration of people with severe mental illness has been studied extensively in the Anglo-Saxon literature, the impact of these studies on the traditional beliefs and services in France remains uncertain. In terms of the scope of the studies so far, there has been an initial interest lasting over many years to uncover individual characteristics of people with severe mental illness which would best predict job tenure. Since, studies have been increasingly investigating various supports in order to facilitate the work integration process. These supports can be illustrated as direct supports or accommodations offered in the workplace, as needed, particularly when people with severe mental illness choose to disclose their mental disorder in the workplace. This awareness of the impact of the workplace environment on the work integration of people with a severe mental illness increases the need to find solutions and develop environmentally sensitive clinical strategies to overcome difficulties during the work integration. To illustrate this thematic, in this special issue, we have gathered together studies conducted in different countries but who share the focus on work integration of people with a severe mental illness. To reflect the advancement in this domain, this special issue is divided in three parts. The first part consists of the presentation of different types of vocational programs: supported employment programs, social firms, and hybrid models. Supported employment programs are very well documented in the specialised literature and are recognized as an evidence-based practice across the world to help people get competitive employment. Social firms is an another alternative model for facilitating the work integration of people with severe mental illness but has to date scarcely been studied empirically. Other hybrid vocational programs implemented in Québec (Canada) and France and inspired by supported employment programs and social firms' principles, are also described. The second part of this special issue is related to the presentation of two adjunct clinical interventions for helping people with a severe mental illness in their work integration, and more particularly for increasing job tenure: cognitive remediation and group cognitive behavioral therapy. Cognitive remediation was developed to reduce the impact of cognitive deficits, such as memory or attention, in people with a severe mental illness whereas group cognitive behavioral therapy was developed to change the dysfunctional beliefs and behaviours that might hinder job tenure in people receiving supported employment services. Finally, the third part of this special issue presents two papers on the influence of the workplace, of stakeholders from the organization (e.g., employers, supervisors) and of the work environment on the work integration of people with severe mental illness. The first paper discusses disclosure of the mental illness in the workplace and its positive and negative consequences such as receiving work accommodations and experiencing stigma, respectively. In the last paper, psychological processes during the hiring process are presented to better understand the elements related to discrimination and stigma during the work integration of people with severe mental illness. Copyright © 2014. Published by Elsevier Masson SAS.

Case Manager Perspectives on the Role of Treatment in Supportive Housing for People with Severe Mental Illness

PubMed Central

Stanhope, Victoria; Choy-Brown, Mimi; Tiderington, Emmy; Henwood, Benjamin F.; Padgett, Deborah K.

2016-01-01

Objective Growing recognition exists of housing as a social determinant of health, and thus, health care reform initiatives are expanding the reach of health care beyond traditional settings. One result of this expansion is increased Medicaid funds for supportive-housing programs for people with severe mental illnesses. This qualitative study explores the ways in which case managers working in a supportive housing program approach treatment and how their approach is influenced by both program requirements and their beliefs about mental illness. Method The study is part of a longitudinal qualitative study on recovery for people with severe mental illnesses living in supportive housing. Multiple interviews (n = 55) with 24 case managers from a residential-continuum supportive-housing program were conducted over 18 months. To provide an in-depth view of case manager perspectives, the study uses thematic analysis with multiple coders. Results Overall, case managers understand supportive housing as being a treatment program but predominantly characterize treatment as medication management. The following themes emerged: believing medication to be the key to success in the program, persuading residents to take medication, and questioning the utility of the program for residents who were not medication adherent. Conclusions Case managers understand supportive housing to be a treatment program; however, given the external constraints and their own beliefs about mental illness, case managers often equate treatment with taking medication. Study findings demonstrate the need to train case managers about mental health recovery and integrated health care. The findings also have implications for policies that tie housing to services. PMID:28163830

Racial disparities in prescription drug use for mental illness among population in US.

PubMed

Han, Euna; Liu, Gordon G

2005-09-01

Racial minorities are a rapidly growing portion of the US population. Research suggests that racial minorities are more vulnerable to mental illness due to risk factors, such as higher rates of poverty. Given that the burden of mental illnesses is significant, equal likelihood of mental health services utilization is important to reduce such burden. Racial minorities have been known to use mental health services less than Whites. However, it is unclear whether racial disparity in prescription drug use for mental illnesses exists in a nationally representative sample. For a valid estimation of prescription drug use patterns, the characteristic in the distribution of prescription drug use should be accounted for in the estimation model. This study is intended to document whether there was a disparity in psychiatric drug use in both extensive and intensive margins between Whites and three racial minorities: Blacks, Hispanics, and Asian-Indians. The study looked at several specified mental illnesses, controlling for underlying health status and other confounding factors. Secondary data analysis was conducted using the multiyear Medical Expenditure Panel Survey (MEPS), a nationally representative panel sample from 1996 through 2000. This analysis provides estimates of the actual expenditure on prescription drug use for people with specified mental illnesses for this study, based on comparison of Whites and other racial minorities. We derived the estimates from the two-part model, a framework that adjusts the likelihood of using prescription drugs for the specified mental illnesses while estimating the total actual expenditures on prescription drugs among the users. This study found that Blacks, Hispanics, and Asian-Indians were less likely than Whites to use prescription drugs by 8.3, 6.1 and 23.6 percentage points, respectively, holding other factors constant in the sample, with at least one of the specified mental illnesses. The expenditure on prescription drugs for the specified mental illnesses differs between each of racial minorities (Blacks, Hispanics, and Asian-Indians) and Whites even after adjusting for the different likelihood of using those prescription drugs. Blacks, Hispanics, and Asian-Indians with the specified mental illnesses were estimated to spend 606.53 US dollars, 9.83 US dollars and 179.60 US dollars less per year, respectively, on their actual prescription drugs than Whites. This study concludes that three racial minorities: Blacks, Hispanics, and Asian-Indians, with the specified mental illnesses are less likely to use psychiatric drugs than Whites. Among users, racial minorities use less psychiatric drugs than Whites in terms of actual spending on those drugs. There is a need to focus on a program to reach out to racial minorities with a diagnosis of mental illnesses, and this program should consider the cultural specificity of each minority group regarding mental illnesses. In the development of mental health policy, it is crucial to understand the underlying non-socioeconomic factors which may significantly determine the access to mental health service. Also, education programs or other outreach programs for racial minorities are necessary to understand the different distribution of mental health services for racial minorities. Future research should examine the causes for racial disparity in the use of prescription drugs for mental illness both in the extensive and intensive margins. An in-depth analysis is needed to map out the attributes for the observed disparity between Whites and racial minorities in mental health service use.

Consumer-operated service program members' explanatory models of mental illness and recovery.

PubMed

Hoy, Janet M

2014-10-01

Incorporating individuals' understandings and explanations of mental illness into service delivery offers benefits relating to increased service relevance and meaning. Existing research delineates explanatory models of mental illness held by individuals in home, outpatient, and hospital-based contexts; research on models held by those in peer-support contexts is notably absent. In this article, I describe themes identified within and across explanatory models of mental illness and recovery held by mental health consumers (N = 24) at one peer center, referred to as a consumer-operated service center (COSP). Participants held explanatory models inclusive of both developmental stressors and biomedical causes, consistent with a stress-diathesis model (although no participant explicitly referenced such). Explicit incorporation of stress-diathesis constructs into programming at this COSP offers the potential of increasing service meaning and relevance. Identifying and incorporating shared meanings across individuals' understandings of mental illness likewise can increase relevance and meaning for particular subgroups of service users. © The Author(s) 2014.

Policy reform dilemmas in promoting employment of persons with severe mental illness.

PubMed

Noble, J H

1998-06-01

Recent evaluations by the U.S. General Accounting Office and the National Alliance for the Mentally Ill of reemployment efforts of the federal-state vocational rehabilitation program found that services offered by state vocational rehabilitation agencies do not produce long-term earnings for clients with emotional or physical disabilities. This paper examines reasons for these poor outcomes and the implications of recent policy reform recommendations. Congress must decide whether to take action at the federal level to upgrade programs affecting persons with severe mental illnesses or to continue to rely on state decision making. The federal-state program largely wastes an estimated $490 million annually on time-limited services to consumers with mental illnesses. Rechanneled into a variety of innovative and more appropriate integrated services models, the money could buy stable annual vocational rehabilitation funding for 62,000 to 90,000 consumers with severe mental illnesses. Larger macrosystem problems involve the dynamics of the labor market that limit job opportunities and the powerful work disincentives for consumers with severe disabilities now inherent in Social Security Disability Insurance, Supplemental Security Income, Medicare, and Medicaid.

Review of mental-health-related stigma in Japan.

PubMed

Ando, Shuntaro; Yamaguchi, Sosei; Aoki, Yuta; Thornicroft, Graham

2013-11-01

The aim of this study is to understand the nature and characteristics of mental-health-related stigma among Japanese people. We searched relevant studies in English or Japanese published since 2001 using MEDLINE and PsycINFO, and found 19 studies that examined mental-health-related stigma in Japan. Regarding knowledge about mental illness, reviewed studies showed that in the Japanese general population, few people think that people can recover from mental disorders. Psychosocial factors, including weakness of personality, are often considered the cause of mental illness, rather than biological factors. In addition, the majority of the general public in Japan keep a greater social distance from individuals with mental illness, especially in close personal relationships. Schizophrenia is more stigmatized than depression, and its severity increases the stigmatizing attitude toward mental illness. The literature also showed an association between more direct social contact between health professionals and individuals with mental illness and less stigmatization by these professionals. Less stigmatization by mental health professionals may be associated with accumulation of clinical experience and daily contact with people who have mental illness. Stigmatizing attitudes in Japan are stronger than in Taiwan or Australia, possibly due to institutionalism, lack of national campaigns to tackle stigma, and/or society's valuing of conformity in Japan. Although educational programs appear to be effective in reducing mental-health-related stigma, future programs in Japan need to address problems regarding institutionalism and offer direct social contact with people with mental illness. © 2013 The Authors. Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology.

Web-Based Cognitive Remediation Improves Supported Employment Outcomes in Severe Mental Illness: Randomized Controlled Trial.

PubMed

Harris, Anthony Wf; Kosic, Tanya; Xu, Jean; Walker, Chris; Gye, William; Redoblado Hodge, Antoinette

2017-09-20

Finding work is a top priority for most people; however, this goal remains out of reach for the majority of individuals with a severe mental illness (SMI) who remain on benefits or are unemployed. Supported employment (SE) programs aimed at returning people with a severe mental illness to work are successful; however, they still leave a significant number of people with severe mental illness unemployed. Cognitive deficits are commonly found in SMI and are a powerful predictor of poor outcome. Fortunately, these deficits are amenable to treatment with cognitive remediation therapy (CRT) that significantly improves cognition in SMI. CRT combined with SE significantly increases the likelihood of individuals with severe mental illness obtaining and staying in work. However, the availability of CRT is limited in many settings. The aim of this study was to examine whether Web-based CRT combined with a SE program can improve the rate return to work of people with severe mental illness. A total of 86 people with severe mental illness (mean age 39.6 years; male: n=55) who were unemployed and who had joined a SE program were randomized to either a Web-based CRT program (CogRem) or an Internet-based control condition (WebInfo). Primary outcome measured was hours worked over 6 months post treatment. At 6 months, those participants randomized to CogRem had worked significantly more hours (P=.01) and had earned significantly more money (P=.03) than those participants randomized to the WebInfo control condition. No change was observed in cognition. This study corroborates other work that has found a synergistic effect of combining CRT with a SE program and extends this to the use of Web-based CRT. The lack of any improvement in cognition obscures the mechanism by which an improved wage outcome for participants randomized to the active treatment was achieved. However, the study substantially lowers the barrier to the deployment of CRT with other psychosocial interventions for severe mental illness. Australian and New Zealand Clinical Trials Registry (ANZCTR) 12611000849998; http://www.anzctr.org.au/TrialSearch.aspx?searchTxt=12611000849998&isBasic=True (Archived by WebCite at http://www.webcitation.org/6sMKwpeos). ©Anthony WF Harris, Tanya Kosic, Jean Xu, Chris Walker, William Gye, Antoinette Redoblado Hodge. Originally published in JMIR Mental Health (http://mental.jmir.org), 20.09.2017.

Research protections for diverted mentally ill individuals: should they be considered prisoners?

PubMed

Amory Carr, W; Amrhein, Charles; Dery, Ryna

2011-01-01

The number of diversion programs for the mentally ill has increased dramatically over the past decade. These programs serve the valuable goal of reducing the growing population of incarcerated mentally ill persons by providing supervised community treatment. Research within these programs, critical for improving outcomes for these vulnerable individuals, is complicated by the fact that participants may have legal statuses which carry significant coercive leverage. In this way their ability to freely consent to research may be limited. In this paper, the authors describe the practice of diversion and review relevant research on coercion, informed consent and decisional capacity among the mentally ill and imprisoned. Current legal protections for prisoners are then discussed in the light of a recent proposal to broaden the legal definition of "prisoner" for research purposes to include community corrections populations, thus including diverted individuals. Copyright © 2011 John Wiley & Sons, Ltd. 2011 John Wiley & Sons, Ltd.

Extermination of the Jewish mentally-ill during the Nazi era--the "doubly cursed".

PubMed

Strous, Rael

2008-01-01

In Nazi Germany, physicians initiated a program of sterilization and euthanasia directed at the mentally-ill and physically disabled. Relatively little is known regarding the fate of the Jewish mentally-ill. Jewish mentally-ill were definitely included and targeted and were among the first who fell victim. They were systematically murdered following transfer as a specialized group, as well as killed in the general euthanasia program along with non-Jewish mentally ill. Their murder constituted an important link between euthanasia and the Final Solution. The targeting of the Jewish mentally-ill was comprised of four processes including public assistance withdrawal, hospital treatment limitations, sterilization and murder. Jewish "patients" became indiscriminate victims not only on the basis of psychiatric diagnosis, but also on the basis of race. The killing was efficiently coordinated with assembly in collection centers prior to being transferred to their deaths. The process included deceiving Jewish patients' family members and caregivers in order to extract financial support long after patients had been killed. Jewish patients were targeted since they were helpless and considered the embodiment of evil. Since nobody stood up for the Jews, the Nazis could treat the Jewish patients as they saw fit. Several differences existed between euthanasia of Jews and non-Jews, among which the Jewish mentally-ill were killed regardless of work ability, hospitalization length or illness severity. Furthermore, there was discrimination in the process leading up to killing (overcrowding, less food). For the Nazis, Jewish mentally-ill patients were unique among victims in that they embodied both "hazardous genes" and "racial toxins." For many years there has been silence relating to the fate of the Jewish mentally-ill. This deserves to be corrected.

Attitudes of Social Distance and Social Responsibility for Mental Illness: A Comparison of Teachers and the General Public

ERIC Educational Resources Information Center

Bentz, W. Kenneth; And Others

1970-01-01

The data suggests that much still must be done to instill a sense of social responsibility for mental illness in the community. The attitudes and feelings of the community regarding social responsibility for cause and cure of mental illness will be crucial in success or failure of programs. (Author)

Building on mental health training for law enforcement: strengthening community partnerships.

PubMed

Campbell, Jorien; Ahalt, Cyrus; Hagar, Randall; Arroyo, William

2017-09-11

Purpose The purpose of this paper is to describe the current state of law enforcement training related to the high number of interactions with persons with mental illness, and to recommend next steps in preparing law enforcement to effectively meet this challenge. Design/methodology/approach The authors reviewed the current literature on relevant law enforcement training programs, focusing primarily on crisis intervention team (CIT) training, and used the case example of California to identify opportunities to improve and enhance law enforcement preparedness for the challenge of responding to persons with mental illness. Findings Broad-based community partnerships working together to develop programs that meet the local needs of both those with mental illness and law enforcement, the availability of mental health treatment centers with no-refusal policies, and a coordinating person or agency to effectively liaise among stakeholders are critical enhancements to CIT training. Originality/value As increasing attention is paid to adverse interactions between police and vulnerable populations, this paper identifies policies that would build on existing training programs to improve police responses to persons with mental illness.

Integrating physical activity into mental health services for persons with serious mental illness.

PubMed

Richardson, Caroline R; Faulkner, Guy; McDevitt, Judith; Skrinar, Gary S; Hutchinson, Dori S; Piette, John D

2005-03-01

This article reviews evidence supporting the need for interventions to promote physical activity among persons with serious mental illness. Principles of designing effective physical activity interventions are discussed along with ways to adapt such interventions for this population. Individuals with serious mental illness are at high risk of chronic diseases associated with sedentary behavior, including diabetes and cardiovascular disease. The effects of lifestyle modification on chronic disease outcomes are large and consistent across multiple studies. Evidence for the psychological benefits for clinical populations comes from two meta-analyses of outcomes of depressed patients that showed that effects of exercise were similar to those of psychotherapeutic interventions. Exercise can also alleviate secondary symptoms such as low self-esteem and social withdrawal. Although structured group programs can be effective for persons with serious mental illness, especially walking programs, lifestyle changes that focus on accumulation of moderate-intensity activity throughout the day may be most appropriate. Research suggests that exercise is well accepted by people with serious mental illness and is often considered one of the most valued components of treatment. Adherence to physical activity interventions appears comparable to that in the general population. Mental health service providers can provide effective, evidence-based physical activity interventions for individuals with serious mental illness.

The correlates of stigma toward mental illness among Jordanian patients with major depressive disorder.

PubMed

Rayan, Ahmad; Mahroum, Maryam Husnee; Khasawneh, Aws

2018-04-01

This study aims to assess the correlates of stigma toward mental illness among patients diagnosed with major depressive disorder (MDD). One hundred and sixty one Jordanian outpatients suffering from MDD completed the study. Participants completed the demographic questionnaire, the Center for Epidemiological Studies for the intensity of depression, and the Devaluation-Discrimination Scale to assess stigma. Participants reported a moderate level of perceived stigma toward mental illness. Age, perceived pain, the number of relapses, and severity of depressive symptoms were significantly correlated with stigma toward mental illness among the study sample. The severity of depressive symptoms was the strongest correlate of stigma toward mental illness. Factors associated with stigma toward mental illness should be carefully considered when implementing anti-stigma programs for patients. © 2017 Wiley Periodicals, Inc.

Implementing residential treatment for prison inmates with mental illness.

PubMed

O'Connor, Frederica W; Lovell, David; Brown, Linda

2002-10-01

There is evidence that mentally ill offenders (MIOs) in prisons commit more infractions, serve longer sentences, and are more likely to be victimized than inmates who are not mentally ill. Humanistic and prison management interests are served if intervention programs minimize symptoms and promote coping and other functional skills. A collaborative agreement was established between Washington State Department of Corrections and a consortium of University of Washington faculty to mutually develop a prison-based program of clinical management and psychoeducation for MIOs. The resulting program is described, along with rationale, planning processes, implementation, and initial evaluation. Most aspects of the planned program are in place. Clinical and behavioral progress by inmates following program participation has been documented. Issues concerning treatment program implementation in prisons are discussed. Copyright 2002, Elsevier Science (USA). All rights reserved.

Prevalence of Criminal Thinking among State Prison Inmates with Serious Mental Illness

PubMed Central

Fisher, William H.; Duan, Naihua; Mandracchia, Jon T.; Murray, Danielle

2010-01-01

To examine the prevalence of criminal thinking in mentally disordered offenders, incarcerated male (n = 265) and female (n = 149) offenders completed measures of psychiatric functioning and criminal thinking. Results indicated 92% of the participants were diagnosed with a serious mental illness, and mentally disordered offenders produced criminal thinking scores on the Psychological Inventory of Criminal Thinking Styles (PICTS) and Criminal Sentiments Scale-Modified (CSS-M) similar to that of non-mentally ill offenders. Collectively, results indicated the clinical presentation of mentally disordered offenders is similar to that of psychiatric patients and criminals. Implications are discussed with specific focus on the need for mental health professionals to treat co-occurring issues of mental illness and criminality in correctional mental health treatment programs. PMID:19551496

Recidivism of Offenders with Mental Illness Released from Prison to an Intensive Community Treatment Program

ERIC Educational Resources Information Center

Theurer, Gregory; Lovell, David

2008-01-01

An intensive case management treatment program for mentally ill offenders (MIOs) is outlined, and subsequent recidivism of participants is evaluated. Features of the program and its development are discussed. Sixty-four (64) participants released from state prison between 1998 and 2003 were matched with a group of MIOs released earlier on eight…

Religious Coping Among Adults Caring for Family Members with Serious Mental Illness.

PubMed

Pearce, Michelle J; Medoff, Deborah; Lawrence, Ryan E; Dixon, Lisa

2016-02-01

This cross-sectional study investigated the use of religious coping strategies among family members of adults with serious mental illness. A sample of 436 individuals caring for a family member with serious mental illness were recruited into a randomized clinical trial for the National Alliance on Mental Illness Family to Family Education Program. Relationships are reported between religious coping and caregiving, care recipient, and mental health services outcomes. Religious coping was associated with more objective caregiving burden, greater care recipient need, less mental health knowledge, and less receipt of mental health services after adjusting for non-religious types of coping. At the same time, religious coping was associated with a positive caregiving experience and greater religious support. Religious coping plays an important role for many caregivers of persons with serious mental illness. Caregivers who use more religious coping may have an especially high need for mental health education and mental health services.

Mental health literacy among caregivers of persons with mental illness: A descriptive survey.

PubMed

Poreddi, Vijayalakshmi; BIrudu, Raju; Thimmaiah, Rohini; Math, Suresh Bada

2015-01-01

Despite of growing evidence of mental disorders in developing countries, research on mental health literacy is limited from India. To examine mental health literacy among caregivers of persons with mental illness. A cross-sectional descriptive survey was carried out among 161 randomly selected caregivers of persons with mental illness at outpatient department of a tertiary care centre. Data was collected through face to face interview using a structured questionnaire. Regarding the causes of mental illness, a majority agreed that genetic inheritance (69%), substance abuse (64%) and brain disease (59.6%) are main factors for developing mental illness. Although more than two-thirds agreed that anyone could suffer from mental illness, 61.5% also agreed that people with mental health problems are largely to blame for their condition. The majority of the participants also agreed that mentally ill are not able to maintain friendships (45.9%), are dangerous (54%), and not capable to work (59.1%). Just over half (55.9%) of the participants would not want people to know if they had a mental illness and nearly half of them also expressed that they would feel ashamed if a family member had a mental illness. Based on the findings of the present study researchers suggest that there is an urgent need to educate and change the attitudes of caregivers through mental health literacy programs specifically designed for them.

Annual Statistical Report, 1988. Client Assistance Program, Protection & Advocacy System for Persons with Mental Illness, Protection & Advocacy System for Persons with Developmental Disabilities.

ERIC Educational Resources Information Center

National Association of Protection and Advocacy Systems, Washington, DC.

The report summarizes: (1) 1988 program data for state Protection and Advocacy Systems for persons with developmental disabilities and persons with mental illness, and (2) 1988 program data for Client Assistance Programs. The data are derived from reports from 56 states and territories. In addition to nationwide data totals, each state's…

Can Completing a Mental Health Nursing Course Change Students' Attitudes?

PubMed

Hastings, Todd; Kroposki, Margaret; Williams, Gail

2017-05-01

Nursing program graduates rarely choose mental health nursing as a career. A quasi-experimental study was conducted to examine attitudes of 310 nursing students towards persons with mental illness. Students completed surveys on the first and last days of their program's psychiatric mental health nursing course. The pre- and post-test survey analysis indicated that students improved their attitude, knowledge and preparedness to care for persons with mental illness. However, students maintained little interest in working as a mental health nurse. Modifications in mental health nursing courses could be made to improve students' interest in choosing a career in mental health nursing.

[A mental health awareness anti-stigma program including user-trainers has a significant impact on knowledge, beliefs and attitudes of job centre professionals in Paris].

PubMed

Jouet, E; Moineville, M; Favriel, S; Leriche, P; Greacen, T

2014-04-01

Developing programs and actions to fight stigma and discrimination against people living with mental disorders is a priority both internationally and in France. Involving mental health service users in these anti-stigma programs has proved to be a key element for effective programs. The present study evaluates the impact of user-trainers in an anti-stigma campaign with job counselors on their knowledge, beliefs, and desire for social distance with regard to mental illness and the mentally ill. Eighty-nine professionals participated in eight mental health awareness days from December 2008 to June 2009. Each training day was built around two pedagogical units: firstly, a psychiatrist providing a theoretical overview of mental illness and care and secondly, user-trainers describing their point of view on mental illness and exchanging with participants. A questionnaire administered at the beginning and at the end of the mental health awareness day assessed the impact of the day on participants' knowledge, beliefs, and desire for social distance. Answers to open questions were evaluated using thematic qualitative analysis. The intervention had statistically significant positive effects on all three training objectives: knowledge, beliefs and desire for social distance. Analysis of qualitative data confirmed participants' need for information and training with regard to providing support to clients with mental health problems; participants frequently attributed their improved self-confidence at the end of the day with regard to providing job coaching for this population group to the presence of user-trainers. A mental health awareness day using mental health service users and psychiatrists as trainers had significant positive effects in terms of reducing stigma with regard to people with mental illness. Further research is needed to understand whether the impact of such awareness approaches can be maintained in everyday professional practice over time. Copyright © 2013 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Promoting Nature-Based Activity for People With Mental Illness Through the US “Exercise Is Medicine” Initiative

PubMed Central

Jette, Shannon

2016-01-01

Nature-based physical activity programming (e.g., countryside walks, hiking, horseback riding) has been found to be an effective way to help improve the health of people with mental illness. Exercise referral initiatives, whereby health practitioners prescribe exercise in an attempt to prevent or treat chronic illnesses, have helped make such nature-based activities accessible to this population in the United Kingdom and Australia; however, there is a dearth of research related to the most prominent exercise referral program in the United States: Exercise is Medicine. Taking into account the barriers to physical activity faced by people with mental illness, we explore how nature-based programming for this population might be mobilized in the United States through the growing Exercise is Medicine initiative. PMID:26985618

Changing the tide: stigma, school youth, and mental illness.

PubMed

Snyder, Marsha

2015-03-01

Schools are in a key position not only to identify mental health concerns early but to address issues of stigma that prevent both children and their parents from seeking help with mental illness. Stigma associated with mental illness perpetuates isolative behavior and poor engagement within the academic community. Programs within schools that address mental health issues and support open communication with families can reduce the pain and isolation that is often the experience of youth with undiagnosed and untreated mental and emotional disorders. © 2014 The Author(s).

An Evaluation of the NAMI Basics Program

ERIC Educational Resources Information Center

Brister, Teri; Cavaleri, Mary A.; Olin, S. Serene; Shen, Sa; Burns, Barbara J.; Hoagwood, Kimberly E.

2012-01-01

This brief report describes results from an evaluation of NAMI Basics, a peer-delivered family education program for family caregivers of children and adolescents with mental illness. Over six classes, family members are given information (e.g. education about mental illness and treatments), skills training (e.g. family communication skills) and…

Youth mental health first aid: a description of the program and an initial evaluation

PubMed Central

2011-01-01

Background Adolescence is the peak age of onset for mental illness, with half of all people who will ever have a mental illness experiencing their first episode prior to 18 years of age. Early onset of mental illness is a significant predictor for future episodes. However, adolescents and young adults are less likely than the population as a whole to either seek or receive treatment for a mental illness. The knowledge and attitudes of the adults in an adolescent's life may affect whether or not help is sought, and how quickly. In 2007, the Youth Mental Health First Aid Program was launched in Australia with the aim to teach adults, who work with or care for adolescents, the skills needed to recognise the early signs of mental illness, identify potential mental health-related crises, and assist adolescents to get the help they need as early as possible. This paper provides a description of the program, some initial evaluation and an outline of future directions. Methods The program was evaluated in two ways. The first was an uncontrolled trial with 246 adult members of the Australian public, who completed questionnaires immediately before attending the 14 hour course, one month later and six months later. Outcome measures were: recognition of schizophrenia or depression; intention to offer and confidence in offering assistance; stigmatising attitudes; knowledge about adolescent mental health problems and also about the Mental Health First Aid action plan. The second method of evaluation was to track the uptake of the program, including the number of instructors trained across Australia to deliver the course, the number of courses they delivered, and the uptake of the YMHFA Program in other countries. Results The uncontrolled trial found improvements in: recognition of schizophrenia; confidence in offering help; stigmatising attitudes; knowledge about adolescent mental health problems and application of the Mental Health First Aid action plan. Most results were maintained at follow-up. Over the first 3 years of this program, a total of 318 instructors were trained to deliver the course and these instructors have delivered courses to 10,686 people across all states and territories in Australia. The program has also spread to Canada, Singapore and England, and will spread to Hong Kong, Sweden and China in the near future. Conclusions Initial evaluation suggests that the Youth Mental Health First Aid course improves participants' knowledge, attitudes and helping behaviour. The program has spread successfully both nationally and internationally. Trial registration ACTRN12609000033246 PMID:21272345

Effectiveness of Universal School-Based Mental Health Awareness Programs among Youth in the United States: A Systematic Review

ERIC Educational Resources Information Center

Salerno, John P.

2016-01-01

Background: Stigmatizing attitudes toward mental illness and low mental health literacy have been identified as links to social adversity, and barriers to seeking and adhering to treatment among adolescents suffering from mental illness. Prior research has found that it is possible to improve these outcomes using school-based mental health…

Common sense model of mental illness: Understanding the impact of cognitive and emotional representations of mental illness on recovery through the mediation of self-stigma.

PubMed

Chan, Randolph C H; Mak, Winnie W S

2016-12-30

The present study applied the common sense model to understand the underlying mechanism of how cognitive and emotional representations of mental illness among people in recovery of mental illness would impact their endorsement of self-stigma, and how that would, in turn, affect clinical and personal recovery. A cross-sectional survey was administered to 376 people in recovery. Participants were recruited from seven public specialty outpatient clinics and substance abuse assessment clinics across various districts in Hong Kong. They were asked to report their perception towards their mental illness, self-stigma, symptom severity, and personal recovery. The results of structural equation modeling partially supported the hypothesized mediation model indicating that controllability, consequences, and emotional concern of mental illness, but not cause, timeline, and identity, were associated with self-stigma, which was subsequently negatively associated with clinical and personal recovery. The present study demonstrated the mediating role of self-stigma in the relationship between individuals' illness representations towards their mental illness and their recovery. Illness management programs aimed at addressing the maladaptive mental illness-related beliefs and emotions are recommended. Implications on developing self-directed and empowering mental health services are discussed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

42 CFR 483.134 - Evaluating whether an individual with mental illness requires specialized services (PASARR/MI).

Code of Federal Regulations, 2012 CFR

2012-10-01

... illness requires specialized services (PASARR/MI). 483.134 Section 483.134 Public Health CENTERS FOR... illness requires specialized services (PASARR/MI). (a) Purpose. The purpose of this section is to identify... this part, needs a specialized services program for mental illness as defined in § 483.120. (b) Data...

42 CFR 483.134 - Evaluating whether an individual with mental illness requires specialized services (PASARR/MI).

Code of Federal Regulations, 2014 CFR

2014-10-01

... illness requires specialized services (PASARR/MI). 483.134 Section 483.134 Public Health CENTERS FOR... illness requires specialized services (PASARR/MI). (a) Purpose. The purpose of this section is to identify... this part, needs a specialized services program for mental illness as defined in § 483.120. (b) Data...

Is the Partners in Recovery program connecting with the intended population of people living with severe and persistent mental illness? What are their prioritised needs?

PubMed

Hancock, Nicola; Smith-Merry, Jennifer; Gillespie, James A; Yen, Ivy

2017-10-01

Objective The Partners in Recovery (PIR) program is an Australian government initiative designed to make the mental health and social care sectors work in more coordinated ways to meet the needs of those with severe and complex mental illness. Herein we reflect on demographic data collected during evaluation of PIR implementation in two Western Sydney sites. The aims of the present study were to: (1) explore whether two Sydney-based PIR programs had recruited their intended population, namely people living with severe and persistent mental illness; and (2) learn more about this relatively unknown population and their self-identified need priorities. Methods Routinely collected initial client assessment data were analysed descriptively. Results The data suggest that the two programs are engaging the intended population. The highest unmet needs identified included psychological distress, lack of daytime activities and company, poor physical health and inadequate accommodation. Some groups remain hard to connect, including people from Aboriginal and other culturally diverse communities. Conclusions The data confirm that the PIR program, at least in the two regions evaluated, is mostly reaching its intended audience. Some data were being collected inconsistently, limiting the usefulness of the data and the ability to build on PIR findings to develop ongoing support for this population. What is known about the topic? PIR is a unique national program funded to engage with and address the needs of Australians living with severe and persistent mental illness by facilitating service access. What does this paper add? This paper reports on recruitment of people living with severe and persistent mental illness, their need priorities and data collection. These are three central elements to successful roll-out of the much anticipated mental health component of the National Disability Insurance Scheme, as well as ongoing PIR operation. What are the implications for practitioners? Active recruitment, exploration of self-reported need priorities and routine outcome measurement are essential yet challenging work practices when working with people living with severe and persistent mental illness.

Ending self-stigma: pilot evaluation of a new intervention to reduce internalized stigma among people with mental illnesses.

PubMed

Lucksted, Alicia; Drapalski, Amy; Calmes, Christine; Forbes, Courtney; DeForge, Bruce; Boyd, Jennifer

2011-01-01

This study evaluated "Ending Self-Stigma" (ESS), a structured 9-session group intervention to help people with serious mental illnesses reduce internalized stigma. Participants from two Veterans Administration mental health sites were assessed before and after the intervention regarding their levels of internalized stigma, empowerment, recovery orientation, perceived social support, and beliefs about societal stigma. Internalized stigma significantly decreased, and perceived social support and recovery orientation significantly increased. "Ending Self-Stigma" is the first of its kind and may be a valuable intervention for reducing internalized stigma among people with serious mental illnesses, suitable for both professionally-delivered psychiatric rehabilitation programs and consumer-led programs and services.

42 CFR 51.43 - Denial or delay of access.

Code of Federal Regulations, 2010 CFR

2010-10-01

... APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Access to Records..., or other legal representative of an individual with mental illness. Access to facilities, records or...

A collaboration of student nurse coaches and students with mental illnesses in a college preparation project.

PubMed

Hsieh, Nancye L

2010-01-01

With refined diagnostic tools, earlier recognition, new pharmacological and other treatment modalities, individuals living with mental illnesses are able to experience considerable recovery. Some individuals require support and guidance to build confidence and to manage in everyday situations. Previous to their illness, many had been functioning and able to meet their needs in most aspects of their lives, including academics, but, following illness, lacked confidence or skill to continue their education. This pilot program was designed to socialize students with a mental illness to life at college. To develop the pilot concept, college departments including nursing faculty and community mental health personnel collaborated together. Potential students attended informational sessions where those interested, applied for entry into the pilot. Each student was paired with a coach, a third year nursing student, with whom they established and evaluated goals geared towards registering independently in a college course the following semester. Evaluation of the program was measured in terms of attendance, registration in a college course for the following semester or job readiness, and focus group evaluation sessions. By the end of the semester, 12 of the 13 students completed the program. With support and guidance of their coaches, students gained confidence, developed a social support network and learned skills needed to be able to navigate the college system. This type of college preparation program is effective in assisting students with mental illness to access college courses and it is recommended that there be further similar programs offered as an orientation at the college level for students with mental illness in preparation for their registration and attendance at college. To minimize cost factors and gain administrative support, practitioners wishing to replicate this study would do well to consider sources of funding, as well as resource personal or volunteers in order to keep costs to a minimum.

Transitions: A Mental Health Literacy Program for Postsecondary Students

ERIC Educational Resources Information Center

Potvin-Boucher, Jacqueline; Szumilas, Magdalena; Sheikh, Tabinda; Kutcher, Stan

2010-01-01

Enhancement of mental health literacy is a mental health promotion strategy that may be effective at destigmatizing mental illness and increasing self-seeking behavior. Transitions is a mental health literacy program intended to heighten students' awareness and discussion of mental health problems and promote help-seeking behaviors. Transitions…

Art Making as a Mental Health Recovery Tool for Change and Coping

ERIC Educational Resources Information Center

Van Lith, Theresa

2015-01-01

The intrinsic benefits of art making may be implicated in how and why people with mental illness turn to art therapy to aid their recovery. In this longitudinal multiple case study adult participants (N = 12) with severe and ongoing mental illness were recruited through their involvement in diverse community mental health art therapy programs. An…

Wellness intervention for patients with serious and persistent mental illness.

PubMed

Hoffmann, Vicki Poole; Ahl, Jonna; Meyers, Adam; Schuh, Leslie; Shults, Kenneth S; Collins, Dorothy M; Jensen, Lara

2005-12-01

Weight gain and obesity that emerge during psychopharmacologic treatment are prevalent in persons with serious and persistent mental illness. Obesity is difficult to reverse, but behavioral programs involving diet and exercise are sometimes successful. Patients with serious and persistent mental illness living in the community were enrolled voluntarily into the Solutions for Wellness Personalized Program. Participants completed an enrollment survey that provided information for the creation of an individualized management plan that included nutrition, exercise, stress management, and sleep improvement components. Weight, body mass index (BMI, kg/m(2)), behavior, and attitudes were assessed at baseline (enrollment) and monthly for 6 months. During the period of July 1, 2002, through June 30, 2003, 7188 patients with serious and persistent mental illness had enrolled in the program, and 83% were either overweight or obese. Follow-up survey responses taken at 6-month endpoint from finishers (N = 1422) indicated that positive changes were made in diet (91%), exercise (85%), reduced stress (93.8%), and sleep (92.9%). Significant decreases in BMI were associated with changes in diet (p = .014) and exercise (p = .035). In addition, 97% of participants reported that they were at least somewhat confident in the ability to maintain lifestyle changes, and this confidence was significantly (p < .001) associated with reaching dietary and exercise goals. Patients suffering from serious and persistent mental illness may benefit from participating in wellness intervention programs.

Social and legal aspects of marriage in women with mental illness in India.

PubMed

Sharma, Indira; Tripathi, C B; Pathak, Abhishek

2015-07-01

The institution of marriage in Hindus is regulated by the prevailing social norms and the Hindu Marriage Act (HMA), 1955. Married women with mental illness are heavily discriminated. This paper examines the social and legal aspects of Hindu marriage in women with mental illness. The HMA, 1955 lays down the conditions for a Hindu marriage and also provides matrimonial reliefs: Nullity of marriage, restitution of conjugal rights, judicial separation and divorce. The application of the provisions of HMA in the setting mental illness is difficult and challenging. There is a wide gap between the legislative provisions of HMA, and societal value systems and attitudes towards marriage in Indian society. Societal norms are powerful and often override the legal provisions. The disparities are most glaring in the setting of mental illness in women. This is a reflection of social stigma for mental illness and patriarchal attitude towards women. Concerted efforts are needed to bridge the gap between the legislative provisions of HMA and societal value systems and attitudes toward marriage. Awareness programs regarding the nature and types of mental illness, advances in treatment and information about good outcome of severe mental illness will be helpful. Improvement in moral and religious values will overcome to some extent the negative attitudes and patriarchal mind set toward married women with mental illness.

Mental Health Systems in Scandinavia.

ERIC Educational Resources Information Center

Vail, David J.

The guidebook is introduced by general observations on the Scandinavian countries concerning history, social policy, medicine, mental health, and psychiatric diagnosis. Discussed individually for Norway, Sweden, and Denmark are the following areas: mental health programs and statistics; mental illness programs, regional, hospital, aftercare,…

Police encounters involving citizens with mental illness: use of resources and outcomes.

PubMed

Charette, Yanick; Crocker, Anne G; Billette, Isabelle

2014-04-01

Few studies have addressed use of resources in police interventions involving individuals with mental illness. The time police officers spend on interventions is a straightforward measure with significant administrative weight, given that it addresses human resource allocation. This study compared the characteristics of police interventions involving individuals with mental illness and a control sample of individuals without mental illness. A total of 6,128 police interventions in Montreal, Québec, were analyzed by using a retrospective analysis of police intervention logs from three days in 2006. Interventions involving citizens with (N=272) and without (N=5,856) mental illness were compared by reason for the intervention, the use of arrest, and the use of police resources. Police interventions involving individuals with mental illness were less likely than those involving individuals without mental illness to be related to more severe offenses. However, interventions for minor offenses were more likely to lead to arrest when they involved citizens with mental illness. Interventions for reasons of equal severity were twice as likely to lead to arrest if the citizen involved had a mental illness. After controlling for the use of arrest and the severity of the situation, the analysis showed that police interventions involving individuals with mental illness used 87% more resources than interventions involving individuals without mental illness. Future studies using administrative police data sets could investigate the use of resources and division of costs involved in new programs or partnerships to better address the interface of criminal justice and mental health care.

Prevention and mental illness: a new era for a healthier tomorrow.

PubMed

Buck, Steven

2010-07-01

The Department of Mental Health and Substance Abuse Services strives to provide the best possible care for Oklahoma communities through preventative programs and approaches such as QPR, Mental Health First Aid and mental health screenings. All of these techniques have been proven in providing adequate knowledge of risk factors in Oklahoma communities for mental health disorders and help to prevent those predisposed to mental illness from experiencing an onset of the disorder.

Identification and Analysis of Learning Preferences of Mentally Ill Adults in Rehabilitative Psychosocial Therapy at the Anderson Mental Health Center.

ERIC Educational Resources Information Center

Newman, Michael K.

A study identified and analyzed the learning preferences of 17 seriously and chronically mentally ill adults participating in the rehabilitative psychosocial therapy program at the Toxaway Church Site of the Anderson Mental Health Center. Staff perceived as boring and unfocused the traditional treatment approach that relied mainly upon…

Mental health literacy among secondary school students in North and Central Uganda: a qualitative study

PubMed Central

Okello, Elialilia S.; Abbo, Catherine; Muhwezi, Wilson W.; Akello, Grace; Ovuga, Emilio

2015-01-01

Objectives There has been limited effort to explore young people’s perceptions about mental illness in Uganda. For mental health programs targeting young people to succeed, it is important to incorporate their understanding of mental illness, their perceptions about causes of mental illness and their attitudes about mentally ill people. The objective of this study was to explore the mental health of young people in secondary schools in Northern and Central Uganda. Subjects and Methods This was a qualitative study where 24 focus group discussions (FGDs) were held with young people in secondary schools. Respondents aged 14-24 years were purposively selected from 4 secondary schools in the two regions. During the FGDs, young people’s perceptions and understanding of three areas listed below were explored: meaning of mental health/mental illness; causes of mental illness and attitudes toward mental illness. Data management and analysis was done with the help of Atlas.ti, a-qualitative-analysis software. Thematic analysis approach was employed. Results FGD participants used concepts like a sound and normal mind, right thinking, normal behavior and normal thoughts to define mental health. Mental illness on the other hand was defined as loss of sense of reality, malfunctioning of the brain, impaired thinking and bizarre behavior. Young people attributed mental illness to; substance abuse (Marijuana, alcohol), witnessing traumatic events (seeing ones your relatives being killed, or being forced to participate in killing-frequently mentioned by young people in Northern Uganda); witch craft, effect of physical illness e.g. HIV/epilepsy, thinking too much, accidents and genetic explanations. They had mixed opinions about interacting with mentally ill individuals. Unpredictability and dangerousness were known to be a recurrent theme among people with negative views about mentally ill. Nonetheless, some FGD participants believed that the level of interaction with mentally ill persons depended on familiarity with mental illness and the severity of the symptoms. Similarly, there were mixed opinions regarding mental illness and work. Three main clusters of responses emerged. These were: i) “mentally ill people should not work”; ii) “mentally ill people should work but..”; iii) “mentally ill people should work like everyone else”. Conclusions Findings point to key gaps in the knowledge and attitudes of young people that need to be targeted by young-people-focused-interventions for mental health. In order for such interventions to succeed, young people must be able to recognize and respond appropriately to signs of distress, reduced functioning, and other early signs of poor mental health. PMID:26113883

Addressing Public Stigma and Disparities Among Persons With Mental Illness: The Role of Federal Policy

PubMed Central

Lucas, Stephen M.; Druss, Benjamin G.

2013-01-01

Stigma against mental illness is a complex construct with affective, cognitive, and behavioral components. Beyond its symbolic value, federal law can only directly address one component of stigma: discrimination. This article reviews three landmark antidiscrimination laws that expanded protections over time for individuals with mental illness. Despite these legislative advances, protections are still not uniform for all subpopulations with mental illness. Furthermore, multiple components of stigma (e.g., prejudice) are beyond the reach of legislation, as demonstrated by the phenomenon of label avoidance; individuals may not seek protection from discrimination because of fear of the stigma that may ensue after disclosing their mental illness. To yield the greatest improvements, antidiscrimination laws must be coupled with antistigma programs that directly address other components of stigma. PMID:23488484

Implications of Recovering for Mental Health Systems and Programs.

ERIC Educational Resources Information Center

Spaniol, LeRoy

This presentation outlines the implications of psychiatric disability recovery for mental health systems and programs. Schizophrenia and other serious psychiatric disabilities have been viewed as irreversible illnesses with increasing disability over time. Mental health program planning, policies, and practices have been developed and implemented…

The Health and Recovery Peer (HARP) Program: A Peer-Led Intervention to Improve Medical Self-Management for Persons with Serious Mental Illness

PubMed Central

Druss, Benjamin G.; Zhao, Liping; von Esenwein, Silke A.; Bona, Joseph R.; Fricks, Larry; Jenkins-Tucker, Sherry; Sterling, Evelina; DiClemente, Ralph; Lorig, Kate

2010-01-01

Objectives Persons with serious mental illnesses (SMI) have elevated rates of comorbid medical conditions, but may also face challenges in effectively managing those conditions. Methods The study team developed and pilot-tested the Health and Recovery Program (HARP), an adaptation of the Chronic Disease Self-Management Program (CDSMP) for mental health consumers. A manualized, six-session intervention, delivered by mental health peer leaders, helps participants become more effective managers of their chronic illnesses. A pilot trial randomized 80 consumers with one or more chronic medical illness to either the HARP program or usual care. Results At six month follow-up, participants in the HARP program had a significantly greater improvement in patient activation than those in usual care (7.7% relative improvement vs. 5.7% decline, p=0.03 for group*time interaction), and in rates of having one or more primary care visit (68.4% vs. 51.9% with one or more visit, p=0.046 for group*time interaction). Intervention advantages were observed for physical health related quality of life (HRQOL), physical activity, medication adherence, and, and though not statistically significant, had similar effect sizes as those seen for the CDSMP in general medical populations. Improvements in HRQOL were largest among medically and socially vulnerable subpopulations. Conclusions This peer-led, medical self-management program was feasible and showed promise for improving a range of health outcomes among mental health consumers with chronic medical comorbidities. The HARP intervention may provide a vehicle for the mental health peer workforce to actively engage in efforts to reduce morbidity and mortality among mental health consumers. PMID:20185272

Theoretical and Practical Considerations for Combating Mental Illness Stigma in Health Care.

PubMed

Ungar, Thomas; Knaak, Stephanie; Szeto, Andrew C H

2016-04-01

Reducing the stigma and discrimination associated with mental illness is becoming an increasingly important focus for research, policy, programming and intervention work. While it has been well established that the healthcare system is one of the key environments in which persons with mental illnesses experience stigma and discrimination there is little published literature on how to build and deliver successful anti-stigma programs in healthcare settings, towards healthcare providers in general, or towards specific types of practitioners. Our paper intends to address this gap by providing a set of theoretical considerations for guiding the design and implementation of anti-stigma interventions in healthcare.

The effects of news stories on the stigma of mental illness.

PubMed

Corrigan, Patrick W; Powell, Karina J; Michaels, Patrick J

2013-03-01

The media are often identified as partially responsible for increasing the stigma of mental illness through their negatively focused representations. For many years, training programs have educated journalists on how to report on mental illness to reduce stigma. This purpose of this study was to evaluate the benefits of reading a positive, neutral or a negative journalism article that discusses mental illness. Consenting adult participants were randomly assigned to read one of three published articles about recovery from mental illness, a dysfunctional public mental health system, or dental hygiene. The participants completed measures immediately before and after the intervention; the measures administered evaluated stigmatizing and affirming attitudes toward people with mental illness. Public stigma was assessed using the nine-item Attribution Questionnaire and the Stigma Through Knowledge Test (STKT). The STKT is a measure of mental illness stigma less susceptible to the impact of social desirability. Affirming attitudes represent public perceptions about recovery, empowerment, and self-determination, indicated as important to accepting and including people with psychiatric disabilities into society. Significant differences were observed between the articles on recovery and dysfunctional public mental health system, as well as the control condition, on the measures of stigma and affirming attitudes. The recovery article reduced stigma and increased affirming attitudes, whereas the dysfunctional public mental health system article increased stigma and decreased affirming attitudes. Not all journalistic stories have positive effects on attitudes about mental illness.

Dealing with mentally ill domestic violence perpetrators: A therapeutic jurisprudence judicial model.

PubMed

Winick, Bruce J; Wiener, Richard; Castro, Anthony; Emmert, Aryn; Georges, Leah S

2010-01-01

People suffering from mental illness are increasingly referred to the domestic violence court. Yet the typical diversion programs available, including batterer's intervention programs, are inappropriate for those with serious mental illness. As a result, the Miami-Dade Domestic Violence Court has developed a new approach for dealing with this population that applies mental health court techniques in domestic violence court. This article will describe and discuss this pioneering model. It also will situate this model within the context of other problem-solving courts and discuss how the court uses principles and approaches of therapeutic jurisprudence. The paper presents some preliminary data that describe the social and legal characteristics of 20 defendants in the Domestic Violence Mental Health Court followed over a two year period between 2005 and 2007. Copyright © 2010 Elsevier Ltd. All rights reserved.

Enrollment of Specialty Mental Health Clinics in a State Medicaid Program to Promote Physical Health Services

PubMed Central

Breslau, Joshua; Yu, Hao; Horvitz-Lennon, Marcela; Leckman-Westin, Emily; Scharf, Deborah M.; Connor, Kathryn; Finnerty, Molly T.

2016-01-01

OBJECTIVE To promote integrated physical health care for individuals with serious mental illness, the New York State Office of Mental Health (NYOMH) established regulations allowing specialty mental health clinics to provide Medicaid-reimbursable health monitoring (HM) and health physicals (HP). This paper examines clinics’ enrollment in this program to understand its potential to reach individuals with serious mental illness. METHODS Information on enrollment and clinic characteristics (N=500) were drawn from NYOMH administrative databases. Clinic enrollment in the HM/HP program was examined from the program’s first five years (2010–2015). Logistic regression models accounting for the clustering of multiple clinics within agencies were used to examine characteristics associated with enrollment. RESULTS Two-hundred ninety one of 500 clinics (58%) enrolled in the HM/HP program, potentially reaching 62.5% of all Medicaid enrollees with serious mental illness seen in specialty mental health clinics in the state. State-operated clinics were required to participate, and had 91.8% enrollment. Over half of hospital-affiliated and freestanding mental health clinics elected to enroll in the program (52.6% and 53.7% respectively). In adjusted models, enrollment was higher among freestanding clinics relative to hospital-affiliated clinics, higher in larger relative to smaller clinics, and higher in county-operated relative to private non-profit clinics. CONCLUSIONS The high level of enrollment in the HM/HP program indicates strong interest among mental health clinics in providing physical health care services. However, supplemental policies may be needed to extend the program to areas of the mental health system where barriers to physical health care services are highest. PMID:27524372

42 CFR 51.41 - Access to records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Access to Records, Facilities... individuals with mental illness: (1) An individual who is a client of the P&A system if authorized by that...) The individual, due to his or her mental or physical condition, is unable to authorize the P&A system...

Validating the Alcohol Use Disorders Identification Test with Persons Who Have a Serious Mental Illness

ERIC Educational Resources Information Center

O'Hare, Thomas; Sherrer, Margaret V.; LaButti, Annamaria; Emrick, Kelly

2004-01-01

Objective/Method: The use of brief, reliable, valid, and practical measures of substance use is critical for conducting individual assessments and program evaluation for integrated mental health-substance abuse services for persons with serious mental illness. This investigation examines the internal consistency reliability, concurrent validity,…

Group treatment for parents of the adult mentally ill.

PubMed

McLean, C S; Greer, K; Scott, J; Beck, J C

1982-07-01

Support and education groups for the families of the mentally ill have been in existence for at least 20 years. The authors describe a group treatment program established in 1979 for parents of chronically mentally ill individuals living in the community. The goal was to help parents become less overprotective, critical, and hostile so that clients would relapse less frequently and improve their social functioning during their time in the community. The groups provided parents with information and support. Some of the results of the groups include the implementation of new hospital procedures, more effective parenting, and a parent-initiated alliance on behalf of the mentally ill in the locality.

Social and legal aspects of marriage in women with mental illness in India

PubMed Central

Sharma, Indira; Tripathi, C. B.; Pathak, Abhishek

2015-01-01

The institution of marriage in Hindus is regulated by the prevailing social norms and the Hindu Marriage Act (HMA), 1955. Married women with mental illness are heavily discriminated. This paper examines the social and legal aspects of Hindu marriage in women with mental illness. The HMA, 1955 lays down the conditions for a Hindu marriage and also provides matrimonial reliefs: Nullity of marriage, restitution of conjugal rights, judicial separation and divorce. The application of the provisions of HMA in the setting mental illness is difficult and challenging. There is a wide gap between the legislative provisions of HMA, and societal value systems and attitudes towards marriage in Indian society. Societal norms are powerful and often override the legal provisions. The disparities are most glaring in the setting of mental illness in women. This is a reflection of social stigma for mental illness and patriarchal attitude towards women. Concerted efforts are needed to bridge the gap between the legislative provisions of HMA and societal value systems and attitudes toward marriage. Awareness programs regarding the nature and types of mental illness, advances in treatment and information about good outcome of severe mental illness will be helpful. Improvement in moral and religious values will overcome to some extent the negative attitudes and patriarchal mind set toward married women with mental illness. PMID:26330650

An Examination of the Leadership Practices That Support and Sustain School Based Mental Health Programs

ERIC Educational Resources Information Center

Perreault, Amy

2013-01-01

Extensive research has shown that children in the United States present with a myriad of mental health concerns, and that those concerns can develop into mental illness if not treated. The consequences of mental illness on students' life both in an out of school is well documented. The need to provide effective treatment to children is also…

Chronic physical conditions in older adults with mental illness and/ or substance use disorders.

PubMed

Lin, Wen-Chieh; Zhang, Jianying; Leung, Gary Y; Clark, Robin E

2011-10-01

To examine the association between mental illness and chronic physical conditions in older adults and investigate whether co-occurring substance use disorders (SUDs) are associated with greater risk of chronic physical conditions beyond mental illness alone. A retrospective cross-sectional study. Medicare and Medicaid programs in Massachusetts. Massachusetts Medicare and Medicaid members aged 65 and older as of January 1, 2005 (N = 679,182). Diagnoses recorded on Medicare and Medicaid claims were used to identify mental illness, SUDs, and 15 selected chronic physical conditions. Community-dwelling older adults with mental illness or SUDs had higher adjusted risk for 14 of the 15 selected chronic physical conditions than those without these disorders; the only exception was eye diseases. Moreover, those with co-occurring SUDs and mental illness had the highest adjusted risk for 11 of these chronic conditions. For residents of long-term care facilities, mental illness and SUDs were only moderately associated with the risk of chronic physical conditions. Community-dwelling older adults with mental illness or SUDs, particularly when they co-occurred, had substantially greater medical comorbidity than those without these disorders. For residents of long-term care facilities, the generally uniformly high medical comorbidity may have moderated this relationship, although their high prevalence of mental illness and SUDs signified greater healthcare needs. These findings strongly suggest the imminent need for integrating general medical care, mental health services, and addiction health services for older adults with mental illness or SUDs. © 2011, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society.

Risk of preterm birth by subtype among Medi-Cal participants with mental illness.

PubMed

Baer, Rebecca J; Chambers, Christina D; Bandoli, Gretchen; Jelliffe-Pawlowski, Laura L

2016-10-01

Previous studies have demonstrated an association between mental illness and preterm birth (before 37 weeks). However, these investigations have not simultaneously considered gestation of preterm birth, the indication (eg, spontaneous or medically indicated), and specific mental illness classifications. The objective of the study was to examine the likelihood of preterm birth across gestational lengths and indications among Medi-Cal (California's Medicaid program) participants with a diagnostic code for mental illness. Mental illnesses were studied by specific illness classification. The study population was drawn from singleton live births in California from 2007 through 2011 in the birth cohort file maintained by the California Office of Statewide Health Planning and Development, which includes birth certificate and hospital discharge records. The sample was restricted to women with Medi-Cal coverage for prenatal care. Women with mental illness were identified using International Classification of Diseases, ninth revision, codes from their hospital discharge record. Women without a mental illness International Classification of Diseases, ninth revision, code were randomly selected at a 4:1 ratio. Adjusting for maternal characteristics and obstetric complications, relative risks and 95% confidence intervals were calculated for preterm birth comparing women with a mental illness diagnostic code with women without such a code. We identified 6198 women with a mental illness diagnostic code and selected 24,792 women with no such code. The risk of preterm birth in women with a mental illness were 1.2 times higher than women without a mental illness (adjusted relative risk, 1.2, 95% confidence interval, 1.1-1.3). Among the specific mental illnesses, schizophrenia, major depression, and personality disorders had the strongest associations with preterm birth (adjusted relative risks, 2.0, 2.0 and 3.3, respectively). Women receiving prenatal care through California's low-income health insurance who had at least 1 mental illness diagnostic code were 1.2-3.3-times more likely to have a preterm birth than women without a mental illness, and these risks persisted across most illness classifications. Although it cannot be determined from these data whether specific treatments for mental illness contribute to the observed associations, elevated risk across different diagnoses suggests that some aspects of mental illness itself may confer risk. Copyright © 2016 Elsevier Inc. All rights reserved.

Relationship of Stigma to HIV Risk Among Women with Mental Illness

PubMed Central

Collins, Pamela Y.; Elkington, Katherine S.; von Unger, Hella; Sweetland, Annika; Wright, Eric R.; Zybert, Patricia A.

2009-01-01

Urban women with severe mental illness (SMI) are vulnerable to stigma and discrimination related to mental illness and other stigmatized labels. Stigma experiences may increase their risk for negative health outcomes, such as HIV infection. This study tests the relationship between perceived stigma and HIV risk behaviors among women with SMI. The authors interviewed 92 women attending community mental health programs using the Stigma of Psychiatric Illness and Sexuality Among Women Questionnaire. There were significant relationships between personal experiences of mental illness and substance use accompanying sexual intercourse; perceived ethnic stigma and having a riskier partner type; and experiences of discrimination and having a casual or sex-exchange partner. Higher scores on relationship stigma were associated with a greater number of sexual risk behaviors. The findings underscore the importance of exploring how stigma attached to mental illness intersects with other stigmatized labels to produce unique configurations of HIV risk. HIV risk reduction interventions and prevention research should integrate attention to stigmatized identities in the lives of women with SMI. PMID:19123772

The children of mentally ill parents.

PubMed

Mattejat, Fritz; Remschmidt, Helmut

2008-06-01

The children of mentally ill parents have a higher risk of developing mental illnesses themselves over the course of their lives. This known risk must be taken into account in the practical provision of health care. Selective literature review. The increased psychiatric risk for children of mentally ill parents is due partly to genetic influences and partly to an impairment of the parent-child interaction because of the parent's illness. Furthermore, adverse factors are more frequent in these families, as well as a higher risk for child abuse. Genetic and psychosocial factors interact with one another. For example, genetic factors moderate environmental effects; that is, the effect of adverse environmental factors depends on the genetic substrate. Preventive measures for children of mentally ill parents urgently need improvement. In this article, positively evaluated programs of preventive measures are discussed. Essential prerequisites for success include appropriate, specialized treatment of the parental illness, psychoeducative measures, and special support (e.g. self-help groups) as indicated by the family's particular needs.

Economic expenditures associated with instrumental caregiving roles of adult siblings of persons with severe mental illness.

PubMed

Lohrer, Steven P; Lukens, Ellen P; Thorning, Helle

2007-04-01

Siblings of persons with mental illness who assume primary caregiving roles experience substantial and tangible economic impacts associated with this responsibility. This study investigated mailed survey responses collected from 156 adult siblings of persons with mental illness from New York State to examine instrumental costs associated with providing support to siblings with illness. Genders of both siblings, severity of the relatives' mental illness, and number of surviving parents in the family distinguished those occupying primary caregiving responsibility from those not in primary roles. Current caregivers incurred greater instrumental costs in the form of financial expenses, time spent in care activities, and crisis involvement than did those who were not primary care providers. Additional demographic and behavioral factors related to siblings with and without illness were associated with specific dimensions of instrumental expenditure. As siblings become increasingly engaged in caregiving, social service professionals must assume leadership in promoting programs and policies that meaningfully support family involvement for relatives with mental illness.

Mental Illness in the Family. Families Today: A Research Sampler on Families and Children.

ERIC Educational Resources Information Center

Corfman, Eunice, Ed.

Science Monographs, published by the National Institute of Mental Health, are book-length, integrative state-of-the-art reviews, critical evaluations of findings, or program assessments of current research on topics related to the NIMH mandate. This set of articles concentrate on mental illness in the family. "Depression and Low-Income,…

Crisis Intervention Teams and People with Mental Illness: Exploring the Factors that Influence the Use of Force

ERIC Educational Resources Information Center

Morabito, Melissa S.; Kerr, Amy N.; Watson, Amy; Draine, Jeffrey; Ottati, Victor; Angell, Beth

2012-01-01

The Crisis Intervention Team (CIT) program was first developed to reduce violence in encounters between the police and people with mental illness as well as provide improved access to mental health services. Although there is overwhelming popular support for this intervention, scant empirical evidence of its effectiveness is…

Community perceptions of mental illness in rural Uganda: An analysis of existing challenges facing the Bwindi Mental Health Programme.

PubMed

Shah, Arya; Wheeler, Lydia; Sessions, Kristen; Kuule, Yusufu; Agaba, Edwin; Merry, Stephen P

2017-10-11

To assess community perceptions of mental illness in the Bwindi Community Hospital (BCH) catchment area: to recognise beliefs about the causes and the treatments for mental illness. To provide community data to staff at BCH as they work to develop more effective community mental health programmes. A shortage of mental health providers in Uganda has prompted research into community-based task-sharing models for the provision of mental health services in underserved communities. Six focus group discussions, with a total of 54 community members (50% male, n = 27; mean age + s.d. [39.9 + 10.9 years]) from the BCH catchment area, were conducted to assess community member and stakeholder perceptions of mental illness and belief in the feasibility of community-based programming. Qualitative study of data through thematic analysis was conducted to assess the presence of commonly occurring perceptions. Qualitative thematic analysis revealed two major themes: (1) belief that any given patient's metal illness results from either an intrinsic or an extrinsic cause and (2) belief in a need to determine treatment of mental illness based on the believed cause. As BCH designs community-based mental health services, our findings provide support for the need for further education of community members and training of community health workers to address and integrate the above-stated beliefs regarding mental illness.

Community perceptions of mental illness in rural Uganda: An analysis of existing challenges facing the Bwindi Mental Health Programme

PubMed Central

2017-01-01

Objectives To assess community perceptions of mental illness in the Bwindi Community Hospital (BCH) catchment area: to recognise beliefs about the causes and the treatments for mental illness. To provide community data to staff at BCH as they work to develop more effective community mental health programmes. Background A shortage of mental health providers in Uganda has prompted research into community-based task-sharing models for the provision of mental health services in underserved communities. Methods Six focus group discussions, with a total of 54 community members (50% male, n = 27; mean age + s.d. [39.9 + 10.9 years]) from the BCH catchment area, were conducted to assess community member and stakeholder perceptions of mental illness and belief in the feasibility of community-based programming. Qualitative study of data through thematic analysis was conducted to assess the presence of commonly occurring perceptions. Results Qualitative thematic analysis revealed two major themes: (1) belief that any given patient’s metal illness results from either an intrinsic or an extrinsic cause and (2) belief in a need to determine treatment of mental illness based on the believed cause. Conclusion As BCH designs community-based mental health services, our findings provide support for the need for further education of community members and training of community health workers to address and integrate the above-stated beliefs regarding mental illness. PMID:29041798

Empowering families with the experience of mental illness. A presentation of the Polish version of CAMILLE training package.

PubMed

Tabak, Izabela; Zabłocka-Żytka, Lidia; Czabała, Jan C

2016-01-01

The paper presents the CAMILLE training package prepared in the EU program Empowerment of Children and Adolescents of Mentally Ill Parents through Training of Professionals working with children and adolescents. The training is designed for psychiatrists, psychologists, social workers, teachers and others working with children and adolescents where a parent experiences mental disorders. The project was realized on 4 stages: (1) pre-analyses (quality and quantity) with professionals, family members and people experiencing mental disorders, in regards to the needs, experiences and expectations in education of professionals working with families of parents with mental illness; (2) development of a new pan-European training program for specialists working with these families; (3) pre-pilot implementation and evaluation of the training; (4) preparing of the final version of the training and pilot implementation in 7 countries participating in the project, also in Poland. The training program consists of 9 subjects, divided into 3 main groups: the basic knowledge (mental disorders, child development, attachment), experiences and needs of the families (experiences of parents, children, stigma), methods of family support (talking with children, resilience, successful services). The pilot implementation of the program showed great professionals' interest in the subject and training methods. The evaluation showed significant positive effects of the training in terms of the raise of awareness of influence of the parent's illness on needs of the child, parental abilities and ability of building the child resilience. The CAMILLE training is a valuable program that can be implemented in Poland.

Mental Illness Training for Licensed Staff in Long-Term Care

PubMed Central

Irvine, A. Blair; Billow, Molly B.; Eberhage, Mark G.; Seeley, John R.; McMahon, Edward; Bourgeois, Michelle

2013-01-01

Licensed care staff working in long-term care facilities may be poorly prepared to work with residents with mental illness. This research reports on the program evaluation of Caring Skills: Working with Mental Illness, a training program delivered on the Internet. It was tested with a randomized treatment-control design, with an eight-week follow-up. The training provided video-based behavioral skills and knowledge training. Measures included video situations testing and assessment of psycho-social constructs including empathy and stigmatization. ANCOVA analysis at 4-weeks posttest showed significant positive effects with medium-large effect sizes, which were largely maintained at the 8-week follow-up. The training was well-received by the users. PMID:22364430

The PII Solution to Mental Healthcare Delivery: Prevention, Intervention, and Integration.

PubMed

King, Mira A

In this essay, the author proposes a new, integrated model for mental healthcare delivery called the PII solution, which builds on the successes of federal government programs and state initiatives. The PII solution includes prevention, intervention, and integration. As a community-centered approach, PII leverages existing programs in concert with new approaches to meet the diverse needs of patients with the spectrum of mental health disorders, from low risk to high risk. The PII solution can be applied to any subgroup in society to create a comprehensive plan to combat mental illness. In this essay, the author uses the PII solution to (a) build upon public-private partnership initiatives that have reduced emergency department utilization and costs for behavioral health patients, (b) improve law enforcement's proficiency in identifying and deescalating situations involving potentially violent individuals with a serious mental illness, and (c) advocate for increased social responsibility of providers to ensure that mentally ill patients are receiving the right care in the right setting.

Empowerment of women and mental health promotion: a qualitative study in rural Maharashtra, India

PubMed Central

Kermode, Michelle; Herrman, Helen; Arole, Rajanikant; White, Joshua; Premkumar, Ramaswamy; Patel, Vikram

2007-01-01

Background The global burden of mental illness is high and opportunities for promoting mental health are neglected in most parts of the world. Many people affected by mental illness live in developing countries, where treatment and care options are limited. In this context, primary health care (PHC) programs can indirectly promote mental health by addressing its determinants i.e. by enhancing social unity, minimising discrimination and generating income opportunities. The objectives of this study were to: 1. Describe concepts of mental health and beliefs about determinants of mental health and illness among women involved with a PHC project in rural Maharashtra, India; 2. Identify perceived mental health problems in this community, specifically depression, suicide and violence, their perceived causes, and existing and potential community strategies to respond to them and; 3. Investigate the impact of the PHC program on individual and community factors associated with mental health Method We undertook qualitative in-depth interviews with 32 women associated with the PHC project regarding: their concepts of mental health and its determinants; suicide, depression and violence; and the perceived impact of the PHC project on the determinants of mental health. The interviews were taped, transcribed, translated and thematically analysed. Results Mental health and illness were understood by these women to be the product of cultural and socio-economic factors. Mental health was commonly conceptualised as an absence of stress and the commonest stressors were conflict with husbands and mother-in-laws, domestic violence and poverty. Links between empowerment of women through income generation and education, reduction of discrimination based on caste and sex, and promotion of individual and community mental health were recognised. However, mental health problems such as suicide and violence were well-described by participants. Conclusion While it is essential that affordable, accessible, appropriate treatments and systems of referral and care are available for people with mental illness in developing country settings, the promotion of mental health by addressing its determinants is another potential strategy for reducing the burden of mental illness for individuals and communities in these settings. PMID:17761003

Empowerment of women and mental health promotion: a qualitative study in rural Maharashtra, India.

PubMed

Kermode, Michelle; Herrman, Helen; Arole, Rajanikant; White, Joshua; Premkumar, Ramaswamy; Patel, Vikram

2007-08-31

The global burden of mental illness is high and opportunities for promoting mental health are neglected in most parts of the world. Many people affected by mental illness live in developing countries, where treatment and care options are limited. In this context, primary health care (PHC) programs can indirectly promote mental health by addressing its determinants i.e. by enhancing social unity, minimising discrimination and generating income opportunities. The objectives of this study were to: 1. Describe concepts of mental health and beliefs about determinants of mental health and illness among women involved with a PHC project in rural Maharashtra, India; 2. Identify perceived mental health problems in this community, specifically depression, suicide and violence, their perceived causes, and existing and potential community strategies to respond to them and; 3. Investigate the impact of the PHC program on individual and community factors associated with mental health We undertook qualitative in-depth interviews with 32 women associated with the PHC project regarding: their concepts of mental health and its determinants; suicide, depression and violence; and the perceived impact of the PHC project on the determinants of mental health. The interviews were taped, transcribed, translated and thematically analysed. Mental health and illness were understood by these women to be the product of cultural and socio-economic factors. Mental health was commonly conceptualised as an absence of stress and the commonest stressors were conflict with husbands and mother-in-laws, domestic violence and poverty. Links between empowerment of women through income generation and education, reduction of discrimination based on caste and sex, and promotion of individual and community mental health were recognised. However, mental health problems such as suicide and violence were well-described by participants. While it is essential that affordable, accessible, appropriate treatments and systems of referral and care are available for people with mental illness in developing country settings, the promotion of mental health by addressing its determinants is another potential strategy for reducing the burden of mental illness for individuals and communities in these settings.

A randomized controlled trial of a supported employment program for persons with long-term mental illness in Hong Kong.

PubMed

Kin Wong, Kenny; Chiu, Rose; Tang, Betty; Mak, Donald; Liu, Joanne; Chiu, Siu Ning

2008-01-01

Supported employment is an evidence-based practice that has proved to be consistently more effective than conventional vocational rehabilitation in helping people with severe mental illness find and sustain competitive employment. Most research on the effectiveness of supported employment comes from the United States. This study examined the effectiveness and applicability of a supported employment program based on the individual placement and support model in a Hong Kong setting. Ninety-two unemployed individuals with long-term mental illness who desired competitive employment were randomly assigned to either a supported employment program or a conventional vocational rehabilitation program and followed up for 18 months. Both vocational and nonvocational outcomes were measured. Over the 18-month study period, compared with participants in the conventional vocational rehabilitation program, those in the supported employment group were more likely to work competitively (70% versus 29%; odds ratio=5.63, 95% confidence interval=2.28-13.84), held a greater number of competitive jobs, earned more income, worked more days, and sustained longer job tenures. Repeated-measures analysis of variance found no substantive differences between participants in the two groups and no significant change from baseline over time for psychiatric symptoms and self-perceived quality of life. Consistent with previous research findings in the United States, the supported employment program was more effective than the conventional vocational rehabilitation program in helping individuals with long-term mental illness find and sustain competitive employment in a Hong Kong setting. The supported employment program based on the individual placement and support model can thus be recommended for wider use in local mental health practice.

Perceptions of discrimination among persons with serious mental illness.

PubMed

Corrigan, Patrick; Thompson, Vetta; Lambert, David; Sangster, Yvette; Noel, Jeffrey G; Campbell, Jean

2003-08-01

The authors sought to gain further perspective on discrimination experienced by persons with mental illness by comparing self-reports of discrimination due to mental illness to self-reports of discrimination due to other group characteristics, such as race, gender, and sexual orientation. A total of 1,824 persons with serious mental illness who participated in a baseline interview for a multistate study on consumer-operated services completed a two-part discrimination questionnaire. The first part of the questionnaire assessed participants' perceptions about discrimination due to mental illness as well as more than half a dozen other group characteristics. The second part of the questionnaire asked participants who reported some experience with discrimination to identify areas in which this discrimination occurred, such as employment, education, and housing. More than half of the study participants (949 participants, or 53 percent) reported some experience with discrimination. The most frequent sources of this discrimination were mental disability, race, sexual orientation, and physical disability. Areas in which discrimination frequently occurred included employment, housing, and interactions with law enforcement. Areas in which discrimination was experienced did not significantly differ among groups of study participants characterized by mental disability, race, gender, sexual orientation, or physical disability. Discrimination based on group characteristics other than mental illness does not diminish the impact of stigma associated with mental illness. Antistigma programs need to target not only discrimination related to mental illness but also that associated with other group characteristics, such as race, gender, sexual orientation, and physical disability.

The portrayal of mental health and illness in Australian non-fiction media.

PubMed

Francis, Catherine; Pirkis, Jane; Blood, R Warwick; Dunt, David; Burgess, Philip; Morley, Belinda; Stewart, Andrew; Putnis, Peter

2004-07-01

To provide a detailed picture of the extent, nature and quality of portrayal of mental health/illness in Australian non-fiction media. Media items were retrieved from Australian newspaper, television and radio sources over a 1-year period, and identifying/descriptive data extracted from all items. Quality ratings were made on a randomly selected 10% of items, using an instrument based on criteria in Achieving the Balance (a resource designed to promote responsible reporting of mental health/illness). Reporting of mental health/illness was common, with 4351 newspaper, 1237 television and 7801 radio items collected during the study period. Media items most frequently focused on policy/program initiatives in mental health (29.0%), or on causes/symptoms/treatment of mental illnesses (23.9%). Stories about mental health issues in the context of crime were relatively uncommon, accounting for only 5.6% of items. Most media items were of good quality on eight of the nine dimensions; the exception was that details of appropriate help services were only included in 6.4% of items. In contrast to previous research, the current study found that media reporting of mental health/illness was extensive, generally of good quality and focused less on themes of crime and violence than may have been expected. This is encouraging, since there is evidence that negative media portrayal of mental health/illness can detrimentally affect community attitudes. However, there are still opportunities for improving media reporting of mental health/illness, which should be taken up in future media strategies.

Policies and Consequences: How America and Psychiatry Took the Detour to Erewhon.

PubMed

Becker, Robert E

2015-10-01

In the mid-1960s, federal legislation provided psychiatry with funds for construction and initial staffing of local community mental health programs and funded university psychiatry departments to support research, innovations, and education in social-community psychiatry. Psychiatry gained resources for treating diseases and for addressing the disabilities that accompany mental illnesses. Abrupt losses of federal funding in the following decades, combined with restrictive insurance reimbursements and the expanding influence of the pharmaceutical industry, undermined psychiatry's abilities to address the needs of persons with severe mental illness. The author describes the perverse shift in social priorities that has occurred-with persons who have chronic mental illness housed in jails and heightened public perceptions that mass murders are the acts of persons with mental illness.

Communicative Imagery: A Qualitative Investigation of the Effectiveness of a Behavior Change Strategy on the Chronically Mentally Ill.

ERIC Educational Resources Information Center

Lippard, Paula V.

An exploratory study investigated the success of a small group behavior change program in eliminating self-defeating behavior (SDB) in outpatients with chronic mental illness. Four of the six subjects were outpatients at the local mental health center but were currently not exhibiting psychotic behavior. The remaining two subjects were student…

A Randomized Controlled Trial of Cognitive-Behavioral Treatment for Posttraumatic Stress Disorder in Severe Mental Illness

ERIC Educational Resources Information Center

Mueser, Kim T.; Rosenberg, Stanley D.; Xie, Haiyi; Jankowski, M. Kay; Bolton, Elisa E.; Lu, Weili; Hamblen, Jessica L.; Rosenberg, Harriet J.; McHugo, Gregory J.; Wolfe, Rosemarie

2008-01-01

A cognitive-behavioral therapy (CBT) program for posttraumatic stress disorder (PTSD) was developed to address its high prevalence in persons with severe mental illness receiving treatment at community mental health centers. CBT was compared with treatment as usual (TAU) in a randomized controlled trial with 108 clients with PTSD and either major…

Anti-Stigma Programs: Stigma in Campus Police Officers

ERIC Educational Resources Information Center

Rafacz, Jennifer D.

2012-01-01

It has been proposed that the most effective way to combat mental illness stigma is to focus on power groups who have a direct impact on the lives of persons with serious mental illness. With the increase of violence and need for mental health services on college campuses, campus police officers are seen as an important power group for persons…

An Exploratory Analysis of Unhealthy and Abusive Relationships for Adults with Serious Mental Illnesses Living in Supportive Housing.

PubMed

Forenza, Brad; Bermea, Autumn M

2017-08-01

Individuals living with serious mental illness are at high risk of chronic homelessness, victimization, and intimate partner violence. In recent years, supportive housing programs have emerged as one way to prevent homelessness and victimization for this population, while also expanding social interactions and social networks. In concert with a focal supportive housing program, this research conducted two focus groups with 18 individuals who have a serious mental illness diagnosis. The authors sought to answer the research question, "What are perceptions of healthy and unhealthy relationships among formerly homeless people with serious mental illness?" To this end, the eight-item questionnaire was created around dimensions of power and control, as well as relationship equality. Findings from an inductive thematic analysis reveal three broad families of themes (relationship ideals, lived experiences, and risk/resources in supportive housing), around which smaller themes and subthemes are organized. Implications for policy, practice, and future research are also discussed.

Ending AIDS as a Public Health Threat: Treatment-as-Usual Risk Reduction Services for Persons With Mental Illness in Brazil.

PubMed

Wainberg, Milton L; McKinnon, Karen; Norcini-Pala, Andrea; Hughes, Olivia K; Schrage, Ezra; Erby, Whitney; Mann, Claudio G; Cournos, Francine

2018-04-01

Persons with mental illness have higher HIV infection rates than the general population. Little is known about whether care systems for this population are effectively participating in global efforts to end AIDS as a public health threat. This study examined treatment-as-usual HIV risk reduction services within public mental health settings. The authors interviewed 641 sexually active adults attending eight public psychiatric clinics in Rio de Janeiro about participation in a sexual risk reduction program, HIV testing, HIV knowledge, and sexual behaviors. Nine percent reported participation in a risk reduction program in the past year, and 75% reported having unprotected sex in the past three months. Program participants had greater HIV knowledge (p=.04) and were more likely to have had HIV testing in the past three months (p=.02), compared with nonparticipants. Participation was not associated with sexual behaviors. Including persons with mental illness in efforts to end AIDS requires a greater commitment to implementing effective interventions in public mental health systems.

Development and Evaluation of Digital Game-Based Training for Managers to Promote Employee Mental Health and Reduce Mental Illness Stigma at Work: Quasi-Experimental Study of Program Effectiveness

PubMed Central

Birner, Ulrich Walter; Oberhauser, Cornelia; Nowak, Dennis; Sabariego, Carla

2017-01-01

Background To counteract the negative impact of mental health problems on business, organizations are increasingly investing in mental health intervention measures. However, those services are often underused, which, to a great extent, can be attributed to fear of stigmatization. Nevertheless, so far only a few workplace interventions have specifically targeted stigma, and evidence on their effectiveness is limited. Objective The objective of this study was to develop and evaluate a digital game-based training program for managers to promote employee mental health and reduce mental illness stigma at work. Methods We describe the empirical development of Leadership Training in Mental Health Promotion (LMHP), a digital game-based training program for leaders. A 1-group pre-post design and a 3-month follow-up were used for training evaluation. We applied multilevel growth models to investigate change over time in the dependent variables knowledge, attitudes, self-efficacy, and intentions to promote employee mental health in 48 managers of a global enterprise in the United Kingdom. Participants were mainly male (44/48, 92%) and ranged in age from 32 to 58 (mean 46.0, SD 7.2) years. Results We found a positive impact of the Web-based training program on managers’ knowledge of mental health and mental illness (P<.001), on attitudes toward people with mental health problems (P<.01), and on their self-efficacy to deal with mental health situations at work (P<.001), with the exception of intentions to promote employee mental health, which was initially high. Conclusions Results provide first evidence of the effectiveness of LMHP to positively affect managers’ skills to promote employee mental health at work. Furthermore, the high rate of participation in LMHP (48/54, 89%) supports the use of digital game-based interventions to increase user engagement and user experience in mental health programs at work. PMID:28778839

Increasing physical activity for veterans in the Mental Health Intensive Case Management Program: A community-based intervention.

PubMed

Harrold, S Akeya; Libet, Julian; Pope, Charlene; Lauerer, Joy A; Johnson, Emily; Edlund, Barbara J

2018-04-01

Individuals with severe mental illness (SMI), experience increased mortality-20 years greater disparity for men and 15 years greater disparity for women-compared to the general population (Thornicroft G. Physical health disparities and mental illness: The scandal of premature mortality. Br J Psychiatr. 2011;199:441-442). Numerous factors contribute to premature mortality in persons with SMI, including suicide and accidental death (Richardson RC, Faulkner G, McDevitt J, Skrinar GS, Hutchinson D, Piette JD. Integrating physical activity into mental health services for persons with serious mental illness. Psychiatr Serv. 2005;56(3):324-331; Thornicroft G. Physical health disparities and mental illness: The scandal of premature mortality. Br J Psychiatr. 2011;199:441-442), but research has shown that adverse health behaviors-including smoking, low rate of physical activity, poor diet, and high alcohol consumption-also significantly contribute to premature deaths (Jones J. Life expectancy in mental illness. Psychiatry Services. 2010. Retrieved from http://psychcentral.com/news/2010/07/13/life-expectancy-in-mental-illness). This quality improvement (QI) project sought to improve health and wellness for veterans in the Mental Health Intensive Case Management Program (MHICM), which is a community-based intensive program for veterans with SMI at risk for decompensation and frequent hospitalizations. At the time of this QI project, the program had 69 veterans who were assessed and treated weekly in their homes. The project introduced a pedometer steps intervention adapted from the VA MOVE! Program-a physical activity and weight management program-with the addition of personalized assistance from trained mental health professionals in the veteran's home environment. Because a large percentage of the veterans in the MHICM program had high blood pressure and increased weight, these outcomes were the focus of this project. Through mental health case management involvement and the comfort of their familiar living environment, veterans were assisted to meet their physical and mental health goals with a program that could easily be integrated into their daily lives. Healthy People 2020 developed goals to improve levels of physical activity and has ranked physical activity as a leading health indicator (US DHHS. Office of Disease Prevention and Health Promotion. Physical activity topic overview. In Healthy People 2020. 2016. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/physical-activity). Individuals with SMI are significantly less active than the general population (Shor and Shalev, 2014). It is sometimes difficult for the average individual to obtain the recommended 10,000 steps and even more difficult for those with SMI. Lifestyle modifications, in particular diet and exercise, are recommended for improvement of chronic disease outcomes (US Preventive Services Counseling Task Force, 2016). The health benefits of physical activity for people with SMI are mixed (Pearsall R, Smith D, Pelosi A, Geddes J. Exercise therapy in adults with serious mental illness: A systematic review and meta-analysis. BMC Psychiatr. 2014;14:117). Some studies found significant physical health benefits, while others did not. However, according to a review by Soundy et al., physical exercise is shown to not only have physical benefits but also psychosocial benefits. One of the barriers that hinder participation in physical activities is accessibility (Shor and Shalev, 2014). Integrating a more personalized supported, and in-home pedometer program into mental healthcare should ensure better access to interventions that could possibly reverse the causes of premature death. The program was offered to 69 veterans in the MHICM. Forty-nine agreed to start the program and 20 declined. Twenty-five clients actually started the program with 17 veterans completing it. Preimplementation data included collecting blood pressure and weight measures for all veterans in the MHICM program. Additionally, a focus group was held with case managers to obtain a group perspective on motivating veterans to participate in this program. Further, a teaching session was held to review pedometers use, the client video, the client booklet, methods for getting veterans started, and the progression of the walking intervention. The pedometer physical activity intervention continued for 2 months. At the end of the 2 months, aggregate de-identified data on number of steps, blood pressure, and weight were collected. At the end of the program, the data were reviewed, synthesized, and analyzed, being careful to account for potentially intervening conditions and other chronic illnesses. The postimplementation data revealed that the mean weight decreased by 9 lbs. The percentage of controlled blood pressure increased from 60 to 84, while the percentage of uncontrolled blood pressure decreased from 40 to 16. Implementation of a multiple component personalized exercise intervention program for veterans with SMI contributed to reduction in weight and blood pressure. © 2017 Wiley Periodicals, Inc.

Childhood Risk Factors in Dually Diagnosed Homeless Adults.

ERIC Educational Resources Information Center

Blankertz, Laura E.; And Others

1993-01-01

Examined prevalence of five childhood risk factors (sexual abuse, physical abuse, parental mental illness, substance abuse, out-of-home placement) among dually diagnosed (mentally ill and substance abusing) homeless adults (n=156) in rehabilitation programs. Findings suggest that childhood risk factors, whether single or multiple, are very…

Barriers to Family Caregivers' Coping With Patients With Severe Mental Illness in Iran.

PubMed

Ebrahimi, Hossein; Seyedfatemi, Naeimeh; Namdar Areshtanab, Hossein; Ranjbar, Fatemeh; Thornicroft, Graham; Whitehead, Bill; Rahmani, Farnaz

2018-05-01

The broad spectrum of problems caused by caring for a patient with mental illness imposes a high burden on family caregivers. This can affect how they cope with their mentally ill family members. Identifying caregivers' experiences of barriers to coping is necessary to develop a program to help them overcome these challenges. This qualitative content analysis study explored barriers impeding family caregivers' ability to cope with their relatives diagnosed with severe mental illness (defined here as schizophrenia, schizoaffective disorders, and bipolar affective disorders). Sixteen family caregivers were recruited using purposive sampling and interviewed using a semi-structured in-depth interview method. Data were analyzed by a conventional content analytic approach. Findings consisted of four major categories: the patient's isolation from everyday life, incomplete recovery, lack of support by the mental health care system, and stigmatization. Findings highlight the necessity of providing support for caregivers by the mental health care delivery service system.

Feasibility, Acceptability, and Initial Efficacy of a Knowledge-Contact Program to Reduce Mental Illness Stigma and Improve Mental Health Literacy in Adolescents

PubMed Central

Pinto-Foltz, Melissa D.; Logsdon, M. Cynthia; Myers, John A.

2011-01-01

The purpose of this school-based cluster-randomized trial was to determine the initial acceptability, feasibility, and efficacy of an existing community-based intervention, In Our Own Voice, in a sample of US adolescent girls aged 13–17 years (n=156). In Our Own Voice is a knowledge-contact intervention that provides knowledge about mental illness to improve mental health literacy and facilitates intergroup contact with persons with mental illness as a means to reduce mental illness stigma. This longitudinal study was set in two public high schools located in a southern urban community of the U.S. Outcomes included measures of mental illness stigma and mental health literacy. Findings support the acceptability and feasibility of the intervention for adolescents who enrolled in the study. Findings to support the efficacy of In Our Own Voice to reduce stigma and improve mental health literacy are mixed. The intervention did not reduce mental illness stigma or improve mental health literacy at one week follow up. The intervention did not reduce mental illness stigma at 4 and 8 weeks follow up. The intervention did improve mental health literacy at 4 and 8 weeks follow up. Previous studies have assessed the preliminary efficacy In Our Own Voice among young adults; rarely has In Our Own Voice been investigated longitudinally and with adolescents in the United States. This study provides initial data on the effects of In Our Own Voice for this population and can be used to further adapt the intervention for adolescents. PMID:21624729

An empirical literature review of definitions of severe and persistent mental illness.

PubMed

Schinnar, A P; Rothbard, A B; Kanter, R; Jung, Y S

1990-12-01

Seventeen definitions of the severely and persistently mentally ill have appeared in the literature over the past decade. These definitions have been used by 13 authors to formulate service programs and to estimate the prevalence of serious mental illness in the population. To test the applicability of these definitions, the authors operationalized each definition and applied it to a representative sample of 222 patients receiving services in one of Philadelphia's inner-city neighborhoods. The analysis showed estimates of prevalence of serious mental illness ranging from 4% to 88% of the treated population, depending on the definition applied. The NIMH (1987) definition was representative of the middle-range estimates of 45% to 55% arrived at by eight authors.

How is unemployment among people with mental illness conceptualized within social policy? A case study of the Ontario Disability Support Program.

PubMed

Gewurtz, Rebecca E; Cott, Cheryl; Rush, Brian; Kirsh, Bonnie

2015-01-01

Government policy shapes and is shaped by society's views of important social issues such as employment among people with disabilities. This article explores how unemployment among people with mental illness has been understood and characterized within social policy. Drawing on a qualitative case study that explored the construction and implementation of policy reform within the employment support branch of the Ontario Disability Support Program, this paper examines assumptions about unemployment among people with mental illness that underlie social policy and their impact on employment services and supports. The most prominent messages that emerged from the data focused on unemployment among people with mental illness as a function of personal responsibility, limitations and a lack of motivation. Although there was awareness of the role of social and systemic factors, these issues were given less weight, especially when describing employment support practices. There is a lack of sufficient attention to complex and deeply-rooted social and systemic inequalities within social policy and employment services. There is a need to expand conceptualizations of unemployment among people with mental illness within social policy, and develop interventions that address complex social factors and systemic constraints that can limit employment opportunities.

The impact on taxpayer costs of a jail diversion program for people with serious mental illness.

PubMed

Cowell, Alexander J; Hinde, Jesse M; Broner, Nahama; Aldridge, Arnie P

2013-12-01

Mental illness is prevalent among those incarcerated. Jail diversion is one means by which people with mental illness are treated in the community - often with some criminal justice system oversight - instead of being incarcerated. Jail diversion may lead to immediate reductions in taxpayer costs because the person is no longer significantly engaged with the criminal justice system. It may also lead to longer term reductions in costs because effective treatment may ameliorate symptoms, reduce the number of future offenses, and thus subsequent arrests and incarceration. This study estimates the impact on taxpayer costs of a model jail diversion program for people with serious mental illness. Administrative data on criminal justice and treatment events were combined with primary and secondary data on the costs of each event. Propensity score methods and a quasi-experimental design were used to compare treatment and criminal justice costs for a group of people who were diverted to a group of people who were not diverted. Diversion was associated with approximately $2800 lower taxpayer costs per person 2 years after the point of diversion (p<.05). Reductions in criminal justice costs drove this result. Jail diversion for people with mental illness may thus be justified fiscally. Copyright © 2013 Elsevier Ltd. All rights reserved.

Evaluating the Effectiveness of Mental Health First Aid Program for Chinese People in Hong Kong

ERIC Educational Resources Information Center

Wong, Daniel F. K.; Lau, Ying; Kwok, Sylvia; Wong, Prudence; Tori, Christopher

2017-01-01

Purpose: Chinese people generally lack knowledge of mental illness. Such phenomenon may lead to a delay in seeking psychiatric treatments. This study evaluated the effectiveness of Mental Health First Aid (MHFA) program in improving mental health knowledge of the general public in Hong Kong. Methods: A quasi-experimental design was adopted whereby…

An Emotional Awareness Based Parenting Group for Parents with Mental Illness: A Mixed Methods Feasibility Study of Community Mental Health Nurse Facilitation.

PubMed

Isobel, Sophie; Meehan, Felicity; Pretty, Danielle

2016-02-01

There has been limited examination of the use of relationship based structured parenting programs that focus on emotional interactions in the parent-child dyad in families where a parent has a mental illness. There is also a lack of awareness of the practicalities of providing such interventions within adult mental health services. This study explores the process and outcomes of a nurse led emotional awareness based parenting program for adult clients of a mental health service. Participants demonstrated a significant reduction in difficult parenting moments and associated stress and distress as well as promising improvements in overall distress and emotional awareness. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Approach to adolescent suicide prevention.

PubMed

Kostenuik, Marcia; Ratnapalan, Mohana

2010-08-01

To provide family physicians with an approach to suicide prevention in youth. A literature review was performed using Ovid MEDLINE with the key words suicide, attempted suicide, and evaluation studies or program evaluation, adolescent. Youth suicide might be prevented by earlier recognition and treatment of mental illness. Family physicians can and should screen for mental illness in youth; there are many diagnostic and treatment resources available to assist with this. Earlier detection and treatment of mental illness are the most important ways family physicians can reduce morbidity and mortality for youth who are contemplating suicide.

Reducing Self-Stigma by Coming Out Proud

PubMed Central

Kosyluk, Kristin A; Rüsch, Nicolas

2013-01-01

Self-stigma has a pernicious effect on the lives of people with mental illness. Although a medical perspective might discourage patients from identifying with their illness, public disclosure may promote empowerment and reduce self-stigma. We reviewed the extensive research that supports this assertion and assessed a program that might diminish stigma’s effect by helping some people to disclose to colleagues, neighbors, and others their experiences with mental illness, treatment, and recovery. The program encompasses weighing the costs and benefits of disclosure in deciding whether to come out, considering different strategies for coming out, and obtaining peer support through the disclosure process. This type of program may also pose challenges for public health research. PMID:23488488

Reducing self-stigma by coming out proud.

PubMed

Corrigan, Patrick W; Kosyluk, Kristin A; Rüsch, Nicolas

2013-05-01

Self-stigma has a pernicious effect on the lives of people with mental illness. Although a medical perspective might discourage patients from identifying with their illness, public disclosure may promote empowerment and reduce self-stigma. We reviewed the extensive research that supports this assertion and assessed a program that might diminish stigma's effect by helping some people to disclose to colleagues, neighbors, and others their experiences with mental illness, treatment, and recovery. The program encompasses weighing the costs and benefits of disclosure in deciding whether to come out, considering different strategies for coming out, and obtaining peer support through the disclosure process. This type of program may also pose challenges for public health research.

Cultural aspects within caregiver interactions of ultra-orthodox Jewish women and their family members with mental illness.

PubMed

Weiss, Penina; Shor, Ron; Hadas-Lidor, Naomi

2013-10-01

The role of cultural dynamics and norms within families of persons with mental illness has been an underexplored subject, although the familial context has been recognized as influential. This subject was studied with 24 ultra-Orthodox Jewish mothers of persons with mental illness who live in a relatively closed religious community. While participating in the Keshet educational program designed for family caregivers in mental health, they wrote Meaningful Interactional Life Episodes that involved a dialogue exchange in their lives. Qualitative analysis of 50 episodes illuminates the significant role that religious and cultural norms have in the perceptions of what are considered stressors and the dynamics in these families surrounding these stressors. The necessity and value of incorporating cultural competence into family educational programs and interventions is emphasized, as this may contribute to the potential use and success of mental health service models within a population that essentially underutilizes these services. © 2013 American Orthopsychiatric Association.

An Evaluation of a Suicide Bereavement Peer Support Program

ERIC Educational Resources Information Center

Barlow, Constance A.; Waegemakers Schiff, Jeannette; Chugh, Urmil; Rawlinson, Dixie; Hides, Elizabeth; Leith, Judy

2010-01-01

Peer support, a cornerstone in recovery programs for mental illness and addiction, has not been widely applied to service programs for survivors of suicide. In 2004-2006 Canadian Mental Health Association Suicide Services in Calgary, Alberta, introduced the Peer Support Program for adults, an adjunct to conventional individual and group…

Predictors of Acquisition of Competitive Employment for People Enrolled in Supported Employment Programs.

PubMed

Corbière, Marc; Lecomte, Tania; Reinharz, Daniel; Kirsh, Bonnie; Goering, Paula; Menear, Matthew; Berbiche, Djamal; Genest, Karine; Goldner, Elliot M

2017-04-01

This study aims at assessing the relative contribution of employment specialist competencies working in supported employment (SE) programs and client variables in determining the likelihood of obtaining competitive employment. A total of 489 persons with a severe mental illness and 97 employment specialists working in 24 SE programs across three Canadian provinces were included in the study. Overall, 43% of the sample obtained competitive work. Both client variables and employment specialist competencies, while controlling for the quality of SE programs implementation, predicted job acquisition. Multilevel analyses further indicated that younger client age, shorter duration of unemployment, and client use of job search strategies, as well as the working alliance perceived by the employment specialist, were the strongest predictors of competitive employment for people with severe mental illness, with 51% of variance explained. For people with severe mental illness seeking employment, active job search behaviors, relational abilities, and employment specialist competencies are central contributors to acquisition of competitive employment.

Exploring opportunities to support mental health care using social media: A survey of social media users with mental illness.

PubMed

Naslund, John A; Aschbrenner, Kelly A; McHugo, Gregory J; Unützer, Jürgen; Marsch, Lisa A; Bartels, Stephen J

2017-10-20

Social media holds promise for expanding the reach of mental health services, especially for young people who frequently use these popular platforms. We surveyed social media users who self-identified as having a mental illness to learn about their use of social media for mental health and to identify opportunities to augment existing mental health services. We asked 240 Twitter users who self-identified in their profile as having a mental illness to participate in an online survey. The survey was in English and inquired about participants' mental health condition, use of social media for mental health and interest in accessing mental health programs delivered through social media. Respondents from 10 countries completed 135 surveys. Most respondents were from the United States (54%), Canada (22%) and the United Kingdom (17%) and reported a psychiatric diagnosis of either schizophrenia spectrum disorder (27%), bipolar disorder (25%), major depressive disorder (16%) or depression (20%). Young adults age ≤35 (46%) were more likely to use Instagram (P = .002), Snapchat (P < .001) and their mobile phone for accessing social media (P < .001) compared to adults age 36 and older (53%). Most participants (85%) expressed interest in mental health programs delivered through social media, especially to promote overall health and wellbeing (72%) and for coping with mental health symptoms (90%). This exploratory study demonstrates the feasibility of reaching social media users with mental illness and can inform efforts to leverage social media to make evidence-based mental health services more widely available to those in need. © 2017 John Wiley & Sons Australia, Ltd.

A Multisite Randomized Trial of a Cognitive Skills Program for Male Mentally Disordered Offenders: Violence and Antisocial Behavior Outcomes

ERIC Educational Resources Information Center

Cullen, Alexis E.; Clarke, Amory Y.; Kuipers, Elizabeth; Hodgins, Sheilagh; Dean, Kimberlie; Fahy, Tom

2012-01-01

Objective: Despite a large evidence base indicating that cognitive skills programs can reduce reoffending in individuals without mental illness, there have been no randomized controlled trials (RCTs) to determine their effectiveness in mentally disordered offenders (MDOs). In the first RCT of a cognitive skills program for MDOs, we aimed to…

Development and Evaluation of Digital Game-Based Training for Managers to Promote Employee Mental Health and Reduce Mental Illness Stigma at Work: Quasi-Experimental Study of Program Effectiveness.

PubMed

Hanisch, Sabine Elisabeth; Birner, Ulrich Walter; Oberhauser, Cornelia; Nowak, Dennis; Sabariego, Carla

2017-08-04

To counteract the negative impact of mental health problems on business, organizations are increasingly investing in mental health intervention measures. However, those services are often underused, which, to a great extent, can be attributed to fear of stigmatization. Nevertheless, so far only a few workplace interventions have specifically targeted stigma, and evidence on their effectiveness is limited. The objective of this study was to develop and evaluate a digital game-based training program for managers to promote employee mental health and reduce mental illness stigma at work. We describe the empirical development of Leadership Training in Mental Health Promotion (LMHP), a digital game-based training program for leaders. A 1-group pre-post design and a 3-month follow-up were used for training evaluation. We applied multilevel growth models to investigate change over time in the dependent variables knowledge, attitudes, self-efficacy, and intentions to promote employee mental health in 48 managers of a global enterprise in the United Kingdom. Participants were mainly male (44/48, 92%) and ranged in age from 32 to 58 (mean 46.0, SD 7.2) years. We found a positive impact of the Web-based training program on managers' knowledge of mental health and mental illness (P<.001), on attitudes toward people with mental health problems (P<.01), and on their self-efficacy to deal with mental health situations at work (P<.001), with the exception of intentions to promote employee mental health, which was initially high. Results provide first evidence of the effectiveness of LMHP to positively affect managers' skills to promote employee mental health at work. Furthermore, the high rate of participation in LMHP (48/54, 89%) supports the use of digital game-based interventions to increase user engagement and user experience in mental health programs at work. ©Sabine Elisabeth Hanisch, Ulrich Walter Birner, Cornelia Oberhauser, Dennis Nowak, Carla Sabariego. Originally published in JMIR Mental Health (http://mental.jmir.org), 04.08.2017.

Microaggressions experienced by persons with mental illnesses: An exploratory study.

PubMed

Gonzales, Lauren; Davidoff, Kristin C; Nadal, Kevin L; Yanos, Philip T

2015-09-01

Microaggressions are subtle verbal or behavioral communications of disparaging messages to people based upon membership in a socially marginalized group. Their negative impact has been demonstrated for racial/ethnic groups, gender, sexual orientation, and physical disability, but currently no research exists on microaggressions as experienced by persons with mental illnesses. Qualitative data were gathered from 4 focus groups with 2 samples: adult mental health consumers in an assertive community treatment program and college students with mental illness diagnoses. Focus group transcripts were then analyzed using an open coding approach (Strauss & Corbin, 1990) to identify hierarchical themes and categories. Five major themes were identified, including invalidation, assumption of inferiority, fear of mental illness, shaming of mental illness, and second class citizen. Perpetrators of microaggressions were most commonly identified as being close friends, family members, and authority figures. Importantly, participants reported experiencing more overt discrimination experiences than subtle microaggression experiences. Reported negative outcomes related to microaggression experiences included isolation, negative emotions, and treatment nonadherence. Reported consequences of microaggressions have important implications for mental health treatment, especially as perpetrators were reported to include treatment providers and were usually unaware of such negative social exchanges. Loss of social support reported by participants and the frequent occurrence of microaggressions within close relationships implies these experiences could contribute to internalization of stigmatizing attitudes toward mental illness. Directions for future research include an investigation of motivation and reasoning behind perpetration of microaggressions against persons with mental illnesses. (c) 2015 APA, all rights reserved).

Self-Stigma in People With Mental Illness

PubMed Central

Watson, Amy C.; Corrigan, Patrick; Larson, Jonathon E.; Sells, Molly

2007-01-01

Persons with mental illnesses such as schizophrenia may internalize mental illness stigma and experience diminished self-esteem and self-efficacy. In this article, we describe a model of self-stigma and examine a hierarchy of mediational processes within the model. Seventy-one individuals with serious mental illness were recruited from a community support program at an outpatient psychiatry department of a community hospital. All participants completed the Self-Stigma of Mental Illness Scale along with measures of group identification (GI), perceived legitimacy (PL), self-esteem, and self-efficacy. Models examining the steps involved in self-stigma process were tested. Specifically, after conducting preliminary bivariate analyses, we examine stereotype agreement as a mediator of GI and PL on stigma self-concurrence (SSC); SSC as a mediator of GI and PL on self-efficacy; and SSC as a mediator of GI and PL on self-esteem. Findings provide partial support for the proposed mediational processes and point to GI, PL, and stereotype agreement as areas to be considered for intervention. PMID:17255118

The Experience of KAI MAHI, an Employment Initiative for People with an Experience of Mental Illness, as Told by Zarna, Zeus, Lulu, Mary, Paul, and Hemi.

PubMed

de Malmanche, Janie; Robertson, Linda

2015-11-01

There is a growing body of evidence endorsing the use of supported employment models for people with an experience of mental illness. However current literature and research regarding the perspective of people with experience of mental illness, as well as alternate models of employment support, is sparse. This study has captured the stories of employment of people with experience of mental illness who participated in KAI MAHI, a group based employment program. Findings identified key components of KAI MAHI, consistent with their overall experiences of employment, which were influential in assisting them to find and sustain employment. These included the opportunity for self-determination, a sense of self-efficacy, and respectful relationships.

African American Men and Women's Attitude Toward Mental Illness, Perceptions of Stigma, and Preferred Coping Behaviors

PubMed Central

Ward, Earlise; Wiltshire, Jacqueline C.; Detry, Michelle A.; Brown, R. L.

2014-01-01

Background Although research focused on African Americans with mental illness has been increasing, few researchers have addressed gender and age differences in beliefs, attitudes, and coping. Objective To examine African Americans' beliefs about mental illness, attitudes toward seeking mental health services, preferred coping behaviors, and whether these variables differ by gender and age. Method An exploratory, cross-sectional survey design was used. Participants were 272 community-dwelling African Americans aged 25-72 years. Data analysis included descriptive statistics and general linear regression models. Results Depression was the most common mental illness and there were no gender differences in prevalence. Both men and women believed they knew some of the symptoms and causal factors of mental illness. Their attitudes suggested they are not very open to acknowledging psychological problems, are very concerned about stigma associated with mental illness, and are somewhat open to seeking mental health services, but they prefer religious coping. Significant gender and age differences were evident in attitudes and preferred coping. Discussion Our findings have implications for gender and age-specific psychoeducation interventions and future research. For instance, psychoeducation or community awareness programs designed to increase openness to psychological problems and reducing stigma are needed. Also, exploration of partnerships between faith-based organizations and mental health services could be helpful to African Americans. PMID:23328705

Coping with the Stigma of Mental Illness: Empirically-Grounded Hypotheses from Computer Simulations

ERIC Educational Resources Information Center

Kroska, Amy; Har, Sarah K.

2011-01-01

This research demonstrates how affect control theory and its computer program, "Interact", can be used to develop empirically-grounded hypotheses regarding the connection between cultural labels and behaviors. Our demonstration focuses on propositions in the modified labeling theory of mental illness. According to the MLT, negative societal…

Effectiveness and Usability of a Web-Based Mindfulness Intervention for Families Living with Mental Illness.

PubMed

Stjernswärd, Sigrid; Hansson, Lars

2017-01-01

Families living with mental illness express needs of support and experiences of burden that may affect their own health detrimentally and hence also their ability to support the patient. Mindfulness-based interventions have shown beneficial health effects in both clinical and healthy populations. The aim of the current study was to explore the effectiveness and usability of a web-based mindfulness program for families living with mental illness, which was first tested in a feasibility study. The study was designed as a randomized controlled trial with an experiment group and a wait-list control group with assessments on primary and secondary outcomes at baseline, post-intervention, and at a 3-month follow-up. Significant positive improvements in mindfulness and self-compassion, and significant decreases in perceived stress and in certain dimensions of caregiver burden were found, with good program usability. Easily accessible mindfulness-based interventions may be useful in addressing caregivers' needs of support and in preventing further ill health in caregivers. Further studies are needed, among others, to further customize interventions and to investigate the cost-effectiveness of such programs.

A School Reentry Program for Chronically Ill Children.

ERIC Educational Resources Information Center

Worchel-Prevatt, Frances F.; Heffer, Robert W.; Prevatt, Bruce C.; Miner, Jennifer; Young-Saleme, Tammi; Horgan, Daniel; Lopez, Molly A.; Frankel, Lawrence; Rae, William A.

1998-01-01

Describes a school reintegration program aimed at overcoming the numerous psychological, physical, environmental, and family-based deterrents to school reentry for chronically ill children. The program uses a systems approach to children's mental health with an emphasis on multiple aspects of the child's environment (i.e., family, medical…

Determining Appropriate Criteria in the Evaluation of Correctional Mental Health Treatment for Inmates.

ERIC Educational Resources Information Center

Alexander, Rudolph, Jr.

1992-01-01

Notes that, despite changed goals of mental health treatment for inmates, some prison treatment programs still evaluate effects in terms of adjustment indicators. Discusses and critiques proposals in Ohio to use adjustment indicators as outcome measures for new treatment program for mentally ill inmates. Discusses proper outcome measures for…

Competency of psychiatric residents in the treatment of people with severe mental illness before and after a community psychiatry rotation.

PubMed

Randall, Melinda; Romero-Gonzalez, Mauricio; Gonzalez, Gerardo; Klee, Anne; Kirwin, Paul

2011-01-01

psychiatric rehabilitation is an evidence-based service with the goal of recovery for people with severe mental illness. Psychiatric residents should understand the services and learn the principles of psychiatric rehabilitation. This study assessed whether a 3-month rotation in a psychiatric rehabilitation center changes the competency level of second-year psychiatric residents in evidence-based treatment of severe mental illness. the study is a prospective, case-control comparison using the validated Competency Assessment Instrument (CAI), which measures 15 provider competencies critical to recovery, rehabilitation, and empowerment for people with severe mental illness, providing a score for each competency. Participants were second-year psychiatric residents attending a 3-month rotation at the Community Reintegration Program, a psychiatric rehabilitation day program. The authors administered the CAI at the beginning and the end of the residents' 3-month rotation in order to assess change in their competency in psychiatric rehabilitation. The authors also administered the CAI to a comparison group of second-year psychiatric residents who did not rotate through the Community Reintegration Program, and therefore had no formal training in psychiatric rehabilitation. a 3-month rotation in psychiatric rehabilitation significantly improved residents' competency in the domains of goal functioning, client preferences, holistic approach, skills, and team value relative to nonrotating residents. a brief community psychiatry rotation in the second year of residency likely improves some skills in the treatment of people with severe mental illness. Future research should evaluate year-long electives and public psychiatry fellowships.

Effects of Family-to-Family Psychoeducation Among Relatives of Patients With Severe Mental Disorders in Mexico City.

PubMed

Domínguez-Martinez, Tecelli; Rascon-Gasca, Maria Luisa; Alcántara-Chabelas, Humberto; Garcia-Silberman, Sara; Casanova-Rodas, Leticia; Lopez-Jimenez, Jorge Luis

2017-04-01

This study examined the effects of a three-month Family-to-Family (FTF) Education Program on expressed emotion and subjective knowledge about mental illness among relatives of Mexican patients with severe mental disorders. A total of 230 relatives of patients with severe mental disorders completed self-reported questionnaires before (pretest) and after (posttest) the FTF program. FTF led to reductions in negative emotional attitudes and improved the understanding of the disorder, regardless of sex or age of the relative. This study supported the evidence-based practice of FTF in a Mexican population and confirmed the importance of providing routine family psychoeducation as an additional component of health care service provision for relatives of people with severe mental illness in the community.

Community mental health care in India.

PubMed

Padmavati, R

2005-04-01

Recent times are witnessing methods in the various forms of community care for the mentally ill in India. Non-governmental organizations (NGO) play a pivotal role in filling the gap in the existing mental health services in India and the substantial need for these services. Various strategies that have been employed in community care have attempted to utilize existing community resources for implementation. Informal manpower resources incorporated with specialist psychiatric care and integrated with existing health care facilities have been general strategies. While the feasibility and cost-effectiveness of the NGO operated community outreach programs for the mentally ill have been demonstrated, various factors are seen to influence the planning and execution of such programs. This paper elucidates some critical factors that would need to be considered in community mental health care in India.

Differential Association of Stigma with Perceived Need and Mental Health Service Use.

PubMed

Wong, Eunice C; Collins, Rebecca L; Breslau, Joshua; Burnam, M Audrey; Cefalu, Matthew; Roth, Elizabeth A

2018-06-01

This study examined the role of stigma at two stages of the treatment-seeking process by assessing associations between various types of stigma and perceived need for mental health treatment as well as actual treatment use. We analyzed cross-sectional data from the 2014 and 2016 California Well-Being Survey, a telephone survey with a representative sample of 1954 California residents with probable mental illness. Multivariable logistic regression indicated that perceived need was associated with less negative beliefs about mental illness (odds ratio [OR] = 0.72; 95% confidence interval [CI] = 0.54, 0.95) and greater intentions to conceal a mental illness (OR = 1.47; 95% CI = 1.12-1.92). Among respondents with perceived need, treatment use was associated with greater mental health knowledge/advocacy (OR = 1.63; 95% CI = 1.03-2.56) and less negative treatment attitudes (OR = 0.66; 95% CI = 0.43-1.00). Understanding which aspects of stigma are related to different stages of the help-seeking process is essential to guiding policy and program initiatives aimed at ensuring individuals with mental illness obtain needed mental health services.

Mental Health Literacy Content for Children of Parents with a Mental Illness: Thematic Analysis of a Literature Review

PubMed Central

Riebschleger, Joanne; Grové, Christine; Cavanaugh, Daniel

2017-01-01

Millions of children have a parent with a mental illness (COPMI). These children are at higher risk of acquiring behavioural, developmental and emotional difficulties. Most children, including COPMI, have low levels of mental health literacy (MHL), meaning they do not have accurate, non-stigmatized information. There is limited knowledge about what kind of MHL content should be delivered to children. The aim of this exploratory study is to identify the knowledge content needed for general population children and COPMI to increase their MHL. A second aim is to explore content for emerging children’s MHL scales. Researchers created and analyzed a literature review database. Thematic analysis yielded five main mental health knowledge themes for children: (1) attaining an overview of mental illness and recovery; (2) reducing mental health stigma; (3) building developmental resiliencies; (4) increasing help-seeking capacities; and (5) identifying risk factors for mental illness. COPMI appeared to need the same kind of MHL knowledge content, but with extra family-contextual content such as dealing with stigma experiences, managing stress, and communicating about parental mental illness. There is a need for MHL programs, validated scales, and research on what works for prevention and early intervention with COPMI children. PMID:29072587

Stigmatizing attitudes about mental illness and allocation of resources to mental health services.

PubMed

Corrigan, Patrick W; Watson, Amy C; Warpinski, Amy C; Gracia, Gabriela

2004-08-01

This study tests a social psychological model (Skitka & Tetlock, 1992). Journal of Experimental Social Psychology, 28, 491-522; [1993]. Journal of Personality & Social Psychology, 65, 1205-1223 stating that policy maker decisions regarding the allocation of resources to mental health services are influenced by their attitudes towards people with mental illness and treatment efficacy. Fifty four individuals participated in a larger study of education about mental health stigma. Participants completed various measures of resource allocation preferences for mandated treatment and rehabilitation services, attributions about people with mental illness, and factors that influence allocation preferences including perceived treatment efficacy. Results showed significant attitudinal correlates with resource allocation preferences for mandated treatment, but no correlates to rehabilitation services. In particular, people who pity people with mental illness as well as those that endorse coercive and segregated treatments, were more likely to rate resource allocation to mandated care as important. Perceived treatment efficacy was also positively associated with resource allocation preferences for mandated treatment. A separate behavioral measure that involved donating money to NAMI was found to be inversely associated with blaming people for their mental illness and not being willing to help them. Implications of these findings on strategies that seek to increase resources for mental health programs are discussed.

Attitudes toward the mentally ill among community health-related personnel in South Korea.

PubMed

Jung, Wook; Choi, Eunkyung; Yu, Jaehak; Park, Doo-Heum; Ryu, Seung-Ho; Ha, Jee Hyun

2017-01-01

Prejudice and negative attitudes toward mental illness are major obstacles in the rehabilitation and functional recovery of patients. The objective of this study was to evaluate the attitudes of health-related personnel toward mentally ill patients in a local urban community in South Korea. In total, 401 participants (men, 132; women, 269; mean age, 37.3 ± 9.5 years) were recruited. The participants were health-related personnel in a district of Seoul, who were recruited from three different workplaces: a local administration office, a public health center, and a community welfare center. Sociodemographic data were gathered, and the community attitudes toward the mentally ill (CAMI) inventory were administered. Comparisons of the CAMI subscales were conducted among participants using statistical analysis. Community welfare center workers showed more authoritarianism and social restriction and less community mental health ideology than the other two groups. Among the demographic variables, a shorter working career, higher education, female gender, and younger age were also related to a more negative attitude toward mentally ill patients. Community health-related personnel who have contact with patients with mental illness should be encouraged to have a fair, hospitable, and open-minded attitude. It is advisable for these workers to receive interventions such as regular educational programs early in their careers.

Does improvement of cognitive functioning by cognitive remediation therapy effect work outcomes in severe mental illness? A secondary analysis of a randomized controlled trial.

PubMed

Ikebuchi, Emi; Sato, Sayaka; Yamaguchi, Sosei; Shimodaira, Michiyo; Taneda, Ayano; Hatsuse, Norifumi; Watanabe, Yukako; Sakata, Masuhiro; Satake, Naoko; Nishio, Masaaki; Ito, Jun-Ichiro

2017-05-01

The aim of this study was to clarify whether improvement of cognitive functioning by cognitive remediation therapy can improve work outcome in schizophrenia and other severe mental illnesses when combined with supported employment. The subjects of this study were persons with severe mental illness diagnosed with schizophrenia, major depression, or bipolar disorder (ICD-10) and cognitive dysfunction who participated in both cognitive remediation using the Thinking Skills for Work program and a supported employment program in a multisite, randomized controlled study. Logistic and multiple linear regression analyses were performed to clarify the influence of cognitive functioning on vocational outcomes, adjusting for demographic and clinical variables. Improvement of cognitive functioning with cognitive remediation significantly contributed to the total days employed and total earnings of competitive employment in supported employment service during the study period. Any baseline demographic and clinical variables did not significantly contribute to the work-related outcomes. A cognitive remediation program transferring learning skills into the real world is useful to increase the quality of working life in supported employment services for persons with severe mental illness and cognitive dysfunction who want to work competitively. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

Maltreatment of people with serious mental illness in the early 20th century: a focus on Nazi Germany and eugenics in America.

PubMed

Fischer, Bernard A

2012-12-01

Prejudice and stigma against people with mental illness can be seen throughout history. The worst instance of this prejudice was connected to the rise of the eugenics movement in the early 20th century. Although the Nazi German T-4 program of killing people with mental illness was the most egregious culmination of this philosophy, the United States has its own dark eugenics history-nearing a slippery slope all too similar to that of the Nazis. Mental health care clinicians need to examine this period to honor the memory of the victims of eugenics and to guarantee that nothing like this will ever happen again.

Approach to adolescent suicide prevention

PubMed Central

Kostenuik, Marcia; Ratnapalan, Mohana

2010-01-01

Abstract OBJECTIVE To provide family physicians with an approach to suicide prevention in youth. SOURCES OF INFORMATION A literature review was performed using Ovid MEDLINE with the key words suicide, attempted suicide, and evaluation studies or program evaluation, adolescent. MAIN MESSAGE Youth suicide might be prevented by earlier recognition and treatment of mental illness. Family physicians can and should screen for mental illness in youth; there are many diagnostic and treatment resources available to assist with this. CONCLUSION Earlier detection and treatment of mental illness are the most important ways family physicians can reduce morbidity and mortality for youth who are contemplating suicide. PMID:20705879

Outcomes of a 4-year program with higher education and employment goals for individuals diagnosed with mental illness.

PubMed

Schindler, Victoria P; Sauerwald, Camille

2013-01-01

This study examined outcomes of the first four years (2005-2009) of the Bridge Program, an occupational therapy (OT) program that incorporates principles of supported education and supported employment. This program was developed to assist individuals with mental illness to achieve higher education and employment goals. Forty-eight adult participants with various mental health diagnoses. A quantitative one-group pretest-posttest survey design and posttest qualitative focus groups were used. Participants enrolled in higher education increased from 7 to 11 (pretest=15%; posttest=23%), participants employed increased from 5 to 19 (pretest=10%; posttest=40%), and the combined category of higher education/employment increased from 12 to 30 (pretest=25%; posttest=63%) Statistical significance was achieved from pre to posttest in the employment sample (p<0.000), and in the combined sample of higher education/employment (p< 0.000), but was not achieved in the higher education sample from pre to posttest (p=0.125). Quantitative and qualitative results support that an OT program incorporating principles of supported education and employment can assist individuals with mental illness to achieve higher education and employment goals. Results also outlined items participants found to be supports and barriers to achieving goals.

Enhancing the Rehabilitation of Persons with Long-Term Mental Illness. [Proceedings of the] Institute on Rehabilitation Issues (15th, Tampa, Florida, December 1988). Report from the Study Group.

ERIC Educational Resources Information Center

Cato, Carol; And Others

This report from a study group on long-term mental illness (LTMI) examines three components of the vocational rehabilitation process (the client, the counselor, and the programs) and the systems through which the three components interact. The first chapter discusses the history and evolution of the vocational rehabilitation (VR) and mental health…

Children of mentally ill parents-a pilot study of a group intervention program.

PubMed

Christiansen, Hanna; Anding, Jana; Schrott, Bastian; Röhrle, Bernd

2015-01-01

The transgenerational transmission of mental disorders is one of the most prominent risk factors for the development of psychological disorders. Children of mentally ill parents are a vulnerable high risk group with overall impaired development and high rates of psychological disorders. To date there are only a few evidence based intervention programs for this group overall and hardly any in Germany. We translated the evidence based Family Talk Intervention by Beardslee (2009) and adapted it for groups. First results of this pilot study are presented. This investigation evaluates a preventive group intervention for children of mentally ill parents. In a quasi-experimental design three groups are compared: an intervention group (Family Talk Intervention group: n = 28), a Wait Control group (n = 9), and a control group of healthy children (n = 40). Mean age of children was 10.41 years and parental disorders were mostly depressive/affective disorders (n = 30), but a small number also presented with Attention-Deficit/Hyperactivity Disorder (n = 7). Children of mentally ill parents showed higher rates of internalizing/externalizing disorders before and after the intervention compared to children of parents with no disorders. Post intervention children's knowledge on mental disorders was significantly enhanced in the Family Talk Intervention group compared to the Wait Control group and the healthy control group. Parental ratings of externalizing symptoms in the children were reduced to normal levels after the intervention in the Family Talk Intervention group, but not in the Wait Control group. This pilot study of a group intervention for children of mentally ill parents highlights the importance of psycho-education on parental mental disorders for children. Long-term effects of children's enhanced knowledge about parental psychopathology need to be explored in future studies.

Children of mentally ill parents—a pilot study of a group intervention program

PubMed Central

Christiansen, Hanna; Anding, Jana; Schrott, Bastian; Röhrle, Bernd

2015-01-01

Objective: The transgenerational transmission of mental disorders is one of the most prominent risk factors for the development of psychological disorders. Children of mentally ill parents are a vulnerable high risk group with overall impaired development and high rates of psychological disorders. To date there are only a few evidence based intervention programs for this group overall and hardly any in Germany. We translated the evidence based Family Talk Intervention by Beardslee (2009) and adapted it for groups. First results of this pilot study are presented. Method: This investigation evaluates a preventive group intervention for children of mentally ill parents. In a quasi-experimental design three groups are compared: an intervention group (Family Talk Intervention group: n = 28), a Wait Control group (n = 9), and a control group of healthy children (n = 40). Mean age of children was 10.41 years and parental disorders were mostly depressive/affective disorders (n = 30), but a small number also presented with Attention-Deficit/Hyperactivity Disorder (n = 7). Results: Children of mentally ill parents showed higher rates of internalizing/externalizing disorders before and after the intervention compared to children of parents with no disorders. Post intervention children's knowledge on mental disorders was significantly enhanced in the Family Talk Intervention group compared to the Wait Control group and the healthy control group. Parental ratings of externalizing symptoms in the children were reduced to normal levels after the intervention in the Family Talk Intervention group, but not in the Wait Control group. Discussion: This pilot study of a group intervention for children of mentally ill parents highlights the importance of psycho-education on parental mental disorders for children. Long-term effects of children's enhanced knowledge about parental psychopathology need to be explored in future studies. PMID:26539129

'You are Okay': a support and educational program for children with mild intellectual disability and their parents with a mental illness: study protocol of a quasi-experimental design.

PubMed

Riemersma, Ivon; van Santvoort, Floor; Janssens, Jan M A M; Hosman, Clemens M H; van Doesum, Karin T M

2015-12-24

Children of parents with a mental illness or substance use disorder (COPMI) have an increased risk of developing social-emotional problems themselves. Fear of stigmatisation or unawareness of problems prevents children and parents from understanding each other. Little is known about COPMI with mild intellectual disabilities (ID), except that they have a high risk of developing social-emotional problems and require additional support. In this study, we introduce a program for this group, the effectiveness of which we will study using a quasi-experimental design based on matching. The program 'You are okay' consists of a support group for children and an online educational program for parents. The goal of the program is to increase children and parents' perceived competence with an aim to prevent social-emotional problems in children. Children between ten and twenty years old with mild ID (IQ between 50 and 85) and at least one of their parents with a mental illness will be included in the study. The children will receive part time treatment or residential care from an institute for children with mild ID and behavioural problems. Participants will be assigned to the intervention or the control group. The study has a quasi-experimental design. The children in the intervention group will join a support group, and their parents will be offered an online educational program. Children in the control group will receive care as usual, and their parents will have no extra offer. Assessments will be conducted at baseline, post-test, and follow up (6 months). Children, parents, and social workers will fill out the questionnaires. The 'You are okay' program is expected to increase children and parents' perceived competence, which can prevent (further) social-emotional problem development. Because the mental illness of parents can be related to the behavioural problems of their children, it is important that children and parents understand each other. When talking about the mental illness of parents becomes standard in children's treatment, stigmatisation and the fear for stigmatisation can decrease. Dutch Trial Register NTR4845 . Registered 9 October 2014.

Communication Strategies to Counter Stigma and Improve Mental Illness and Substance Use Disorder Policy.

PubMed

McGinty, Emma; Pescosolido, Bernice; Kennedy-Hendricks, Alene; Barry, Colleen L

2018-02-01

Despite the high burden and poor rates of treatment associated with mental illness and substance use disorders, public support for allocating resources to improving treatment for these disorders is low. A growing body of research suggests that effective policy communication strategies can increase public support for policies benefiting people with these conditions. In October 2015, the Center for Mental Health and Addiction Policy Research at Johns Hopkins University convened an expert forum to identify what is currently known about the effectiveness of such policy communication strategies and produce recommendations for future research. One of the key conclusions of the forum was that communication strategies using personal narratives to engage audiences have the potential to increase public support for policies benefiting persons with mental illness or substance use disorders. Specifically, narratives combining personal stories with depictions of structural barriers to mental illness and substance use disorder treatment can increase the public's willingness to invest in the treatment system. Depictions of mental illness and violence significantly increase public stigma toward people with mental illness and are no more effective in increasing willingness to invest in mental health services than nonstigmatizing messages about structural barriers to treatment. Future research should prioritize development and evaluation of communication strategies to increase public support for evidence-based substance use disorder policies, including harm reduction policies-such as needle exchange programs-and policies expanding treatment.

California’s Historic Effort to Reduce the Stigma of Mental Illness: The Mental Health Services Act

PubMed Central

Clark, Wayne; Berry, Sandra H.; Collentine, Ann M.; Collins, Rebecca; Lebron, Dorthy; Shearer, Amy L.

2013-01-01

In a historic effort to reduce the stigma of mental illness, California voters approved the Mental Health Services Act in 2004. The law funds a comprehensive statewide prevention initiative that places stigma and discrimination reduction at its center, with 25 projects providing interventions at the institutional, societal, and individual levels. Stakeholders selected specific strategies from the research-based California Strategic Plan on Reducing Stigma and Discrimination. Strategies range from social marketing to increase public knowledge to capacity building at the local level, including training that emphasizes participation by consumers of mental health services and cultural competence. Collectively, these strategies aim to foster permanent change in the public perception of mental illness and in the individual experience of stigma. We examined the context, planning, programming, and evaluation of this effort. PMID:23488486

California's historic effort to reduce the stigma of mental illness: the Mental Health Services Act.

PubMed

Clark, Wayne; Welch, Stephanie N; Berry, Sandra H; Collentine, Ann M; Collins, Rebecca; Lebron, Dorthy; Shearer, Amy L

2013-05-01

In a historic effort to reduce the stigma of mental illness, California voters approved the Mental Health Services Act in 2004. The law funds a comprehensive statewide prevention initiative that places stigma and discrimination reduction at its center, with 25 projects providing interventions at the institutional, societal, and individual levels. Stakeholders selected specific strategies from the research-based California Strategic Plan on Reducing Stigma and Discrimination. Strategies range from social marketing to increase public knowledge to capacity building at the local level, including training that emphasizes participation by consumers of mental health services and cultural competence. Collectively, these strategies aim to foster permanent change in the public perception of mental illness and in the individual experience of stigma. We examined the context, planning, programming, and evaluation of this effort.

Improving Depression Care for Adults With Serious Mental Illness in Underresourced Areas: Community Coalitions Versus Technical Support.

PubMed

Castillo, Enrico G; Shaner, Roderick; Tang, Lingqi; Chung, Bowen; Jones, Felica; Whittington, Yolanda; Miranda, Jeanne; Wells, Kenneth B

2018-02-01

Community Partners in Care (CPIC) was a group-randomized study of two approaches to implementing expanded collaborative depression care: Community Engagement and Planning (CEP), a coalition approach, and Resources for Services (RS), a technical assistance approach. Collaborative care networks in both arms involved health care and other agencies in five service sectors. This study examined six- and 12-month outcomes for CPIC participants with serious mental illness. This secondary analysis focused on low-income CPIC participants from racial-ethnic minority groups with serious mental illness in underresourced Los Angeles communities (N=504). Serious mental illness was defined as self-reported severe depression (≥20 on the Patient Health Questionnaire-8) at baseline or a lifetime history of bipolar disorder or psychosis. Logistic and Poisson regression with multiple imputation and response weights, controlling for covariates, was used to model intervention effects. Among CPIC participants, 50% had serious mental illness. Among those with serious mental illness, CEP relative to RS reduced the likelihood of poor mental health-related quality of life (OR=.62, 95% CI=.41-.95) but not depression (primary outcomes); reduced the likelihood of having homelessness risk factors and behavioral health hospitalizations; increased the likelihood of mental wellness; reduced specialty mental health medication and counseling visits; and increased faith-based depression visits (each p<.05) at six months. There were no statistically significant 12-month effects. Findings suggest that a coalition approach to implementing expanded collaborative depression care, compared with technical assistance to individual programs, may reduce short-term behavioral health hospitalizations and improve mental health-related quality of life and some social outcomes for adults with serious mental illness, although no evidence was found for long-term effects in this subsample.

Maslow and Mental Health Recovery: A Comparative Study of Homeless Programs for Adults with Serious Mental Illness

PubMed Central

Derejko, Katie-Sue; Couture, Julie; Padgett, Deborah K.

2014-01-01

This mixed-methods study uses Maslow’s hierarchy as a theoretical lens to investigate the experiences of 63 newly enrolled clients of housing first and traditional programs for adults with serious mental illness who have experienced homelessness. Quantitative findings suggests that identifying self-actualization goals is associated with not having one’s basic needs met rather than from the fulfillment of basic needs. Qualitative findings suggest a more complex relationship between basic needs, goal setting, and the meaning of self-actualization. Transforming mental health care into a recovery-oriented system will require further consideration of person-centered care planning as well as the impact of limited resources especially for those living in poverty. PMID:24518968

Maslow and mental health recovery: a comparative study of homeless programs for adults with serious mental illness.

PubMed

Henwood, Benjamin F; Derejko, Katie-Sue; Couture, Julie; Padgett, Deborah K

2015-03-01

This mixed-methods study uses Maslow's hierarchy as a theoretical lens to investigate the experiences of 63 newly enrolled clients of housing first and traditional programs for adults with serious mental illness who have experienced homelessness. Quantitative findings suggests that identifying self-actualization goals is associated with not having one's basic needs met rather than from the fulfillment of basic needs. Qualitative findings suggest a more complex relationship between basic needs, goal setting, and the meaning of self-actualization. Transforming mental health care into a recovery-oriented system will require further consideration of person-centered care planning as well as the impact of limited resources especially for those living in poverty.

Longitudinal effects of integrated treatment on alcohol use for persons with serious mental illness and substance use disorders.

PubMed

Herman, S E; Frank, K A; Mowbray, C T; Ribisl, K M; Davidson, W S; BootsMiller, B; Jordan, L; Greenfield, A L; Loveland, D; Luke, D A

2000-08-01

A randomized experimental design was used to assign participants to an integrated mental health and substance use treatment program or to standard hospital treatment. A multilevel, nonlinear model was used to estimate hospital treatment effects on days of alcohol use for persons with serious mental illness and substance use disorders over 18 months. The integrated treatment program had a significant effect on the rate of alcohol use at 2 months postdischarge, reducing the rate of use by 54%. Motivation for sobriety at hospital discharge, posttreatment self-help attendance, and social support for sobriety were also found to reduce the rate of use during the follow-up period. Implications for mental health treatment and aftercare support are discussed.

Psychometric Properties of the Vocational Rehabilitation Engagement Scale When Used with People with Mental Illness in Clubhouse Settings

ERIC Educational Resources Information Center

Fitzgerald, Sandra; Deiches, Jonathan; Umucu, Emre; Brooks, Jessica; Muller, Veronica; Wu, Jia-Rung; Chan, Fong

2016-01-01

Purpose: The purpose of this study was to validate the Vocational Rehabilitation Engagement Scale (VRES) for use in the Clubhouse Model of Psychosocial Rehabilitation. Method: There were 124 individuals with serious mental illness recruited from 8 Clubhouse programs in Hawaii. Measurement structure of the VRES was evaluated using exploratory…

Children of Parents Hospitalized for Mental Illness: II. The Evaluation of an Intervention Program for Mentally Ill Mothers of Young Children.

ERIC Educational Resources Information Center

Cohler, Bertram J.; Grunebaum, Henry

1982-01-01

Among three groups of disturbed mothers of young children studied, women hospitalized more often were found to be less able to differentiate between their own and their children's needs; this group showed greater life-event stress and more maternal role conflict. (Author/CMG)

Challenging Stereotypes: An Action Guide. Consumer Information Series, Volume 5.

ERIC Educational Resources Information Center

Arnold, Jean; Weinerth, Nora

This booklet is intended to help decrease the barriers of prejudice toward people who have mental illnesses. It serves as an educational tool to eliminate the stigma associated with mental illness and to help develop anti-stigma or anti-discrimination programs. Increasingly, the media is doing a better job of breaking down the stereotypes…

Service-Learning with the Mentally Ill: Softening the Stigma

ERIC Educational Resources Information Center

Barney, Steve T.; Corser, Grant C.; White, Lynn H.

2010-01-01

Stigmas toward those who have mental illnesses are wide-spread and detrimental to the health and well-being of those suffering from these debilitating conditions, and to society as a whole. Stigma-reducing programs are plentiful but many are only marginally effective. In this paper we describe and evaluate a course in Psychopathology that included…

Adolescent mental health education InSciEd Out: a case study of an alternative middle school population.

PubMed

Yang, Joanna; Lopez Cervera, Roberto; Tye, Susannah J; Ekker, Stephen C; Pierret, Chris

2018-04-03

Mental illness contributes substantially to global disease burden, particularly when illness onset occurs during youth and help-seeking is delayed and/or limited. Yet, few mental health promotion interventions target youth, particularly those with or at high risk of developing mental illness ("at-risk" youth). Community-based translational research has the capacity to identify and intervene upon barriers to positive health outcomes. This is especially important for integrated care in at-risk youth populations. Here the Integrated Science Education Outreach (InSciEd Out) program delivered a novel school-based anti-stigma intervention in mental health to a cohort of seventh and eighth grade at-risk students. These students were assessed for changes in mental health knowledge, stigmatization, and help-seeking intentions via a classroom activity, surveys, and teacher interviews. Descriptive statistics and Cohen's d effect sizes were employed to assess pre-post changes. Inferential statistical analyses were also conducted on pilot results to provide a benchmark to inform future studies. Elimination of mental health misconceptions (substance weakness p = 0.00; recovery p = 0.05; prevention p = 0.05; violent p = 0.05) was accompanied by slight gains in mental health literacy (d = 0.18) and small to medium improvements in help-seeking intentions (anxiety d = 0.24; depression d = 0.48; substance d = 0.43; psychosis d = 0.53). Within this particular cohort of students, stigma was exceptionally low at baseline and remained largely unchanged. Teacher narratives revealed positive teacher views of programming, increased student openness to talk about mental illness, and higher peer and self-acceptance of mental health diagnoses and help-seeking. Curricular-based efforts focused on mental illness in an alternative school setting are feasible and integrated well into general curricula under the InSciEd Out framework. Preliminary data suggest the existence of unique help-seeking barriers in at-risk youth. Increased focus upon community-based programming has potential to bridge gaps in translation, bringing this critical population to clinical care in pursuit of improved mental health for all. Trial registration ClinicalTrials.gov, ID:NCT02680899. Registered 12 February 2016, https://clinicaltrials.gov/ct2/show/NCT02680899.

The use of peer mentors to enhance a smoking cessation intervention for persons with serious mental illnesses.

PubMed

Dickerson, Faith B; Savage, Christina L G; Schweinfurth, Lucy A B; Medoff, Deborah R; Goldberg, Richard W; Bennett, Melanie; Lucksted, Alicia; Chinman, Matthew; Daumit, Gail; Dixon, Lisa; DiClemente, Carlo

2016-03-01

We evaluated a well-specified peer mentor program that enhanced a professionally led smoking cessation group for persons with serious mental illnesses. Participants were 8 peer mentors, persons with serious mental illnesses who had successfully quit smoking, and 30 program participants, persons with serious mental illnesses enrolled in a 6-month intervention. Peer mentors were trained and then helped to deliver a smoking cessation group and met with program participants individually. We assessed the mentors' skills after training, their fidelity to the model, and the program's feasibility and acceptability. We also measured the smoking outcomes of the program participants including change in exhaled carbon monoxide, a measure of recent smoking, and aspects of the peer mentor-program participant relationship. Peer mentors attained a mean score of 13.6/14 on role play assessments after training and delivered the intervention with fidelity as assessed by adherence and competence ratings (mean scores of 97% and 93%, respectively). The feasibility and acceptability of the intervention was demonstrated in that 28/30 participants met with their peer mentors regularly and only 1 participant and no peer mentor discontinued in the study. Both parties rated the interpersonal alliance highly, mean of 5.9/7. The program participants had a decline in carbon monoxide levels and number of cigarettes smoked per day (repeated measures ANOVA F = 6.04, p = .008; F = 15.87, p < .001, respectively). A total of 22/30 (73%) made a quit attempt but only 3 (10%) achieved sustained abstinence. Our study adds to the growing literature about peer-delivered interventions. (c) 2016 APA, all rights reserved).

Development of a 2-h suicide prevention program for medical staff including nurses and medical residents: A two-center pilot trial.

PubMed

Nakagami, Yukako; Kubo, Hiroaki; Katsuki, Ryoko; Sakai, Tomomichi; Sugihara, Genichi; Naito, Chisako; Oda, Hiroyuki; Hayakawa, Kohei; Suzuki, Yuriko; Fujisawa, Daisuke; Hashimoto, Naoki; Kobara, Keiji; Cho, Tetsuji; Kuga, Hironori; Takao, Kiyoshi; Kawahara, Yoko; Matsumura, Yumi; Murai, Toshiya; Akashi, Koichi; Kanba, Shigenobu; Otsuka, Kotaro; Kato, Takahiro A

2018-01-01

Suicide is a crucial global health concern and effective suicide prevention has long been warranted. Mental illness, especially depression is the highest risk factor of suicide. Suicidal risk is increased in people not only with mental illness but also with physical illnesses, thus medical staff caring for physically-ill patients are also required to manage people with suicidal risk. In the present study, we evaluated our newly developed suicide intervention program among medical staff. We developed a 2-h suicide intervention program for medical staff, based on the Mental Health First Aid (MHFA), which had originally been developed for the general population. We conducted this program for 74 medical staff members from 2 hospitals. Changes in knowledge, perceived skills, and confidence in early intervention of depression and suicide-prevention were evaluated using self-reported questionnaires at 3 points; pre-program, immediately after the program, and 1 month after program. This suicide prevention program had significant effects on improving perceived skills and confidence especially among nurses and medical residents. These significant effects lasted even 1 month after the program. Design was a single-arm study with relatively small sample size and short-term follow up. The present study suggests that the major target of this effective program is nurses and medical residents. Future research is required to validate the effects of the program with control groups, and also to assess long-term effectiveness and actual reduction in suicide rates. Copyright © 2017 Elsevier B.V. All rights reserved.

Engagement processes in model programs for community reentry from prison for people with serious mental illness.

PubMed

Angell, Beth; Matthews, Elizabeth; Barrenger, Stacey; Watson, Amy C; Draine, Jeffrey

2014-01-01

Linking prisoners with mental illness with treatment following release is critical to preventing recidivism, but little research exists to inform efforts to engage them effectively. This presentation compares the engagement process in two model programs, each representing an evidence-based practice for mental health which has been adapted to the context of prison reentry. One model, Forensic Assertive Community Treatment (FACT), emphasizes a long-term wrap-around approach that seeks to maximize continuity of care by concentrating all services within one interdisciplinary team; the other, Critical Time Intervention (CTI), is a time-limited intervention that promotes linkages to outside services and bolsters natural support systems. To compare engagement practices, we analyze data from two qualitative studies, each conducted in a newly developed treatment program serving prisoners with mental illness being discharged from prisons to urban communities. Findings show that the working relationship in reentry services exhibits unique features and is furthered in both programs by the use of practitioner strategies of engagement, including tangible assistance, methods of interacting with consumers, and encouragement of service use via third parties such as families and parole officers. Nevertheless, each program exhibited distinct cultures and rituals of reentry that were associated with fundamental differences in philosophy and differences in resources available to each program. Copyright © 2014 Elsevier Ltd. All rights reserved.

Mental Health Nurse Incentive Program: facilitating physical health care for people with mental illness?

PubMed

Happell, Brenda; Platania-Phung, Chris; Scott, David

2013-10-01

People with serious mental illness have increased rates of physical ill-health and reduced contact with primary care services. In Australia, the Mental Health Nurse Incentive Program (MHNIP) was developed to facilitate access to mental health services. However, as a primary care service, the contribution to physical health care is worthy of consideration. Thirty-eight nurses who were part of the MHNIP participated in a national survey of nurses working in mental health about physical health care. The survey invited nurses to report their views on the physical health of consumers and the regularity of physical health care they provide. Physical health-care provision in collaboration with general practitioners (GPs) and other health-care professionals was reported as common. The findings suggest that the MHNIP provides integrated care, where nurses and GPs work in collaboration, allowing enough time to discuss physical health or share physical health activities. Consumers of this service appeared to have good access to physical and mental health services, and nurses had access to primary care professionals to discuss consumers' physical health and develop their clinical skills in the physical domain. The MHNIP has an important role in addressing physical health concerns, in addition to the mental health issues of people accessing this service. © 2012 The Authors; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Basic Strategies of Dynamic Supportive Therapy

PubMed Central

Misch, Donald A.

2000-01-01

Supportive therapy is the psychotherapeutic approach employed with the majority of mentally ill individuals. Nevertheless, most mental health professional training programs dedicate little time and effort to the teaching and learning of supportive therapy, and many mental health professionals are unable to clearly and concisely articulate the nature or process of supportive work. Although supportive therapy incorporates many specific techniques from a wide variety of psychotherapy schools, it can be conceptualized as consisting of a more limited number of underlying strategies. The fundamental strategies that underpin effective supportive therapy with mentally ill individuals are described. PMID:11069130

How does outcome-based funding affect service delivery? An analysis of consequences within employment services for people living with serious mental illness.

PubMed

Gewurtz, Rebecca E; Cott, Cheryl; Rush, Brian; Kirsh, Bonnie

2015-01-01

This paper explores the impact of outcome-based funding on service delivery within employment services for people with serious mental illness. It draws on a case study of a policy change in the provincial disability support program in Ontario, Canada where funding for employment programs and services was changed from a fee-for-service to an outcome-based model. The findings highlight that the financial imperative for programs to meet employment targets in order to secure their funding has shifted the focus away from the provision of pre-employment supports to job development and job placements. However, there remains little attention to job matching and career development, and there is concern about access to services among those with complex barriers to employment. There is a need to reconcile tensions between the goals of outcome-based funding and on-the-ground service delivery to promote ongoing innovation in employment services for people with serious mental illness.

COMMUNITY MENTAL HEALTH SERVICES ACT—Five Years of Operation Under the California Law

PubMed Central

Rudin, Edward; McInnes, Robert S.

1963-01-01

The Short-Doyle program represents a small part of the needed response to the base problem of mental illness. However, in the five years since the signing of the original bill, programs receiving aid under the Short-Doyle Act for Community Mental Health Services have made impressive steps toward meeting the need for community mental health services. They have done so under local auspices and working closely with general health and medical programs available locally. PMID:13982995

Self-reported alcohol and drug use six months after brief intervention: do changes in reported use vary by mental-health status?

PubMed Central

2012-01-01

Background Although brief intervention (BI) for alcohol and other drug problems has been associated with subsequent decreased levels of self-reported substance use, there is little information in the extant literature as to whether individuals with co-occurring hazardous substance use and mental illness would benefit from BI to the same extent as those without mental illness. This is an important question, as mental illness is estimated to co-occur in 37% of individuals with an alcohol use disorder and in more than 50% of individuals with a drug use disorder. The goal of this study was to explore differences in self-reported alcohol and/or drug use in patients with and without mental illness diagnoses six months after receiving BI in a hospital emergency department (ED). Methods This study took advantage of a naturalistic situation where a screening, brief intervention, and referral to treatment (SBIRT) program had been implemented in nine large EDs in the US state of Washington as part of a national SBIRT initiative. A subset of patients who received BI was interviewed six months later about current alcohol and drug use. Linear regression was used to assess whether change in substance use measures differed among patients with a mental illness diagnosis compared with those without. Data were analyzed for both a statewide (n = 828) and single-hospital (n = 536) sample. Results No significant differences were found between mentally ill and non-mentally ill subgroups in either sample with regard to self-reported hazardous substance use at six-month follow-up. Conclusion These results suggest that BI may not have a differing impact based on the presence of a mental illness diagnosis. Given the high prevalence of mental illness among individuals with alcohol and other drug problems, this finding may have important public health implications. PMID:23186062

38 CFR 52.160 - Specialized rehabilitative services.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., but not limited to, physical therapy, speech therapy, occupational therapy, and mental health services for mental illness are required in the participant's comprehensive plan of care, program management...

Self-stigma among caregivers of people with mental illness: toward caregivers’ empowerment

PubMed Central

Girma, Eshetu; Möller-Leimkühler, Anne Maria; Dehning, Sandra; Mueller, Norbert; Tesfaye, Markos; Froeschl, Guenter

2014-01-01

Background In addition to economic and material burdens, caregivers of people with mental illness are exposed to psychosocial challenges. Self-stigma is among the psychological challenges that can be exacerbated by intrinsic and/or extrinsic factors. Caregivers’ self-stigma can negatively influence the patients’ treatment and rehabilitation process. The objective of this study was to measure the level and correlates of self-stigma among caregivers of people with mental illness. Methods An interviewer-administered cross-sectional study was conducted in the Jimma University Specialized Hospital Psychiatry Clinic in Ethiopia on a sample of 422 caregivers. Data were collected by trained nurses working in the clinic using a pretested questionnaire. Multivariate linear regression was performed to identify the correlates of self-stigma among caregivers of people with mental illness. Results The majority (70.38%) of the caregivers were male. On a scale of 0 to 15, with 0 being low and 15 being high, the average self-stigmatizing attitude score was 4.68 (±4.11). A statistically significant difference in mean self-stigma score was found between urban and rural respondents (t=3.95, P<0.05). Self-stigma of caregivers showed significant positive correlation with perceived signs of mental illness (r=0.18, P<0.001), perceived supernatural explanations of mental illness (r=0.26, P<0.001), and perceived psychosocial and biological explanations of mental illness (r=0.12, P<0.01). The only independent predictor of caregivers’ self-stigma was perceived supernatural explanation of mental illness (standardized β=0.22, P<0.001). Conclusion The tendency of caregivers to avoid being identified with the patients was observed. Low exposure to mental health information was also reported. Caregivers’ self-stigma in this study was significantly correlated with perceived supernatural explanation of mental illness. Since caregivers’ self-stigma may negatively influence patients’ treatment-seeking, adherence, and rehabilitation processes, programs that enhance coping strategies by strengthening self-esteem and empowerment by health care providers and establish family support groups may be helpful to tackle self-stigma among caregivers of people with mental illness. PMID:24470760

Self-stigma among caregivers of people with mental illness: toward caregivers' empowerment.

PubMed

Girma, Eshetu; Möller-Leimkühler, Anne Maria; Dehning, Sandra; Mueller, Norbert; Tesfaye, Markos; Froeschl, Guenter

2014-01-01

In addition to economic and material burdens, caregivers of people with mental illness are exposed to psychosocial challenges. Self-stigma is among the psychological challenges that can be exacerbated by intrinsic and/or extrinsic factors. Caregivers' self-stigma can negatively influence the patients' treatment and rehabilitation process. The objective of this study was to measure the level and correlates of self-stigma among caregivers of people with mental illness. An interviewer-administered cross-sectional study was conducted in the Jimma University Specialized Hospital Psychiatry Clinic in Ethiopia on a sample of 422 caregivers. Data were collected by trained nurses working in the clinic using a pretested questionnaire. Multivariate linear regression was performed to identify the correlates of self-stigma among caregivers of people with mental illness. The majority (70.38%) of the caregivers were male. On a scale of 0 to 15, with 0 being low and 15 being high, the average self-stigmatizing attitude score was 4.68 (±4.11). A statistically significant difference in mean self-stigma score was found between urban and rural respondents (t=3.95, P<0.05). Self-stigma of caregivers showed significant positive correlation with perceived signs of mental illness (r=0.18, P<0.001), perceived supernatural explanations of mental illness (r=0.26, P<0.001), and perceived psychosocial and biological explanations of mental illness (r=0.12, P<0.01). The only independent predictor of caregivers' self-stigma was perceived supernatural explanation of mental illness (standardized β=0.22, P<0.001). The tendency of caregivers to avoid being identified with the patients was observed. Low exposure to mental health information was also reported. Caregivers' self-stigma in this study was significantly correlated with perceived supernatural explanation of mental illness. Since caregivers' self-stigma may negatively influence patients' treatment-seeking, adherence, and rehabilitation processes, programs that enhance coping strategies by strengthening self-esteem and empowerment by health care providers and establish family support groups may be helpful to tackle self-stigma among caregivers of people with mental illness.

Individual and societal impact on earnings associated with serious mental illness in metropolitan China

PubMed Central

Lee, Sing; Tsang, Adley; Huang, Yue-qin; He, Yan-ling; Liu, Zhao-rui; Zhang, Ming-yuan; Shen, Yu-cun; Kessler, Ronald C.

2013-01-01

To evaluate individual-level and societal-level losses of income associated with serious mental illness in metropolitan China, a multi-stage probability survey was administered to adults aged 18–70 in Beijing and Shanghai. We used data to estimate individual-level expected earnings from a model that included information about the respondents’ education level, marital status, age, and gender. Expected earnings were compared to observed earnings among respondents with mental illness and serious disability. The result shows that the 12-month prevalence of such serious mental illness was 0.6%. Its impact on earnings was significant in the total sample and was higher for males (76% of gender-specific expected salary was lost) than females (32%). When projected to societal level, the annual impact was estimated to be 466 million Renminbi (RMB 8.27= USD 1), less than 0.2% of the Gross Domestic Product (GDP) of the two cities. Serious mental illness was associated with a substantial decrease in individual-level earnings, but the burden that resulted from societal-level loss of earnings was not large enough to help drive mental health policy and programs in China. PMID:20493555

Using systems of care to reduce incarceration of youth with serious mental illness.

PubMed

Erickson, Chris D

2012-06-01

Youth with serious mental illness come into contact with juvenile justice more than 3 times as often as other youth, obliging communities to expend substantial resources on adjudicating and incarcerating many who, with proper treatment, could remain in the community for a fraction of the cost. Incarceration is relatively ineffective at remediating behaviors associated with untreated serious mental illness and may worsen some youths' symptoms and long-term prognoses. Systems of care represent a useful model for creating systems change to reduce incarceration of these youth. This paper identifies the systemic factors that contribute to the inappropriate incarceration of youth with serious mental illness, including those who have committed non-violent offenses or were detained due to lack of available treatment. It describes the progress of on-going efforts to address this problem including wraparound and diversion programs and others utilizing elements of systems of care. The utility of systems of care principles for increasing access to community-based mental health care for youth with serious mental illness is illustrated and a number of recommendations for developing collaborations with juvenile justice to further reduce the inappropriate incarceration of these youth are offered.

Experience of emotional stress and resilience in street-involved youth: the need for early mental health intervention.

PubMed

McCay, Elizabeth

2011-01-01

Mental illness left untreated in adolescence and young adulthood can readily become a chronic illness in adulthood, seriously hampering the capacity of individuals to become healthy contributing members of society. Mental health challenges are of paramount importance to the health and well-being of Canadian adolescents and young adults, with 18% of Canadian youth, ages 15-24, reporting a mental illness (Leitch 2007). However, it is unlikely that this statistic accounts for those invisible youth (Rachlis et al. 2009) who are disconnected from families and caregivers, bereft of stable housing and familial support - in other words, youth who are street-involved. Mental health risk is amplified in street-involved youth and, as such, must be recognized as a priority for policy development that commits to accessible mental health programming, in order to realize the potential of these vulnerable youth.

Randomized Trial of Social Rehabilitation and Integrated Health Care for Older People with Severe Mental Illness

ERIC Educational Resources Information Center

Mueser, Kim T.; Pratt, Sarah I.; Bartels, Stephen J.; Swain, Karin; Forester, Brent; Cather, Corinne; Feldman, James

2010-01-01

Objective: The Helping Older People Experience Success (HOPES) program was developed to improve psychosocial functioning and reduce long-term medical burden in older people with severe mental illness (SMI) living in the community. HOPES includes 1 year of intensive skills training and health management, followed by a 1-year maintenance phase.…

The Effects of a Leisure Education Program upon Persons with Chronic Mental Illnesses Who Reside in Group Homes

ERIC Educational Resources Information Center

Mitchell, Lynda Leftridge

1998-01-01

The purpose of the research study was to investigate the leisure behavior, social avoidance and distress, social self-efficacy, life satisfaction, global function, and negative symptoms of 26 individuals with chronic mental illnesses who reside in group homes. The study used a treatment group and a control group design to evaluate the…

Federal Policies and Programs to Expand Employment Services Among Individuals with Serious Mental Illnesses.

PubMed

Karakus, Mustafa; Riley, Jarnee; Goldman, Howard

2017-05-01

Previous studies suggest that providing employment services to individuals with serious mental illnesses can help them obtain competitive, real-world employment. However, these services are still not easily accessible to this population. This paper provides a brief summary of recent federal initiatives that may influence widespread implementation of employment services. While there is an increasing recognition of the need to remove barriers and provide supported employment services to individuals with mental illnesses, a wide-spread coordination across Federal polices, financing and regulatory changes are necessary to promote measurable and lasting effects on the broad availability of employment services among this population.

Unique Practice, Unique Place: Exploring Two Assertive Community Treatment Teams in Maine.

PubMed

Schroeder, Rebecca A

2018-06-01

Assertive Community Treatment (ACT) is a model of care that provides comprehensive community-based psychiatric care for persons with serious mental illness. This model has been widely documented and has shown to be an evidence-based model of care for reducing hospitalizations for this targeted population. Critical ingredients of the ACT model are the holistic nature of their services, a team based approach to treatment and nurses who assist with illness management, medication monitoring, and provider collaboration. Although the model remains strong there are clear differences between urban and rural teams. This article describes present day practice in two disparate ACT programs in urban and rural Maine. It offers a new perspective on the evolving and innovative program of services that treat those with serious mental illness along with a review of literature pertinent to the ACT model and future recommendations for nursing practice. The success and longevity of these two ACT programs are testament to the quality of care and commitment of staff that work with seriously mentally ill consumers. Integrative care models such as these community-based treatment teams and nursing driven interventions are prime elements of this successful model.

The Use of Peer Mentors to Enhance a Smoking Cessation Intervention for Persons with Serious Mental Illnesses

PubMed Central

Dickerson, Faith B.; Savage, Christina L.G.; Schweinfurth, Lucy A.B.; Medoff, Deborah R.; Goldberg, Richard W.; Bennett, Melanie; Lucksted, Alicia; Chinman, Matthew; Daumit, Gail; Dixon, Lisa; DiClemente, Carlo

2015-01-01

Objective We evaluated a well-specified peer mentor program that enhanced a professionally-led smoking cessation group for persons with serious mental illnesses. Methods Participants were 8 peer mentors, persons with serious mental illnesses who had successfully quit smoking, and 30 program participants, persons with serious mental illnesses enrolled in a 6 month intervention. Peer mentors were trained and then helped to deliver a smoking cessation group and met with program participants individually. We assessed the mentors’ skills after training, their fidelity to the model, and the program’s feasibility and acceptability. We also measured the smoking outcomes of the program participants including change in exhaled carbon monoxide, a measure of recent smoking, and aspects of the peer mentor-program participant relationship. Results Peer mentors attained a mean score of 13.6/14 on role play assessments after training and delivered the intervention with fidelity as assessed by adherence and competence ratings (mean scores of 97% and 93%, respectively). The feasibility and acceptability of the intervention was demonstrated in that 28/30 participants met with their peer mentors regularly and only 1 participant and no peer mentor discontinued in the study. Both parties rated the interpersonal alliance highly, mean of 5.9/7. The program participants had a decline in carbon monoxide levels and number of cigarettes smoked per day (repeated measures ANOVA F=6.04, p=.008; F=15.87, p<.001, respectively). A total of 22/30 (73%) made a quit attempt but only 3 (10%) achieved sustained abstinence. Conclusions and Implications for Practice Our study adds to the growing literature about peer-delivered interventions. PMID:26461436

Organizational determinants of efficiency and effectiveness in mental health partial care programs.

PubMed Central

Schinnar, A P; Kamis-Gould, E; Delucia, N; Rothbard, A B

1990-01-01

The use of partial care as a treatment modality for mentally ill patients, particularly the chronically mentally ill, has greatly increased. However, research into what constitutes a "good" program has been scant. This article reports on an evaluation study of staff productivity, cost efficiency, and service effectiveness of adult partial care programs carried out in New Jersey in fiscal year 1984/1985. Five program performance indexes are developed based on comparisons of multiple measures of resources, service activities, and client outcomes. These are used to test various hypotheses regarding the effect of organizational and fiscal variables on partial care program efficiency and effectiveness. The four issues explored are: auspices, organizational complexity, service mix, and fiscal control by the state. These were found to explain about half of the variance in program performance. In addition, partial care programs demonstrating midlevel performance with regard to productivity and efficiency were observed to be the most effective, implying a possible optimal level of efficiency at which effectiveness is maximized. PMID:2113046

Individual Placement And Support Services Boost Employment For People With Serious Mental Illnesses, But Funding Is Lacking.

PubMed

Drake, Robert E; Bond, Gary R; Goldman, Howard H; Hogan, Michael F; Karakus, Mustafa

2016-06-01

The majority of people with serious mental illnesses want to work. Individual placement and support services, an evidence-based supported employment intervention, enables about 60 percent of people with serious mental illnesses who receive the services to gain competitive employment and improve their lives, but the approach does not lead to fewer people on government-funded disability rolls. Yet individual placement and support employment services are still unavailable to a large majority of people with serious mental illnesses in the United States. Disability policies and lack of a simple funding mechanism remain the chief barriers. A recent federal emphasis on early-intervention programs may increase access to employment services for people with early psychosis, but whether these interventions will prevent disability over time is unknown. Project HOPE—The People-to-People Health Foundation, Inc.

Evaluation of an employment program for people with mental illness using the Supported Employment Fidelity Scale.

PubMed

Cocks, Errol; Boaden, Ross

2009-10-01

The Individual Placement and Support (IPS) model aims to achieve open employment for people with mental illness. The Supported Employment Fidelity Scale (SEFS) is a 15-item instrument that evaluates the extent to which a service follows the IPS principles of best practice. This paper describes the IPS model and an evaluation of a specialist employment program for people with mental illness using the SEFS. The SEFS enabled a quantitative assessment of service provision against the criteria of evidence-based practice principles. Data were collected from multiple sources. In addition, a literature review was conducted, and personnel engaged in implementation of the IPS model at other Australian employment programs were consulted. The program achieved a score of 59 of a possible 75 on the SEFS, which is described as fair supported employment. Analysis of the 15-scale items resulted in the identification of strengths, areas for further development, and a set of recommendations. The program was operating substantially in line with evidence-based practice principles and had considerable scope for further development. Issues arising from the evaluation, areas of applicability of the SEFS and the underlying literature, and implications for occupational therapy are highlighted.

Previous Homelessness as a Risk Factor for Recovery from Serious Mental Illnesses.

PubMed

Castellow, Jennifer; Kloos, Bret; Townley, Greg

2015-08-01

This paper argues that the experience of homelessness is inherently traumatic and thus has the potential to affect the manifestation of mental illness. The experiences related to being homeless might act as specific and unique sources of vulnerability. This study included 424 people diagnosed with serious mental illnesses living in supported housing programs in South Carolina. Three hierarchical regression analyses measuring the impact of homelessness on three types of outcomes revealed the following: (1) ever experiencing homelessness as well as the amount of time spent homeless were related to higher levels of psychiatric distress, (2) ever experiencing homelessness was related to higher levels of reported alcohol use, and (3) total amount of time spent homeless was related to lower perceived recovery from mental illness. These findings suggest that experiencing homelessness might contribute to psychosocial vulnerability to negative mental health outcomes. Future investigations examining this concept of risk and vulnerability as a result of homelessness are in order.

Developing a quit smoking website that is usable by people with severe mental illnesses.

PubMed

Ferron, Joelle C; Brunette, Mary F; McHugo, Gregory J; Devitt, Timothy S; Martin, Wendy M; Drake, Robert E

2011-01-01

Evidence-based treatments may be delivered in computerized, web-based formats. This strategy can deliver the intervention consistently with minimal treatment provider time and cost. However, standard web sites may not be usable by people with severe mental illnesses who may experience cognitive deficits and low computer experience. This manuscript reports on the iterative development and usability testing of a website designed to educate and motivate adults with severe mental illnesses to engage in smoking cessation activities. Three phases of semi-structured interviews were performed with participants after they used the program and combined with information from screen-recorded usability data. T-tests compared the differences between uses of the first computer program version and a later version. Iteratively conducted usability tests demonstrated an increased ease of use from the first to the last version of the website through significant improvement in the percentage of unproductive clicking along with fewer questions asked about how to use the program. The improvement in use of the website resulted from changes such as: integrating a mouse tutorial, increasing font sizes, and increasing button sizes. The website usability recommendations provide some guidelines for interventionists developing web tools for people who experience serious psychiatric disabilities. In general, insights from the study highlight the need for thoughtful design and usability testing when creating a website for people with severe mental illness.

Physical activity attitudes and preferences among inpatient adults with mental illness.

PubMed

Fraser, Sarah J; Chapman, Justin J; Brown, Wendy J; Whiteford, Harvey A; Burton, Nicola W

2015-10-01

The life expectancy of adults with mental illness is worse than that of the general population and is largely due to poor physical health status. Physical activity has been consistently recommended for the prevention and management of many chronic physical health conditions and can also have benefits for mental health. This cross sectional study assessed the attitudes towards and preferences for physical activity among inpatient adults with mental illness, and differences by distress and gender. Self-report questionnaires were completed by 101 patients. Findings indicated that inpatient adults with mental illness are interested in doing physical activity while in hospital, primarily to maintain good physical health and improve emotional wellbeing. Fewer than half of participants agreed that physical activity has benefits for serious mental illness. Participants indicated a preference for walking and physical activity that can be done alone, at a fixed time and with a set routine and format. Major barriers were fatigue and lack of motivation. Females were more likely than males to prefer activities done with others of the same gender (P = 0.001) and at the same level of ability (P < 0.001). There were no significant differences by level of distress. These findings can inform physical activity intervention programming in hospital settings, which may contribute to decreasing the chronic disease burden and improve the psychological wellbeing in adults with mental illness. © 2015 Australian College of Mental Health Nurses Inc.

Are universities preparing nurses to meet the challenges posed by the Australian mental health care system?

PubMed

Wynaden, D; Orb, A; McGowan, S; Downie, J

2000-09-01

The preparedness of comprehensive nurses to work with the mentally ill is of concern to many mental health professionals. Discussion as to whether current undergraduate nursing programs in Australia prepare a graduate to work as a beginning practitioner in the mental health area has been the centre of debate for most of the 1990s. This, along with the apparent lack of interest and motivation of these nurses to work in the mental health area following graduation, remains a major problem for mental health care providers. With one in five Australians now experiencing the burden of a major mental illness, the preparation of a nurse who is competent to work with the mentally ill would appear to be a priority. The purpose of the present study was to determine third year undergraduate nursing students' perceived level of preparedness to work with mentally ill clients. The results suggested significant differences in students' perceived level of confidence, knowledge and skills prior to and following theoretical and clinical exposure to the mental health area. Pre-testing of students before entering their third year indicated that the philosophy of comprehensive nursing: integration, although aspired to in principle, does not appear to occur in reality.

5 CFR 1207.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... NONDISCRIMINATION ON THE BASIS OF DISABILITY IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE MERIT SYSTEMS PROTECTION... a disability means any person who has a physical or mental impairment that substantially limits one... mental retardation, organic brain syndrome, emotional or mental illness, and specific learning...

32 CFR 1807.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... NONDISCRIMINATION ON THE BASIS OF DISABILITY IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL COUNTERINTELLIGENCE... real or personal property. Individual with disabilities means any person who has a physical or mental... mental retardation, organic brain syndrome, emotional or mental illness, and specific learning...

Outcomes of an illness self-management group using wellness recovery action planning.

PubMed

Starnino, Vincent R; Mariscal, Susana; Holter, Mark C; Davidson, Lori J; Cook, Karen S; Fukui, Sadaaki; Rapp, Charles A

2010-01-01

The aim of this preliminary study was to examine the impact of participation in an illness self-management recovery program (Wellness Recovery Action Planning-WRAP) on the ability of individuals with severe mental illnesses to achieve key recovery related outcomes. A total of 30 participants from three mental health centers were followed immediately before and after engaging in a 12-week WRAP program. Three paired sample t-tests were conducted to determine the effectiveness of WRAP on hope, recovery orientation, and level of symptoms. A significant positive time effect was found for hope and recovery orientation. Participants showed improvement in symptoms, but the change was slightly below statistical significance. These preliminary results offer promising evidence that the use of WRAP has a positive effect on self-reported hope and recovery-related attitudes, thereby providing an effective complement to current mental health treatment.

Art and mental health in Samoa.

PubMed

Ryan, Brigid; Goding, Margaret; Fenner, Patricia; Percival, Steven; Percival, Wendy; Latai, Leua; Petaia, Lisi; Pulotu-Endemann, Fuimaono Karl; Parkin, Ian; Tuitama, George; Ng, Chee

2015-12-01

To pilot an art and mental health project with Samoan and Australian stakeholders. The aim of this project was to provide a voice through the medium of art for people experiencing mental illness, and to improve the public understanding in Samoa of mental illness and trauma. Over 12 months, a series of innovative workshops were held with Samoan and Australian stakeholders, followed by an art exhibition. These workshops developed strategies to support the promotion and understanding of mental health in Samoa. Key stakeholders from both art making and mental health services were engaged in activities to explore the possibility of collaboration in the Apia community. The project was able to identify the existing resources and community support for the arts and mental health projects, to design a series of activities aimed to promote and maintain health in the community, and to pilot these programs with five key organizations. This project demonstrates the potential for art and mental health projects to contribute to both improving mental health and to lowering the personal and social costs of mental ill health for communities in Samoa. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Experiences of peer support for children and adolescents whose parents and siblings have mental illness.

PubMed

Foster, Kim; Lewis, Peter; McCloughen, Andrea

2014-05-01

There is minimal published literature on experiences of peer support programs for children/adolescents in families affected by mental illness. This study aimed to explore children's and adolescents' perspectives of the ON FIRE peer support program. An exploratory qualitative study with 14 children/adolescents 9-17 years of age who participated in semi-structured interviews. Thematic analysis resulted in three themes of experience. Participants made connections with others in the program, developed personal strengths, and learned how to contribute to others' well-being. Participants derived substantial personal benefit from peer support. Use of social media and the Internet may facilitate future program delivery. © 2014 Wiley Periodicals, Inc.

Moving from rhetoric to reality: adapting Housing First for homeless individuals with mental illness from ethno-racial groups.

PubMed

Stergiopoulos, Vicky; O'Campo, Patricia; Gozdzik, Agnes; Jeyaratnam, Jeyagobi; Corneau, Simon; Sarang, Aseefa; Hwang, Stephen W

2012-10-02

The literature on interventions addressing the intersection of homelessness, mental illness and race is scant. The At Home/Chez Soi research demonstration project is a pragmatic field trial investigating a Housing First intervention for homeless individuals with mental illness in five cities across Canada. A unique focus at the Toronto site has been the development and implementation of a Housing First Ethno-Racial Intensive Case Management (HF ER-ICM) arm of the trial serving 100 homeless individuals with mental illness from ethno-racial groups. The HF ER-ICM program combines the Housing First approach with an anti-racism/anti-oppression framework of practice. This paper presents the findings of an early implementation and fidelity evaluation of the HF ER-ICM program, supplemented by participant narrative interviews to inform our understanding of the HF ER-ICM program theory. Descriptive statistics are used to describe HF ER-ICM participant characteristics. Focus group interviews, key informant interviews and fidelity assessments were conducted between November 2010 and January 2011, as part of the program implementation evaluation. In-depth qualitative interviews with HF ER-ICM participants and control group members were conducted between March 2010 and June 2011. All qualitative data were analysed using grounded theory methodology. The target population had complex health and social service needs. The HF ER-ICM program enjoyed a high degree of fidelity to principles of both anti-racism/anti-oppression practice and Housing First and comprehensively addressed the housing, health and sociocultural needs of participants. Program providers reported congruence of these philosophies of practice, and program participants valued the program and its components. Adapting Housing First with anti-racism/anti-oppression principles offers a promising approach to serving the diverse needs of homeless people from ethno-racial groups and strengthening the service systems developed to support them. The use of fidelity and implementation evaluations can be helpful in supporting successful adaptations of programs and services.

The effect of cognitive impairment on mental healthcare costs for individuals with severe psychiatric illness.

PubMed

Mackin, R Scott; Delucchi, Kevin L; Bennett, Robert W; Areán, Patricia A

2011-02-01

This study was conducted to determine the effect of cognitive impairment (CI) on mental healthcare costs for older low-income adults with severe psychiatric illness. Data were collected from 62 ethnically diverse low-income older adults with severe psychiatric illness who were participating in day programming at a large community mental health center. CI was diagnosed by a neuropsychologist utilizing the Mattis Dementia Rating Scale-Second Edition and structured ratings of functional impairment (Clinical Dementia Rating Scale). Mental healthcare costs for 6, 12, and 24-month intervals before cognitive assessments were obtained for each participant. Substance abuse history was evaluated utilizing a structured questionnaire, depression symptom severity was assessed utilizing the Hamilton Depression Rating Scale, and psychiatric diagnoses were obtained through medical chart abstraction. CI was exhibited by 61% of participants and was associated with significantly increased mental healthcare costs during 6, 12, and 24-month intervals. Results of a regression analysis indicated that ethnicity and CI were both significant predictors of log transformed mental healthcare costs over 24 months with CI accounting for 13% of the variance in cost data. CI is a significant factor associated with increased mental healthcare costs in patients with severe psychiatric illness. Identifying targeted interventions to accommodate CI may lead to improving treatment outcomes and reducing the burden of mental healthcare costs for individuals with severe psychiatric illness.

Mental illness in Bwindi, Uganda: Understanding stakeholder perceptions of benefits and barriers to developing a community-based mental health programme.

PubMed

Sessions, Kristen L; Wheeler, Lydia; Shah, Arya; Farrell, Deenah; Agaba, Edwin; Kuule, Yusufu; Merry, Stephen P

2017-11-30

Mental illness has been increasingly recognised as a source of morbidity in low- and middle-income countries and significant treatment gaps exist worldwide. Studies have demonstrated the effectiveness of task sharing through community-based treatment models for addressing international mental health issues. This paper aims to evaluate the perceptions of a wide range of mental health stakeholders in a Ugandan community regarding the benefits and barriers to developing a community-based mental health programme. Bwindi Community Hospital (BCH) in south-west Uganda provides services through a team of community health workers to people in the Kanungu District. Thematic analysis of 13 semi-structured interviews and 6 focus group discussions involving 54 community members and 13 mental health stakeholders within the BCH catchment area. Stakeholders perceived benefits to a community-based compared to a hospital-based programme, including improved patient care, lower costs to patients and improved community understanding of mental illness. They also cited barriers including cost, insufficient workforce and a lack of community readiness. Stakeholders express interest in developing community-based mental health programmes, as they feel that it will address mental health needs in the community and improve community awareness of mental illness. However, they also report that cost is a significant barrier to programme development that will have to be addressed prior to being able to successfully establish such programming. Additionally, many community members expressed unique sociocultural beliefs regarding the nature of mental illness and those suffering from a psychiatric disease.

Mental Health Services for Children and Youth: Strengthening the Promise of the Future. Human Services Series.

ERIC Educational Resources Information Center

Craig, Rebecca T.

1988-01-01

Many mentally ill children, especially those who are seriously disturbed, are not receiving the mental health care they need. Although the federal government offers financing to the states for child and adolescent mental health programming, the primary responsibility for financing mental health services has been assumed by state governments. At…

Full Service Community Schools: Prevention of Delinquency in Students with Mental Illness and/or Poverty

ERIC Educational Resources Information Center

Kronick, Robert F.

2005-01-01

This book is about children who are living dangerously close to the edge, the edge of delinquency, mental illness, and poverty. Beginning with a discussion of the role of Joy Dryfoos in the development of comprehensive schools, this work is based on the Full Service Schools program which began in 1998 in three elementary inner-city schools in…

Operant Conditioning - Token Economy.

ERIC Educational Resources Information Center

Montgomery, Jacqueline; McBurney, Raymond D.

Described is an Operant Conditioning-Token Economy Program, teaching patients to be responsible for their own behavior, to make choices, and to be motivated to change. The program was instigated with mentally ill patients in a state hospital and was later used with institutionalized mentally handicapped groups. After two years, only four of the…

Scientific Research and Corporate Influence: Smoking, Mental Illness, and the Tobacco Industry

PubMed Central

Hirshbein, Laura

2012-01-01

Mentally ill individuals have always smoked at high rates and continue to do so, despite public health efforts to encourage smoking cessation. In the last half century, the tobacco industry became interested in this connection, and conducted and supported psychiatric and basic science research on the mental health implications of smoking, long before most mental health professionals outside the industry investigated this issue. Initially, representatives of tobacco industry research organizations supported genetics and psychosomatic research to try to disprove findings that smoking causes lung cancer. Tobacco industry research leaders engaged with investigators because of shared priorities and interests in the brain effects of nicotine. By the 1980s, collaborative funding programs and individual company research and development teams engaged in intramural and extramural basic science studies on the neuropharmacology of nicotine. When mental health researchers outside the industry became interested in the issue of the mentally ill and smoking in the mid-1990s, they increasingly explained it in terms of a disease of nicotine addiction. Both the idea that smoking/nicotine does something positive for the mentally ill and the conclusion that it is the result of nicotine dependence have the potential to support corporate agendas (tobacco or pharmaceutical). PMID:21596723

Scientific research and corporate influence: smoking, mental illness, and the tobacco industry.

PubMed

Hirshbein, Laura

2012-07-01

Mentally ill individuals have always smoked at high rates and continue to do so, despite public health efforts to encourage smoking cessation. In the last half century, the tobacco industry became interested in this connection, and conducted and supported psychiatric and basic science research on the mental health implications of smoking, long before most mental health professionals outside the industry investigated this issue. Initially, representatives of tobacco industry research organizations supported genetics and psychosomatic research to try to disprove findings that smoking causes lung cancer. Tobacco industry research leaders engaged with investigators because of shared priorities and interests in the brain effects of nicotine. By the 1980s, collaborative funding programs and individual company research and development teams engaged in intramural and extramural basic science studies on the neuropharmacology of nicotine. When mental health researchers outside the industry became interested in the issue of the mentally ill and smoking in the mid-1990s, they increasingly explained it in terms of a disease of nicotine addiction. Both the idea that smoking/nicotine does something positive for the mentally ill and the conclusion that it is the result of nicotine dependence have the potential to support corporate agendas (tobacco or pharmaceutical).

Population targeting amid complex mental health programming: Are California's Full Service Partnerships reaching underserved children?

PubMed

Cordell, Katharan D; Snowden, Lonnie R

2017-01-01

California's Mental Health Services Act (MHSA) created Full Service Partnership programs (FSPs) targeting socially and economically vulnerable children with mental illness who are underserved by counties' public mental health treatment system. To determine whether FSPs reach a distinctive group of children, this study compares indicators of FSP-targeted underservice for FSP entrants (n = 15,598) versus everyone treated in the counties' public mental health systems (n = 282,178) and for FSP entrants versus entrants in the most intensive Medicaid delivered program in California, Therapeutic Behavioral Services (TBS, n = 11,993). Results identify that, despite first encountering mental health services systems at earlier ages, FSP clients had fewer months of treatment and were less likely to have been treated in the prior 6 months, except for crisis care, as compared to all other children served, after considering clinical severity and indicators of service need. FSP entrants also had more substance abuse and trauma-related problems. Although less seriously ill than TBS served children, FSP served children were significantly underserved. The results indicate that, amid overlapping policies and programs, carving out and reaching a distinctly underserved population can be achieved in practice, and that specialized programs, such as the FSP program, which target underserved children, have the potential to augment a system's ability to reach the underserved. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Co-Occurring Disorders

MedlinePlus

... Life on Campus Minority Mental Health Workplace Wellness Work-Life Balance Mental Illness and Work Support an Employee Workplace ... Programs Care For Your Health For Providers For Family & Friends Person-Centered Language Psychiatric Advance Directives Creating ...

Attitudes towards mental illness in Malawi: a cross-sectional survey

PubMed Central

2012-01-01

Background Stigma and discrimination associated with mental illness are strongly linked to suffering, disability and poverty. In order to protect the rights of those with mental disorders and to sensitively develop services, it is vital to gain a more accurate understanding of the frequency and nature of stigma against people with mental illness. Little research about this issue has been conducted in Sub- Saharan Africa. Our study aimed to describe levels of stigma in Malawi. Methods A cross-sectional survey of patients and carers attending mental health and non-mental health related clinics in a general hospital in Blantyre, Malawi. Participants were interviewed using an adapted version of the questionnaire developed for the “World Psychiatric Association Program to Reduce Stigma and Discrimination Because of Schizophrenia”. Results 210 participants participated in our study. Most attributed mental disorder to alcohol and illicit drug abuse (95.7%). This was closely followed by brain disease (92.8%), spirit possession (82.8%) and psychological trauma (76.1%). There were some associations found between demographic variables and single question responses, however no consistent trends were observed in stigmatising beliefs. These results should be interpreted with caution and in the context of existing research. Contrary to the international literature, having direct personal experience of mental illness seemed to have no positive effect on stigmatising beliefs in our sample. Conclusions Our study contributes to an emerging picture that individuals in Sub-Saharan Africa most commonly attribute mental illness to alcohol/ illicit drug use and spirit possession. Our work adds weight to the argument that stigma towards mental illness is an important global health and human rights issue. PMID:22823941

A theory-informed approach to mental health care capacity building for pharmacists.

PubMed

Murphy, Andrea L; Gardner, David M; Kutcher, Stan P; Martin-Misener, Ruth

2014-01-01

Pharmacists are knowledgeable, accessible health care professionals who can provide services that improve outcomes in mental health care. Various challenges and opportunities can exist in pharmacy practice to hinder or support pharmacists' efforts. We used a theory-informed approach to development and implementation of a capacity-building program to enhance pharmacists' roles in mental health care. Theories and frameworks including the Consolidated Framework for Implementation Research, the Theoretical Domains Framework, and the Behaviour Change Wheel were used to inform the conceptualization, development, and implementation of a capacity-building program to enhance pharmacists' roles in mental health care. The More Than Meds program was developed and implemented through an iterative process. The main program components included: an education and training day; use of a train-the-trainer approach from partnerships with pharmacists and people with lived experience of mental illness; development of a community of practice through email communications, a website, and a newsletter; and use of educational outreach delivered by pharmacists. Theories and frameworks used throughout the program's development and implementation facilitated a means to conceptualize the component parts of the program as well as its overall presence as a whole from inception through evolution in implementation. Using theoretical foundations for the program enabled critical consideration and understanding of issues related to trialability and adaptability of the program. Theory was essential to the underlying development and implementation of a capacity-building program for enhancing services by pharmacists for people with lived experience of mental illness. Lessons learned from the development and implementation of this program are informing current research and evolution of the program.

Development of an e-supported illness management and recovery programme for consumers with severe mental illness using intervention mapping, and design of an early cluster randomized controlled trial.

PubMed

Beentjes, Titus A A; van Gaal, Betsie G I; Goossens, Peter J J; Schoonhoven, Lisette

2016-01-19

E-mental health is a promising medium to keep mental health affordable and accessible. For consumers with severe mental illness the evidence of the effectiveness of e-health is limited. A number of difficulties and barriers have to be addressed concerning e-health for consumers with severe mental illness. One possible solution might be to blend e-health with face-to-face delivery of a recovery-oriented treatment, like the Illness Management & Recovery (IMR) programme. This paper describes the development of an e-health application for the IMR programme and the design of an early clustered randomized controlled trial. We developed the e-IMR intervention according to the six-step protocol of Intervention Mapping. Consumers joined the development group to address important and relevant issues for the target group. Decisions during the six-step development process were based on qualitative evaluations of the Illness Management & Recovery programme, structured interviews, discussion in the development group, and literature reviews on qualitative papers concerning consumers with severe mental illness, theoretical models, behavioural change techniques, and telemedicine for consumers with severe mental illness. The aim of the e-IMR intervention is to help consumers with severe mental illness to involve others, manage achieving goals, and prevent relapse. The e-IMR intervention consists of face-to-face delivery of the Illness Management & Recovery programme and an e-health application containing peer-testimonials on videos, follow up on goals and coping strategies, monitoring symptoms, solving problems, and communication opportunities. We designed an early cluster randomized controlled trial that will evaluate the e-IMR intervention. In the control condition the Illness Management & Recovery programme is provided. The main effect-study parameters are: illness management, recovery, psychiatric symptoms severity, self-management, quality of life, and general health. The process of the IMR program will be evaluated on fidelity and feasibility in semi-structured interviews with participants and trainers. Intervention Mapping provided a systematic procedure for the development of this e-health intervention for consumers with severe mental illness and the preparation of an early randomized controlled trial. The trial is registered in the Dutch Trial Register: NTR4772 .

Critical Factors in Mental Health Programming for Juveniles in Corrections Facilities

ERIC Educational Resources Information Center

Underwood, Lee A.; Phillips, Annie; von Dresner, Kara; Knight, Pamela D.

2006-01-01

Juveniles with mental health and other specialized needs are overrepresented in the juvenile justice system, and while juvenile corrections have not historically provided standardized and evidence-based mental health services for its incarcerated youth, the demand is evident. The reality is that juveniles with serious mental illness are committed…

Primary health care, mental health, and the dietitian's role.

PubMed

Davison, Karen

2006-01-01

Individuals with mental illness are at nutritional risk because of health, social, and economic factors. To address this problem, the Canadian Collaborative Mental Health Initiative (CCMHI) and Dietitians of Canada (DC) commissioned the development of a toolkit that outlines the role of the registered dietitian (RD) and advocates for RDs in primary health care (PHC) mental health programs. The development of the toolkit followed a four-stage process: a comprehensive literature review, a focus group discussion with a national working group, interviews with consumers about RD services, and evaluation of the toolkit. The costs of mental illness in Canada are at least US dollars 6.85 billion per year. Currently, little evidence exists on how RD services can reduce these expenses. The focus group identified accessibility as the predominant issue facing individuals with mental illness. To explain consumer experiences with RD services, a three-tier theory based on in-depth interviews was developed. Consumer experiences with RDs occur in five categories: financial concerns, perception of service, status of mental illness, engagement, and self-esteem (tier 1). These are further influenced by five individual and contextual factors, e.g., social environment, the mental illness (tier 2), which are weighed as benefits and barriers instrumental in determining actions (tier 3). The evaluation of the final draft of the RD toolkit confirmed that it reflected the visions of PHC. The toolkit is intended to act as a blueprint for action. Dietitians are encouraged to use its contents to advocate for positions in mental health PHC settings.

"It's overwhelming... everything seems to be too much:" A theory of crisis for individuals with severe persistent mental illness.

PubMed

Ball, Jeffrey S; Links, Paul S; Strike, Carol; Boydell, Katherine M

2005-01-01

Crisis in individuals with severe persistent mental illness (SPMI) is a poorly understood phenomenon for which traditional crisis models do not apply. In this study we explored the crisis experience using in-depth interviews conducted with individuals with severe persistent mental illness from two community support programs. A grounded theory of the crisis experience was developed and the results illustrate that underlying vulnerability sets the stage for crisis occurrence which involves feeling overwhelmed and lacking control and manifests as agitation/anger/aggression, being low, feeling anxious, or euphoria. Immediate responses to crises involve getting help or managing alone and numerous factors contribute to crisis resolution and prevention.

Human rights violations among economically disadvantaged women with mental illness: An Indian perspective

PubMed Central

Poreddi, Vijayalakshmi; Ramachandra; Thimmaiah, Rohini; Math, Suresh Bada

2015-01-01

Background: Globally women confront manifold violations of human rights and women with poverty and mental illness are doubly disadvantaged. Aim: The aim was to examine the influence of poverty in meeting human rights needs among recovered women with mental illness at family and community level. Materials and Methods: This was a descriptive study carried out among randomly selected (n = 100) recovered women with mental illness at a tertiary care center. Data were collected through face-to-face interview using structured needs assessment questionnaire. Results: Our findings revealed that below poverty line (BPL) participants were not satisfied in meeting their physical needs such as “access to safe drinking water” (χ2 = 8.994, P < 0.02), “served in the same utensils” (χ2 = 13.648, P < 0.00), had adequate food (χ2 = 11.025, P < 0.02), and allowed to use toilet facilities (χ2 = 13.565, P < 0.00). The human rights needs in emotional dimension, that is, afraid of family members (χ2 = 8.233, P < 0.04) and hurt by bad words (χ2 = 9.014, P < 0.02) were rated higher in above poverty line (APL) participants. Similarly, 88.9% of women from APL group expressed that they were discriminated and exploited by the community members (χ2 = 17.490, P < 0.00). More than three-fourths of BPL participants (76.1%) believed that there were wondering homeless mentally ill in their community (χ2 = 11.848, P < 0.01). Conclusion: There is an urgent need to implement social welfare programs to provide employment opportunities, disability allowance, housing and other social security for women with mental illness. Further, mental health professionals play an essential role in educating the family and public regarding human rights of people with mental illness. PMID:26124524

Human rights violations among economically disadvantaged women with mental illness: An Indian perspective.

PubMed

Poreddi, Vijayalakshmi; Ramachandra; Thimmaiah, Rohini; Math, Suresh Bada

2015-01-01

Globally women confront manifold violations of human rights and women with poverty and mental illness are doubly disadvantaged. The aim was to examine the influence of poverty in meeting human rights needs among recovered women with mental illness at family and community level. This was a descriptive study carried out among randomly selected (n = 100) recovered women with mental illness at a tertiary care center. Data were collected through face-to-face interview using structured needs assessment questionnaire. Our findings revealed that below poverty line (BPL) participants were not satisfied in meeting their physical needs such as "access to safe drinking water" (χ(2) = 8.994, P < 0.02), "served in the same utensils" (χ(2) = 13.648, P < 0.00), had adequate food (χ(2) = 11.025, P < 0.02), and allowed to use toilet facilities (χ(2) = 13.565, P < 0.00). The human rights needs in emotional dimension, that is, afraid of family members (χ(2) = 8.233, P < 0.04) and hurt by bad words (χ(2) = 9.014, P < 0.02) were rated higher in above poverty line (APL) participants. Similarly, 88.9% of women from APL group expressed that they were discriminated and exploited by the community members (χ(2) = 17.490, P < 0.00). More than three-fourths of BPL participants (76.1%) believed that there were wondering homeless mentally ill in their community (χ(2) = 11.848, P < 0.01). There is an urgent need to implement social welfare programs to provide employment opportunities, disability allowance, housing and other social security for women with mental illness. Further, mental health professionals play an essential role in educating the family and public regarding human rights of people with mental illness.

Housing choice and control, housing quality, and control over professional support as contributors to the subjective quality of life and community adaptation of people with severe mental illness.

PubMed

Nelson, Geoffrey; Sylvestre, John; Aubry, Tim; George, Lindsey; Trainor, John

2007-03-01

This research examined two premises of supported housing: (a) that consumer choice/control over housing and support and the quality of housing are important contributors to the subjective quality of life and adaptation to community living of people with mental illness, and (b) that apartments provide mental health consumers with more choice/control over housing and support than group living arrangements. To test these two hypotheses, we collected data from participants with mental illness housed through a government initiative in Ontario, Canada. A total of 130 participants completed a baseline interview, and 91 of those participants also completed a follow-up interview 9-months later. Support was found for both hypotheses. The results were discussed in terms of the paradigm of supported housing, previous research, and implications for housing policy and program development in the community mental health sector.

Mental Health Providers' Attitudes About Criminal Justice-Involved Clients With Serious Mental Illness.

PubMed

Bandara, Sachini N; Daumit, Gail L; Kennedy-Hendricks, Alene; Linden, Sarah; Choksy, Seema; McGinty, Emma E

2018-04-01

Community mental health providers' attitudes toward criminal justice-involved clients with serious mental illness were examined. A total of 627 Maryland psychiatric rehabilitation program providers responded to a survey (83% response rate). Measures assessed providers' experience with, positive regard for, and perceptions of similarity, with their clients with serious mental illness. Chi-square tests were used to compare providers' attitudes toward clients with and without criminal justice involvement. Providers reported lower regard for criminal justice-involved clients than for clients without such involvement. Providers were less likely to report having a great deal of respect for clients with (79%) versus without (95%) criminal justice involvement. On all items that measured providers' perceived similarity with their clients, less than 50% of providers rated themselves as similar, regardless of clients' criminal justice status. Future research should explore how providers' attitudes toward criminal justice-involved clients influence service delivery for this group.

A scoping review of weight bias by community pharmacists towards people with obesity and mental illness.

PubMed

Murphy, Andrea L; Gardner, David M

2016-07-01

Community pharmacists are accessible health care professionals who are increasingly offering weight management programs. People living with serious mental illness have markedly higher rates of obesity and associated illness outcomes than the general population, providing pharmacists who are interested in offering weight management services with an identifiable patient subgroup with increased health needs. Issues with stigma within obesity and mental illness care are prevalent and can lead to inequities and reduced quality of care. We conducted a scoping review to map and characterize the available information from published and grey literature sources regarding community pharmacists and weight bias towards obese people with lived experience of mental illness. A staged approach to the scoping review was used. Six articles and 6 websites were abstracted after we removed duplicates and applied our inclusion and exclusion criteria. The published studies that we found indicated that pharmacists and pharmacy students do demonstrate implicit and explicit weight bias. Very limited research is available regarding weight bias in pharmacists and stigma towards people with obesity, and we found no information on these phenomena relating to people with lived experience of mental illness. Investigations are needed to characterize the extent and nature of anti-fat bias and attitudes by pharmacists and the consequences of these attitudes for patient care.

Paranoia and Delusional Disorders

MedlinePlus

... Life on Campus Minority Mental Health Workplace Wellness Work-Life Balance Mental Illness and Work Support an Employee Workplace ... Programs Care For Your Health For Providers For Family & Friends Person-Centered Language Psychiatric Advance Directives Creating ...

Police Responses to Persons With Mental Illness: Going Beyond CIT Training.

PubMed

Steadman, Henry J; Morrissette, David

2016-10-01

Since 1988, a major development to reduce lethal encounters between police and persons displaying signs of mental illness has been the adoption by many police departments of crisis intervention teams (CITs). Created in Memphis, Tennessee, CIT programs incorporate deescalation training, police-friendly drop-off centers, and linkage to community treatment programs. The authors summarize issues discussed at a recent Substance Abuse and Mental Health Services Administration workshop at which participants highlighted the importance of going beyond CIT training to most effectively include police in a crisis care continuum model. Such an approach focuses on how police can be engaged as partners with behavioral health providers who are designing and implementing services in the crisis care continuum. Reframing the approach to police responses to persons in mental health crises offers the prospect of improving both public health and public safety goals.

HIV/STI Prevention Among Heterosexually Active Black Adolescents With Mental Illnesses: Focus Group Findings for Intervention Development.

PubMed

Brawner, Bridgette M; Jemmott, Loretta Sweet; Wingood, Gina; Reason, Janaiya; Mack, Niya

Heterosexually active Black adolescents with mental illnesses are at increased risk for sexually transmitted infections (STIs), including HIV. However, few HIV/STI prevention interventions exist for this demographic. We held seven focus groups (N = 33) to elucidate social, cultural, and psychological factors that influence HIV/STI risk-related sexual behaviors in this understudied population. Seven themes emerged: (a) Blackness and media portrayals, (b) Blackness as a source of cultural resilience and pride, (c) psychosocial determinants of condom use, (d) consequences of engaging in sexual activity, (e) attitudes and beliefs toward sexual behaviors, (f) benefits of sexual activity, and (g) coping mechanisms. Participants also supported the feasibility of and interest in HIV/STI prevention programs integrated with mental health treatment. Transportation, potential breaches of confidentiality, and time were noted barriers to participation. Psychoeducational, skills-based programs are needed to address the sequelae of mental illnesses as they relate to the sexual decision-making process in adolescents. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

There is no health without mental health: are we educating Australian nurses to care for the health consumer of the 21st century?

PubMed

Wynaden, Dianne

2010-06-01

One in five Australians has a diagnosable mental illness and the impact of the illness on the individual, their family, and the community is significant. Since comprehensive nursing was introduced in the 1980s there have been repeated concerns raised regarding the preparedness of graduates from Australian undergraduate nursing programs to care for people who have a mental illness. In 2009, despite a recent comprehensive national review of the mental health/illness content in pre-registration curricula, these concerns remain. The nursing profession must have a responsibility to the global community to ensure that registered nurses are educated to meet evolving health challenges and the needs of the health consumer in the 21st Century. The purpose of this paper is to highlight the prevalence and impact of mental illness on health care outcomes in all settings and to challenge the profession to acknowledge that mental health nursing content must be a core area of all undergraduate curricula. A nationally coordinated response to address the long standing identified deficits in the educational preparation of comprehensive nurses is now a priority to ensure that nurses remain a major stakeholder group in the delivery of health care and key health informants and decision makers within the global health care arena.

Internalized stigma of mental illness and depressive and psychotic symptoms in homeless veterans over 6 months.

PubMed

Boyd, Jennifer E; Hayward, H'Sien; Bassett, Elena D; Hoff, Rani

2016-06-30

We investigated the relationship between internalized stigma of mental illness at baseline and depressive and psychotic symptoms 3 and 6 months later, controlling for baseline symptoms. Data on homeless veterans with severe mental illness (SMI) were provided by the Northeast Program Evaluation Center (NEPEC) Special Needs-Chronic Mental Illness (SN-CMI) study (Kasprow and Rosenheck, 2008). The study used the Internalized Stigma of Mental Illness (ISMI) scale to measure internalized stigma at baseline and the Symptom Checklist-90-R (SCL-90-R) to measure depressive and psychotic symptoms at baseline and 3 and 6 month follow-ups. Higher levels of internalized stigma were associated with greater levels of depressive and psychotic symptoms 3 and 6 months later, even controlling for symptoms at baseline. Alienation and Discrimination Experience were the subscales most strongly associated with symptoms. Exploratory analyses of individual items yielded further insight into characteristics of potentially successful interventions that could be studied. Overall, our findings show that homeless veterans with SMI experiencing higher levels of internalized stigma are likely to experience more depression and psychosis over time. This quasi-experimental study replicates and extends findings of other studies and has implications for future controlled research into the potential long-term effects of anti-stigma interventions on mental health recovery. Published by Elsevier Ireland Ltd.

Effectiveness of a program to facilitate recovery for people with long-term mental illness in Japan.

PubMed

Chiba, Rie; Miyamoto, Yuki; Kawakami, Norito; Harada, Naoko

2014-09-01

Recovery is defined as the process of developing new meaning and purpose in life as one grows beyond the catastrophic effects of mental illness. This study aimed to develop a program to facilitate recovery and examine its effectiveness in a randomized controlled trial. The program was developed with three components that enhance benefit finding, personal meaning, and a sense of happiness. Sixty-three participants with long-term mental illness were randomly allocated to the intervention group (n = 32) or the control group (n = 31). The intervention group attended eight 2-h group sessions, with one held every week. Recovery was assessed at baseline, post-intervention, and at a three-month follow-up. In the per-protocol analysis, after excluding those who dropped out, the intervention group showed significant improvement in recovery compared with the control group (P < 0.05). In the intention-to-treat analysis, a repeated measures analysis of variance did not show any significant intervention effect (time × group) (P > 0.05). The program had the potential to facilitate recovery. © 2013 Wiley Publishing Asia Pty Ltd.

Public stigma against family members of people with mental illness: findings from the Gilgel Gibe Field Research Center (GGFRC), Southwest Ethiopia.

PubMed

Girma, Eshetu; Möller-Leimkühler, Anne Maria; Müller, Norbert; Dehning, Sandra; Froeschl, Guenter; Tesfaye, Markos

2014-02-21

Public stigma against family members of people with mental illness is a negative attitude by the public which blame family members for the mental illness of their relatives. Family stigma can result in self social restrictions, delay in treatment seeking and poor quality of life. This study aimed at investigating the degree and correlates of family stigma. A quantitative cross-sectional house to house survey was conducted among 845 randomly selected urban and rural community members in the Gilgel Gibe Field Research Center, Southwest Ethiopia. An interviewer administered and pre-tested questionnaire adapted from other studies was used to measure the degree of family stigma and to determine its correlates. Data entry was done by using EPI-DATA and the analysis was performed using STATA software. Unadjusted and adjusted linear regression analysis was done to identify the correlates of family stigma. Among the total 845 respondents, 81.18% were female. On a range of 1 to 5 score, the mean family stigma score was 2.16 (± 0.49). In a multivariate analysis, rural residents had significantly higher stigma scores (std. β = 0.43, P < 0.001) than urban residents. As the number of perceived signs (std. β = -0.07, P < 0.05), perceived supernatural (std. β = -0.12, P < 0.01) and psychosocial and biological (std. β = -0.11, P < 0.01) explanations of mental illness increased, the stigma scores decreased significantly. High supernatural explanation of mental illness was significantly correlated with lower stigma among individuals with lower level of exposure to people with mental illness (PWMI). On the other hand, high exposure to PWMI was significantly associated with lower stigma among respondents who had high education. Stigma scores increased with increasing income among respondents who had lower educational status. Our findings revealed moderate level of family stigma. Place of residence, perceived signs and explanations of mental illness were independent correlates of public stigma against family members of people with mental illness. Therefore, mental health communication programs to inform explanations and signs of mental illness need to be implemented.

Physical health care for people with mental illness: training needs for nurses.

PubMed

Happell, Brenda; Platania-Phung, Chris; Scott, David

2013-04-01

People diagnosed with serious mental illness have higher rates of physical morbidity and decreased longevity, yet these people are not adequately served by health care systems. Nurses may provide improved physical health support to consumers with serious mental illness but this is partly dependent on nurses having necessary skills and interest in training opportunities for this component of their work. This survey investigated Australian nurses' interest in training across areas of physical health care including lifestyle factors, cardiovascular disease, and identifying health risks. A nation-wide online survey of nurse members of the Australian College of Mental Health Nurses. The survey included an adapted version of a sub-section of the Physical Health Attitudes Scale. Participants were asked to indicate their interest in various aspects of physical health care training. Most (91.6%) participants viewed educating nurses in physical health care as of moderate or significant value in improving the physical health of people with serious mental illness. Interest in training in all areas of physical health care was over 60% across the health care settings investigated (e.g. public, private, primary care). Forty-two percent sought training in all nine areas of physical health care, from supporting people with diabetes, to assisting consumers with sexually-related and lifestyle issues. The findings suggest that nurses in mental health services in Australia acknowledge the importance of training to improve physical health care of consumers with serious mental illness. Training programs and learning opportunities for nurses are necessary to reduce inequalities in health of people with serious mental illness. Copyright © 2013. Published by Elsevier Ltd.

The effects of individual factors and school environment on mental health and prejudiced attitudes among Norwegian adolescents.

PubMed

Andersson, Helle Wessel; Bjørngaard, Johan Håkon; Kaspersen, Silje Lill; Wang, Catharina E A; Skre, Ingunn; Dahl, Thomas

2010-05-01

The aim was to examine the prevalence of mental health difficulties and prejudices toward mental illness among adolescents, and to analyze possible school and school class effects on these issues. The sample comprised 4,046 pupils (16-19 years) in 257 school classes from 45 Norwegian upper secondary schools. The estimated response rate among the pupils was about 96%. Self-reported mental health difficulties were measured with a four-item scale that covered emotional and behavioral difficulties. Prejudiced attitudes toward mental illness were assessed using a nine-item scale. Multilevel regression analysis was used to estimate the contribution of factors at the individual level, and at the school and class levels. Most of the variance in self-reported mental health difficulties and prejudices was accounted for by individual level factors (92-94%). However, there were statistically significant school and class level effects (P < 0.01), confounded by socioeconomic factors. Mental health difficulties were commonly reported, more often by females than males (P < 0.01). Difficulties with emotions and attention were the two main problem areas, with definite to severe difficulties being reported by 19 and 21% of the females, and by 9 and 16% of the males, respectively. Prejudices were reported more often by males than females (P < 0.01). Both self-reported mental health difficulties and prejudiced attitudes were related to educational program, living situation, and parental education (P < 0.01). The relatively high prevalences of mental health difficulties and prejudiced attitudes toward mental illness among adolescents indicate a need for effective mental health intervention programs. Targeted intervention strategies should be considered when there is evidence of a high number of risk factors in schools and school classes. Furthermore, the gender differences found in self-reported mental health difficulties and prejudices suggest a need for gender-differentiated programs.

Relationships, environment, and the brain: how emerging research is changing what we know about the impact of families on human development.

PubMed

Patterson, Jo Ellen; Vakili, Susanna

2014-03-01

Recent research is providing family therapists with new information about the complex interaction between an individual's biological makeup and his/her social and physical environment. Family and social relationships, particularly during sensitive periods early in life, can affect a child's biological foundation. Additionally, stress during the early years can have a lasting effect on an individual's physical and mental health and contribute to the onset of severe mental illness. Community programs have been developed to intervene early with families who have an at-risk child to prevent or minimize the onset of mental illness including providing partnerships with at-risk mothers of infants to shape attachment relationships. Programs are also developing individual and family interventions to prevent the onset of psychosis. Practicing family therapists can incorporate emerging neuroscience and early intervention research and leverage the growing base of community programs to enhance the effectiveness and sustainability of mental health outcomes for clients. Additionally, family therapy education programs should broaden student training to incorporate the growing body of information about how family relationships affect individual mental health development. © 2013 FPI, Inc.

A Multimodal Mindfulness Training to Address Mental Health Symptoms in Providers Who Care for and Interact With Children in Relation to End-of-Life Care.

PubMed

O'Mahony, Sean; Gerhart, James; Abrams, Ira; Greene, Michelle; McFadden, Rory; Tamizuddin, Sara; Levy, Mitchell M

2017-11-01

Medical providers may face unique emotional challenges when confronted with the suffering of chronically ill, dying, and bereaved children. This study assessed the preliminary outcomes of participation in a group-based multimodal mindfulness training pilot designed to reduce symptoms of burnout and mental health symptoms in providers who interact with children in the context of end-of-life care. A total of 13 medical providers who care for children facing life-threatening illness or bereaved children participated in a 9-session multimodal mindfulness session. Mental health symptoms and burnout were assessed prior to the program, at the program midpoint, and at the conclusion of the program. Participation in the pilot was associated with significant reductions in depressive and posttraumatic stress disorder (PTSD) symptoms among providers ( P < .05). Mindfulness-based programs may help providers recognize and address symptoms of depression and PTSD. Additional research is needed to enhance access and uptake of programming among larger groups of participants.

Perceptions of Strategies for Successful Weight Loss in Persons with Serious Mental Illness Participating in a Behavioral Weight Loss Intervention: A Qualitative Study

PubMed Central

Vazin, Roza; McGinty, Emma E.; Dickerson, Faith; Dalcin, Arlene; Goldsholl, Stacy; Enriquez, Meghan Oefinger; Jerome, Gerald J.; Gennusa, Joseph V.; Daumit, Gail L.

2016-01-01

Objective The purpose of this study was to describe perceptions of weight loss strategies, benefits, and barriers among persons with serious mental illness who lost weight in the ACHIEVE behavioral weight loss intervention. Methods Semi-structured interviews with 20 ACHIEVE participants were conducted and analyzed using an inductive coding approach. Results Participants perceived tailored exercise sessions, social support, and dietary strategies taught in ACHIEVE – such as reducing portion sizes and avoiding sugar-sweetened beverages – as useful weight loss strategies. Health benefits, improved physical appearance, self-efficacy, and enhanced ability to perform activities of daily living were commonly cited benefits of intervention participation and weight loss. Some participants reported challenges with giving up snack food and reducing portion sizes, and barriers to exercise related to medical conditions. Conclusions and Implications for Practice There is emerging evidence that behavioral weight loss interventions can lead to clinically meaningful reductions in body weight among persons with serious mental illness. The perspective of persons with serious mental illness regarding strategies for, benefits of, and barriers to weight loss during participation in behavioral weight loss programs provide insight into which elements of multicomponent interventions such as ACHIEVE are most effective. The results of this study suggest that tailored exercise programs, social support, and emphasis on non-clinical benefits of intervention participation, such as improvements in self-efficacy and the ability to participate more actively in family and community activities, are promising facilitators of engagement and success in behavioral weight loss interventions for the population with serious mental illness. PMID:27054900

Needs and Preferences for Receiving Mental Health Information in an African American Focus Group Sample

PubMed Central

Mishra, Shiraz I.; Lucksted, Alicia; Gioia, Deborah; Barnet, Beth; Baquet, Claudia R.

2013-01-01

The purpose of this study is to better understand the mental health/illness information and service delivery preferences among African American residents of Baltimore. We conducted four focus groups (n=42) among African American adults currently unconnected with the mental health system. Participants expressed fear of stigma and perceptions of racism as major barriers to seeking information and/or services and discussed some normalizing strategies to address these barriers. African Americans harbor cultural and traditional beliefs regarding mental illness which could also act as barriers. Findings have implications for imparting acceptable and culturally-sensitive mental health education and service delivery programs in community settings. PMID:18633704

Barriers and Facilitators of a Healthy Lifestyle Among Persons with Serious and Persistent Mental Illness: Perspectives of Community Mental Health Providers

PubMed Central

McKibbin, Christine L.; Kitchen, Katherine A.; Wykes, Thomas L.; Lee, Aaron A.

2014-01-01

The investigators used qualitative methods to examine perspectives of community mental health professionals on obesity management in adults with serious mental illness. Data from 5 focus groups were subjected to constant comparison analysis and grounded theory. Results showed that influences at individual, social, community, and societal levels impact development and maintenance of obesity. Mental health providers desired a collaborative relationship with providers of health promotion program staff. They also believed that frequent, group-based health promotion should include participation incentives for adults with SMI and should occur over durations of at least 6-months to achieve improved health outcomes for this population. PMID:24129587

A student manual for promoting mental health among high school students.

PubMed

Gigantesco, Antonella; Del Re, Debora; Cascavilla, Isabella

2013-01-01

We describe a school program based on a student manual for promoting mental health and preventing mental illness. A preliminary version of the manual was assessed for face validity by two focus groups. The final version was evaluated for acceptability among 253 students in 10 high schools and 1 middle school in Italy. The manual included 18 chapters (or "units") which address skills for enabling students to cope with their daily lives: communication skills, problem-solving, assertive skills, negotiation, stress management, anger management and conflict resolution. The manual was found to have been acceptable by high school students. The effectiveness of the manual in actually promoting mental health and preventing mental illness is currently being evaluated.

Campus Solidarity Campaign: Developing a Program to Promote an Environment of Solidarity and Support on College Campuses for Students with Mental Illness

ERIC Educational Resources Information Center

Kosyluk, Kristin A.; Corrigan, Patrick W.; Jones, Nev; James, Drexler; Abelson, Sara; Malmon, Alison

2016-01-01

Purpose: The aim of this work was to develop a campaign to promote an environment of solidarity and support on college campuses for students with mental illnesses. Method: Data were gathered from 24 members of a Chicago university campus who were selected as representatives of key campus stakeholder groups including students, administrative staff,…

Cooking and Nutrition Basics. An Instructors Guide for Teaching Cooking Skills and Basic Nutrition to the Chronically Mentally Ill Who Are Being Trained for Independent Living.

ERIC Educational Resources Information Center

Barngrover, Lavone

Designed for those with teaching skills as well as those without and for those with backgrounds in nutrition and those without, this handbook provides information on how to organize and conduct nutrition education and cooking training for the chronically mentally ill. The first section describes the pilot program which developed the handbook,…

WORK INTEREST AS A PREDICTOR OF COMPETITIVE EMPLOYMENT: POLICY IMPLICATIONS FOR PSYCHIATRIC REHABILITATION

PubMed Central

Macias, Cathaleene; DeCarlo, Lawrence T.; Wang, Qi; Frey, Jana; Barreira, Paul

2015-01-01

Consumers with serious mental illness (N=166) enrolling in two community-based mental health programs, a vocational Program of Assertive Community Treatment and a clubhouse certified by the International Center for Clubhouse Development (ICCD), were asked about their interest in work. About one third of the new enrollees expressed no interest in working. Equivalent supported employment services were then offered to all participants in each program. Stated interest in work and receipt of vocational services were statistically significant predictors of whether a person would work and how long it would take to get a job. Two thirds of those interested in work and half of those with no initial interest obtained a competitive job if they received at least one hour of vocational service. Once employed, these two groups held comparable jobs for the same length of time. These findings demonstrate the importance of making vocational services continuously available to all people with serious mental illness, and the viability of integrating these services into routine mental health care. PMID:11577655

Work interest as a predictor of competitive employment: policy implications for psychiatric rehabilitation.

PubMed

Macias, C; DeCarlo, L T; Wang, Q; Frey, J; Barreira, P

2001-03-01

Consumers with serious mental illness (N = 166) enrolling in two community-based mental health programs, a vocational Program of Assertive Community Treatment and a clubhouse certified by the International Center for Clubhouse Development (ICCD), were asked about their interest in work. About one third of the new enrollees expressed no interest in working. Equivalent supported employment services were then offered to all participants in each program. Stated interest in work and receipt of vocational services were statistically significant predictors of whether a person would work and how long it would take to get a job. Two thirds of those interested in work and half of those with no initial interest obtained a competitive job if they received at least one hour of vocational service. Once employed, these two groups held comparable jobs for the same length of time. These findings demonstrate the importance of making vocational services continuously available to all people with serious mental illness, and the viability of integrating these services into routine mental health care.

The conceptual model and guiding principles of a supported-education program for Orthodox Jewish persons with severe mental illness.

PubMed

Shor, Ron; Avihod, Guy; Aivhod, Guy

2011-10-01

An innovative culturally-oriented supported-education program has been established in Israel to address the needs of religious Jewish persons with severe mental illness. This program is utilizing a highly regarded institution in the Orthodox communities, a Beit Midrash, a study hall for religious studies, as a context for rehabilitation. Based on open-ended interviews conducted with the staff members of this program, its conceptual framework and guiding principles have been identified and analyzed. In this program common principles of psychiatric rehabilitation have been adapted and incorporated into a context which has not been known so far as a context for psychiatric rehabilitation. In addition, innovative supported-education methods of work which are compatible with the cultural context of Orthodox Jewish persons have been implemented, such as opportunities provided to the participants to reconstruct their views of their daily struggles and enhance their sense of spirituality via the discussion of socially-oriented religious texts. The culturally-oriented context of the Beit Midrash enables outreach to a population which might otherwise not receive any services. This is a promising model for addressing the unique needs of religious persons with severe mental illness and for filling a gap in the resources available for the rehabilitation of this population in the community.

Effects of a Brief Empowerment Program for Families of Persons with Mental Illness in South Korea: A Pilot Study.

PubMed

Hyun, Myung-Sun; Nam, Kyoung A; Kim, Hyunlye

2018-05-30

Families of persons with mental illness (PMIs) are considered important resources for PMIs rather than as contributors to their mental illness. However, these families experience not only the burden of caregiving but also social stigma and discrimination in various aspects of their lives, and their psychosocial needs tend to be overlooked. This was a pilot study to explore the effects of a brief empowerment program on the empowerment and quality of life of families of PMIs in South Korea. A repeated-measures design with a control group and pre/post-follow-up testing was used. We enrolled 18 participants (experimental group = 9, control group = 9). The experimental group participated in an empowerment program consisting of four sessions over 4 weeks. Data were collected before and after the program, and again 4 weeks later. The χ 2 -test, Fisher's exact probability test, t-test, and repeated-measures analysis of covariance were used, as appropriate, to analyze data. The program significantly increased empowerment (F = 4.66, p = .020) and quality of life (F = 5.83, p = .009) among participants in the experimental group over time. Its therapeutic features, such as sharing their experiences, discussion, and presentations, can be applied to create effective psychosocial interventions for families of PMIs.

Emerging issues with mentally ill offenders: causes and social consequences.

PubMed

Rock, M

2001-01-01

Persons with mental illness and co-occurring substance abuse disorders are incarcerated at disproportionately high rates in comparison to the general population. Reasons may include high standards for involuntary commitment, an overall increase in substance abuse and the policy of deinstitutionalization. However, one significant reason may be that psychiatric institutions serve a social control function, which has not been appreciated by policymakers and program developers since deinstitutionalization. This paper presents provider views of the population and issues of concern for clients, families, and the agencies. Discussion includes service-provider response to the population, new program models, and implications for policymakers.

An ethnographic study of job seeking among people with severe mental illness.

PubMed

Alverson, Hoyt; Carpenter, Elizabeth; Drake, Robert E

2006-01-01

An ethnographic study employing intensive participant observation methods identified critical differences in styles of searching for competitive employment among people with severe mental illness and explored the social/cultural correlates of these job-seeking styles. Propensity for active job seeking was strongly associated with younger age, with participants' involvement in interdependent kin networks or households, with ethno-racial minority background, and with capacity for coherent discourse. Active job seekers did particularly well in a supported employment program, but also were able to find employment when assigned to other programs; passive job seekers had little success in any vocational program. The authors discuss several implications of these findings for vocational services.

Models of Service Delivery for the Elderly Mentally Ill.

ERIC Educational Resources Information Center

VandeCreek, Leon

This paper is concerned with the problem that elderly persons do not seek or receive mental health services as frequently as their numbers or the incidence of mental health problems would indicate is appropriate. The report focuses on the identification of innovative mental health service delivery programs which have been designed to reach and to…

The advent of mental health nurses in Australian general practice.

PubMed

Olasoji, Michael; Maude, Phil

2010-01-01

The remarkable progress that has been witnessed in the physical and material wellbeing for most Australians over the 20th century has not been paralleled by gains in the mental and subjective wellbeing of the population. General practice plays a strategic role in Australia's primary health care, which has been recognised as an essential health system that is able to deliver health to the population in a timely and equitable manner (World Health Organisation [WHO], 2008). General Practitioners are unable to provide adequate care to people experiencing a severe mental illness without support from specialist mental health professional such as a mental health nurse in the practice. The mental health nurse incentive program (MHNIP) offers opportunity for mental health nurses to work collaboratively with GPs in primary health care in the delivery of care to people with a severe mental illness.

Changing public stigma with continuum beliefs.

PubMed

Corrigan, Patrick W; Schmidt, Annie; Bink, Andrea B; Nieweglowski, Katherine; Al-Khouja, Maya A; Qin, Sang; Discont, Steve

2017-10-01

Given the egregious effect of public stigma on the lives of people with mental illness, researchers have sought to unpack and identify effective components of anti-stigma programs. We expect to show that continuum messages have more positive effect on stigma and affirming attitudes (beliefs that people with mental illness recover and should be personally empowered) than categorical perspectives. The effect of continuum beliefs will interact with contact strategies. A total of 598 research participants were randomly assigned to online presentations representing one of the six conditions: three messages (continuum, categorical, or neutral control) by two processes (education or contact). Participants completed measures of continuum beliefs (as a manipulation check), stigma and affirming attitudes after viewing the condition. Continuum messages had significantly better effect on views that people with mental illness are "different," a finding that interacted with contact. Continuum messages also had better effects on recovery beliefs, once again an effect that interacted significantly with contact. Implications of these findings for improving anti-stigma programs are discussed.

Individuals with severe mental illnesses have improved eating behaviors and cooking skills after attending a 6-week nutrition cooking class.

PubMed

Clark, Alena; Bezyak, Jill; Testerman, Nora

2015-09-01

This study assessed current meal planning/cooking behaviors and dietary intake of individuals with severe mental illnesses and determined differences after a 6-week nutrition education cooking class. Eighteen individuals with severe mental illnesses participated in a 6-week nutrition education cooking class and completed pre- and posttest 24-hr recalls and a postretrospective survey. Paired samples t tests were used. Participants met their calories needs, but they consumed high amounts of sodium and fat and low amounts of fiber. Significant increases in calcium, vitamin D, grains, and fruit occurred from pre- to posttest (p < .05). Self-efficacy in cooking and grocery shopping skills improved. Participants desire nutrition education programming that includes simple messages, hands-on cooking demonstrations, and health-related incentives. More research is needed to determine how nutrition education programs lead to sustained knowledge and behavior change within this specialized population. (c) 2015 APA, all rights reserved).

Primary Prevention and the Marital Enrichment Group

ERIC Educational Resources Information Center

Sauber, S. Richard

1974-01-01

Mental illness constitutes a major hazard to public health. The author advodates the implementation of programs of primary prevention, using the marital enrichment group as a model to follow in promoting mental health and specific protection. (Author)

Living well: an intervention to improve self-management of medical illness for individuals with serious mental illness.

PubMed

Goldberg, Richard W; Dickerson, Faith; Lucksted, Alicia; Brown, Clayton H; Weber, Elyssa; Tenhula, Wendy N; Kreyenbuhl, Julie; Dixon, Lisa B

2013-01-01

Individuals with serious mental illness have elevated rates of comorbid chronic general medical conditions and may benefit from interventions designed to support illness self-management. This study examined the effectiveness of a modified version of the Chronic Disease Self-Management Program called Living Well for individuals with serious mental illness. A total of 63 mental health consumers with serious mental illness and at least one concurrent chronic general medical condition were randomly assigned to receive the 13-session peer-cofacilitated Living Well intervention or usual care. Participants were evaluated on attitudinal, behavioral, and functional outcomes at baseline, at the end of the intervention, and at a two-month follow-up. Living Well participants showed significant postintervention improvements across a range of attitudinal (self-efficacy and patient activation), behavioral (illness self-management techniques), and functional (physical and emotional well-being and general health functioning) outcomes. Although attenuation of effect was observed for most outcomes at two months postintervention, evidence was found of continued improvement in general self-management behaviors (use of action planning, brainstorming, and problem-solving). Continued advantage was found for the Living Well group in other areas, such as health-related locus of control and reports of healthy eating and physical activity. Receipt of Living Well was associated with a notable decrease in use of the emergency room for medical care, although the between-group difference was not statistically significant. Living Well shows promise in helping mental health consumers more effectively manage chronic general medical conditions and experience improved functioning and well-being.

"Chronicity," "nervios" and community care: a case study of Puerto Rican psychiatric patients in New York City.

PubMed

Swerdlow, M

1992-06-01

The role of ethnicity, community structure, and folk concepts of mental illness in facilitating the adaptation of long term psychiatric patients to community living has received little attention. This article examines the cultural concepts of mental illness and the community involvement of 30 Puerto Rican psychiatric patients participating in a New York City treatment program. It is shown that many of the attributes usually associated with chronic mental illness do not apply to this population. It is argued that the folk concept of nervios helps to foster the integration of these patients in a wide range of community networks. The impact of gentrification on these patients' community integration is also discussed.

A hybrid supported employment program for persons with schizophrenia in Japan.

PubMed

Fuller, T R; Oka, M; Otsuka, K; Yokoyama, N; Liberman, R P; Niwa, S I

2000-07-01

INTRODUCTION BY THE COLUMN EDITORS: Because the mental health system in Japan has emphasized hospital-based treatment (1), patients with schizophrenia often remain institutionalized for long periods, even after their symptoms have stabilized. In addition, the introduction of modern community-based methods of treatment and rehabilitation was delayed by an antipsychiatry movement in the 1970s and the ascendance of a reductionistic biological approach to services (2). Lack of adequate outpatient services and community residential care in Japan has been a serious obstacle to destigmatization of mental disorders and has contributed to the heavy burden and stress experienced by families of mentally ill persons (3). More than 80 percent of patients discharged from mental hospitals return to live with their families, who are ill prepared to provide the supportive services required for community tenure. Involvement in work activities can facilitate community reentry for people with serious and persistent mental illness because employment displaces symptoms, provides structure and meaning in daily life, offers socialization with peers, and permits workers to earn income for shelter and food. In this issue's Rehab Rounds column, the authors describe an innovative vocational rehabilitation program for patients with schizophrenia that was designed to overcome obstacles to discharge and community adjustment. The program at Yabuki Prefecture Psychiatric Hospital, in the northern prefecture of Fukushima, Japan, has been successful in training patients for competitive work while capitalizing on the importance of work in Japanese culture and its traditionally supportive employer-employee relationships. The program is termed "hybrid" because it combines elements of transitional employment with supported employment (4).

A narrative framework for understanding experiences of people with severe mental illnesses.

PubMed

Kirkpatrick, Helen

2008-04-01

This article discusses the value of a narrative approach to understand the experiences of people with severe mental illnesses and the systems around them, and the importance of narrative in the patient-practitioner relationship. These are important concepts in the shift to recovery-oriented systems. People lead storied lives which provide coherence and meaning, but that story has the potential to be change. Both consumers and practitioners have stories, and it is the shared decision-making between them that can lead to recovery. Narratives can be illness narratives, initiated by an illness and the search for meaning in it, or counterstories which are inherently political. The article identifies a Framework for Understanding Stories as a means for listening to and understanding stories at multiple levels. It can be useful for nurses to understand complexity and multilevel aspects of an individual's experience. Although people tell their own individual stories, they compose them by adapting narrative types, which a culture makes available. Programs tells a story and provide an important context for both consumers and practitioners. Dominant societal narratives provide an overall context which can be empowering or disempowering for programs, consumers and practitioners. Thus, as the recovery paradigm has become more prominent, people with mental illnesses have increasingly talked and written about recovery.

Clinical characteristics and service use of persons with mental illness living in an intermediate care facility.

PubMed

Anderson, R L; Lewis, D A

1999-10-01

The study examined the characteristics of residents living in a 450-bed intermediate care facility for persons with severe mental illness in Illinois and sought to determine the factors predicting their utilization of mental health services. Data on 100 randomly selected residents with a chart diagnosis of schizophrenia were collected using chart review and interviews. Data for 78 residents whose diagnosis of schizophrenia or schizoaffective disorder was confirmed using the Structured Clinical Interview for DSM-IV were included in the analyses. Fifty-three percent of the residents used facility-based specialty mental health services beyond medication management, such as group therapy or a day program. Persons with the least severe psychiatric illnesses and with higher levels of motivation for overall care used the most mental health services. Thirty-five percent of the residents had been discharged to an inpatient psychiatric unit during the previous year. Residents most likely to be discharged to those settings were young men with a history of homelessness who refused facility-based health services. Despite recent policy-driven efforts to improve care in this intermediate care facility for persons with mental illness, the facility continues to have problems addressing the mental health needs of the residents.

A retrospective quasi-experimental study of a community crisis house for patients with severe and persistent mental illness.

PubMed

Siskind, Dan; Harris, Meredith; Kisely, Steve; Brogan, James; Pirkis, Jane; Crompton, David; Whiteford, Harvey

2013-07-01

There is increasing international evidence that crisis houses can reduce the time spent in acute psychiatric inpatient units for patients with severe and persistent mental illness, at a lower cost and in an environment preferable to patients. We evaluated the Alternatives to Hospitalisation (AtH) program, a crisis house operating in outer suburban Brisbane. One hundred and ninety-three AtH patients were compared to 371 matched controls admitted to a peer hospital district acute psychiatric unit. Hospitalisations, demographics and illness acuity were compared one year before and after an acute index episode of residential care involving hospital and/or AtH. Hospital bed-days during the index episode were compared between AtH participants and controls. The cost of bed-days averted was compared to the cost of providing the AtH program. AtH participants spent 5.35 fewer days in hospital during the index episode than controls, after adjustment for illness acuity, living conditions, marital status and emergency department (ED) presentations. Per patient cost of averted psychiatric inpatient bed-days, $5948.22, was higher than the per patient cost of providing AtH, $3071.44. AtH participants had higher levels of illness acuity, ED presentations and acute psychiatric admissions than controls in the year after the index episode. For acutely unwell, stably housed patients, able to be managed outside of a secure facility, a crisis house program can reduce acute psychiatric bed-days, providing a cost saving for mental health services.

The impact of changes in psychiatric bed supply on jail use by persons with severe mental illness.

PubMed

Yoon, Jangho; Domino, Marisa E; Norton, Edward C; Cuddeback, Gary S; Morrissey, Joseph P

2013-06-01

There is an on-going concern that reductions in psychiatric inpatient bed capacity beyond a critical threshold will further exacerbate the incarceration of persons with mental illness. However, research to date to assess the proposed relationship between inpatient bed capacity and jail use has been limited in several ways. In addition, mechanisms through which changes in psychiatric bed capacity may affect jail use by persons with mental illness remain unexamined empirically. The aim of this study is to test whether changes in inpatient psychiatric resources, measured by per-capita psychiatric beds, inversely affect the likelihood of jail use by persons with severe mental illness. We also examine mechanisms that link psychiatric bed supply and jail detention. We analyze unique individual-level panel data on 41,236 adults in King County, Washington who were users of jails, the public mental health system, or the Medicaid program from 1993 to 1998. Using administrative records, we identify persons ever diagnosed with severe mental illness during the study period. Our analyses build upon a system of simultaneous equations that captures mechanisms from changes in psychiatric bed supply to jail detention. We estimate a reduced-form model and calculate the total effect of a shift in psychiatric bed supply on the likelihood of jail use by persons with severe mental illness. We also estimate a semi-reduced-form equation to examine whether changes in mental health and substance use mediate the relationship between bed supply and jail detention. We estimate linear probability models with person-level fixed effects to control for individual heterogeneity. Standard errors are adjusted for intra-cluster correlations. When an equation includes an endogenous variable, we calculate generalized method of moments estimators with instrumental variables. A decrease in the supply of psychiatric hospital beds is significantly associated with a greater probability of jail detention for minor charges among persons diagnosed with severe mental illness. Substance use appears to mediate this relationship. A reduction of inpatient psychiatric beds, ceteris paribus, is associated with an increase in jail detention among persons with severe mental illness via substance use problems. Further research should examine whether the magnitude of this relationship is greater for persons who have severe mental illness but are unable to obtain necessary treatment. This study further confirms an identified relationship between the supply of inpatient psychiatric beds, substance use and jail detention among persons with severe mental illness. These important relationships should be incorporated in the policy planning process, especially at the time of psychiatric inpatient bed reductions.

Are "goods for guns" good for the community? An update of a community gun buyback program.

PubMed

Green, Jonathan; Damle, Rachelle N; Kasper, Rebecca E; Violano, Pina; Manno, Mariann; Nazarey, Pradeep P; Aidlen, Jeremy T; Hirsh, Michael P

2017-08-01

Gun violence remains a leading cause of death in the United States. Community gun buyback programs provide an opportunity to dispose of extraneous firearms. The purpose of this study was to understand the demographics, motivation, child access to firearms, and household mental illness of buyback participants in hopes of improving the program's effectiveness. A 2015 Injury Free Coalition for Kids gun buyback program which collaborated with local police departments was studied. We administered a 23-item questionnaire survey to gun buyback participants assessing demographic characteristics, motivation for relinquishing firearms, child firearm accessibility, and mental illness/domestic violence history. A total of 186 individuals from Central/Western Massachusetts turned in 339 weapons. Participants received between US $25 and US $75 in gift cards dependent on what type of gun was turned in, with an average cost of $41/gun. A total of 109 (59%) participants completed the survey. Respondents were mostly white (99%), men (90%) and first-time participants in the program (85.2%). Among survey respondents, 54% turned in firearms "for safety reasons." Respondents reported no longer needing/wanting their weapons (47%) and approximately one in eight participants were concerned the firearm(s) were accessible to children. Most respondents (87%) felt the program encouraged neighborhood awareness of firearm safety. Three of every five participants reported that guns still remained in their homes; additionally, 21% where children could potentially access them and 14% with a history of mental illness/suicide/domestic violence in the home. Gun buybacks can provide a low-cost means of removing unwanted firearms from the community. Most participants felt their homes were safer after turning in the firearm(s). In homes still possessing guns, emphasis on secure gun storage should continue, increasing the safety of children and families. The results of this survey also provided new insights into the association between mental illness/suicide and gun ownership. Epidemiological, level III.

Opening Doors to Recovery: Recidivism and Recovery Among Persons With Serious Mental Illnesses and Repeated Hospitalizations.

PubMed

Compton, Michael T; Kelley, Mary E; Pope, Alicia; Smith, Kelly; Broussard, Beth; Reed, Thomas A; DiPolito, June A; Druss, Benjamin G; Li, Charles; Lott Haynes, Nora

2016-02-01

Repeated hospitalizations and arrests or incarcerations diminish the ability of individuals with serious mental illnesses to pursue recovery. Community mental health systems need new models to address recidivism as well as service fragmentation, lack of engagement by local stakeholders, and poor communication between mental health providers and the police. This study examined the initial effects on institutional recidivism and measures of recovery among persons enrolled in Opening Doors to Recovery, an intensive, team-based community support program for persons with mental illness and a history of inpatient psychiatric recidivism. A randomized controlled trial of the model is underway. The number of hospitalizations, days hospitalized, and arrests (all from state administrative sources) in the year before enrollment and during the first 12 months of enrollment in the program were compared. Longitudinal trajectories of recovery-using three self-report and five clinician-rated measures-were examined. Analyses accounted for baseline symptom severity and intensity of involvement in the program. One hundred participants were enrolled, and 72 were included in the analyses. Hospitalizations decreased, from 1.9±1.6 to .6±.9 (p<.001), as did hospital days, from 27.6±36.4 to 14.9±41.3 (p<.001), although number of arrests (which are rare events) did not. Significant linear trends were observed for recovery measures, and trajectories of improvement were apparent across the entire follow-up period. Opening Doors to Recovery holds promise as a new service approach for reducing hospital recidivism and promoting recovery in community mental health systems and is deserving of further controlled testing.

Mental health and substance abuse insurance parity for federal employees: how did health plans respond?

PubMed

Barry, Colleen L; Ridgely, M Susan

2008-01-01

A fundamental concern with competitive health insurance markets is that they will not supply efficient levels of coverage for treatment of costly, chronic, and predictable illnesses, such as mental illness. Since the inception of employer-based health insurance, coverage for mental health services has been offered on a more limited basis than coverage for general medical services. While mental health advocates view insurance limits as evidence of discrimination, adverse selection and moral hazard can also explain these differences in coverage. The intent of parity regulation is to equalize private insurance coverage for mental and physical illness (an equity concern) and to eliminate wasteful forms of competition due to adverse selection (an efficiency concern). In 2001, a presidential directive requiring comprehensive parity was implemented in the Federal Employees Health Benefits (FEHB) Program. In this study, we examine how health plans responded to the parity directive. Results show that in comparison with a set of unaffected health plans, federal employee plans were significantly more likely to augment managed care through contracts with managed behavioral health "carve-out" firms after parity. This finding helps to explain the absence of an effect of the FEHB Program directive on total spending, and is relevant to the policy debate in Congress over federal parity.

Mental Health Services in the Marine Corps: An Exploratory Study of Stigma and Potential Benefits of Destigmatization Training Within the Operational Stress Control and Readiness (OSCAR) Program

DTIC Science & Technology

2004-12-01

table. This organization believes that the prevalence of misrepresented mental patients and/or actors / actresses with mental illness in shows and... vs . appropriate mental health care 40 utilization) produce high rates of absenteeism. These rates of absenteeism are compounded by a lack of

Moving from rhetoric to reality: adapting Housing First for homeless individuals with mental illness from ethno-racial groups

PubMed Central

2012-01-01

Background The literature on interventions addressing the intersection of homelessness, mental illness and race is scant. The At Home/Chez Soi research demonstration project is a pragmatic field trial investigating a Housing First intervention for homeless individuals with mental illness in five cities across Canada. A unique focus at the Toronto site has been the development and implementation of a Housing First Ethno-Racial Intensive Case Management (HF ER-ICM) arm of the trial serving 100 homeless individuals with mental illness from ethno-racial groups. The HF ER-ICM program combines the Housing First approach with an anti-racism/anti-oppression framework of practice. This paper presents the findings of an early implementation and fidelity evaluation of the HF ER-ICM program, supplemented by participant narrative interviews to inform our understanding of the HF ER-ICM program theory. Methods Descriptive statistics are used to describe HF ER-ICM participant characteristics. Focus group interviews, key informant interviews and fidelity assessments were conducted between November 2010 and January 2011, as part of the program implementation evaluation. In-depth qualitative interviews with HF ER-ICM participants and control group members were conducted between March 2010 and June 2011. All qualitative data were analysed using grounded theory methodology. Results The target population had complex health and social service needs. The HF ER-ICM program enjoyed a high degree of fidelity to principles of both anti-racism/anti-oppression practice and Housing First and comprehensively addressed the housing, health and sociocultural needs of participants. Program providers reported congruence of these philosophies of practice, and program participants valued the program and its components. Conclusions Adapting Housing First with anti-racism/anti-oppression principles offers a promising approach to serving the diverse needs of homeless people from ethno-racial groups and strengthening the service systems developed to support them. The use of fidelity and implementation evaluations can be helpful in supporting successful adaptations of programs and services. Trial registration Current Controlled Trials ISRCTN42520374 PMID:23031406

Substance use and mental illness among nurses: workplace warning signs and barriers to seeking assistance.

PubMed

Cares, Alexa; Pace, Elizabeth; Denious, Jean; Crane, Lori A

2015-01-01

Although some studies have examined the prevalence of substance use among nurses, few have assessed substance use in the workplace or early cues for identifying these health conditions. Primary data collected as part of a larger program evaluation were examined with the purpose of better understanding (a) the context and perceived consequences of substance use and mental illness among nurses and (b) barriers and opportunities for earlier identification and treatment of these issues among nurses, their colleagues, and employers. Anonymous surveys were mailed to 441 active and recent participants of a peer health assistance program in the summer of 2010. The survey examined drug-related behaviors in the workplace; behavioral cues that may permit earlier identification of substance use and mental illness; perceptions of barriers to seeking assistance; and strategies for preventing problems and overcoming barriers to seeking assistance. Responses were received from 302 nurses (69%). Nearly half (48%) reported drug or alcohol use at work, and two fifths (40%) felt that their competency level was affected by their use. More than two thirds of respondents thought their problem could have been recognized earlier. The most highly rated barriers to seeking assistance for substance use and mental illness included fear and embarrassment and concerns about losing one's nursing license. Respondents recommended greater attention be paid to early identification of risk factors during nurses' professional training as a prevention strategy. Findings from this study provide preliminary data that can be used by schools of nursing and health care employers to improve early identification of nurses' substance use and mental illness treatment needs. These data also suggest a need for more research to explore the prevention and early identification of co-occurring disorders in health care settings where nurses practice.

Peer Support Among Adults With Serious Mental Illness: A Report From the Field

PubMed Central

Davidson, Larry; Chinman, Matthew; Sells, David; Rowe, Michael

2006-01-01

Peer support is based on the belief that people who have faced, endured, and overcome adversity can offer useful support, encouragement, hope, and perhaps mentorship to others facing similar situations. While this belief is well accepted for many conditions, such as addiction, trauma, or cancer, stigma and stereotypes about mental illness have impeded attempts on the part of people in recovery to offer such supports within the mental health system. Beginning in the early 1990s with programs that deployed people with mental illness to provide conventional services such as case management, opportunities for the provision and receipt of peer support within the mental health system have proliferated rapidly across the country as part of the emerging recovery movement. This article defines peer support as a form of mental health care and reviews data from 4 randomized controlled trials, which demonstrated few differences between the outcomes of conventional care when provided by peers versus non-peers. We then consider what, if any, unique contributions can be made by virtue of a person's history of serious mental illness and recovery and review beginning efforts to identify and evaluate these potential valued-added components of care. We conclude by suggesting that peer support is still early in its development as a form of mental health service provision and encourage further exploration and evaluation of this promising, if yet unproven, practice. PMID:16461576

Somali Refugees' Perceptions of Mental Illness.

PubMed

Bettmann, Joanna E; Penney, Deb; Clarkson Freeman, Pamela; Lecy, Natalie

2015-01-01

Nearly 13% of the U.S. population is comprised of foreign-born individuals, with Somalis constituting one of the largest resettled groups. Research suggests that, among Somali refugees, rates of mental illness are high. Yet research shows Somalis underutilize mental health services. Understanding their perceptions of mental illness and its cures may help practitioners to design more effective treatments for this population. Thus, this pilot study investigated Somali refugees' perceptions of mental illness and its treatments. Using purposive sampling, this qualitative study interviewed 20 Somali refugees using a semi-structured interview guide. Qualitative analysis yielded participants' perceptions of mental illness through their descriptions of physical symptoms accompanying mental illness, the stigma of mental illness, causes of mental illness, medical and non-medical treatments for mental illness, spirit possession causing mental illness, and the Qur'an as treatment for mental illness. Such information may help practitioners in the United States approach Somali clients in the most culturally coherent manner.

Mental health services then and now.

PubMed

Mechanic, David

2007-01-01

Over the past twenty-five years, psychiatric services have shifted from hospital to community. Managed care reinforces this trend. Mental illness is better understood and less stigmatized, and services are more commonly used. But many in need do not receive care consistent with evidence-based standards, or at all. Challenges are greatest for people with serious and persistent mental illnesses who depend on generic health and welfare programs and integrated services. Evidence-based rehabilitative care is often unavailable. Failures in community care lead to arrest; jail diversion and treatment are required. Despite progress, implementing an effective, patient-centered care system remains a formidable challenge.

An Online Health Prevention Intervention for Youth with Addicted or Mentally Ill Parents: Experiences and Perspectives of Participants and Providers from a Randomized Controlled Trial.

PubMed

Woolderink, Marla; Bindels, Jill A P M; Evers, Silvia M A A; Paulus, Aggie T G; van Asselt, Antoinette D I; van Schayck, Onno C P

2015-12-02

Mental illnesses affect many people around the world, either directly or indirectly. Families of persons suffering from mental illness or addiction suffer too, especially their children. In the Netherlands, 864,000 parents meet the diagnostic criteria for a mental illness or addiction. Evidence shows that offspring of mentally ill or addicted parents are at risk for developing mental disorders or illnesses themselves. The Kopstoring course is an online 8-week group course with supervision by 2 trained psychologists or social workers, aimed to prevent behavioral and psychological problems for children (aged 16 to 25 years) of parents with mental health problems or addictions. The course addresses themes such as roles in the family and mastery skills. An online randomized controlled trial (RCT) was conducted to assess the effectiveness of the Kopstoring course. The aim was to gain knowledge about expectations, experiences, and perspectives of participants and providers of the online Kopstoring course. A process evaluation was performed to evaluate the online delivery of Kopstoring and the experiences and perspectives of participants and providers of Kopstoring. Interviews were performed with members from both groups. Participants were drawn from a sample from the Kopstoring RCT. Thirteen participants and 4 providers were interviewed. Five main themes emerged from these interviews: background, the requirements for the intervention, experience with the intervention, technical aspects, and research aspects. Overall, participants and providers found the intervention to be valuable because it was online; therefore, protecting their anonymity was considered a key component. Most barriers existed in the technical sphere. Additional barriers existed with conducting the RCT, namely gathering informed consent and gathering parental consent in the case of minors. This study provides valuable insight into participants' and providers' experiences and expectations with the online preventive intervention Kopstoring. It also sheds light on the process of the online provision of Kopstoring and the accompanying RCT. The findings of this study may partly explain dropout rates when delivering online interventions. The change in the (financial) structure of the youth mental health care system in the Netherlands has financial implications for the delivery of prevention programs for youth. Lastly, there are few RCTs that assess the effectiveness and cost-effectiveness of online prevention programs in the field of (youth) mental health care and not many process evaluations of these programs exist. This hampers a good comparison between online interventions and the expectations and experiences of the participants and providers. Nederlands Trial Register: NTR1982; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1982 (Archived by WebCite® at http://www.webcitation.org/6d8xYDQbB).

What is a mental illness? Public views and their effects on attitudes and disclosure.

PubMed

Rüsch, Nicolas; Evans-Lacko, Sara; Thornicroft, Graham

2012-07-01

'Mental illness' is a common label. However, the general public may or may not consider various conditions, ranging from major psychiatric disorders to stress, as mental illnesses. It is unclear how such public views affect attitudes towards people with mental illness and reactions to one's own potential mental illness, e.g. in terms of help-seeking or disclosure. In representative English population surveys the classification of six conditions (schizophrenia, bipolar disorder, depression, drug addiction, stress, grief) as a mental illness was assessed as well as attitudes towards, and contact with, people with mental illness, intentions to disclose a mental illness and to seek treatment. A factor analysis of how strongly respondents perceived the six conditions as a mental illness yielded two factors: (i) major psychiatric disorders and (ii) stress- and behaviour-related conditions including drug addiction. In regression analyses, higher scores on the first, but not the second, factor predicted less perceived responsibility of people with mental illness for their actions, and more support for a neurobiological illness model and help-seeking. Classifying stress-related/behaviour-related conditions as mental illnesses, as well as not referring to major psychiatric disorders as mental illnesses, was associated with more negative attitudes and increased social distance, but also with stronger intentions to disclose a mental illness to an employer. Negative attitudes and social distance were also related to ethnic minority status and lower social grade. Referring to major psychiatric disorders as mental illnesses may reflect higher mental health literacy, better attitudes towards people with mental illness and help-seeking. A broader concept of mental illness could, although increasing negative attitudes, facilitate disclosure in the workplace. Public views on what is a mental illness may have context-dependent effects and should be taken into account in anti-stigma campaigns.

Deinstitutionalization and the rise of violence.

PubMed

Fuller Torrey, E

2015-06-01

The deinstitutionalization of individuals with serious mental illness was driven by 4 factors: public revelations regarding the state of public mental hospitals, the introduction of antipsychotic medications, the introduction of federal programs to fund patients who had been discharged, and civil libertarian lawyers. The result is approximately 3.2 million individuals with untreated serious mental illness living in the community. Beginning in the 1970s in the United States, there began to be reported increasing incidents of violent behavior, including homicides, committed by these untreated individuals. Such incidents became more numerous in the 1980s and 1990s, and have further increased since the turn of the century. Existing studies suggest that individuals with untreated severe mental illness are responsible for at least 10% of all homicides and approximately half of all mass killings. Studies have also shown that when these individuals are treated, the incidence of violent behavior decreases significantly. Examples of treatment mechanisms that have proven effective include assisted outpatient treatment (AOT), conditional release, and mental health courts.

Public Stigma Toward Mental Illness in Jordan: A Cross-Sectional Survey of Family Members of Individuals With Schizophrenia, Depression, and Anxiety.

PubMed

Hasan, Abd Al-Hadi; Musleh, Mahmoud

2017-06-01

Stigma affects family members of individuals with mental illness. A survey of 640 family members of individuals with mental illness was conducted. Three factors were found to influence stigma regarding schizophrenia, depression, and anxiety: (a) preconceived stereotypes, (b) a sense of personal responsibility or blame for the condition, and (c) perceptions of the patient's inability to recover from the condition. A stronger association between negative stereotypes and inability to recover was found with schizophrenia than depression or anxiety. Conversely, depression and anxiety were found to be correlated with personal responsibility or blame for the condition. The public perception of mental health conditions (e.g., depression, anxiety, schizophrenia) has a crucial role in deriving programs for reducing stigma and raising awareness. Personalized and efficacious treatment regimens may be facilitated by understanding these perceptions and the underlying explanations for why they exist. [Journal of Psychosocial Nursing and Mental Health Services, 55(6), 36-43.]. Copyright 2017, SLACK Incorporated.

Public stigma against family members of people with mental illness: findings from the Gilgel Gibe Field Research Center (GGFRC), Southwest Ethiopia

PubMed Central

2014-01-01

Background Public stigma against family members of people with mental illness is a negative attitude by the public which blame family members for the mental illness of their relatives. Family stigma can result in self social restrictions, delay in treatment seeking and poor quality of life. This study aimed at investigating the degree and correlates of family stigma. Methods A quantitative cross-sectional house to house survey was conducted among 845 randomly selected urban and rural community members in the Gilgel Gibe Field Research Center, Southwest Ethiopia. An interviewer administered and pre-tested questionnaire adapted from other studies was used to measure the degree of family stigma and to determine its correlates. Data entry was done by using EPI-DATA and the analysis was performed using STATA software. Unadjusted and adjusted linear regression analysis was done to identify the correlates of family stigma. Results Among the total 845 respondents, 81.18% were female. On a range of 1 to 5 score, the mean family stigma score was 2.16 (±0.49). In a multivariate analysis, rural residents had significantly higher stigma scores (std. β = 0.43, P < 0.001) than urban residents. As the number of perceived signs (std. β = -0.07, P < 0.05), perceived supernatural (std. β = -0.12, P < 0.01) and psychosocial and biological (std. β = -0.11, P < 0.01) explanations of mental illness increased, the stigma scores decreased significantly. High supernatural explanation of mental illness was significantly correlated with lower stigma among individuals with lower level of exposure to people with mental illness (PWMI). On the other hand, high exposure to PWMI was significantly associated with lower stigma among respondents who had high education. Stigma scores increased with increasing income among respondents who had lower educational status. Conclusions Our findings revealed moderate level of family stigma. Place of residence, perceived signs and explanations of mental illness were independent correlates of public stigma against family members of people with mental illness. Therefore, mental health communication programs to inform explanations and signs of mental illness need to be implemented. PMID:24555444

A Randomized Controlled Trial of Cognitive-Behavioral Treatment of Posttraumatic Stress Disorder in Severe Mental Illness

PubMed Central

Mueser, Kim T.; Rosenberg, Stanley D.; Xie, Haiyi; Jankowski, M. Kay; Bolton, Elisa E.; Lu, Weili; Hamblen, Jessica L.; Rosenberg, Harriet J.; McHugo, Gregory J.; Wolfe, Rosemarie

2014-01-01

A cognitive-behavioral therapy (CBT) program for PTSD was developed to address its high prevalence in persons with severe mental illness receiving treatment at community mental health centers. CBT was compared to treatment as usual (TAU) in a randomized controlled trial with 108 clients with PTSD and either major mood disorder (85%) or schizophrenia or schizoaffective disorder (15%), of whom 25% also had borderline personality disorder. Eighty-one percent of clients assigned to CBT participated in the program. Intent-to-treat analyses showed that CBT clients improved significantly more than clients in TAU at blinded post-treatment and 3- and 6-month follow-up assessments in PTSD symptoms, other symptoms, perceived health, negative trauma-related beliefs, knowledge about PTSD, and case manager working alliance. The effects of CBT on PTSD were strongest in clients with severe PTSD. Homework completion in CBT predicted greater reductions in symptoms. Changes in trauma-related beliefs in CBT mediated improvements in PTSD. The findings suggest that clients with severe mental illness and PTSD can benefit from CBT, despite severe symptoms, suicidal thinking, psychosis, and vulnerability to hospitalizations. PMID:18377122

Cultural Variation in Implicit Mental Illness Stigma.

PubMed

Cheon, Bobby K; Chiao, Joan Y

2012-10-01

Culture shapes how individuals perceive and respond to others with mental illness. Prior studies have suggested that Asians and Asian Americans typically endorse greater stigma of mental illness compared to Westerners (White Europeans and Americans). However, whether these differences in stigma arise from cultural variations in automatic affective reactions or deliberative concerns of the appropriateness of one's reactions to mental illness remains unknown. Here we compared implicit and explicit attitudes toward mental illness among Asian and Caucasian Americans. Asian Americans showed stronger negative implicit attitudes toward mental illness relative to Caucasian Americans, suggesting that cultural variation in stigma of mental illness can be observed even when concerns regarding the validity and appropriateness of one's attitudes toward mental illness are minimized. Asian Americans also explicitly endorsed greater desire for social distance from mental illness relative to Caucasian Americans. These findings suggest that cultural variations in mental illness stigma may arise from cultural differences in automatic reactions to mental illness, though cultural variations in deliberative processing may further shape differences in these immediate reactions to mental illness.

Using exercise to treat patients with severe mental illness: how and why?

PubMed

Tetlie, Trine; Heimsnes, Maria Charlotte; Almvik, Roger

2009-02-01

In this study, one focus group and five individual semi-structured interviews were conducted to investigate nursing staff's ways of using exercise as part of the routine treatment for patients with severe mental illness (SMI). The study also explored the patients' experiences and views of the exercise program given in this secure hospital. The organization and delivery of the exercise program are also discussed. The findings indicate that successful outcomes and adherence to exercise programs for patients with SMI in a secure setting rely on therapeutic relationships, having exercise as a mandatory part of the treatment, positive reinforcement, and experienced instructors. More research is needed to identify effective exercise interventions and feasible delivery models for individuals with SMI in secure settings.

Adding a vocational focus to mental health rehabilitation.

PubMed

Blankertz, L; Robinson, S

1996-11-01

The study examined the effect of adding two employment specialists to the staff of a community mental health center; their sole responsibility was to develop the skills and positive work attitudes that clients with severe mental illness need to enter the state vocational rehabilitation system or to seek employment. A total of 122 clients were randomly assigned to a program with an employment specialist or to a control group with no specialized vocational services. Clients in the program were taught work skills and attitudes in group and individual sessions and through a trial work experience. A schedule of rewards reinforced positive changes. Outcomes measured were skill gains, changes in work attitudes, attainment of employment, and entry into the state vocational rehabilitation system. At nine months, 34 of the 61 clients in the program achieved positive changes in vocational status that included competitive employment, participation in training and evaluation programs operated by the state vocational system, and formal referral to the system. Only one client in the control group was linked to the state system. Skill gains and positive changes in work attitudes were found for all program clients. Logistical regression suggested that program participation, rather than client characteristics, was an important predictor of a positive outcome. Over a relatively short time period, targeted vocational programs can help clients with severe mental illness develop the skills and attitudes necessary to attain employment or entry into the vocational rehabilitation system. Vocational rehabilitation can be an integral part of the rehabilitation process for all mental health clients.

Do biogenetic causal beliefs reduce mental illness stigma in people with mental illness and in mental health professionals? A systematic review.

PubMed

Larkings, Josephine S; Brown, Patricia M

2018-06-01

Viewing mental illness as an 'illness like any other' and promoting biogenetic causes have been explored as a stigma-reduction strategy. The relationship between causal beliefs and mental illness stigma has been researched extensively in the general public, but has gained less attention in more clinically-relevant populations (i.e. people with mental illness and mental health professionals). A systematic review examining whether endorsing biogenetic causes decreases mental illness stigma in people with mental illness and mental health professionals was undertaken using the preferred reporting items for systematic reviews and meta-analyses guidelines. Multiple databases were searched, and studies that explored the relationship between biogenetic causal beliefs and mental illness stigma in people with mental illness or mental health professionals were considered. Studies were included if they focussed on depression, schizophrenia, or mental illness in general, were in English, and had adult participants. The search identified 11 journal articles reporting on 15 studies, which were included in this review. Of these, only two provided evidence that endorsing biogenetic causes was associated with less mental illness stigma in people with mental illness or mental health professionals. The majority of studies in the present review (n = 10) found that biogenetic causal beliefs were associated with increased stigma or negative attitudes towards mental illness. The present review highlights the lack of research exploring the impacts of endorsing biogenetic causes in people with mental illness and mental health professionals. Clinical implications associated with these results are discussed, and suggestions are made for further research that examines the relationship between causal beliefs and treatment variables. © 2017 Australian College of Mental Health Nurses Inc.

Medicaid program; mental retardation--definition of "persons with related conditions"--Health Care Financing Administration. Proposed rule.

PubMed

1983-02-23

We propose to amend the 1978 Medicaid regulations on intermediate care facility services for the mentally retarded and persons with related conditions to correct the definition of "persons with related conditions". This definition, because of an inadvertent error in 1978, is currently tied to the definition of developmental disability in the Developmental Disabilities Assistance and Bill of Rights Act (DDABRA) as amended in 1978. The DDABRA, as amended, covers the mentally ill. The 1978 regulations intended to make "no substantive change" to prior Medicaid regulations which did not cover the mentally ill. The cross-reference to the DDABRA produced the unintended result of incorporating into Medicaid regulations the revision to the definition of the developmentally disabled created by the 1978 amendments to the DDABRA and may tend to cause confusion about the kind of care that is covered by the Medicaid program. Therefore, a correction of this drafting error is necessary. To avoid results of this kind in the future this proposal would establish a Medicaid definition of conditions related to mental retardation that would meet specific needs of the Medicaid program and would be independent of the definition of developmental disability in the DDABRA.

Interwoven histories: Mental health nurses with experience of mental illness, qualitative findings from a mixed methods study.

PubMed

Oates, Jennifer; Drey, Nicholas; Jones, Julia

2018-02-15

The effects of mental health nurses' own experience of mental illness or being a carer have rarely been researched beyond the workplace setting. This study aimed to explore how the experience of mental illness affects mental health nurses' lives outside of and inside work. A sample of 26 mental health nurses with personal experience of mental illness took part in semistructured interviews. Data were analysed thematically using a six-phase approach. The analysis revealed the broad context of nurses' experiences of mental illness according to three interwoven themes: mental illness as part of family life; experience of accessing services; and life interwoven with mental illness. Participants typically described personal and familial experience of mental illness across their life course, with multiple causes and consequences. The findings suggest that nurses' lives outside of work should be taken into account when considering the impact of their personal experience of mental illness. Similarly being a nurse influences how mental illness is experienced. Treatment of nurses with mental illness should account for their nursing expertise whilst recognizing that the context for nurses' mental illness could be much broader than the effect of workplace stress. © 2018 Australian College of Mental Health Nurses Inc.

Descriptive Analysis of a Novel Health Care Approach: Reverse Colocation—Primary Care in a Community Mental Health “Home”

PubMed Central

Sirna, Megan; Mangurian, Christina; Dilley, James W.; Shumway, Martha

2013-01-01

Objective: Persons with serious mental illness have increased rates of chronic medical conditions, have limited access to primary care, and incur significant health care expenditures. Few studies have explored providing medical care for these patients in the ambulatory mental health setting. This study describes a real-world population of mental health patients receiving primary care services in a community mental health clinic to better understand how limited primary care resources are being utilized. Method:Chart review was performed on patients receiving colocated primary care (colocation group, N = 143) and randomly chosen patients receiving mental health care only (mental-health group, N = 156) from January 2006 through June 2011. Demographic and mental and physical health variables were assessed. Results: Compared to the mental-health group, the colocation patients had more psychiatric hospitalizations (mean = 1.07 vs 0.23, P < .01), were more likely to be homeless (P < .01), and were more likely to require intensive case management (P < .01). Interestingly, the colocation group was not more medically ill than the mental-health group on key metabolic measures, including mean body mass index (colocation = 27.8 vs mental-health = 28.7, P = .392), low-density liprotein (colocation = 110.0 vs mental-health = 104.4, P = .480), and glucose (colocation = 94.1 vs mental-health = 109.2, P = .059). The most common medical disorders in the colocation group were related to metabolic syndrome. Conclusions: Colocated primary care services were allocated on the basis of severity of psychiatric impairment rather than severity of medical illness. This program serves as a model for other systems to employ for integrated primary and behavioral health services for patients with serious mental illness. PMID:24511447

Examining the psychological sense of community for individuals with serious mental illness residing in supported housing environments.

PubMed

Townley, Greg; Kloos, Bret

2011-08-01

The psychological sense of community is an important aspect of community life; yet, it remains largely unexamined among individuals with serious mental illness (SMI). Sense of community represents the strength of bonding among community members; and this social phenomenon likely impacts the process by which individuals with SMI integrate into community life. The current study examined sense of community (SOC) for individuals with SMI by assessing the relationships between neighborhood experiences, unique factors related to SMI (e.g., mental illness diagnosis), and sense of community in the neighborhood. Participants were 402 residents of supported housing programs who used mental health services in South Carolina. Hierarchical linear regression was utilized to determine which components of community life helped to explain variability in sense of community. In total, 214 participants reported that it is very important for them to feel a sense of community in their neighborhoods. Neighbor relations, neighborhood safety, neighborhood satisfaction, neighborhood tolerance for mental illness, and housing site type emerged as significant explanatory variables of sense of community. These findings have implications for interventions aimed at enhancing SOC and community integration for individuals with SMI.

Pathways between stigma and suicidal ideation among people at risk of psychosis.

PubMed

Xu, Ziyan; Müller, Mario; Heekeren, Karsten; Theodoridou, Anastasia; Metzler, Sibylle; Dvorsky, Diane; Oexle, Nathalie; Walitza, Susanne; Rössler, Wulf; Rüsch, Nicolas

2016-04-01

Mental illness stigma may contribute to suicidality and is associated with social isolation and low self-esteem among young people at risk of psychosis. However, it is unclear whether mental illness stigma contributes to suicidality in this population. We therefore examined the associations of self-labeling and stigma stress with suicidality among young people at risk. Self-labeling as "mentally ill", stigma stress, social isolation, self-esteem, symptoms and suicidal ideation were assessed in 172 individuals at risk of psychosis. Self-labeling and stigma stress were examined as predictors of suicidality by path analysis. Increased self-labeling as "mentally ill" was associated with suicidality, directly as well as indirectly mediated by social isolation. More stigma stress was related to social isolation which in turn was associated with low self-esteem, depression and suicidal ideation. Social isolation fully mediated the link between stigma stress and suicidal ideation. Interventions to reduce the public stigma associated with risk of psychosis as well as programs to facilitate non-stigmatizing awareness of at-risk mental state and to reduce stigma stress among young people at risk of psychosis might strengthen suicide prevention in this population. Copyright © 2016 Elsevier B.V. All rights reserved.

[Attitudes toward disabilities and mental illness in work settings: a review].

PubMed

Mangili, Edoardo; Ponteri, Marco; Buizza, Chiara; Rossi, Giuseppe

2004-01-01

The aim of the present work is to analyse employers' and employees' attitudes towards the job integration of people with mental illness or disability and to highlight the socio-demographic and organizational characteristic that are more significantly associated with such attitudes. We performed PsycINFO, AskERIC and Medline searches for studies published from 1961 to 2002, with key words such as attitudes, stigma, schizophrenia, mental illness, disability, employers, employees, co-workers and supported employment. Our review of the literature showed that the possibility for people with severe mental illness or disability to enter job market is limited by the discriminating attitudes of employers. The socio-demographic and organizational characteristics, which are more significantly associated with employers' more positive attitudes, are: dimension of the company, previous positive contact with people with disability and employers' high educational level. Such information could be useful to identify and, perhaps, select those companies, which can be predicted as more likely to accept people with mental disorders as part of their work force; they could also be used to train job applicants to improve their social skills. Finally such information could be used to plan specific programs to modify attitudes of employees and employers.

Using the MAYSI-2 to identify mental disorder among Latino juvenile offenders.

PubMed

Eno Louden, Jennifer; Kang, Tamara; Ricks, Elijah P; Marquez, Lorae

2017-06-01

Many juvenile justice agencies have adopted the Massachusetts Youth Screening Inventory-Version 2 (MAYSI-2; Grisso & Barnum, 2006) to facilitate appropriate programming for young offenders with mental illness. Although Latinos are the fastest-growing ethnic group in the criminal justice system, there is scant research on the utility of the MAYSI-2 among Latino adolescents. The present study examined the utility of the MAYSI-2 in detecting diagnosable mental illness among 398 Latino and 60 European American adolescents in a juvenile justice agency. In addition to testing the scoring configuration used by the agency to identify adolescents in need of further attention, we tested 2 additional scoring configurations of the MAYSI-2. We found that the MAYSI-2 had similar utility at identifying serious mood and anxiety disorders for both ethnic groups, but was less sensitive to behavioral and substance use disorders among Latinos than it was among European Americans. In addition, the MAYSI-2 overall was less sensitive to mental illness among Latino boys compared with Latina girls. We discuss these findings within the context of best practices for identifying adolescents with mental illness in juvenile justice agencies. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Opening minds in Canada: targeting change.

PubMed

Stuart, Heather; Chen, Shu-Ping; Christie, Romie; Dobson, Keith; Kirsh, Bonnie; Knaak, Stephanie; Koller, Michelle; Krupa, Terry; Lauria-Horner, Bianca; Luong, Dorothy; Modgill, Geeta; Patten, Scott B; Pietrus, Mike; Szeto, Andrew; Whitley, Rob

2014-10-01

To summarize the ongoing activities of the Opening Minds (OM) Anti-Stigma Initiative of the Mental Health Commission of Canada regarding the 4 groups targeted (youth, health care providers, media, and workplaces), highlight some of the key methodological challenges, and review lessons learned. The approach used by OM is rooted in community development philosophy, with clearly defined target groups, contact-based education as the central organizing element across interventions, and a strong evaluative component so that best practices can be identified, replicated, and disseminated. Contact-based education occurs when people who have experienced a mental illness share their personal story of recovery and hope. Results have been generally positive. Contact-based education has the capacity to reduce prejudicial attitudes and improve social acceptance of people with a mental illness across various target groups and sectors. Variations in program outcomes have contributed to our understanding of active ingredients. Contact-based education has become a cornerstone of the OM approach to stigma reduction. A story of hope and recovery told by someone who has experienced a mental illness is powerful and engaging, and a critical ingredient in the fight against stigma. Building partnerships with existing community programs and promoting systematic evaluation using standardized approaches and instruments have contributed to our understanding of best practices in the field of anti-stigma programming. The next challenge will be to scale these up so that they may have a national impact.

Empowerment and Peer Support: Structure and Process of Self-Help in a Consumer-Run Center for Individuals with Mental Illness

ERIC Educational Resources Information Center

Schutt, Russell K.; Rogers, E. Sally

2009-01-01

Personal empowerment is a guiding philosophy of many mental health service programs, but there has been little empirical research on the empowerment process in these programs. The authors examine social processes and consumer orientations within a self-help drop-in center for individuals with psychiatric disabilities, using intensive interviews…

Physiotherapy Students' Attitudes toward Psychiatry and Mental Health: A Cross-Sectional Study.

PubMed

Connaughton, Joanne; Gibson, William

Purpose: A cross-sectional exploration of Notre Dame Australia physiotherapy students' attitudes toward psychiatry and mental illness, students' perceptions regarding preparation in this area for general clinical practice, and a cross-sectional investigation of current mental health-and psychiatry-related content in physiotherapy curricula across Australia and New Zealand. Methods: A questionnaire including demographic details, level of exposure to mental illness, and the Attitudes Toward Psychiatry-30 items (ATP-30) was completed by pre-clinical and clinically experienced physiotherapy students from the University of Notre Dame Australia. Students with clinical experience were asked additional questions about preparedness for practice. Staff of 10 of 17 physiotherapy programmes across Australia and New Zealand responded to an online questionnaire investigating relevant content and quantity of learning experiences in mental health. Results: Student response rate was 89%. Students generally had a positive attitude about psychiatry and mental health. Women were significantly more positive than men, and students who had completed clinical experience had a significantly more positive attitude. Physiotherapy program responses (response rate=59%) highlighted disparate approaches to psychiatry and mental health learning opportunities in terms of quantity and content. Conclusion: Entry-level physiotherapy students who have clinical experience generally have a more positive attitude toward psychiatry and people with mental illness. Given the prevalence of mental health problems and the increase in physical and mental health comorbidities, it is imperative that future clinicians have positive educational experiences in psychiatry. A coherent, integrated approach to mental illness and psychiatry is suggested for entry-level physiotherapy programmes in Australia and New Zealand.

Physiotherapy Students' Attitudes toward Psychiatry and Mental Health: A Cross-Sectional Study

PubMed Central

Gibson, William

2016-01-01

Purpose: A cross-sectional exploration of Notre Dame Australia physiotherapy students' attitudes toward psychiatry and mental illness, students' perceptions regarding preparation in this area for general clinical practice, and a cross-sectional investigation of current mental health—and psychiatry-related content in physiotherapy curricula across Australia and New Zealand. Methods: A questionnaire including demographic details, level of exposure to mental illness, and the Attitudes Toward Psychiatry–30 items (ATP-30) was completed by pre-clinical and clinically experienced physiotherapy students from the University of Notre Dame Australia. Students with clinical experience were asked additional questions about preparedness for practice. Staff of 10 of 17 physiotherapy programmes across Australia and New Zealand responded to an online questionnaire investigating relevant content and quantity of learning experiences in mental health. Results: Student response rate was 89%. Students generally had a positive attitude about psychiatry and mental health. Women were significantly more positive than men, and students who had completed clinical experience had a significantly more positive attitude. Physiotherapy program responses (response rate=59%) highlighted disparate approaches to psychiatry and mental health learning opportunities in terms of quantity and content. Conclusion: Entry-level physiotherapy students who have clinical experience generally have a more positive attitude toward psychiatry and people with mental illness. Given the prevalence of mental health problems and the increase in physical and mental health comorbidities, it is imperative that future clinicians have positive educational experiences in psychiatry. A coherent, integrated approach to mental illness and psychiatry is suggested for entry-level physiotherapy programmes in Australia and New Zealand. PMID:27909364

Domain-Specific Physical Activity and Mental Health: A Meta-analysis.

PubMed

White, Rhiannon Lee; Babic, Mark J; Parker, Philip D; Lubans, David R; Astell-Burt, Thomas; Lonsdale, Chris

2017-05-01

The mental health benefits of physical activity are well established. However, less is known about whether the relationship between physical activity and mental health is consistent across different life domains. It is important to understand how context may influence the relationship between physical activity and mental health so that interventions and policy guidelines can be tailored to maximize positive effects. In 2015, systematic searches of four databases identified 13,435 records, of which 98 studies met the inclusion criteria. Included studies were published between 1988 and 2015 and had a combined sample size of 648,726. Of the 98 included studies, 93 examined leisure-time physical activity, 14 examined work-related physical activity, 15 examined transport physical activity, 16 examined household physical activity, three examined school sport, and three examined physical education. Multi-level meta-analyses showed that leisure-time physical activity (r =0.13) and transport physical activity (r =0.13) both had a positive association with mental health. Leisure-time physical activity (r = -0.11) and school sport (r = -0.09) both had an inverse association with mental ill-health. However, physical activity was not consistently associated with lower mental ill-health across domains, as work-related physical activity was positively associated with mental ill-health (r =0.09). Household physical activity and participation in physical education had no relationship with mental health or mental ill-health. The domain in which physical activity occurs influences the relationship between physical activity and mental health and should, therefore, be considered when developing interventions, treatment programs, and policy guidelines. Copyright © 2017 American Journal of Preventive Medicine. All rights reserved.

Crime, violence, and behavioral health: collaborative community strategies for risk mitigation.

PubMed

Pinals, Debra A

2015-06-01

Criminal conduct is not always violent, and violence does not always lead to criminal charges. Moreover, crime and violence have multifaceted etiologies. Most violence in society is not attributable to mental illness. Where there is a small relationship between violence and mental illness, the risk of violence increases for individuals with substance use histories. Underlying trauma can also play a role. Antisocial attitudes, behaviors, and peer groups further increase the risk that individuals, including those with mental illness, will find themselves at risk of criminal recidivism. Criminal histories among public mental health populations, and mental health and substance use disorders among criminal populations are each higher than general population comparisons. Care within behavioral health settings should therefore target decreased criminal recidivism and decreased violence as part of recovery for those individuals at risk, using trauma-informed approaches and peer supports. Interventions that show promise bring criminal justice and behavioral health systems together, and include police-based diversion, specialty courts, court-based alternatives to incarceration, and coordinated re-entry programs. This article reviews these options along with specific risk management strategies, such as using risk, needs, and responsivity factors as a means of improving overall outcomes for persons with mental illness, while minimizing their risk of further criminalization and victimization.

Pragmatic replication trial of health promotion coaching for obesity in serious mental illness and maintenance of outcomes.

PubMed

Bartels, Stephen J; Pratt, Sarah I; Aschbrenner, Kelly A; Barre, Laura K; Naslund, John A; Wolfe, Rosemarie; Xie, Haiyi; McHugo, Gregory J; Jimenez, Daniel E; Jue, Ken; Feldman, James; Bird, Bruce L

2015-04-01

Few studies targeting obesity in serious mental illness have reported clinically significant risk reduction, and none have been replicated in community settings or demonstrated sustained outcomes after intervention withdrawal. The authors sought to replicate positive health outcomes demonstrated in a previous randomized effectiveness study of the In SHAPE program across urban community mental health organizations serving an ethnically diverse population. Persons with serious mental illness and a body mass index (BMI) >25 receiving services in three community mental health organizations were recruited and randomly assigned either to the 12-month In SHAPE program, which included membership in a public fitness club and weekly meetings with a health promotion coach, or to fitness club membership alone. The primary outcome measures were weight and cardiorespiratory fitness (as measured with the 6-minute walk test), assessed at baseline and at 3, 6, 9, 12, and 18 months. Participants (N=210) were ethnically diverse (46% were nonwhite), with a mean baseline BMI of 36.8 (SD=8.2). At 12 months, the In SHAPE group (N=104) had greater reduction in weight and improved fitness compared with the fitness club membership only group (N=106). Primary outcomes were maintained at 18 months. Approximately half of the In SHAPE group (51% at 12 months and 46% at 18 months) achieved clinically significant cardiovascular risk reduction (a weight loss ≥5% or an increase of >50 meters on the 6-minute walk test). This is the first replication study confirming the effectiveness of a health coaching intervention in achieving and sustaining clinically significant reductions in cardiovascular risk for overweight and obese persons with serious mental illness.

Challenging the public stigma of mental illness: a meta-analysis of outcome studies.

PubMed

Corrigan, Patrick W; Morris, Scott B; Michaels, Patrick J; Rafacz, Jennifer D; Rüsch, Nicolas

2012-10-01

Public stigma and discrimination have pernicious effects on the lives of people with serious mental illnesses. Given a plethora of research on changing the stigma of mental illness, this article reports on a meta-analysis that examined the effects of antistigma approaches that included protest or social activism, education of the public, and contact with persons with mental illness. The investigators heeded published guidelines for systematic literature reviews in health care. This comprehensive and systematic review included articles in languages other than English, dissertations, and population studies. The search included all articles from the inception of the databases until October 2010. Search terms fell into three categories: stigma, mental illness (such as schizophrenia and depression), and change program (including contact and education). The search yielded 72 articles and reports meeting the inclusion criteria of relevance to changing public stigma and sufficient data and statistics to complete analyses. Studies represented 38,364 research participants from 14 countries. Effect sizes were computed for all studies and for each treatment condition within studies. Comparisons between effect sizes were conducted with a weighted one-way analysis of variance. Overall, both education and contact had positive effects on reducing stigma for adults and adolescents with a mental illness. However, contact was better than education at reducing stigma for adults. For adolescents, the opposite pattern was found: education was more effective. Overall, face-to-face contact was more effective than contact by video. Future research is needed to identify moderators of the effects of both education and contact.

A SYSTEMATIC REVIEW OF INTERVENTIONS TARGETING PATERNAL MENTAL HEALTH IN THE PERINATAL PERIOD.

PubMed

Rominov, Holly; Pilkington, Pamela D; Giallo, Rebecca; Whelan, Thomas A

2016-05-01

Interventions targeting parents' mental health in the perinatal period are critical due to potential consequences of perinatal mental illness for the parent, the infant, and their family. To date, most programs have targeted mothers. This systematic review explores the current status and evidence for intervention programs aiming to prevent or treat paternal mental illness in the perinatal period. Electronic databases were systematically searched to identify peer-reviewed studies that described an intervention targeting fathers' mental health in the perinatal period. Mental health outcomes included depression, anxiety, and stress as well as more general measures of psychological functioning. Eleven studies were identified. Three of five psychosocial interventions and three massage-technique interventions reported significant effects. None of the couple-based interventions reported significant effects. A number of methodological limitations were identified, including inadequate reporting of study designs, and issues with the timing of interventions. The variability in outcomes measures across the studies made it difficult to evaluate the overall effectiveness of the interventions. Father-focused interventions aimed at preventing perinatal mood problems will be improved if future studies utilize more rigorous research strategies. © 2016 Michigan Association for Infant Mental Health.

[Psychiatric patients and relatives instruct German police officers - an anti-stigma project of "BASTA - the alliance for mentally ill people"].

PubMed

Wundsam, Kerstin; Pitschel-Walz, Gabi; Leucht, Stefan; Kissling, Werner

2007-05-01

Contact with police officers due to schizophrenia and resort to violence in such interactions is a common occurrence and represents a source for stigmatisation of mentally ill people. Aim of this project was to establish a program for police officers to reduce that stigma. The seminar was developed by a German anti-stigma organisation in cooperation with sociology teachers of the Bavarian police academy. Evaluations focussed on the police officers "social distance" and "negative stereotypes" towards mentally ill people. The personal contact between officers and the referees (patients, relatives, professionals) was the core of the seminar. Results of a debriefing after the pilot-project was overall positive. Evaluations in the renewal years showed significant improvement within the scale "social distance" (p < 0.0001) and amelioration in the stereotype-categories "violence" and "treatability". The need for special training of the police regarding mental illnesses was acknowledged by all participants. Personal contact of police officers with patients and relatives appeared to be important for the efficacy of this seminar and should become a main focus in similar anti-stigma interventions.

Mental Illness and Juvenile Offenders

PubMed Central

Underwood, Lee A.; Washington, Aryssa

2016-01-01

Within the past decade, reliance on the juvenile justice system to meet the needs of juvenile offenders with mental health concerns has increased. Due to this tendency, research has been conducted on the effectiveness of various intervention and treatment programs/approaches with varied success. Recent literature suggests that because of interrelated problems involved for youth in the juvenile justice system with mental health issues, a dynamic system of care that extends beyond mere treatment within the juvenile justice system is the most promising. The authors provide a brief overview of the extent to which delinquency and mental illness co-occur; why treatment for these individuals requires a system of care; intervention models; and the juvenile justice systems role in providing mental health services to delinquent youth. Current and future advancements and implications for practitioners are provided. PMID:26901213

45 CFR 707.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ON THE BASIS OF DISABILITY IN PROGRAMS OR ACTIVITIES CONDUCTED BY U.S. COMMISSION ON CIVIL RIGHTS... real or personal property. (e) Individual with disabilities means any person who has a physical or... mental retardation, organic brain syndrome, emotional or mental illness, and specific learning...

Rehabilitation of Persons with Long-Term Mental Illness in the 1990s. A Report of the Mary E. Switzer Memorial Seminar (12th, Washington, D.C., June 15-17, 1988). Switzer Monograph, 12th Edition.

ERIC Educational Resources Information Center

Perlman, Leonard G., Ed.; Hansen, Carl E., Ed.

The focus of the six seminar papers is on the rehabilitation needs of persons with long-term mental illness, followed by excerpts of reviews and comments, as well as summary recommendations. "Rehabilitation Programs in the 1980s: Laying the Groundwork for the 1990s" (William Anthony) notes that deinstitutionalization is a historical fact…

Measuring the Impact of Programs that Challenge the Public Stigma of Mental Illness

PubMed Central

Corrigan, Patrick W.; Shapiro, Jenessa R.

2010-01-01

Public stigma robs people with mental illnesses from rightful opportunities related to work and other important life goals. Advocates have developed anti-stigma programs meant to address the prejudice and discrimination associated with these conditions. Evidence is now needed to make sense of program impact; this paper looks at measurement issues related to stigma change. Community based participatory research is central to this research and includes the involvement of a diverse collection of stakeholders in all phases of evaluation. Investigators should be cautious about measures vis-à-vis social desirability effects and should directed by social validity of targeted audiences. Conceptual domains with some research support that correspond with assessments include behavior, penetration, psychological perspective, knowledge, and physiological/information processes. These issues are summarized as ten recommendations for evaluation of anti-stigma programs. PMID:20674114

La CLAve to Increase Psychosis Literacy of Spanish-Speaking Community Residents and Family Caregivers

PubMed Central

López, Steven R.; Kopelowicz, Alex; Solano, Susana; del Carmen Lara, Ma.; Foncerrada, Hector; Aguilera, Adrian

2014-01-01

The authors developed and tested a 35-min psychoeducational program with the goal of increasing Spanish-speaking persons’ literacy of psychosis. The program uses popular cultural icons derived from music, art, and videos, as well as a mnemonic device—La CLAve (The Clue)—to increase (a) knowledge of psychosis, (b) efficacy beliefs that one can identify psychosis in others, (c) attributions to mental illness, and (d) professional help-seeking. Assessments were conducted before and after administering the program to both community residents (n = 57) and family caregivers of persons with schizophrenia (n = 38). For community residents, the authors observed increases across the 4 domains of symptom knowledge, efficacy beliefs, illness attributions, and recommended help-seeking. For caregivers, increases were observed in symptom knowledge and efficacy beliefs. La CLAve is a conceptually informed psychoeducational tool with a developing empirical base aimed at helping Spanish-speaking Latinos with serious mental illness obtain care in a timely manner. PMID:19634968

Culturally prescribed beliefs about mental illness among the Akan of Ghana.

PubMed

Opare-Henaku, Annabella; Utsey, Shawn O

2017-08-01

Mental illness is a culturally laden phenomenon, and different cultures have unique ways of constructing mental illness. In this study, conceptions of mental illness were explored among 30 participants of Akan descent in Ghana through individual and group interviews. Participants demonstrated a wide range of knowledge on mental illness indicating that poor self-care, deficits in social functioning, and disordered behaviors are the cardinal features of mental illness. The data revealed that Akan cultural beliefs influenced notions of etiology of mental illness and care of the mentally ill. While participants recognized the role of multiple factors such as genetics, substance abuse, daily hassles (for example, concerns about basic needs such as food, clothing, and shelter), and trauma in the cause of mental illness, the predominant belief was that mental illness is a retributive and/or a spiritual illness. This belief encourages pluralistic health-seeking behaviors: use of hospitals, prayer camps, herbalists, and traditional healers. The implications of these findings for public health education on mental illness, and clinical training and practice are discussed.

The stigma of mental illness in the labor market.

PubMed

Hipes, Crosby; Lucas, Jeffrey; Phelan, Jo C; White, Richard C

2016-03-01

Mental illness labels are accompanied by devaluation and discrimination. We extend research on reactions to mental illness by utilizing a field experiment (N = 635) to test effects of mental illness labels on labor market discrimination. This study involved sending fictitious applications to job listings, some applications indicating a history of mental illness and some indicating a history of physical injury. In line with research indicating that mental illness leads to stigma, we predicted fewer callbacks to candidates with mental illness. We also predicted relatively fewer callbacks for applicants with mental illness when the jobs involved a greater likelihood for interpersonal contact with the employer. Results showed significant discrimination against applicants with mental illness, but did not indicate an effect of potential proximity to the employer. This contributes a valuable finding in a natural setting to research on labor market discrimination towards people with mental illness. Copyright © 2015 Elsevier Inc. All rights reserved.

The changing face of newspaper representations of the mentally ill.

PubMed

Murphy, Neil A; Fatoye, Francis; Wibberley, Christopher

2013-06-01

Negative stereotypes presented in the media may contribute to the stigma associated with mental illness. People's attitudes towards the mentally ill are initially influenced and subsequently maintained in part by the frequent media presentation of negative stereotypes of mental illness. This could result in social rejection of individuals with mental illnesses. To explore how four main U.K. national newspapers reported on mental health/mental illness stories over a 10-year period. This study utilised content analysis to identify words, themes and trends of representation related to the mentally ill in articles from the four newspapers. The findings indicated that there was an increase in the number of articles related to mental health/illness over the time of the study. The rate of increase was far greater than that for the increase in the total number of articles carried in the press over this time period. It was also identified that pejorative terms were used, in a number of the articles, to describe the mentally ill person. Many of the newspaper reports highlighted the need for protection of the general public from the mentally ill, and that the mentally ill were in some way different to the general public. In particular, both the words "violence" and "drugs" were linked to mental health/mental illness in these articles.

The Influence of Treatment Attendance on Subsequent Aggression among Severely Mentally Ill Substance Abusers

PubMed Central

Zhuo, Yue; Bradizza, Clara M.; Maisto, Stephen A.

2014-01-01

The interrelationships between severe mental illness, substance use, and aggression are of longstanding importance with implications for community treatment programs, treatment research and public policy. Through the analysis of longitudinal data collected from 278 patients over a 6-month period following admission to an outpatient dual diagnosis treatment program, this study examined the association between dual diagnosis treatment attendance and subsequent aggression among individuals diagnosed with both a severe mental illness and a substance use disorder. We also tested substance use and psychiatric symptoms as mediators of this treatment-aggression relationship. The results of structural equation modeling analyses indicated that dual diagnosis treatment was associated with lower levels of subsequent aggression. Mediational analyses indicated that greater treatment involvement was associated with reduced substance use, which was associated with lower levels of aggression; thus, substance use was found to mediate the relationship between dual diagnosis treatment and aggression. Surprisingly, severity of psychiatric symptoms did not predict later aggression. These findings suggest that targeting substance use reduction in treatment may have the additional benefit of reducing the risk of later aggression among dual diagnosis patients. PMID:25124261

Persisting Barriers to Employment for Recently Housed Adults with Mental Illness Who Were Homeless.

PubMed

Poremski, Daniel; Woodhall-Melnik, Julia; Lemieux, Ashley J; Stergiopoulos, Vicky

2016-02-01

Adults with mental illness who are homeless experience multiple barriers to employment, contributing to difficulties securing and maintaining housing. Housing First programs provide quick, low-barrier access to housing and support services for this population, but their success in improving employment outcomes has been limited. Supported employment interventions may augment Housing First programs and address barriers to employment for homeless adults with mental illness. The present paper presents data from qualitative interviews to shed light on the persisting barriers to employment among people formerly homeless. Once housed, barriers to employment persisted, including the following: (1) worries about disclosing sensitive information, (2) fluctuating motivation, (3) continued substance use, and (4) fears about re-experiencing homelessness-related trauma. Nevertheless, participants reported that their experiences of homelessness helped them develop interpersonal strength and resilience. Discussing barriers with an employment specialist helps participants develop strategies to overcome them, but employment specialists must be sensitive to specific homelessness-related experiences that may not be immediately evident. Supported housing was insufficient to help people return to employment. Supported employment may help people return to work by addressing persisting barriers.

[Awareness and attitude toward suicide in community mental health professionals and hospital workers].

PubMed

Kim, Soung Nam; Lee, Kang Sook; Lee, Seon Young; Yu, Jae Hee; Hong, A Rum

2009-05-01

The purpose of this study was to evaluate community mental health professionals and hospital workers attitude and awareness towards suicide. This study investigated 264 community mental health professionals and 228 hospital workers. SOQs (Suicidal Opinion Questionnaires) were used from July 2007 to September 2007. After a factor analysis for the attitude towards suicide, the items on ethics, mental illness, religion, risk, and motivation were included in the subsequent analysis. There were significant differences in the attitude towards suicide according to religion, age, educational background, the marriage status, the economic position, and different professional licenses. Hospital workers' view was different from the community workers'. The hospital workers judged that suicide was due to mental illness, and suicide was high for the people in a special environment and who lacked motivation, which caused them to fall in a dangerous situation. For the lower educational group, they thought that suicide was attributable to mental illness. The awareness for suicide was significantly higher in the group with a postgraduate education, unmarried people, mental health professionals and the persons who had concern and experience with suicide. The factors that had an influence on the awareness of suicide were the items of mental illness, religion, risk and motivational factors. This study suggested that the factors to increase the awareness and attitude for suicide were the experience of increased education and case management of suicide. Therefore, education dealing with suicide and reinforcement of crisis management programs should be developed.

From recovery programs to recovery-oriented practice? A qualitative study of mental health professionals' experiences when facilitating a recovery-oriented rehabilitation program.

PubMed

Dalum, Helle Stentoft; Pedersen, Inge Kryger; Cunningham, Harry; Eplov, Lene Falgaard

2015-12-01

The recovery model has influenced mental health services and fostered new standards for best practice. However, knowledge about how mental health care professionals (HCPs) experience recovery-oriented programs is sparse. This paper explores HCPs' experiences when facilitating a recovery-oriented rehabilitation program. The research question is how do HCPs experience a change in their attitude and practice when applying recovery-oriented programs? This paper draws on semi-structured in-depth qualitative interviews conducted with 16 HCPs experienced in facilitating a recovery-oriented rehabilitation program in either the USA or Denmark. Three themes emerged from the HCPs' reflections on changes in attitudes and practices: "Hopeful Attitude" captures a change in the HCPs' attitude toward a more positive view on the future for clients' living with mental illness; "A New Focus in the Dialogue With Clients" thematizes how the HCPs focus more on the individual's own goal for recovery rather than disease-induced goals in the dialog with clients; "A Person-Centered Role" comprises a shift in the professional role whereby the HCPs value the client's own ideas in addition to the professional's standards. This study supports the theory of the recovery model by its empirical findings and indications that when facilitating a recovery-oriented program, HCPs experience recovery-oriented changes in their attitude toward life with mental illness, and it alters their professional practice toward a stronger focus on client's own goals during treatment. More studies are needed to further clarify how changes in HCPs' attitudes translate into changes in mental health practices. Copyright © 2015 Elsevier Inc. All rights reserved.

What Do Final Year Medical Students Understand by the Concept of Recovery? A Descriptive Qualitative Study.

PubMed

Newton-Howes, Giles; Beverley, Georgia; Ellis, Pete M; Gordon, Sarah; Levack, William

2018-06-01

Traditional teaching in psychiatry does little to address recovery concepts. The aim of this study was to evaluate the incorporation of a recovery-focused teaching program for medical students in psychiatry. Recovery, as understood by medical students who had participated in a recovery-focused teaching program, was assessed by thematic analysis of recovery-focused assessment reflections. Six major themes emerged from the recovery reflections from final year medical students are as follows: (1) recovery as a person-centered approach, (2) the need for social integration, (3) non-diagnostic framing of mental illness, (4) tensions between the medical model and personal recovery, (5) a patient's willingness to engage with mental health services, and (6) the development of a positive sense of self. A recovery teaching program was associated with students expressing knowledge of recovery principles and positive attitudes towards people with experience of mental illness. Psychiatric placements for medical students may benefit from a recovery focus.

38 CFR 52.160 - Specialized rehabilitative services.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., but not limited to, physical therapy, speech therapy, occupational therapy, and mental health services for mental illness are required in the participant's comprehensive plan of care, program management... AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.160...

Correlates of Co-Occurring Diabetes and Obesity Among Community Mental Health Program Members With Serious Mental Illnesses.

PubMed

Cook, Judith A; Razzano, Lisa; Jonikas, Jessica A; Swarbrick, Margaret A; Steigman, Pamela J; Hamilton, Marie M; Carter, Tina M; Santos, Alberto B

2016-11-01

This study examined the prevalence and correlates of co-occurring obesity and diabetes among community mental health program members. Medical screenings of 457 adults with serious mental illnesses were conducted by researchers and peer wellness specialists in four U.S. states. Body mass index was measured directly. Diabetes was assessed via glycosylated hemoglobin and interview self-report. Multivariable logistic regression analysis examined associations with known predictors. In the sample, 59% were obese, 25% had diabetes, and 19% had both conditions. When gender, diagnosis, and site were controlled, co-occurring diabetes and obesity was almost three times as likely among African Americans (OR=2.93) as among participants from other racial groups and half as likely among smokers as among nonsmokers (OR=.58). Older persons and those with poorer self-rated physical health also were more likely to have these co-occurring conditions. Results support the need for culturally competent treatment and for smoking cessation options with sensitivity to the potential for weight gain.

Mental health consumer parents' recommendations for designing psychoeducation interventions for their minor children.

PubMed

Riebschleger, Joanne; Onaga, Esther; Tableman, Betty; Bybee, Deborah

2014-09-01

This research explores consumer parents' recommendations for developing psychoeducation programs for their minor children. Data were drawn from a purposive sample of 3 focus groups of parent consumers of a community mental health agency. The research question was: "What do consumer parents recommend for developing psychoeducation programs for their minor children?" Parents recommended content foci of mental illness, recovery, heritability, stigma, and coping. The next step is youth psychoeducation intervention development and evaluation. Parents, youth, and professionals should be included in the program planning. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Mental health consultant to law enforcement: Secret Service development of a Mental Health Liaison Program.

PubMed

Coggins, M H; Pynchon, M R

1998-01-01

The Mental Health Liaison Program developed and used by the Secret Service is presented as a model for comprehensive, multidimensional interactions between law enforcement and mental health systems, with particular focus on assessing and preventing violent behavior. The structure of the program pairs consultants--psychologists and psychiatrists--with Secret Service field offices to provide (a) consultation regarding risk assessment and case management of individuals who threaten or display inappropriate interest in the President or other protectees; (b) training for agents on risk assessment, mental illness, and mental health care issues; and (c) liaison activities between the Secret Service and the mental health community. Practical benefits to the Secret Service are discussed to encourage more systematic use of broad based psychological and psychiatric consultation to law enforcement, with a goal of enhanced intersystem communication and collaboration. The need for program evaluation and outcome research is discussed in the context of applying the model to improve other mental health and law enforcement systems interactions.

Cultural misconceptions and public stigma against mental illness among Lebanese university students.

PubMed

Rayan, Ahmad; Fawaz, Mirna

2018-04-01

The purpose of this study was to examine cultural misconceptions about mental illness and how they are associated with the public stigma against mental illness among Lebanese university students. A sample of 203 participants completed the study. Data about cultural misconceptions, attitudes about mental illness, and public stigma of mental illness were obtained. The researchers examined the mean difference in public stigma according to cultural beliefs about mental illness. The majority of students believe that mental health professionals have inadequate knowledge and expertise to treat mental disorders. Various cultural misconceptions about mental illness were reported. Public stigma significantly differed based on these cultural misconceptions. Psychiatric nurses should play a vital role in reshaping the inappropriate cultural view about mental illness. © 2017 Wiley Periodicals, Inc.

PTSD as a mediator between lifetime sexual abuse and substance use among jail diversion participants.

PubMed

Cusack, Karen J; Herring, Amy H; Steadman, Henry J

2013-08-01

Many of the individuals with serious mental illness involved in the criminal justice system have experienced interpersonal victimization, such as sexual abuse, and have high rates of alcohol and drug use disorders. Little attention has been paid to the prevalence of posttraumatic stress disorder (PTSD) and its potential role in the substance misuse of offenders with mental illness. The study used a path analytic framework to test the hypothesis that PTSD mediates the relationship between sexual abuse and level of alcohol and drug use among individuals (N=386) with mental illness enrolled in a multisite (N=7) jail diversion project. Sexual abuse was strongly associated with PTSD, which was in turn associated with both heavy drug use and heavy drinking. These findings suggest that PTSD may be an important target for jail diversion programs.

Information needs, care difficulties, and coping strategies in families of people with mental illness

PubMed Central

Sabanciogullari, Selma; Tel, Havva

2015-01-01

Objective: To determine information needs, care difficulties, and coping mechanisms of family members of people with mental illness. Methods: In this descriptive cross-sectional study, the study sample consisted of the families of 134 patients who were treated in the Psychiatric Unit of Cumhuriyet University Training and Research Hospital in Sivas, Turkey between January and May 2011. Data was collected by a questionnaire and analysed descriptively, and by chi-square testing. Results: It was determined that 79.1% of family members were knowledgeable of the patients’ illness. It was found that they experienced difficulties in communicating with the patient, and in ensuring drug compliance and anger management and that they used psychological and social coping strategies. Conclusion: Our results indicate that access to medical information on its own is not sufficient for carers of people with mental illness, and the necessity of developing positive attitudes when dealing with the illness and its symptoms. We recommend that nurses and other health professionals offer long term support and consultation programs to family members. PMID:25864067

Effectiveness of Universal School-Based Mental Health Awareness Programs Among Youth in the United States: A Systematic Review.

PubMed

Salerno, John P

2016-12-01

Stigmatizing attitudes toward mental illness and low mental health literacy have been identified as links to social adversity, and barriers to seeking and adhering to treatment among adolescents suffering from mental illness. Prior research has found that it is possible to improve these outcomes using school-based mental health awareness interventions. The purpose of this study was to review empirical literature pertaining to universal mental health awareness interventions aiming to improve mental health related outcomes among students enrolled in US K-12 schools, especially minorities vulnerable to health disparities. PsycINFO, Cochrane Library, PUBMED, and reference lists of relevant articles were searched for K-12 school-based mental health awareness interventions in the United States. Universal studies that measured knowledge, attitudes, and/or help-seeking pertinent to mental health were included. A total of 15 studies were selected to be part of the review. There were 7 pretest/post-test case series, 5 nonrandomized experimental trial, 1 Solomon 4-groups, and 2 randomized controlled trial (RCT) designs. Nine studies measuring knowledge, 8 studies measuring attitudes, and 4 studies measuring help-seeking, indicated statistically significant improvements. Although results of all studies indicated some level of improvement, more research on implementation of universal school-based mental health awareness programs is needed using RCT study designs, and long-term follow-up implementation. © 2016, American School Health Association.

How often and how consistently do symptoms directly precede criminal behavior among offenders with mental illness?

PubMed

Peterson, Jillian K; Skeem, Jennifer; Kennealy, Patrick; Bray, Beth; Zvonkovic, Andrea

2014-10-01

Although offenders with mental illness are overrepresented in the criminal justice system, psychiatric symptoms relate weakly to criminal behavior at the group level. In this study of 143 offenders with mental illness, we use data from intensive interviews and record reviews to examine how often and how consistently symptoms lead directly to criminal behavior. First, crimes rarely were directly motivated by symptoms, particularly when the definition of symptoms excluded externalizing features that are not unique to Axis I illness. Specifically, of the 429 crimes coded, 4% related directly to psychosis, 3% related directly to depression, and 10% related directly to bipolar disorder (including impulsivity). Second, within offenders, crimes varied in the degree to which they were directly motivated by symptoms. These findings suggest that programs will be most effective in reducing recidivism if they expand beyond psychiatric symptoms to address strong variable risk factors for crime like antisocial traits. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Folk concepts of mental disorders among Chinese-Australian patients and their caregivers.

PubMed

Hsiao, Fei-Hsiu; Klimidis, Steven; Minas, Harry I; Tan, Eng S

2006-07-01

This paper reports a study of (a) popular conceptions of mental illness throughout history, (b) how current social and cultural knowledge about mental illness influences Chinese-Australian patients' and caregivers' understanding of mental illness and the consequences of this for explaining and labelling patients' problems. According to traditional Chinese cultural knowledge about health and illness, Chinese people believe that psychotic illness is the only type of mental illness, and that non-psychotic illness is a physical illness. Regarding patients' problems as not being due to mental illness may result in delaying use of Western mental health services. Data collection took place in 2001. Twenty-eight Chinese-Australian patients with mental illness and their caregivers were interviewed at home, drawing on Kleinman's explanatory model and studies of cultural transmission. Interviews were tape-recorded and transcribed, and analysed for plots and themes. Chinese-Australians combined traditional knowledge with Western medical knowledge to develop their own labels for various kinds of mental disorders, including 'mental illness', 'physical illness', 'normal problems of living' and 'psychological problems'. As they learnt more about Western conceptions of psychology and psychiatry, their understanding of some disorders changed. What was previously ascribed to non-mental disorders was often re-labelled as 'mental illness' or 'psychological problems'. Educational programmes aimed at introducing Chinese immigrants to counselling and other psychiatric services could be made more effective if designers gave greater consideration to Chinese understanding of mental illness.

Patients' Perceptions of an Exercise Program Delivered Following Discharge From Hospital After Critical Illness (the Revive Trial).

PubMed

Ferguson, Kathryn; Bradley, Judy M; McAuley, Daniel F; Blackwood, Bronagh; O'Neill, Brenda

2017-01-01

The REVIVE randomized controlled trial (RCT) investigated the effectiveness of an individually tailored (personalized) exercise program for patients discharged from hospital after critical illness. By including qualitative methods, we aimed to explore patients' perceptions of engaging in the exercise program. Patients were recruited from general intensive care units in 6 hospitals in Northern Ireland. Patients allocated to the exercise intervention group were invited to participate in this qualitative study. Independent semistructured interviews were conducted at 6 months after randomization. Interviews were audio-recorded, transcribed, and content analysis used to explore themes arising from the data. Of 30 patients allocated to the exercise group, 21 completed the interviews. Patients provided insight into the physical and mental sequelae they experienced following critical illness. There was a strong sense of patients' need for the exercise program and its importance for their recovery following discharge home. Key facilitators of the intervention included supervision, tailoring of the exercises to personal needs, and the exercise manual. Barriers included poor mental health, existing physical limitations, and lack of motivation. Patients' views of outcome measures in the REVIVE RCT varied. Many patients were unsure about what would be the best way of measuring how the program affected their health. This qualitative study adds an important perspective on patients' attitude to an exercise intervention following recovery from critical illness, and provides insight into the potential facilitators and barriers to delivery of the program and how programs should be evolved for future trials.

UNITED STATES DENTAL PROFESSIONALS’ PERCEPTIONS OF DENTAL ANXIETY AND NEED FOR SEDATION IN PATIENTS WITH MENTAL ILLNESS

PubMed Central

Heaton, Lisa J.; Hyatt, Halee A.; Huggins, Kimberly Hanson; Milgrom, Peter

2012-01-01

Dental fear is a barrier to receiving dental care, particularly for those patients who also suffer from mental illnesses. The current study examined United States dental professionals’ perceptions of dental fear experienced by patients with mental illness, and frequency of sedation of patients with and without mental illness. Dentists and dental staff members (n = 187) completed a survey about their experiences in treating patients with mental illness. More participants agreed (79.8%) than disagreed (20.2%) that patients with mental illness have more anxiety regarding dental treatment (p < .001) than dental patients without mental illness. Further, significantly more participants reported mentally ill patients’ anxiety is “possibly” or “definitely” a barrier to both receiving (96.8%; p < .001) and providing (76.9%; p < .01) dental treatment. Despite reporting more fear in these patients, there were no significant differences in frequency of sedation procedures between those with and without mental illness, regardless of type of sedation (p’s > .05). This lack of difference in sedation for mentally ill patients suggests hesitancy on the part of dental providers to sedate patients with mental illness and highlights a lack of clinical guidelines for this population in the US. Suggestions are given for the assessment and clinical management of patients with mental illness. PMID:24876662

Mental Illness Training on the Internet for Nurse Aides: A Replication Study

PubMed Central

Irvine, A. Blair; Billow, Molly B.; McMahon, Edward; Eberhage, Mark G.; Seeley, John R.; Bourgeois, Michelle

2013-01-01

Internet training courses for Nurse Aides (NA) in long term care facilities (LTCs) have been shown to be effective., Little is known, however, about Internet training effects on NAs in a non-research context, or about continued utilization of an available training program. In this research, a replication study was conducted with the Internet training program Caring Skills: Working with Mental Illness. Three LTCs provided the training to all NAs, each within a one-month interval scheduled during consecutive months. Supervisors were interviewed subsequently about their experiences organizing and supervising the training. Participants in all three LTCs showed positive pre-posttests effects with large effect sizes on situational knowledge and self-efficacy, and knowledge about mental illness. Users rated the program highly, and they indicated that it would improve quality of their resident care. Supervisors praised the training, and they said NAs were using recommended training behaviors. Although available to all staff, nursing and other staff made little use of the training in subsequent months. Training for NAs on the internet thus appears feasible, and it is perceived to be beneficial for resident care. Plans for continued utilization and dissemination of best practices to other staff, however, should be integrated when planning for staff training on the Internet. PMID:23379724

Improving police response to persons with mental illness: A Multi-level conceptualization of CIT

PubMed Central

Watson, Amy C; Morabito, Melissa Schaefer; Draine, Jeffrey; Ottati, Victor

2009-01-01

The large numbers of people with mental illness in jails and prisons has fueled policy concern in all domains of the justice system. This includes police practice, where initial decisions to involve persons in the justice system or divert them to mental health services are made. One approach to focus police response in these situations is the implementation of Crisis Intervention Teams (CIT). The CIT model is being implemented widely, with over 400 programs currently operating. While the limited evidence on CIT effectiveness is promising, research on CIT is limited in scope and conceptualization-much of it focusing on officer characteristics and training. In this paper we review the literature on CIT and present a conceptual model of police response to persons with mental illness that accounts for officer, organizational, mental health system and community level factors likely to influence implementation and effectiveness of CIT and other approaches. By moving our conceptualizations and research in this area to new levels of specificity, we may contribute more to effectiveness research on these interventions. PMID:18632154

How Perceptions of Mental Illness Impact EAP Utilization.

PubMed

McRee, Jayme

2017-01-01

Studies of employee assistance program (EAP) clinical use across multiple industries and multiple EAP delivery models range from highs greater than 5% to lows of less than 1 %. Despite the range in utilization, the rates of employee behaviors that indicate a behavioral health issue are significantly higher, suggesting far too little use of EAPs overall. Studies of the costs to an employer for an employee with a mental health issue are as high as 37% lost annual productivity. EAPs have attempted to raise utilization through a variety of efforts, with mixed results. Most EAP utilization initiatives fail to address the impact of stigma, misunderstandings about mental illness and the reluctance of many employees to seek counseling as an option for better management of stress, work-life balance and overall mental wellness. For both employers and EAPs, addressing the impact of stigma and perceptions of mental illness is costly, requiring greater direct employee engagement and education. However, it is a more effective means of increasing EAP use than current practices and, ultimately, can result in significantly higher net gains in productivity while reducing employers' direct costs.

Healthy Amistad: improving the health of people with severe mental illness.

PubMed

Martin, Maurice Bud; Martin, Sarah L

2014-10-01

Here, we report evaluation results of implementing a health promotion program for individuals with serious mental illnesses. Healthy Amistad aimed to address four behaviors: physical inactivity, nutrition choices, smoking, and seeking access to health care. The evaluation employed a mixed-method study design to assess changes in the health of individuals in the program. Process measures assessed the implementation of the program. A pre-post examination was used to compare data associated with behaviors. Data sources included the 2008 and 2009 annual surveys, clinical data, interviews for staff, interviews with members, and an on-site observation. Participants were staff and members of Amistad. Those involved with the Peer Patient Navigator lost weight; new physically active activities were being offered. A new salad bar and healthier menu was offered in the Amistad cafeteria. Interviews revealed that 11 members lost a total of 150 pounds. The percentage reporting visits to an emergency room more than once in the last 6 months decreased from 58% to 37%, the percentage calling the crisis line less often increased from 75% to 86%, and the percentage reporting that they had become more satisfied with their life since joining Amistad improved from 76% to 88%. Individuals with serious mental illnesses are benefiting from programs that focus on the mitigation of disease states manifested from issues with physical inactivity, nutrition, smoking, and health access. Evaluation of the Healthy Amistad program has shown a positive influence.

[Stigma - risk factor and consequence of suicidal behavior : Implications for suicide prevention].

PubMed

Oexle, N; Rüsch, N

2017-11-16

Mental illness, previous suicidal behavior and loss of a relative by suicide are strong risk factors for suicidality. Both mental illness and suicide are stigmatized, which is a burden for those affected and potentially contributes to suicidality among stigmatized individuals. Many consequences of stigma, e. g. social isolation, low self-esteem and hopelessness, are well-known predictors of suicidality. Interventions to reduce stigmatization might therefore be an important component of successful suicide prevention. This paper discusses the currently available knowledge regarding this hypothesis. Many studies confirmed the association between the stigmatization of mental illness and suicidality and there is initial evidence for the influence of suicide stigma and suicidality. Nevertheless, the effectiveness of anti-stigma interventions to reduce suicidality and prevent suicide has not yet been tested. Reducing stigma among members of the general population and mental health care professionals as well as programs to support individuals in coping with stigmatization could be important components of successful suicide prevention.

Health service staff's attitudes towards patients with mental illness.

PubMed

Arvaniti, Aikaterini; Samakouri, Maria; Kalamara, Eleni; Bochtsou, Valentini; Bikos, Constantinos; Livaditis, Miltos

2009-08-01

Stereotypes and prejudices against patients with mental illness are widespread in many societies. The aim of the present study is to investigate such attitudes among the staff and medical students, including employees and trainees, in a general university hospital. Six hundred individuals (361 employees, 231 students) completed the following questionnaires: Level of Contact Report (LCR), Authoritarianism Scale (AS), and Opinion about Mental Illness (OMI), a scale yielding five factors (social discrimination, social restriction, social care, social integration, and aetiology). Multivariate linear regression models were applied in order to search for the simultaneous effect of many variables on the scores of OMI factors. An important part of the sample held negative attitudes especially concerning social discrimination and restriction of the patients. Women, older and less educated staff, nursing staff, and people scoring higher on authoritarianism were more prejudiced. Higher scores on familiarity were associated with less negative attitudes. The results indicate the need to develop sensitisation and training programs considering mental health topics among health service employees.

Population-based initiatives in college mental health: students helping students to overcome obstacles.

PubMed

Kirsch, Daniel J; Pinder-Amaker, Stephanie L; Morse, Charles; Ellison, Marsha L; Doerfler, Leonard A; Riba, Michelle B

2014-12-01

College students' need for mental health care has increased dramatically, leaving campus counseling and mental health centers struggling to meet the demand. This has led to the investigation and development of extra-center, population-based interventions. Student-to-student support programs are but one example. Students themselves are a plentiful, often-untapped resource that extends the reach of mental health services on campus. Student-to-student programs capitalize on students' natural inclination to assist their peers. A brief review of the prevalence and effects of mental disorders in the college population is provided, followed by a broad overview of the range of peer-to-peer programs that can be available on college campuses. Two innovative programs are highlighted: (1) a hospital- and community-based program, the College Mental Health Program (CMHP) at McLean Hospital, and 2) the Student Support Network (SSN) at Worcester Polytechnic Institute. The subsequent section reviews the literature on peer-to-peer programs for students with serious and persistent mental illness for which there is a small but generally positive body of research. This lack of an empirical basis in college mental health leads the authors to argue for development of broad practice-research networks.

The employment status of people with mental illness: National survey data from 2009 and 2010

PubMed Central

Luciano, Alison; Meara, Ellen

2014-01-01

Objective The aim of this study was to describe employment by mental illness severity in the U.S. during 2009-2010. Methods The sample included all working-age participants (age 18 to 64) from the 2009 and 2010 National Survey on Drug Use and Health (N = 77,326). Two well-established scales of mental health distinguished participants with none, mild, moderate, and serious mental illness. Analyses compared employment rate and income by mental illness severity and estimated logistic regression models of employment status controlling for demographic characteristics and substance use disorders. In secondary analyses, we assessed how the relationship between mental illness and employment varied by age and education status. Results Employment rates decreased with increasing mental illness severity (none = 75.9%, mild = 68.8%, moderate = 62.7%, serious = 54.5%, p<0.001). Over a third of people with serious mental illness, 39%, had incomes below $10,000 (compared to 23% among people without mental illness p<0.001). The gap in adjusted employment rates comparing serious to no mental illness was 1% among people 18-25 years old versus 21% among people 50-64 (p < .001). Conclusions More severe mental illness was associated with lower employment rates in 2009-2010. People with serious mental illness are less likely to be employed after age 49 than people with no, mild, or moderate mental illness. PMID:24933361

The economic status of parents with serious mental illness in the United States.

PubMed

Luciano, Alison; Nicholson, Joanne; Meara, Ellen

2014-09-01

Parents with serious mental illness may be vulnerable to financial insecurity, making successful parenting especially difficult. We explored relationships among parenting, serious mental illness, and economic status in a nationally representative sample. The sample included all working-age participants from the 2009 and 2010 National Survey on Drug Use and Health (n = 77,326). Two well-established scales of mental health distinguished participants with none, mild, moderate, and serious mental illness. We compared economic status by parenthood status and mental illness severity. Rates of employment were low for parents with serious mental illness (38% full time and 17% part time among mothers; 60% full time and 9% part time among fathers) compared with parents with no mental illness (50% full time and 19% part time among mothers; 85% full time and 5% part time among fathers). Mothers and fathers with serious mental illness were twice as likely to fall below the U.S. Census poverty threshold as their peers without mental illness. Parents with serious mental illness are less likely to be employed than those without mental illnesses, and are highly likely to be living in poverty. Reducing poverty by helping parents with serious mental illness achieve better jobs and education is likely to translate into family stability and better outcomes. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Three Nontraditional Approaches to Improving the Capacity, Accessibility, and Quality of Mental Health Services: An Overview.

PubMed

Grant, Kiran L; Simmons, Magenta Bender; Davey, Christopher G

2018-05-01

To provide evidence for wider use of peer workers and other nonprofessionals, the authors examined three approaches to mental health service provision-peer support worker (PSW) programs, task shifting, and mental health first-aid and community advocacy organizations-summarizing their effectiveness, identifying similarities and differences, and highlighting opportunities for integration. Relevant articles obtained from PubMed, MEDLINE, and Google Scholar searches are discussed. Studies indicate that PSWs can achieve outcomes equal to or better than those achieved by nonpeer mental health professionals. PSWs can be particularly effective in reducing hospital admissions and inpatient days and engaging severely ill patients. When certain care tasks are given to individuals with less training than professionals (task shifting), these staff members can provide psychoeducation, engage service users in treatment, and help them achieve symptom reduction and manage risk of relapse. Mental health first-aid and community organizations can reduce stigma, increase awareness of mental health issues, and encourage help seeking. Most PSW programs have reported implementation challenges, whereas such challenges are fewer in task-shifting programs and minimal in mental health first-aid. Despite challenges in scaling and integrating these approaches into larger systems, they hold promise for improving access to and quality of care. Research is needed on how these approaches can be combined to expand a community's capacity to provide care. Because of the serious shortage of mental health providers globally and the rising prevalence of mental illness, utilizing nontraditional providers may be the only solution in both low- and high-resource settings, at least in the short term.

Wearable Devices and Mobile Technologies for Supporting Behavioral Weight Loss Among People with Serious Mental Illness

PubMed Central

Naslund, John A.; Aschbrenner, Kelly A.; Scherer, Emily A.; McHugo, Gregory J.; Marsch, Lisa A.; Bartels, Stephen J.

2016-01-01

Promoting physical activity is essential for addressing elevated cardiovascular risk and high obesity rates affecting people with serious mental illness. Numerous challenges interfere with exercise participation in this high-risk group including mental health symptoms, low motivation, and limited access to safe and affordable options for physical activity. Wearable devices and mobile health technologies may afford new opportunities for promoting physical activity and supporting behavioral weight loss efforts. This exploratory study examined whether daily step count measured using Fitbit wearable devices was associated with weight loss and improved fitness among individuals with serious mental illness enrolled in a 6-month lifestyle program. Participants (n=34) had a schizophrenia spectrum disorder (23.5%), major depression (50.0%), or bipolar disorder (26.5%), and wore Fitbits most of the days (M=86.2%; SD=18.4%) they were enrolled in the study. At 6-months, higher average daily step count was associated with greater weight loss (F=5.07; df=1,32; p=0.0314), but not improved fitness (F=1.92; df=1,31; p=0.176). These findings demonstrate that encouraging participants with serious mental illness enrolled in lifestyle interventions to collect more steps may contribute to greater weight loss. This suggests that wearable devices may offer a feasible and potentially effective strategy for supporting behavioral weight loss in community mental health settings. PMID:27479104

Opening Minds in Canada: Targeting Change

PubMed Central

Stuart, Heather; Chen, Shu-Ping; Christie, Romie; Dobson, Keith; Kirsh, Bonnie; Knaak, Stephanie; Koller, Michelle; Krupa, Terry; Lauria-Horner, Bianca; Luong, Dorothy; Modgill, Geeta; Patten, Scott B; Pietrus, Mike; Szeto, Andrew; Whitley, Rob

2014-01-01

Objective: To summarize the ongoing activities of the Opening Minds (OM) Anti-Stigma Initiative of the Mental Health Commission of Canada regarding the 4 groups targeted (youth, health care providers, media, and workplaces), highlight some of the key methodological challenges, and review lessons learned. Method: The approach used by OM is rooted in community development philosophy, with clearly defined target groups, contact-based education as the central organizing element across interventions, and a strong evaluative component so that best practices can be identified, replicated, and disseminated. Contact-based education occurs when people who have experienced a mental illness share their personal story of recovery and hope. Results: Results have been generally positive. Contact-based education has the capacity to reduce prejudicial attitudes and improve social acceptance of people with a mental illness across various target groups and sectors. Variations in program outcomes have contributed to our understanding of active ingredients. Conclusions: Contact-based education has become a cornerstone of the OM approach to stigma reduction. A story of hope and recovery told by someone who has experienced a mental illness is powerful and engaging, and a critical ingredient in the fight against stigma. Building partnerships with existing community programs and promoting systematic evaluation using standardized approaches and instruments have contributed to our understanding of best practices in the field of anti-stigma programming. The next challenge will be to scale these up so that they may have a national impact. PMID:25565697

Paternal history of mental illness associated with posttraumatic stress disorder among veterans.

PubMed

Shepherd-Banigan, Megan; Kelley, Michelle L; Katon, Jodie G; Curry, John F; Goldstein, Karen M; Brancu, Mira; Wagner, H Ryan; Fecteau, Teresa E; Van Houtven, Courtney H

2017-10-01

This study examined the association between parent and family reported history of non-PTSD mental illness (MI), PTSD specifically, and substance use problems, and participant clinical diagnosis of PTSD. Participants were drawn from the US Department of Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC) Post-Deployment Mental Health (PDMH) study (n = 3191), an ongoing multi-site cohort study of US Afghanistan and Iraq conflict era veterans. Participants who recalled a father history of PTSD had a 26-percentage point higher likelihood of meeting criteria for PTSD; while participants reporting any family history of PTSD had a 15-percentage point higher probability of endorsing symptoms consistent with PTSD. Mother history of substance use problems was associated with Veteran current PTSD, but results were sensitive to model specification. Current PTSD was not associated with family/parent history of non-PTSD mental illness, mother history of PTSD, or family/father history of substance use problems. Family history of PTSD may increase PTSD risk among veterans exposed to trauma, particularly when a father history is reported. Knowledge of family history could improve clinical decision-making for trauma-exposed individuals and allow for more effective targeting of programs and clinical services. Published by Elsevier B.V.

Insurance status, use of mental health services, and unmet need for mental health care in the United States

PubMed Central

Walker, Elizabeth Reisinger; Cummings, Janet R.; Hockenberry, Jason M.; Druss, Benjamin G.

2015-01-01

Objective The purpose of this study was to provide updated national estimates and correlates of service use, unmet need, and barriers to mental health treatment among adults with mental disorders. Method The sample included 36,647 adults aged 18–64 years (9723 with any mental illness and 2608 with serious mental illness) from the 2011 National Survey on Drug Use and Health. Logistic regression models were used to examine predictors of mental health treatment and perceived unmet need. Results Substantial numbers of adults with mental illness did not receive treatment (any mental illness: 62%; serious mental illness: 41%) and perceived an unmet need for treatment (any mental illness: 21%; serious mental illness: 41%). Having health insurance was a strong correlate of mental health treatment use (any mental illness: private insurance: AOR=1.63 (95% CI=1.29–2.06), Medicaid: AOR=2.66, (95% CI=2.04–3.46); serious mental illness: private insurance: AOR=1.65 (95% CI=1.12–2.45), Medicaid: AOR=3.37 (95% CI=2.02–5.61)) and of reduced perceived unmet need (any mental illness: private insurance: AOR=.78 (95% CI:.65–.95), Medicaid: AOR=.70 (95% CI=.54–.92)). Among adults with any mental illness and perceived unmet need, 72% reported at least one structural barrier and 47% reported at least one attitudinal barrier. Compared to respondents with insurance, uninsured individuals reported significantly more structural barriers and fewer attitudinal barriers. Conclusions Low rates of treatment and high unmet need persist among adults with mental illness. Strategies to reduce both structural barriers, such as cost and insurance coverage, and attitudinal barriers are needed. PMID:25726980

Prevalence of psychopathology in children of parents with mental illness and/or addiction: an up to date narrative review.

PubMed

Leijdesdorff, Sophie; van Doesum, Karin; Popma, Arne; Klaassen, Rianne; van Amelsvoort, Therese

2017-07-01

Children of parents with a mental illness and/or addiction are at high risk for developing a mental illness themselves. Parental mental illness is highly prevalent leading to a serious number of children at high risk. The aim of this review is to give an up-to-date overview of psychopathology in children of parents with various mental illnesses and/or addiction, based on recent literature. Worldwide, 15-23% of children live with a parent with a mental illness. These children have up to 50% chance of developing a mental illness. Parental anxiety disorder sets children at a more specific risk for developing anxiety disorder themselves, where children of parents with other mental illnesses are at high risk of a large variety of mental illnesses. Although preventive interventions in children of mentally ill parents may decrease the risk of problem development by 40%; currently, these children are not automatically identified and offered help. This knowledge should encourage mental health services to address the needs of these children which requires strong collaboration between Child and Adolescent Mental Health Services and Adult Mental Health Services. Directions for further research would be to include both parents, allow for comorbidity and to look deeper into a broader variety of mental illnesses such as autism and personality disorder other than borderline.

Evaluation of an interaction-skills training for reducing the burden of family caregivers of patients with severe mental illness: a pre-posttest design.

PubMed

Gharavi, Yasmin; Stringer, Barbara; Hoogendoorn, Adriaan; Boogaarts, Jan; Van Raaij, Bas; Van Meijel, Berno

2018-03-27

Family members who care for patients with severe mental illness experience emotional distress and report a higher incidence of mental illness than those in the general population. They report feeling inadequately prepared to provide the necessary practical and emotional support for these patients. The MAT training, an Interaction-Skills Training program (IST) for caregivers, was developed to meet those needs. This study used a single-arm pretest-posttest design to examine the impact of the training on caregivers' sense of competence (self-efficacy) and burden. One hundred family caregivers recruited from three mental health institutions participated in the training. Burden was assessed using the Involvement Evaluation Questionnaire, and self-efficacy using the Self-Efficacy Questionnaire. Analysis of variance with repeated measures was used to investigate whether participation in the training changed the level of family caregivers' burden and self-efficacy. Pearson's correlation was used to examine the relationships between self-efficacy and burden. Our results indicate that, after the training, self-efficacy increased significantly over time (p < 0.001) and that burden decreased significantly (p < 0.001). However, the results could not demonstrate the expected association between an increase of self-efficacy and decrease of burden. Caregivers expressed high appreciation for the training. After following the IST program, family caregivers of patients with severe mental illness experienced a greater sense of competence and a significant decrease in burden. The training was greatly appreciated and satisfied caregivers' need to acquire the skills required in complex caregiving situations. This study was retrospectively registered (14/01/2018) in the ISRCTN registry with study ID ISRCTN44495131 .

Serious mental illness and negative substance use consequences among adults on probation.

PubMed

Rossheim, Matthew E; Livingston, Melvin D; Lerch, Jennifer A; Taxman, Faye S; Walters, Scott T

2018-03-22

Adults on probation are at greater risk of both using substances and having a mental disorder compared to the general population. Several theories explain the relationship between substance use and poor mental health. However, the interaction between substance use, mental health, and substance-related consequences is not well understood. A better understanding of this relationship may help treatment programs become more responsive to people with serious mental illness (SMI). The current study used interview data from 313 adults on probation who reported recent substance use. We examined associations between SMI risk, substance use, and substance use consequences. A substantial proportion of the sample (37.5%) screened at risk of having a SMI. Adjusting for type and amount of substance use, those who screened at risk of having a SMI reported more negative substance use consequences. Significant interaction effects were observed between use of alcohol or opiates and SMI risk. Alcohol use was associated with more negative substance use consequences among those at risk of SMI, while opiate use was associated with more consequences among those not at risk. Programs are sorely needed to identify and treat adults with comorbid substance use and mental health symptoms, particularly for adults in the justice system. Clinicians should carefully consider how mental health may interact with substance use to exacerbate consequences.

Effects of Stigma and Discrimination Reduction Programs Conducted Under the California Mental Health Services Authority

PubMed Central

Cerully, Jennifer L.; Collins, Rebecca L.; Wong, Eunice C.; Roth, Elizabeth; Marks, Joyce; Yu, Jennifer

2016-01-01

Abstract Describes the methods and results of a RAND evaluation of stigma and discrimination reduction efforts by Runyon Saltzman Einhorn, Inc., involving screenings of a documentary film called “A New State of Mind: Ending the Stigma of Mental Illness.” PMID:28083418

Randomized Trial of Supported Employment Integrated With Assertive Community Treatment for Rural Adults With Severe Mental Illness

PubMed Central

Gold, Paul B; Meisler, Neil; Santos, Alberto B; Carnemolla, Mark A; Williams, Olivia H; Keleher, Jennie

2006-01-01

Urban-based randomized clinical trials of integrated supported employment (SE) and mental health services in the United States on average have doubled the employment rates of adults with severe mental illness (SMI) compared to traditional vocational rehabilitation. However, studies have not yet explored if the service integrative functions of SE will be effective in coordinating rural-based services that are limited, loosely linked, and geographically dispersed. In addition, SE's ability to replicate the work outcomes of urban programs in rural economies with scarce and less diverse job opportunities remains unknown. In a rural South Carolina county, we designed and implemented a program blending Assertive Community Treatment (ACT) with an SE model, Individual Placement and Support (IPS). The ACT-IPS program operated with ACT and IPS subteams that tightly integrated vocational with mental health services within each self-contained team. In a 24-month randomized clinical trial, we compared ACT-IPS to a traditional program providing parallel vocational and mental health services on competitive work outcomes for adults with SMI (N = 143; 69% schizophrenia, 77% African American). More ACT-IPS participants held competitive jobs (64 versus 26%; p < .001, effect size [ES] = 0.38) and earned more income (median [Mdn] = $549, interquartile range [IQR] = $0–$5,145, versus Mdn = $0, IQR = $0–$40; p < .001, ES = 0.70) than comparison participants. The competitive work outcomes of this rural ACT-IPS program closely resemble those of urban SE programs. However, achieving economic self-sufficiently and developing careers probably require increasing access to higher education and jobs imparting marketable technical skills. PMID:16177278

Co-occurring mental illness and health care utilization and expenditures in adults with obesity and chronic physical illness.

PubMed

Shen, Chan; Sambamoorthi, Usha; Rust, George

2008-06-01

The objectives of the study were to compare health care expenditures between adults with and without mental illness among individuals with obesity and chronic physical illness. We performed a cross-sectional analysis of 2440 adults (older than age 21) with obesity using a nationally representative survey of households, the Medical Expenditure Panel Survey. Chronic physical illness consisted of self-reported asthma, diabetes, heart disease, hypertension, or osteoarthritis. Mental illness included affective disorders; anxiety, somatoform, dissociative, personality disorders; and schizophrenia. Utilization and expenditures by type of service (total, inpatient, outpatient, emergency room, pharmacy, and other) were the dependent variables. Chi-square tests, logistic regression on likelihood of use, and ordinary least squares regression on logged expenditures among users were performed. All regressions controlled for gender, race/ethnicity, age, martial status, region, education, employment, poverty status, health insurance, smoking, and exercise. All analyses accounted for the complex design of the survey. We found that 25% of adults with obesity and physical illness had a mental illness. The average total expenditures for obese adults with physical illness and mental illness were $9897; average expenditures were $6584 for those with physical illness only. Mean pharmacy expenditures for obese adults with physical illness and mental illness and for those with physical illness only were $3343 and $1756, respectively. After controlling for all independent variables, among adults with obesity and physical illness, those with mental illness were more likely to use emergency services and had higher total, outpatient, and pharmaceutical expenditures than those without mental illness. Among individuals with obesity and chronic physical illness, expenditures increased when mental illness is added. Our study findings suggest cost-savings efforts should examine the reasons for high utilization and expenditures for those with obesity, chronic physical illness, and mental illness.

Defining Mental Illness: The Relationship between College Students' Beliefs about the Definition of Mental Illness and Tolerance.

ERIC Educational Resources Information Center

Granello, Darcy Haag; Granello, Paul F.

2000-01-01

Investigates the relationship between college undergraduate students' (N=102) beliefs about the definition of mental illness and their tolerance toward individuals with mental illnesses. Results show that students with broad and inclusive definitions of mental illness had more benevolent, less authoritarian, and less socially restrictive attitudes…

The Impact of Local Environmental Health Capacity on Foodborne Illness Morbidity in Maryland

PubMed Central

Resnick, Beth A.; Fox, Mary A.; McGready, John; Yager, James P.; Burke, Thomas A.

2011-01-01

Objectives. We evaluated the relationship between local food protection capacity and service provision in Maryland's 24 local food protection programs (FPPs) and incidence of foodborne illness at the county level. Methods. We conducted regression analyses to determine the relationship between foodborne illness and local FPP characteristics. We used the Centers for Disease Control and Prevention's FoodNet and Maryland Department of Health and Mental Hygiene outbreak data set, along with data on Maryland's local FPP capacity (workforce size and experience levels, budget) and service provision (food service facility inspections, public notification programs). Results. Counties with higher capacity, such as larger workforce, higher budget, and greater employee experience, had fewer foodborne illnesses. Counties with better performance and county-level regulations, such as high food service facility inspection rates and requiring certified food manager programs, respectively, had lower rates of illness. Conclusions. Counties with strong local food protection capacity and services can protect the public from foodborne illness. Research on public health services can enhance our understanding of the food protection infrastructure, and the effectiveness of food protection programs in preventing foodborne illness. PMID:21750282

Art promoting mental health literacy and a positive attitude towards people with experience of mental illness.

PubMed

Koh, Eugen; Shrimpton, Bradley

2014-03-01

Exhibitions of art by people with experience of mental illness are increasingly being staged to improve awareness of mental health issues in the general community and to counter the stigma of mental illness. However, few exhibitions have incorporated research to ascertain their actual effectiveness. This paper reports the results of a study that considered the responses of 10,000 people after they viewed exhibitions of art produced by people with experience of mental illness. These works were selected from the Cunningham Dax Collection, one of the world's most extensive collection of artworks by people with experience of mental illness and/or psychological trauma. More than 90% of respondents agreed with three propositions that the exhibitions helped them: (1) gain a better understanding of mental illness; (2) gain a more sympathetic understanding of the suffering of people with mental illness; and (3) appreciate the ability and creativity of people with mental illness. The results suggest that exhibitions can successfully promote mental health literacy and contribute to positive attitudes towards people with experience of mental illness. This paper explores these findings and raises questions about how the presentation of artworks in an exhibition influences their effectiveness in mental health promotion.

A Dynamic Cycle of Familial Mental Illness.

PubMed

Murphy, Gillian; Peters, Kathleen; Wilkes, Lesley; Jackson, Debra

2014-12-01

In this paper, we present A Dynamic Cycle of Familial Mental Illness; an innovative framework, which considers family members' experiences and responses to mental illness. There is an acknowledged discourse noting parental experiences of mental illness alongside a growing body of knowledge acknowledging children's needs while living with parental mental illness. However, there is a paucity of literature that makes reference to the concept of familial mental illness and the cyclic interface of parental and child distress and symptoms. The model is supported by published research studies from several differing disciplines to demonstrate the relationship between parent and child experiences and to synthesise the published short- and longer-term possible impact of familial mental illness. An extensive search of the literature using recognised search engines, keywords and phrases has been undertaken, to generate an appropriate literature base for this work. This literature demonstrates how a child's possible emotional distancing as a response to parental mental illness could increase parental distress. A Dynamic Cycle of Familial Mental Illness adopts the underpinning philosophy of a Stress Vulnerability Model of Mental Illness, which assumes that predisposing factors and increased stress for a parent may have possible links to exacerbation of parental mental distress and symptomology. We advocate for further research of familial mental illness, and argue for a family approach to mental health assessment and treatment in mainstream health and social care sectors.

Comprehensive SDG goal and targets for non-communicable diseases and mental health.

PubMed

Minas, Harry; Tsutsumi, Atsuro; Izutsu, Takashi; Goetzke, Kathryn; Thornicroft, Graham

2015-01-01

The negotiations on the SDG goals and targets, leading to the sustainable development Declaration in September 2015, are now in the final stages. Ensuring that people with mental disorders are not left behind in the global development program from 2015 to 2030 will require specific and explicit commitments and targets against which progress in mental health can be measured and reported. The arguments for inclusion of explicit mental health targets in the SDGs are compelling. The final negotiations on the SDG goals and targets will now determine whether people with mental illness and psychosocial disabilities will continue to be neglected or will benefit equitably from inclusion in the post-2015 development program.

Risk factors for homelessness among women with schizophrenia.

PubMed Central

Caton, C L; Shrout, P E; Dominguez, B; Eagle, P F; Opler, L A; Cournos, F

1995-01-01

A study of risk factors for homelessness among the severely mentally ill was extended to include women, and a case-control study of 100 indigent women with schizophrenia meeting criteria for literal homelessness and 100 such women with no history of homelessness was conducted. Subjects were recruited from shelters, clinics, and inpatient psychiatric programs in New York City. Clinical interviewers used standardized research instruments to probe three domains of risk factors: severity of mental illness, family background, and prior mental health service use. Findings adjusted for ethnicity revealed that homeless women had higher rates of a concurrent diagnosis of alcohol abuse, drug abuse, and antisocial personality disorder. Homeless women also had less adequate family support. PMID:7625518

A Survey of Online and Mobile Technology Use at Peer Support Agencies.

PubMed

Aschbrenner, Kelly A; Naslund, John A; Grinley, Thomas; Bienvenida, John Carlo M; Bartels, Stephen J; Brunette, Mary

2018-01-04

Understanding how individuals with mental illness who receive services at peer support agencies use technology can inform the development of online and mobile health interventions tailored for users in these non-traditional mental health settings. The purpose of this study was to assess the use of technology among individuals with mental illness at peer support agencies. A survey delivered within peer support agencies (PSAs) in one state assessed technology use among individuals ages 18 and over with a self-identified mental illness receiving services at these agencies. In total, 195 individuals from 10 PSAs completed the survey. Eighty-two percent of respondents used the internet, with 63% of respondents connected to the internet at the PSAs. Eighty one percent of respondents owned a cell phone, 70% used text messaging, 58% owned smartphones, 61% used mobile applications, and 72% used social media. PSA users under age 55 were significantly more likely to own a smartphone than PSA users age 55 and older. Among internet users, 71% had searched for health information online and 57% had searched for mental health information online. Many individuals who receive services at PSAs have access to online and mobile technologies. These technologies may be leveraged to expand the reach of evidence-based health and mental health programs to individuals in these non-traditional mental health settings. Future research should explore the feasibility of intervention strategies that involve PSAs as a resource for linking people with mental illness to online and mobile support for their health and wellness goals.

Barriers to involvement in physical activities of persons with mental illness.

PubMed

Shor, Ron; Shalev, Anat

2016-03-01

Participating in physical activities could be essential for reducing the multiple risk factors for health problems that persons with severe mental illness (SMI) may suffer. However, people with SMI are significantly less active than the general population. To develop knowledge about factors related to the perceived barriers hindering this population's participation in physical activities and the benefits this participation would have, a study was conducted in Israel with 86 people with mental illness living in community mental health facilities prior to their participation in a health promotion program. A mixed method was implemented and included: a scale designed to measure participants' perceptions of the barriers to and benefits of involvement in physical activities; instruments focusing on bio-psycho-social factors that may affect the level of barriers experienced; and personal interviews. The findings revealed high ranking for accessibility barriers hindering the participation in physical activities. Bio-psycho-social factors stemming from the participants' mental health, such as level of depression, were correlated with higher ranking of accessibility barriers. Bio-psycho-social factors reflecting positive mental health and health, such as positive appraisal of body weight, were correlated with lower ranking of accessibility barriers. Other barriers may include organizational and broader systemic barriers in the mental health facilities where the participants reside. These findings illuminate the need to consider the unique challenges that persons with mental illness may face in any attempt to advance their involvement in physical activity. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Community Attitude and Associated Factors towards People with Mental Illness among Residents of Worabe Town, Silte Zone, Southern Nation's Nationalities and People's Region, Ethiopia.

PubMed

Bedaso, Asres; Yeneabat, Tebikew; Yohannis, Zegeye; Bedasso, Kufa; Feyera, Fetuma

2016-01-01

Mental illnesses worldwide are accompanied by another pandemic, that of stigma and discrimination. Public understanding about mental illnesses and attitudes towards people with mental illness play a paramount role in the prevention and treatment of mental illness and the rehabilitation of people with mental illness. To assess community attitude and associated factors towards people with mental illness. Community based cross-sectional study was conducted from April 28 to May 28, 2014. Quantitative data were collected through interview from 435 adults selected using simple random sampling. Data were collected using community attitude towards mentally ill (CAMI) tool to assess community attitude towards people with mental illness and associated factors. Multiple linear regression analysis was performed to identify predictors of community attitude towards people with mental illness and the level of significance association was determined by beta with 95% confidence interval and P less than 0.05. The highest mean score was on social restrictiveness subscale (31.55±5.62). Farmers had more socially restrictive view (β = 0.291, CI [0.09, 0.49]) and have less humanistic view towards mentally ill (β = 0.193, CI [-0.36, -0.03]). Having mental health information had significantly less socially restrictive (β = -0.59, CI [-1.13, -0.05]) and less authoritarian (β = -0.10, CI [-1.11, -0.06]) view towards mentally ill but respondents who are at university or college level reported to be more socially restrictive (β = 0.298, CI [0.059, 0.54]). Respondents whose age is above 48 years old had significantly less view of community mental health ideology (β = -0.59, CI [-1.09, -0.08]). Residents of Worabe town were highly socially restrictive but less authoritarian. There was high level of negative attitude towards people with mental illness along all the subscales with relative variation indicating a need to develop strategies to change negative attitude attached to mental illness in Worabe town at community level.

Attitudes to Mental Illness in the U.K. Military: A Comparison With the General Population

PubMed Central

Forbes, Harriet J.; Boyd, Caroline F. S.; Jones, Norman; Greenberg, Neil; Jones, Edgar; Wessely, Simon; Iversen, Amy C.; Fear, Nicola T.

2016-01-01

Objectives To compare attitudes to mental illness in the U.K. military and in the general population in England. Methods Using data from a cross-sectional survey of 821 U.K. military personnel and a separate cross-sectional survey of 1,729 members of the general population in England, levels of agreement with five statements about mental illness were compared in the military and the general population. Results The majority of respondents from both populations showed positive attitudes toward mental illness. The general population showed slightly more positive attitudes toward integrating people with mental illness into the community (68.0% [65.7%–70.1%] agreed that “People with mental illness have the same rights to a job as everyone else,” vs. 56.7% [51.5%–61.7%] of the military). However, the general population showed more negative attitudes about the causes of mental illness (62.4% [60.1%–64.6%] disagreed that “One of the main causes of mental illness is a lack of self-discipline and willpower,” vs. 81.3% [77.0%–84.9%] of the military). Conclusions Overall, attitudes toward mental illness are comparable in the general population in England and the U.K. military. Differences included the military holding more positive attitudes about the causes of mental illness, but more negatives attitudes about job rights of those with mental illness. Strategies aiming to improve attitudes toward mental illness could focus particularly on personnel’s concerns around mental illness impacting on their career. PMID:24005543

Knowledge, attitude and social distance practices of young undergraduates towards mental illness in India: A comparative analysis.

PubMed

Shruti, Aggarwal; Singh, Shalini; Kataria, Dinesh

2016-10-01

The success of the current model of psychiatric care depends on de-stigmatization of mental illnesses, highlighting the need for research on perception of mental illnesses. This study compared the knowledge, attitude and social distancing practices of the young undergraduate sub-population towards mental illness. A cross-sectional survey was done using a pretested questionnaire, which in addition to demographic details assessed exposure, knowledge, attitude and social distancing practices for mental illnesses. The study included (N=289; 55% Females; Average age 20.5 years) responses from nearly equal number of students from medical, psychology and other courses. Medical students chiefly attributed mental illness to biological factors while students from other courses perceived mental illness as God's punishment. More medical students believed that mental illnesses can be successfully treated and appeared to have less social distancing from the mentally ill. Males mostly reported stress and brain damage as the causative factors while females attributed mental illnesses to other biological factors. Males were found to be less afraid of a communication with mentally ill and more open to the possibility of marriage with someone suffering from a mental illness. Exposure to information about mental illness led to no significant variation in the studied variables. Thus, demographic variables and the academic course contribute to variations in knowledge and attitude of young adults. Education received by medical students has a positive impact on their attitudes, highlighting the need of introduction of informative awareness measures among other courses as well. Copyright © 2016 Elsevier B.V. All rights reserved.

The mentally ill in jails and prisons: towards an integrated model of prevention.

PubMed

Lamberti, J S; Weisman, R L; Schwarzkopf, S B; Price, N; Ashton, R M; Trompeter, J

2001-01-01

Jails and prisons have become a final destination for persons with severe mental illness in America. Addiction, homelessness, and fragmentation of services have contributed to the problem, and have underscored the need for new models of service delivery. Project Link is a university-led consortium of five community agencies in Monroe County, New York that spans healthcare, social service and criminal justice systems. The program features a mobile treatment team with a forensic psychiatrist, a dual diagnosis treatment residence, and culturally competent staff. This paper discusses the importance of service integration in preventing jail and hospital recidivism, and describes steps that Project Link has taken towards integrating healthcare, criminal justice, and social services. Results from a preliminary evaluation suggest that Project Link may be effective in reducing recidivism and in improving community adjustment among severely mentally ill patients with histories of arrest and incarceration.

On the self-stigma of mental illness: stages, disclosure, and strategies for change.

PubMed

Corrigan, Patrick W; Rao, Deepa

2012-08-01

People with mental illness have long experienced prejudice and discrimination. Researchers have been able to study this phenomenon as stigma and have begun to examine ways of reducing this stigma. Public stigma is the most prominent form observed and studied, as it represents the prejudice and discrimination directed at a group by the larger population. Self-stigma occurs when people internalize these public attitudes and suffer numerous negative consequences as a result. In our article, we more fully define the concept of self-stigma and describe the negative consequences of self-stigma for people with mental illness. We also examine the advantages and disadvantages of disclosure in reducing the impact of stigma. In addition, we argue that a key to challenging self-stigma is to promote personal empowerment. Lastly, we discuss individual- and societal-level methods for reducing self-stigma, programs led by peers as well as those led by social service providers.

Difficulties Experienced by University Students with Severe Mental Illness Who Participate in Supported Education Programs.

PubMed

Shor, Ron

2017-04-01

Knowledge about the difficulties students with severe mental illness (SMI) encounter is essential to helping them meet the challenges of studying in universities. Therefore, a study was conducted in Israel with 80 university students with SMI to ascertain their difficulties and the relationship between these difficulties and their level of recovery. The two subscales of an instrument measuring students' difficulties that were ranked the highest were "Learning Skills and Management of Academic Tasks" and "Social Inclusion Difficulties." Inverse relationships were found between the students' difficulties and their perceived level of recovery. The findings illuminate that one of the major challenges that students with SMI experience is to meet academic requirements while coping with mental illness. They also indicate that students' difficulties may not be limited to academic functioning. Therefore, there is a need to broaden the view of students' difficulties to include social and contextual factors in the university environment.

The role of "evidence" in recovery from mental illness.

PubMed

Tanenbaum, Sandra J

2006-12-01

Evidence-based practice (EBP), a derivative of evidence-based medicine (EBM), is ascendant in the United States' mental health system; the findings of randomized controlled trials and other experimental research are widely considered authoritative in mental health practice and policy. The concept of recovery from mental illness is similarly pervasive in mental health programming and advocacy, and it emphasizes consumer expertise and self-determination. What is the relationship between these two powerful and potentially incompatible forces for mental health reform? This paper identifies four attempts, in the mental health literature, to delineate the role of "evidence" in recovery. One is the strong version of evidence-based practice-an applied science model-and three others address weaknesses in the first by limiting the authority of probabilistic findings. The paper also offers a fifth version, based on the concept of communicative accountability, which is derived from Habermas' work on communicative action. The fifth version responds to the other four and emphasizes learning, disclosure and respect in clinical and other helping relationships.

Undergraduate nursing students' attitudes toward mental health nursing.

PubMed

Thongpriwan, Vipavee; Leuck, Susan E; Powell, Rhonda L; Young, Staci; Schuler, Suzanne G; Hughes, Ronda G

2015-08-01

The purpose of this study was to describe undergraduate nursing students' attitudes toward mental health nursing and how these attitudes influenced their professional career choices in mental health nursing. A descriptive, online survey was utilized to examine students' perceptions of mental health nursing. A total of 229 junior and senior nursing students were recruited from eight nursing colleges in Midwestern United States to participate in this survey. Students of different ages, genders, ethnicities, and nursing programs did not report significantly different perceptions of: (a) knowledge of mental illness; (b) negative stereotypes; (c) interest in mental health nursing as a future career; and (d), and beliefs that psychiatric nurses provide a valuable contribution to consumers and the community. Negative stereotypes were significantly different between students who had mental health nursing preparation either in class (p=0.0147) or in clinical practice (p=0.0018) and students who had not. There were significant differences in anxiety about mental illness between students who had classes on mental health nursing (p=.0005), clinical experience (p=0.0035), and work experience in the mental health field (p=0.0012). Significant differences in an interest in a future career in mental health nursing emerged between students with and without prior mental health experience and between students with and without an interest in an externship program with p-values of 0.0012 and <0.0001, respectively. The more exposure that students have to mental health nursing through clinical experiences, theory classes, and previous work in the field, the more prepared they feel about caring for persons with mental health issues. Published by Elsevier Ltd.

Talking to children about parental mental illness: The experiences of well parents.

PubMed

Ballal, Divya; Navaneetham, Janardhana

2018-06-01

Children of parents with mental illness are not routinely included in psychoeducational and supportive family interventions provided by adult mental health systems. The family, therefore, is an important and, sometimes, the only source of information and support for them. To understand the experiences of well parents in talking to their children about parental mental illness. This article presents the findings of a qualitative study of the experiences of well parents in talking to their children about parental mental illness. Ten well parents whose spouses were diagnosed with a severe mental illness participated in the study. Socio-demographic information, family details and history of the spouse's mental illness along with their experiences of talking to children about parental mental illness, the perceived risks and benefits, challenges they faced and the role of others in the process were recorded. Qualitative data were analysed using interpretative phenomenological analysis. The themes of 'distancing children from parental mental illness', 'avoiding conversations about the illness', 'giving and receiving emotional support', 'providing explanations of the illness' and 'regulating other sources of information' show the complex ways in which well parents influence their children's understanding of parental mental illness. The findings are examined in the background of what is known about this topic from the perspective of children or of the parent with illness. Possible ways to support well parents in families affected by parental mental illness are discussed. This study is a step forward in the understanding of how families talk to children about parental mental illness and provides the perspective of the well parent.

Small business employers' views on hiring individuals with mental illness.

PubMed

Hand, Carri; Tryssenaar, Joyce

2006-01-01

This study investigated the beliefs of small business employers regarding hiring individuals with mental illness. Fifty-eight participants completed mail-in questionnaires concerning beliefs and willingness to hire persons with mental illness. Employers were most concerned regarding the social and emotional skills of individuals with mental illness. Those employers who reported positive beliefs, had positive interactions with individuals with mental illness, or operated in public/social services, stated greater willingness to hire a person with mental illness. Methods to decrease stigma are discussed.

Mental Health Professionals' Attitudes Toward Offenders With Mental Illness (Insanity Acquittees) in Ghana.

PubMed

Adjorlolo, Samuel; Abdul-Nasiru, Inusah; Chan, Heng Choon Oliver; Bambi, Laryea Efua

2018-02-01

Mental health professionals' attitudes toward offenders with mental illness have significant implications for the quality of care and treatment rendered, making it imperative for these professionals to be aware of their attitudes. Yet, this topical issue has received little research attention. Consequently, the present study investigates attitudes toward offenders with mental illness (insanity acquittees) in a sample of 113 registered mental health nurses in Ghana. Using a cross-sectional survey and self-report methodology, the participants respond to measures of attitudes toward offenders with mental illness, attitudes toward mental illness, conviction proneness, and criminal blameworthiness. The results show that mental health nurses who reportedly practiced for a longer duration (6 years and above) were more likely to be unsympathetic, while the male nurses who were aged 30 years and above were more likely to hold offenders with mental illness strictly liable for their offenses. Importantly, the nurses' scores in conviction proneness and criminal blameworthiness significantly predict negative attitudes toward the offenders even after controlling for their attitudes toward mental illness. Yet, when the nurses' conviction proneness and criminal blameworthiness were held constant, their attitudes toward mental illness failed to predict attitudes toward the offenders. This initial finding implies that the nurses' views regarding criminal blameworthiness and conviction may be more influential in understanding their attitudes toward offenders with mental illness relative to their attitudes toward mental illness.

The City MISS: development of a scale to measure stigma of perinatal mental illness.

PubMed

Moore, Donna; Ayers, Susan; Drey, Nicholas

2017-07-01

This study aimed to develop and validate a scale to measure perceived stigma for perinatal mental illness in women. Stigma is one of the most frequently cited barriers to seeking treatment and many women with perinatal mental illness fail to get the treatment they need. However, there is no psychometric scale that measures how women may experience the unique aspects of perinatal mental illness stigma. A draft scale of 30 items was developed from a literature review. Women with perinatal mental illness (n = 279) were recruited to complete the City Mental Illness Stigma Scale. Concurrent validity was measured using the Internalised Stigma of Mental Illness Scale. Factor analysis was used to create the final scale. The final 15-item City Mental Illness Stigma Scale has a three-factor structure: perceived external stigma, internal stigma and disclosure stigma. The scale accounted for 54% of the variance and had good internal reliability and concurrent validity. The City Mental Illness Stigma Scale appears to be a valid measure which provides a potentially useful tool for clinical practice and research in stigma and perinatal mental illness, including assessing the prevalence and characteristics of stigma. This research can be used to inform interventions to reduce or address the stigma experienced by some women with perinatal mental illness.

Biogenetic models of psychopathology, implicit guilt, and mental illness stigma.

PubMed

Rüsch, Nicolas; Todd, Andrew R; Bodenhausen, Galen V; Corrigan, Patrick W

2010-10-30

Whereas some research suggests that acknowledgment of the role of biogenetic factors in mental illness could reduce mental illness stigma by diminishing perceived responsibility, other research has cautioned that emphasizing biogenetic aspects of mental illness could produce the impression that mental illness is a stable, intrinsic aspect of a person ("genetic essentialism"), increasing the desire for social distance. We assessed genetic and neurobiological causal attributions about mental illness among 85 people with serious mental illness and 50 members of the public. The perceived responsibility of persons with mental illness for their condition, as well as fear and social distance, was assessed by self-report. Automatic associations between Mental Illness and Guilt and between Self and Guilt were measured by the Brief Implicit Association Test. Among the general public, endorsement of biogenetic models was associated with not only less perceived responsibility, but also greater social distance. Among people with mental illness, endorsement of genetic models had only negative correlates: greater explicit fear and stronger implicit self-guilt associations. Genetic models may have unexpected negative consequences for implicit self-concept and explicit attitudes of people with serious mental illness. An exclusive focus on genetic models may therefore be problematic for clinical practice and anti-stigma initiatives. Copyright © 2009 Elsevier Ltd. All rights reserved.

Knowledge and attitudes towards mental illness among college students: insights into the wider English-speaking Caribbean population.

PubMed

Youssef, Farid F; Bachew, Raecho; Bodie, Dalecia; Leach, Richanna; Morris, Kevin; Sherma, Glenderia

2014-02-01

Mental illness is a significant contributor to global disease burden and this is expected to increase over the coming decades. Traditionally mental illness has not been well understood by the general public, resulting in poor attitudes towards persons with mental illness and stigmatization. Such conditions are common in the Caribbean where less than 5% of the health budget is allocated to mental illness. To assess knowledge and attitudes towards mental illness among college students within the English-speaking Caribbean. A self-report questionnaire was adapted from previous studies designed to measure knowledge and attitudes of mental illness. Students were sampled from the University of the West Indies campuses in Jamaica, Barbados and Trinidad & Tobago. Responses were collected from 673 persons with a response rate of 84%. While participants were agreed that particular diseases were mental illnesses, overall knowledge scores were low. Knowledge was higher among those persons who knew someone with a mental illness. Attitude scores were suggestive of stigmatization, with drug abuse and schizophrenia seen in a particularly poor light. These results suggest that widespread educational campaigns need to be implemented across the region, designed to both increase knowledge about mental illness and reduce discrimination towards persons suffering with mental illness.

Organisational systems and services for children of parents with mental illness and their families: processes of change and sustainability.

PubMed

Owen, Susanne

2010-09-01

Adult mental illness in the community including depression and anxiety has achieved greater public awareness and visibility in recent years and this has also resulted in increased recognition about the widespread impact on dependent children. During the past decade in Australia, policies and specific programs for infants, children and youth in terms of prevention, early intervention and promotion in relation to children of parents with a mental illness ('copmi') have been devised. However, these have generally been disconnected projects, essentially supported only by non-recurrent funding. In more recent years, systematic and interconnected responses involving a wider range of government, non-government and consumer and carer organisations to build sustainability have become the focus. However, little research about change processes affecting the organisational systems serving children of parents with mental illness and their families has been undertaken. This aim of the current study is to describe the enablers and barriers that contribute to change in systems and government and non-government organisations in relation to children of parents with a mental illness in Australia over the past decade, within the context of sustainability. The study involved interviews, focus groups and website and literature searches regarding systems change across Australian states and territories and nationally in relation to the enablers, barriers and future directions. Strategic and intentional processes within organisations, more evolutionary ongoing cross-agency processes and links to sustained changes are key systems change findings. Relevance for change in other health services is highlighted.

Does gender matter? Exploring mental health recovery court legal and health outcomes.

PubMed

Kothari, Catherine L; Butkiewicz, Robert; Williams, Emily R; Jacobson, Caron; Morse, Diane S; Cerulli, Catherine

2014-12-05

Based upon therapeutic justice principles, mental health courts use legal leverage to improve access and compliance to treatment for defendants who are mentally ill. Justice-involved women have a higher prevalence of mental illness than men, and it plays a greater role in their criminal behavior. Despite this, studies examining whether women respond differently than men to mental health courts are lacking. Study goals were to examine gender-related differences in mental health court participation, and in criminal justice, psychiatric and health-related outcomes. This study utilized a quasi-experimental pre-posttest design without a control group. The data were abstracted from administrative records of Kalamazoo Community Mental Health and Substance Abuse agency, the county jail and both county hospitals, 2008 through 2011. Generalized estimating equation regression was used to assess gender-differences in pre-post program outcomes (jail days, psychiatric and medical hospitalization days, emergency department visits) for the 30 women and 63 men with a final mental health court disposition. Program-eligible females were more likely than males to become enrolled in mental health court. Otherwise they were similar on all measured program-participation characteristics: treatment compliance, WRAP participation and graduation rate. All participants showed significant reductions in emergency department visits, but women-completers had significantly steeper drops than males: from 6.7 emergency department visits to 1.3 for women, and from 4.1 to 2.4 for men. A similar gender pattern emerged with medical-hospitalization-days: from 2.2 medical hospital days down to 0.1 for women, and from 0.9 days up to 1.8 for men. While women had fewer psychiatric hospitalization days than men regardless of program involvement (2.5 and 4.6, respectively), both genders experienced fewer days after MHRC compared to before. Women and men showed equal gains from successful program completion in reduced jail days. Despite similar participation characteristics, findings point to greater health gains by female compared to male participants, and to lower overall psychiatric acuity. Mental-health-court participation was associated with decreased psychiatric hospitalization days and emergency department visits. Successful program completion correlated to fewer jail days for both women and men.

The Development of a Substance Abuse Treatment Program for Forensic Patients with Cognitive Impairment

ERIC Educational Resources Information Center

Glassmire, David M.; Welsh, Robert K.; Clevenger, Jeanne K.

2007-01-01

The Substance Abuse and Mental Illness (SAMI) program combines cognitive rehabilitation and dual-diagnosis substance abuse treatment within a stages of change context. This article describes the development, implementation, and preliminary outcome analysis of the SAMI program in a forensic hospital.

An Online Survey of Family Members' Beliefs and Attitudes About Smoking and Mental Illness.

PubMed

Aschbrenner, Kelly A; Dixon, Lisa B; Naslund, John A; Bienvenida, John Carlo M; McManus, Kinsey L; Bartels, Stephen J; Brunette, Mary F

2017-01-01

Family beliefs about smoking and cessation may influence whether individuals with mental illness who smoke use effective cessation treatment. We surveyed family members online regarding beliefs about smoking and cessation among people with mental illness. Method: Two hundred fifty-six family members of individuals with mental illness completed an online survey. Responses were summarized and t tests were used to compare responses based on the family member's smoking status. One-quarter of respondents agreed that people with mental illness must smoke to manage mental health symptoms, nearly half (48%) expressed uncertainty about the whether nicotine replacement therapy is harmful for this population, and 69% believed that family members do not have the skills to help an individual with mental illness quit smoking. Misconceptions about smoking and mental illness and uncertainty about the safety of cessation treatment may interfere with family support for quitting smoking among people with mental illness.

Swedish attitudes towards persons with mental illness.

PubMed

Högberg, Torbjörn; Magnusson, Annabella; Lützén, Kim; Ewalds-Kvist, Béatrice

2012-04-01

Negative and stigmatizing attitudes towards persons with mental illness must be dealt with to facilitate the sufferers' social acceptance. The present study aimed at survey Swedish attitudes towards persons with mental illness related to factors impacting these attitudes. New CAMI-S based on the questionnaire "Community Attitudes to Mental Illness in Sweden" ([CAMI] Taylor & Dear, 1981) was developed with nine behavioral-intention items and thus comprised a total of 29 items. Of 5000 Swedish people, 2391 agreed to complete the questionnaire. Principal component analysis rendered four factors reflecting attitudes towards the mentally ill: Intention to Interact, Fearful and Avoidant, Open-minded and Pro-Integration, as well as Community Mental Health Ideology. The factors were analyzed for trends in attitudes. By MANOVA, the experience of mental illness effects on mind-set towards the sufferers was assessed. By means of logistic regression, demographic factors contributing to positive attitudes towards persons with mental illness residing in the neighborhood were assessed. By New CAMI-S, the Swedish attitudes towards the mentally ill were surveyed and trends in agreement with living next to a person with mental illness were revealed in three out of four factors derived by principal component analysis. Aspects impacting the Swedish attitudes towards persons with mental illness and willingness to have him/her residing in the neighborhood comprised experience of mental illness, female gender, age (31-50 years), born in Scandinavia or outside Europe, only 9 years of compulsory school and accommodation in flat. The New CAMI-S came out as a useful tool to screen Swedish attitudes towards persons with mental illness. Most Swedes were prepared to live next to the mentally ill.

Perceptions of mental illness among Muslim general practitioners in South Africa.

PubMed

Mohamed-Kaloo, Zaakiyah; Laher, Sumaya

2014-03-26

Mental health literacy on the part of medical practitioners is an important component of mental healthcare. General practitioners (GPs) are typically the first doctors consulted by a person who is ill. Exploration of their perceptions regarding mental illness, aetiological issues and treatment is important. To investigate perceptions of mental illness in a sample of ten South African Muslim GPs (five male, five female) in the Lenasia area (Johannesburg, South Africa). Using a qualitative approach, semi-structured interviews were conducted with each GP. The questionnaire encompassed 37 questions relating to the context in which the GPs practised, perceptions of mental illness, understanding of religion and culture, and treatment of mental illness (including aspects of spiritual illness). Thematic content analysis was used to analyse the data. Six dominant themes were identified, namely GPs' understanding of mental illness and its causation; stigma, secrecy and somatisation; the beneficial effects of religion in mental illnesses; perceptions of spiritual illnesses; collaboration with traditional healers; and collaboration with psychiatrists and psychologists. Greater awareness regarding the stigmatisation of mental illness is needed. Furthermore, it is important that healthcare professionals have an understanding of religious and cultural taxonomies of illness as well as the use of traditional healing as a mode of treatment. Participants identified a need for increased collaboration between healthcare professionals, including traditional healers.

How the Media Cover Mental Illnesses: A Review

ERIC Educational Resources Information Center

Ma, Zexin

2017-01-01

Purpose: Mental illness has become an important public health issue in society, and media are the most common sources of information about mental illnesses. Thus, it is important to review research on mental illnesses and media. The purpose of this paper is to provide a narrative review of studies on mental illnesses in the media and identifies…

76 FR 48204 - Fund Availability Under VA's Homeless Providers Grant and Per Diem Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-08

... homeless veteran populations: Women, including women who have care of minor dependents; Frail elderly; Terminally ill; or Chronically mentally ill. Definitions of women and women who have care of minor dependents... service, operation, or personnel to facilitate the following with regard to the targeted group: Women...

Local suffering and the global discourse of mental health and human rights: An ethnographic study of responses to mental illness in rural Ghana

PubMed Central

Read, Ursula M; Adiibokah, Edward; Nyame, Solomon

2009-01-01

Background The Global Movement for Mental Health has brought renewed attention to the neglect of people with mental illness within health policy worldwide. The maltreatment of the mentally ill in many low-income countries is widely reported within psychiatric hospitals, informal healing centres, and family homes. International agencies have called for the development of legislation and policy to address these abuses. However such initiatives exemplify a top-down approach to promoting human rights which historically has had limited impact at the level of those living with mental illness and their families. Methods This research forms part of a longitudinal anthropological study of people with severe mental illness in rural Ghana. Visits were made to over 40 households with a family member with mental illness, as well as churches, shrines, hospitals and clinics. Ethnographic methods included observation, conversation, semi-structured interviews and focus group discussions with people with mental illness, carers, healers, health workers and community members. Results Chaining and beating of the mentally ill was found to be commonplace in homes and treatment centres in the communities studied, as well as with-holding of food ('fasting'). However responses to mental illness were embedded within spiritual and moral perspectives and such treatment provoked little sanction at the local level. Families struggled to provide care for severely mentally ill relatives with very little support from formal health services. Psychiatric services were difficult to access, particularly in rural communities, and also seen to have limitations in their effectiveness. Traditional and faith healers remained highly popular despite the routine maltreatment of the mentally ill in their facilities. Conclusion Efforts to promote the human rights of those with mental illness must engage with the experiences of mental illness within communities affected in order to grasp how these may underpin the use of practices such as mechanical restraint. Interventions which operate at the local level with those living with mental illness within rural communities, as well as family members and healers, may have greater potential to effect change in the treatment of the mentally ill than legislation or investment in services alone. PMID:19825191

Local suffering and the global discourse of mental health and human rights: an ethnographic study of responses to mental illness in rural Ghana.

PubMed

Read, Ursula M; Adiibokah, Edward; Nyame, Solomon

2009-10-14

The Global Movement for Mental Health has brought renewed attention to the neglect of people with mental illness within health policy worldwide. The maltreatment of the mentally ill in many low-income countries is widely reported within psychiatric hospitals, informal healing centres, and family homes. International agencies have called for the development of legislation and policy to address these abuses. However such initiatives exemplify a top-down approach to promoting human rights which historically has had limited impact at the level of those living with mental illness and their families. This research forms part of a longitudinal anthropological study of people with severe mental illness in rural Ghana. Visits were made to over 40 households with a family member with mental illness, as well as churches, shrines, hospitals and clinics. Ethnographic methods included observation, conversation, semi-structured interviews and focus group discussions with people with mental illness, carers, healers, health workers and community members. Chaining and beating of the mentally ill was found to be commonplace in homes and treatment centres in the communities studied, as well as with-holding of food ('fasting'). However responses to mental illness were embedded within spiritual and moral perspectives and such treatment provoked little sanction at the local level. Families struggled to provide care for severely mentally ill relatives with very little support from formal health services. Psychiatric services were difficult to access, particularly in rural communities, and also seen to have limitations in their effectiveness. Traditional and faith healers remained highly popular despite the routine maltreatment of the mentally ill in their facilities. Efforts to promote the human rights of those with mental illness must engage with the experiences of mental illness within communities affected in order to grasp how these may underpin the use of practices such as mechanical restraint. Interventions which operate at the local level with those living with mental illness within rural communities, as well as family members and healers, may have greater potential to effect change in the treatment of the mentally ill than legislation or investment in services alone.

Mental illness among journalists: a systematic review.

PubMed

Aoki, Yuta; Malcolm, Estelle; Yamaguchi, Sosei; Thornicroft, Graham; Henderson, Claire

2013-06-01

Mass media depictions of people with mental illness have a strong influence on public attitudes, to the extent that changes in these depictions can reduce public stigmatization of people with such illness. Journalists' mental health may influence their depiction of those with mental illness, but little is known about this. To investigate mental illness among journalists in five key areas: (1) journalists' mental health status; (2) journalists' personal attitudes towards mental illness; (3) attitudes and support journalists expect or have experienced from colleagues when they have a mental health problem; (4) effect of journalism's professional culture on the course of mental illness; and (5) effect of journalism's professional culture on mass media depictions of people with mental illness. We performed a systematic screening of MEDLINE, PsycINFO, EMBASE, Web of Science and the Cochrane Library regarding the study aims. We identified 19, 12, seven and four studies for aims 1, 2, 3, and 4, respectively. No articles were found for aim 5. The prevalence of post-traumatic stress disorder (PTSD) among journalists is higher than that among the general population. Journalists have positive personal attitudes towards mental illness, but there are perceived workplace disincentives to disclose mental health problems.

Are the mentally ill homeless a distinct homeless subgroup?

PubMed

North, C S; Smith, E M; Pollio, D E; Spitznagel, E L

1996-09-01

The question has been raised whether it is useful or meaningful to dichotomize the homeless population by mental illness - i.e., to consider the mentally ill homeless as distinct from other homeless people. The current article presents evidence from a single data set to address this question empirically. Data from a randomly sampled population of 900 homeless men and women systemically interviewed using the Diagnostic Interview Schedule were examined to determine associations of mental illness with the problems of homelessness, controlling for the presence of substance abuse in the analyses. Although a few clinically meaningful associations with mental illness were found that might suggest directions for appropriate interventions, mental illness did not differentiate individuals in many important demographic and biographic respects. Individual diagnoses did not perform much better in differentiating the homeless by mental illness. Schizophrenia and bipolar mania showed a few significant associations not identified by the "major mental illness" construct. Major depression, constituting the majority of nonsubstance Axis I disorder in the homeless, provided no association beyond that obtained with the "major mental illness" category. The data provide little support for conceptualizing homeless subgroups or homelessness in general on the basis of mental illness alone. To do so also risks neglecting the emotional distress of the majority without major mental illness and the other problems that homeless persons share regardless of psychiatric illness. While serious mental illness is overrepresented among the homeless, it represents just one of many important vulnerability factors for homelessness. Substance abuse is far more prevalent than other Axis I disorders. Media images equating homelessness with major mental illness unnecessarily stigmatize homeless people and encourage oversimplified and narrowly conceived psychiatric interventions. While continuing attention is needed on improving identification and management of serious mental illness among the homeless, this must be accomplished within the broader context of social and economic aspects of homelessness.

Burden of Mental Illness and Non-communicable Diseases and Risk Factors for Mental Illness Among Refugees in Buffalo, NY, 2004-2014.

PubMed

Mulugeta, Wudeneh; Xue, Hong; Glick, Myron; Min, Jungwon; Noe, Michael F; Wang, Youfa

2018-05-21

Limited is known about mental illness and non-communicable diseases (NCDs) and their risk factors among refugees. These were studied using data collected from a refugee population in Buffalo, NY. Longitudinal data collected on 1055 adults (> 18 years) at a large refugee health center in Buffalo, NY, during 2004-2014 were used. Main outcomes were hypertension, diabetes, tobacco use, obesity, overweight/obesity, and mental illness. Risk factors were assessed using multivariate regression models. Compared to those without mental illness, refugees with mental illness had higher rates of hypertension (16.9 vs 28.4%, P < 0.001), diabetes (8.4 vs 13.6%, P = 0.03), tobacco use (9.3 vs 18.3%, P < 0.001), obesity (13.0 vs 25.4%, P < 0.001), and overweight/obesity rates (45.0 vs 61.5%, P < 0.001). During 2004-2014, obesity rates increased among those with mental illness (25.4 to 36.7%, P < 0.001) and without mental illness (13.0 to 24.5%, P < 0.001). The overall mental illness prevalence among refugees was 16%, ranging from 6.9% among Asians to 43.9% among Cubans. Women were more likely to have mental illness (odds ratio = 2.45; 95% confidence interval [CI] = 1.68-3.58) than men. Refugees who lived longer in the USA were more likely to carry psychiatric diagnoses (OR = 1.12; 95% CI = 1.04-1.21). Mental illness rates varied considerably across various refugee groups. Rates of obesity and NCDs among refugees with mental illness were higher than among those without mental disorders. Gender, region of origin, and length of stay in the USA were associated with mental illness. Accurate and culturally sensitive screenings and assessments of mental illness are needed to reduce these health disparities.

Healthcare Utilization and Expenditures for Persons with Diabetes Comorbid with Mental Illnesses.

PubMed

Su, Chen-Hsiang; Chiu, Herng-Chia; Hsieh, Hui-Min; Yen, Ju-Yu; Lee, Mei-Hsuan; Li, Chih-Yi; Chang, Kao-Ping; Huang, Chun-Jen

2016-09-01

The aim of this study was to investigate healthcare utilization and expenditure for patients with diabetes comorbid with and without mental illnesses in Taiwan. People with diabetes comorbid with and without mental illnesses in 2000 were identified and followed up to 2004 to explore the healthcare utilization and expenditure. Healthcare utilization included outpatient visits and use of hospital inpatient services, and expenditure included outpatient, inpatient and total medical expenditure. General estimation equation models were used to explore the factors associated with outpatient visits and expenditure. To identify the factors associated with hospitalization, multiple logistic regressions were applied. The average number of annual outpatient visits of the patients with mental illnesses ranged from 37.01 to 41.91, and 28.83 to 31.79 times for the patients without mental illnesses from 2000 to 2004. The average annual total expenditure for patients with mental illnesses during this period ranged from NT$77,123-NT$90,790, and NT$60,793- NT$84,984 for those without mental illnesses. After controlling for covariates, the results indicated that gender, age, mental illness and time factor were associated with outpatient visits. Gender, age, and time factor were associated with total expenditure. Age and mental illness were associated with hospitalization in logistic regression. The healthcare utilization and expenditure for patients with mental illnesses was significantly higher than for patients without mental illnesses. The factors associated with healthcare utilization and expenditure included gender, age, mental illness and time trends.

[The challenge of inclusion in mental health: an analysis of a community center and its work with social bonds].

PubMed

Ardila-Gómez, Sara; Hartfiel, María Isabel; Fernández, Marina A; Ares Lavalle, Guadalupe; Borelli, Mariana; Stolkiner, Alicia

2016-01-01

Social inclusion is a key component of transformations in mental health care, because it takes into account the benefits of community life for both those with mental illness and the other members of the community. In order to understand the scope of inclusion within mental health, 45 participants of a community center linked to a psychiatric hospital discharge program which explicitly seeks to provide social inclusion were interviewed. The possible changes in social relationships between users and other community members based in their sustained daily interactions in the community center were explored. Results suggest that the building of social bonds, as part of informal support networks, is one of the benefits of attending the community center. Positive changes in ideas regarding people with "mental illness" were also observed, although these ideas seemed to be more connected to the notion of integration than to social inclusion.

The Stigma of Mental Illness

ERIC Educational Resources Information Center

Overton, Stacy L.; Medina, Sondra L.

2008-01-01

Stigma surrounding major mental illness creates many barriers. People who experience mental illness face discrimination and prejudice when renting homes, applying for jobs, and accessing mental health services. The authors review the current literature regarding stigma and mental illness. They define stigma and review theories that explain its…

The double stigma of obesity and serious mental illnesses: promoting health and recovery.

PubMed

Mizock, Lauren

2012-12-01

This article contrasts the traditional medical approach and size acceptance perspectives on obesity among people with serious mental illnesses. Higher incidences of obesity among populations with serious mental illnesses have been identified. In response, a recent initiative in mental health has urged providers to address the obesity rates among populations with mental illnesses by monitoring weight, prescribing weight loss medication, and recommending bariatric surgery. However, literature is emerging with regards to the double stigma experienced by individuals with obesity and a mental illness. Therefore, the traditional focus on weight loss can benefit from a size acceptance approach to focus on health promotion and avoid stigmatizing size. Citations of theoretical and behavioral health literature on the experiences of individuals with mental illnesses and obesity are presented. Recommendations for interventions, training, and future research related to obesity and mental illnesses are provided. Implications are suggested for a size acceptance approach to interventions for individuals in recovery from mental illnesses to promote health at every size within mental health and medical settings.

Stigma in mental illness: attitudes of medical students towards mental illness.

PubMed

Mas, A; Hatim, A

2002-12-01

Negative attitudes towards people with mental illness can be attributed to stigma. The objective of this study was to determine the attitudes of medical students towards mental illness by comparing those who have had contact with mental patients and those who have not. This study also assesses to what extent knowledge about mental illness can affect the students' attitude. A vignette and two dependent measures (social distance scale and dangerousness scale) were used to assess the attitudes of medical students towards mental illness. They comprised of 108 first year and 85 final year medical students in University of Malaya, Kuala Lumpur. The first year students didn't have any prior psychiatric training. The final year students who had knowledge and contact (undergone 8 weeks of clinical psychiatric training) were less stigmatizing toward mentally ill patients. There were no significant differences in the attitudes towards mentally ill patient among the first year students (no knowledge) regardless they had previous contact or not. Knowledge seems to have the effect in inculcating greater tolerance of mental illness. Contact by itself is not sufficient for attitude changes.

Association between psychosomatic health symptoms and common mental illness in Ghanaian adolescents: Age and gender as potential moderators.

PubMed

Glozah, Franklin N; Pevalin, David J

2017-09-01

Little is known about the role of age and gender in the association between psychosomatic symptoms and common mental illness in Ghanaian adolescents. This cross-sectional study examined age and gender as moderators between psychosomatic symptoms and common mental illness using data from a school-based survey ( N = 770). Males reported higher psychosomatic symptoms and common mental illness, while younger adolescents reported higher common mental illness only. Psychosomatic symptoms were positively associated with common mental illness, but age and gender did not moderate this association. Interventions aimed at reducing the prevalence rate in psychosomatic symptoms are crucial in decreasing common mental illness in Ghanaian adolescents.

Receipt and Perceived Helpfulness of Mental Illness Information: Findings from the Australian National Survey of Mental Health and Wellbeing.

PubMed

Graham, Annette L; Brooker, Joanne; Hasking, Penelope; Clarke, David; Meadows, Graham

2017-10-20

The distribution of mental illness information is a crucial element of mental health promotion initiatives. We assessed the receipt and perceived helpfulness of such information in Australia. Data from the Australian National Survey of Mental Health and Wellbeing indicated that, during the year prior to the survey, 33.7% of Australians received mental illness information; of these, 51.2% found it helpful. Among people with a mental disorder, 46.1% received information; of these, 67.4% found it helpful. Non-English speakers and the socially disadvantaged were less likely to receive mental illness information. Older and less educated respondents were less likely to both receive mental illness information and find it helpful. Mental health service users were more likely to receive mental illness information perceived as helpful than those who had not accessed such services. Better targeted information interventions are required to ensure those most likely to benefit receive mental illness-related information.

Impact of Illness Management and Recovery Programs on Hospital and Emergency Room Use by Medicaid Enrollees

PubMed Central

Salyers, Michelle P.; Rollins, Angela L.; Clendenning, Daniel; McGuire, Alan B.; Kim, Edward

2011-01-01

Objective Illness management and recovery is a structured program that helps consumers with severe mental illness learn effective ways to manage illness and pursue recovery goals. This study examined the impact of the program on health service utilization. Methods This was a retrospective cohort study of five assertive community treatment (ACT) teams in Indiana that implemented illness management and recovery. With Medicaid claims data from July 1, 2003, to June 30, 2008, panel data were created with person-months as the level of analysis, resulting in 14,261 observations, for a total of 498 unique individuals. Zero-inflated negative binomial regression models were used to predict hospitalization days and emergency room visits, including covariates of demographic characteristics, employment status, psychiatric diagnosis, and concurrent substance use disorder. The main predictor variables of interest were receipt of illness management and recovery services, dropout from the program, and program graduation status. Results Consumers who received some illness management and recovery services had fewer hospitalization days than those receiving only ACT. Graduates had fewer emergency room visits than did ACT-only consumers. Conclusions This is the first study to examine the impact of illness management and recovery on service utilization. Controlling for a number of background variables, the study showed that illness management and recovery programs were associated with reduced inpatient hospitalization and emergency room use over and above ACT. PMID:21532077

A Home Training Program for Young Mentally Ill Children.

ERIC Educational Resources Information Center

Doernberg, Nanette; And Others

To develop a meaningful intervention for waiting list families and their preschool emotionally disturbed children, a home training program for the parent and child was initiated. The focus of the program was on productive cooperation between parents and professionals. During a period of 2 years, 45 families completed the program. The program…

Creating a Science of Homelessness During the Reagan Era

PubMed Central

JONES, MARIAN MOSER

2015-01-01

Policy Points: A retrospective analysis of federally funded homeless research in the 1980s serves as a case study of how politics can influence social and behavioral science research agendas today in the United States. These studies of homeless populations, the first funded by the National Institute of Mental Health, demonstrated that only about a third of the homeless population was mentally ill and that a diverse group of people experienced homelessness. This groundbreaking research program set the mold for a generation of research and policy characterizing homelessness as primarily an individual-level problem rather than a problem with the social safety net. Context A decade after the nation's Skid Rows were razed, homelessness reemerged in the early 1980s as a health policy issue in the United States. While activists advocated for government-funded programs to address homelessness, officials of the Reagan administration questioned the need for a federal response to the problem. In this climate, the National Institute of Mental Health (NIMH) launched a seminal program to investigate mental illness and substance abuse among homeless individuals. This program serves as a key case study of the social and behavioral sciences’ role in the policy response to homelessness and how politics has shaped the federal research agenda. Methods Drawing on interviews with former government officials, researchers, social activists, and others, along with archival material, news reports, scientific literature, and government publications, this article examines the emergence and impact of social and behavioral science research on homelessness. Findings Research sponsored by the NIMH and other federal research bodies during the 1980s produced a rough picture of mental illness and substance abuse prevalence among the US homeless population, and private foundations supported projects that looked at this group's health care needs. The Reagan administration's opposition to funding “social research,” together with the lack of private-sector support for such research, meant that few studies examined the relationship between homelessness and structural factors such as housing, employment, and social services. Conclusions The NIMH's homelessness research program led to improved understanding of substance abuse and mental illness in homeless populations. Its primary research focus on behavioral disorders nevertheless unwittingly reinforced the erroneous notion that homelessness was rooted solely in individual pathology. These distortions, shaped by the Reagan administration's policies and reflecting social and behavioral scientists’ long-standing tendencies to emphasize individual and cultural rather than structural aspects of poverty, fragmented homelessness research and policy in enduring ways. PMID:25752353

Creating a science of homelessness during the Reagan era.

PubMed

Jones, Marian Moser

2015-03-01

POLICY POINTS: A retrospective analysis of federally funded homeless research in the 1980s serves as a case study of how politics can influence social and behavioral science research agendas today in the United States. These studies of homeless populations, the first funded by the National Institute of Mental Health, demonstrated that only about a third of the homeless population was mentally ill and that a diverse group of people experienced homelessness. This groundbreaking research program set the mold for a generation of research and policy characterizing homelessness as primarily an individual-level problem rather than a problem with the social safety net. A decade after the nation's Skid Rows were razed, homelessness reemerged in the early 1980s as a health policy issue in the United States. While activists advocated for government-funded programs to address homelessness, officials of the Reagan administration questioned the need for a federal response to the problem. In this climate, the National Institute of Mental Health (NIMH) launched a seminal program to investigate mental illness and substance abuse among homeless individuals. This program serves as a key case study of the social and behavioral sciences' role in the policy response to homelessness and how politics has shaped the federal research agenda. Drawing on interviews with former government officials, researchers, social activists, and others, along with archival material, news reports, scientific literature, and government publications, this article examines the emergence and impact of social and behavioral science research on homelessness. Research sponsored by the NIMH and other federal research bodies during the 1980s produced a rough picture of mental illness and substance abuse prevalence among the US homeless population, and private foundations supported projects that looked at this group's health care needs. The Reagan administration's opposition to funding "social research," together with the lack of private-sector support for such research, meant that few studies examined the relationship between homelessness and structural factors such as housing, employment, and social services. The NIMH's homelessness research program led to improved understanding of substance abuse and mental illness in homeless populations. Its primary research focus on behavioral disorders nevertheless unwittingly reinforced the erroneous notion that homelessness was rooted solely in individual pathology. These distortions, shaped by the Reagan administration's policies and reflecting social and behavioral scientists' long-standing tendencies to emphasize individual and cultural rather than structural aspects of poverty, fragmented homelessness research and policy in enduring ways. © 2015 Milbank Memorial Fund.

Attitudes toward mental illness in adults by mental illness-related factors and chronic disease status: 2007 and 2009 Behavioral Risk Factor Surveillance System.

PubMed

Kobau, Rosemarie; Zack, Matthew M

2013-11-01

We examined how attitudes toward mental illness treatment and its course differ by serious psychological distress, mental illness treatment, chronic disease, and sociodemographic factors using representative state-based data. Using data from jurisdictions supporting the Behavioral Risk Factor Surveillance System's Mental Illness and Stigma Module (35 states, the District of Columbia, and Puerto Rico), we compared adjusted proportions of adults agreeing that "Treatment can help people with mental illness lead normal lives" (treatment effectiveness) and that "People are generally caring and sympathetic to people with mental illness" (supportive environment), by demographic characteristics, serious psychological distress, chronic disease status, and mental illness treatment. Attitudes regarding treatment effectiveness and a supportive environment for people with mental illness varied within and between groups. Most adults receiving mental illness treatment agreed that treatment is effective. Fewer adults with serious psychological distress than those without such distress agreed that treatment is effective. Fewer of those receiving treatment, those with psychological distress, and those with chronic disease perceived the environment as supportive. These data can be used to target interventions for population subgroups with less favorable attitudes and for surveillance.

Adolescent construction of mental illness: implication for engagement and treatment.

PubMed

Chisholm, Katharine; Patterson, Paul; Greenfield, Sheila; Turner, Erin; Birchwood, Max

2016-05-11

Understanding how adolescents perceive mental illness is important for clinicians wishing to improve engagement, and for the development of educational programmes and health-behaviour directed policies. The current research aimed to develop a preliminary model of how adolescents perceive mental illness and construct their understanding of mental health. Forty-six participants aged 11-18 from six schools in Birmingham, UK, took part in one of 12 group interviews. A thematic analysis highlighted a dual perception of mental illness. Adolescents discussed stereotypes and extreme examples of illness, but also displayed an insightful understanding of mental distress which had developed through participants' own experiences. Participants attempted to reconcile and negotiate these conflicting perceptions by creating distinctions between concepts of 'craziness' and 'normality', and reported experiencing negative emotions relating to both perceptions of illness. The findings suggest that once media stereotypes have been acknowledged, adolescents demonstrate a relatively sophisticated understanding of mental illness, although one which differed at times from the diagnostic medical model of mental illness. Focusing on individual symptoms, prevalence rates and prior contact adolescents have had with individuals with mental illnesses provides a framework to discuss mental health and ill-health with adolescents. John Wiley & Sons Australia, Ltd.

Experiencing stigma as a nurse with mental illness.

PubMed

Peterson, A L

2017-06-01

WHAT IS KNOWN ON THE SUBJECT?: Stigma involves connecting individuals with a particular label to negative characteristics; this is based not on the stigmatized condition itself, but cultural reactions to it. Stigma exists towards nurses with mental illness. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper offers a first-person account of experiencing stigma as a nurse with a mental illness. This paper incorporates the existing literature to offer a broader cultural perspective on the experiences of a nurse with a mental illness. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses are likely to encounter a nurse with a mental illness at some point in their practice. Nurses' reactions towards colleagues with mental illness can have significant implications for those colleague(s)' wellbeing. Nurses with mental illness will have to navigate their person and professional journey while giving consideration to the attitudes of their nursing peers and leaders. Limited research has been done on the stigma faced by nurses with mental illness from their nursing peers. Mental illness is not generally considered acceptable within the context of nursing culture, so when nurses do experience mental illness, their experiences in a professional context may be influenced by stereotypes, particularly those relating to dangerousness. Using autoethnography as a research method, the author examines her own subjective experiences of stigma as a nurse with a mental illness, and draws upon existing literature on stigma, deviance and the phenomenon of mental illness in nurses to analyse broader cultural implications for nursing. Assessment of suitability to return to work arises throughout the narratives, and consideration is given to the way that risk assessment by nursing leaders is impacted by negative stereotypes that surround mental illness. © 2017 John Wiley & Sons Ltd.

Public stigma associated with mental illnesses in Pakistani university students: a cross sectional survey

PubMed Central

Zubair, Muhammad; Ghulam, Hamzah; Wajih Ullah, Muhammad; Zubair Tariq, Muhammad

2014-01-01

Background. The objectives of the study were to explore the knowledge and attitudes of Pakistani university students toward mental illnesses. People with mental illnesses are challenged not only by their symptoms but also by the prejudices associated with their illness. Acknowledging the stigma of mental illness should be the first essential step toward devising an appropriate treatment plan. Methods. A cross-sectional survey was conducted at the University of Punjab, Lahore, CMH Lahore Medical and Dental College, Lahore, and University of Sargodha, Sub-campus Lahore, from February to May 2014. The self-administered questionnaire consisted of three sections: demographics, general knowledge of psychiatric illnesses, and Community Attitudes towards Mental Illnesses (CAMI) Scale. The questionnaire was distributed to 650 participants enrolled in different disciplines (Social Sciences, Medicine and Formal Sciences). Results. Response rate was 81% (527/650 respondents). Mean age was 20.98 years. Most of the students (331, 62.8%) had an urban background and studied Social Sciences (238, 45.2%). Four hundred and eighteen respondents (79.3%) considered religion very important and most respondents considered psychiatrists (334, 63.4%) and spiritual leaders (72, 13.7%) to be best able to treat mental illnesses. One hundred and sixty nine respondents (32.1%) considered black magic to be a cause of mental illness. Only 215 (41%) respondents had ever read an article on mental illnesses. Multiple regression analysis revealed study discipline, exposure, perceived causes of mental illnesses and superstitions to be significantly associated with attitudes towards mental illnesses (p < .05). Conclusion. Although low awareness and exposure were found in this sample of Pakistani university students, their attitude towards mental illnesses was generally positive. Most respondents gave supernatural explanations for mental illnesses but only a few believed that spiritual leaders can play a role in treatment. PMID:25548734

Supported employment for persons with serious mental illness: current status and future directions.

PubMed

Mueser, K T; McGurk, S R

2014-06-01

The individual placement and supported (IPS) model of supported employment is the most empirically validated model of vocational rehabilitation for persons with schizophrenia or another serious mental illness. Over 18 randomized controlled trials have been conducted throughout the world demonstrating the effectiveness of supported employment at improving competitive work compared to other vocational programs: IPS supported employment is defined by the following principles: 1) inclusion of all clients who want to work; 2) integration of vocational and clinical services; 3) focus on competitive employment; 4) rapid job search and no required prevocational skills training; 5) job development by the employment specialist; 6) attention to client preferences about desired work and disclosure of mental illness to prospective employers; 7) benefits counseling; and 8) follow-along supports after a job is obtained. Supported employment has been successfully implemented in a wide range of cultural and clinical populations, although challenges to implementation are also encountered. Common challenges are related to problems such as the failure to access technical assistance, system issues, negative beliefs and attitudes of providers, funding restrictions, and poor leadership. These challenges can be overcome by tapping expertise in IPS supported employment, including standardized and tested models of training and consultation. Efforts are underway to increase the efficiency of training methods for supported employment and the overall program, and to improve its effectiveness for those clients who do not benefit. Progress in IPS supported employment offers people with a serious mental illness realistic hope for achieving their work goals, and taking greater control over their lives. Copyright © 2014. Published by Elsevier Masson SAS.

Gun policy and serious mental illness: priorities for future research and policy.

PubMed

McGinty, Emma Elizabeth; Webster, Daniel W; Barry, Colleen L

2014-01-01

In response to recent mass shootings, policy makers have proposed multiple policies to prevent persons with serious mental illness from having guns. The political debate about these proposals is often uninformed by research. To address this gap, this review article summarizes the research related to gun restriction policies that focus on serious mental illness. Gun restriction policies were identified by researching the THOMAS legislative database, state legislative databases, prior review articles, and the news media. PubMed, PsycINFO, and Web of Science databases were searched for publications between 1970 and 2013 that addressed the relationship between serious mental illness and violence, the effectiveness of gun policies focused on serious mental illness, the potential for such policies to exacerbate negative public attitudes, and the potential for gun restriction policies to deter mental health treatment seeking. Limited research suggests that federal law restricting gun possession by persons with serious mental illness may prevent gun violence from this population. Promotion of policies to prevent persons with serious mental illness from having guns does not seem to exacerbate negative public attitudes toward this group. Little is known about how restricting gun possession among persons with serious mental illness affects suicide risk or mental health treatment seeking. Future studies should examine how gun restriction policies for serious mental illness affect suicide, how such policies are implemented by states, how persons with serious mental illness perceive policies that restrict their possession of guns, and how gun restriction policies influence mental health treatment seeking among persons with serious mental illness.

Media portrayal of mental illness and its treatments: what effect does it have on people with mental illness?

PubMed

Stuart, Heather

2006-01-01

This article reviews dominant media portrayals of mental illness, the mentally ill and mental health interventions, and examines what social, emotional and treatment-related effects these may have. Studies consistently show that both entertainment and news media provide overwhelmingly dramatic and distorted images of mental illness that emphasise dangerousness, criminality and unpredictability. They also model negative reactions to the mentally ill, including fear, rejection, derision and ridicule. The consequences of negative media images for people who have a mental illness are profound. They impair self-esteem, help-seeking behaviours, medication adherence and overall recovery. Mental health advocates blame the media for promoting stigma and discrimination toward people with a mental illness. However, the media may also be an important ally in challenging public prejudices, initiating public debate, and projecting positive, human interest stories about people who live with mental illness. Media lobbying and press liaison should take on a central role for mental health professionals, not only as a way of speaking out for patients who may not be able to speak out for themselves, but as a means of improving public education and awareness. Also, given the consistency of research findings in this field, it may now be time to shift attention away from further cataloguing of media representations of mental illness to the more challenging prospect of how to use the media to improve the life chances and recovery possibilities for the one in four people living with mental disorders.

Mental health system funding of cognitive enhancement interventions for schizophrenia: summary and update of the New York Office of Mental Health expert panel and stakeholder meeting.

PubMed

McGurk, Susan R; Mueser, Kim T; Covell, Nancy H; Cicerone, Keith D; Drake, Robert E; Silverstein, Steven M; Medialia, Alice; Myers, Robert; Bellack, Alan S; Bell, Morris D; Essock, Susan M

2013-09-01

A growing research literature indicates that cognitive enhancement (CE) interventions for people with schizophrenia can improve cognitive functioning and may benefit psychosocial functioning (e.g., competitive employment, quality of social relationships). Debate continues regarding the strength of evidence for CE and related policy implications, such as the appropriateness of funding CE services. This paper summarizes and updates a meeting of experts and stakeholders convened in 2008 by the New York Office of Mental Health to review evidence on the impact of CE for people with schizophrenia and other serious mental illnesses, and addresses whether the evidence base for CE interventions is sufficient to warrant funding. Specific recommendations based on the extant literature are provided regarding the structure and components of CE programs that should be present in order to improve cognitive and psychosocial outcomes and therefore merit consideration of funding. These recommendations may serve as a starting point in developing standards for CE programs. Establishing evidence-based practice standards for implementing CE interventions for people with serious mental illnesses may facilitate dissemination of programs that have the greatest potential for improving individuals' functional outcomes while minimizing incremental costs associated with providing CE services. Important open questions include how the performance of CE programs should be monitored and which individuals might be expected to benefit from CE as evidenced by improved functioning in their everyday lives. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Comorbidity between pain and mental illness - Evidence of a bidirectional relationship.

PubMed

Bondesson, E; Larrosa Pardo, F; Stigmar, K; Ringqvist, Å; Petersson, I F; Jöud, A; Schelin, M E C

2018-03-25

Pain from various locations in the body and mental illness are common and the comorbidity between the two is well-known although the temporal relationship remains to be determined. Our aim was to follow patients over time to study if pain (here dorsalgia/abdominal pain) or fibromyalgia lead to an increased risk of developing mental illness (here depression/anxiety) and/or the reverse, that is whether patients with mental illness have an increased risk to develop pain or fibromyalgia, compared to the rest of the population. This prospective cohort study used the Skåne Healthcare Register, covering all care in the region of Skåne, southern Sweden (population ~1.3 million). The cohort included healthcare consultations in primary care, outpatient specialized care and inpatient care between 2007 and 2016 for all patients without prior registered diagnosis of mental illness or pain, aged 18 or older (n = 504,365). The incidence rate ratio (IRR) for developing mental illness after pain was 2.18 (95% CI = 2.14-2.22) compared to without pain. IRR for developing pain after mental illness was 2.02 (95% CI = 1.98-2.06) compared to without mental illness. Corresponding IRR for developing mental illness after fibromyalgia was 4.05 (95% CI = 3.58-4.59) and for developing fibromyalgia after mental illness 5.54 (95% CI = 4.99-6.16). This study shows a bidirectional influence of similar magnitude of pain and mental illness, respectively. In monitoring patients with pain or mental illness, a focus on both conditions is thus important to develop appropriate, targeted interventions and may increase the likelihood of improved outcomes. We followed a population-based cohort over a period of 10 years, including incident cases of both exposure and outcome and found a bidirectional relationship between pain and mental illness. Clinicians need to pay attention on both conditions, in patients seeking care due to mental illness or pain. © 2018 European Pain Federation - EFIC®.

Animal-Assisted Therapy with Female Inmates with Mental Illness: A Case Example from a Pilot Program

ERIC Educational Resources Information Center

Jasperson, Rachael A.

2010-01-01

Female offenders' mental health needs have consistently been shown to exceed those of male offenders. Incarcerated women report higher rates of violent victimization, major depression, post-traumatic stress disorder, mood disorders, substance use disorders, and personality disorders. For years, researchers have examined the human-animal…

Effects of Stigma and Discrimination Reduction Programs Conducted Under the California Mental Health Services Authority: An Evaluation of Runyon Saltzman Einhorn, Inc., Documentary Screening Events.

PubMed

Cerully, Jennifer L; Collins, Rebecca L; Wong, Eunice C; Roth, Elizabeth; Marks, Joyce; Yu, Jennifer

2016-05-09

Describes the methods and results of a RAND evaluation of stigma and discrimination reduction efforts by Runyon Saltzman Einhorn, Inc., involving screenings of a documentary film called "A New State of Mind: Ending the Stigma of Mental Illness."

Witchcraft and Biopsychosocial Causes of Mental Illness: Attitudes and Beliefs About Mental Illness Among Health Professionals in Five Countries.

PubMed

Stefanovics, Elina A; He, Hongbo; Cavalcanti, Maria; Neto, Helio; Ofori-Atta, Angelo; Leddy, Meaghan; Ighodaro, Adesuwa; Rosenheck, Robert

2016-03-01

This study examines the intercorrelation of measures reflecting beliefs about and attitudes toward people with mental illness in a sample of health professionals (N = 902) from five countries: Brazil, China, Ghana, Nigeria, and the United States, and, more specifically, the association of beliefs in supernatural as contrasted with biopsychosocial causes of mental illness. Factor analysis of a 43-item questionnaire identified four factors favoring a) socializing with people with mental illness; b) normalizing their roles in society; c) belief in supernatural causes of mental illness (e.g., witchcraft, curses); and d) belief in biopsychosocial causes of mental illness. Unexpectedly, a hypothesized negative association between belief in supernatural and biopsychosocial causation of mental illness was not found. Belief in the biopsychosocial causation was weakly associated with less stigmatized attitudes towards socializing and normalized roles.

Person-Centered Care for Older Adults With Serious Mental Illness and Substance Misuse Within a Program of All-Inclusive Care for the Elderly.

PubMed

Cacchione, Pamela Z; Eible, Lisa; Gill, Le'Roi L; Huege, Steven F

2016-05-01

Providing person-centered care (PCC) to older adults with dual diagnosis, co-occurring serious mental illness (SMI), and substance misuse is complex and requires an interprofessional team. Older adults, who qualify for both Medicaid and Medicare (i.e., dual-eligibles) are overrepresented in the population of older adults with SMI and substance misuse. Programs of All-Inclusive Care for the Elderly (PACE) exist to support community living needs of nursing home-eligible older adults and are increasingly in a position to serve older adults with SMI and substance misuse issues. PACE programs provide integrated person-centered mental health care to address the serious medical, social, and emotional complications posed by having SMI and substance misuse disorders. The case study presented illustrates PCC provided to a dual-diagnosis PACE participant, illustrating the impact of recent and past trauma on current psychopathology and substance misuse. Finally, recommendations for addressing PCC of dual diagnosis within the PACE model are provided. [Journal of Gerontological Nursing, 42(5), 11-17.]. Copyright 2016, SLACK Incorporated.

The Relationship Between the Perceived Risk of Harm by a Family Member with Mental Illness and the Family Experience.

PubMed

Katz, Judith; Medoff, Deborah; Fang, Li Juan; Dixon, Lisa B

2015-10-01

Family members of people with serious mental illness (SMI) at times report that they act to stop their ill relative from self harm or harming others. This study examines the relationship between the perception of risk of harm and family distress, burden, empowerment, coping, physical and mental health, appraisal of the caregiving experience, family communication, and family functioning. The study is a secondary analysis of baseline data collected for a randomized study of the family-to-family peer driven education program (FTF). Four hundred thirty-four enrolled individuals who were seeking to participate in FTF completed survey items that asked if they had tried to stop or prevent their ill family member from harming themselves or others in the last 30 days. Participants who perceived a recent risk of harm by their ill relative reported more negative appraisals of caregiving, greater psychological distress, poorer mental health and greater objective burden compared with those who did not perceive a recent risk of harm. The results suggest that families of persons with SMI should be asked about perceived risk of harm to self and others, and the presence of perceived risk of harm should serve as a red flag indicating the need for further evaluation of the family experience and additional support for the family.

The relationship between the perceived risk of harm by a family member with mental illness and the family experience

PubMed Central

Katz, Judith; Medoff, Deborah; Fang, Li Juan; Dixon, Lisa B.

2014-01-01

Family members of people with serious mental illness (SMI) at times report that they act to stop their ill relative from self harm or harming others. This study examines the relationship between the perception of risk of harm and family distress, burden, empowerment, coping, physical and mental health, appraisal of the caregiving experience, family communication, and family functioning. The study is a secondary analysis of baseline data collected for a randomized study of the family-to-family peer driven education program (FTF). Four hundred thirty-four enrolled individuals who were seeking to participate in FTF completed survey items that asked if they had tried to stop or prevent their ill family member from harming themselves or others in the last 30 days. Participants who perceived a recent risk of harm by their ill relative reported more negative appraisals of caregiving, greater psychological distress, poorer mental health and greater objective burden compared with those who did not perceive a recent risk of harm. The results suggest that families of persons with SMI should be asked about perceived risk of harm to self and others, and the presence of perceived risk of harm should serve as a red flag indicating the need for further evaluation of the family experience and additional support for the family. PMID:25535047

Evaluation of an Evidence-Based Tobacco Treatment Curriculum for Psychiatry Residency Training Programs

PubMed Central

Prochaska, Judith J.; Fromont, Sebastien C.; Leek, Desiree; Hudmon, Karen Suchanek; Louie, Alan K.; Jacobs, Marc H.; Hall, Sharon M.

2009-01-01

Objective Smokers with mental illness and addictive disorders account for nearly one in two cigarettes sold in the United States and are at high risk for smoking-related deaths and disability. Psychiatry residency programs provide a unique arena for disseminating tobacco treatment guidelines, influencing professional norms, and increasing access to tobacco cessation services among smokers with mental illness. The current study evaluated the Rx for Change in Psychiatry curriculum, developed for psychiatry residency programs and focused on identifying and treating tobacco dependence among individuals with mental illness. Methods The 4-hour curriculum emphasized evidence-based, patient-oriented cessation treatments relevant for all tobacco users, including those not yet ready to quit. The curriculum was informed by comprehensive literature review, consultation with an expert advisory group, faculty interviews, and a focus group with psychiatry residents. This study reports on evaluation of the curriculum in 2005–2006, using a quasi-experimental design, with 55 residents in three psychiatry residency training programs in Northern California. Results The curriculum was associated with improvements in psychiatry residents’ knowledge, attitudes, confidence, and counseling behaviors for treating tobacco use among their patients, with initial changes from pre- to posttraining sustained at 3-months’ follow-up. Residents’ self-reported changes in treating patients’ tobacco use were substantiated through systematic chart review. Conclusion The evidence-based Rx for Change in Psychiatry curriculum is offered as a model tobacco treatment curriculum that can be implemented in psychiatry residency training programs and disseminated widely, thereby effectively reaching a vulnerable and costly population of smokers. PMID:19190293

Wearable devices and mobile technologies for supporting behavioral weight loss among people with serious mental illness.

PubMed

Naslund, John A; Aschbrenner, Kelly A; Scherer, Emily A; McHugo, Gregory J; Marsch, Lisa A; Bartels, Stephen J

2016-10-30

Promoting physical activity is essential for addressing elevated cardiovascular risk and high obesity rates affecting people with serious mental illness. Numerous challenges interfere with exercise participation in this high-risk group including mental health symptoms, low motivation, and limited access to safe and affordable options for physical activity. Wearable devices and mobile health technologies may afford new opportunities for promoting physical activity and supporting behavioral weight loss efforts. This exploratory study examined whether daily step count measured using Fitbit wearable devices was associated with weight loss and improved fitness among individuals with serious mental illness enrolled in a 6-month lifestyle program. Participants (n=34) had a schizophrenia spectrum disorder (23.5%), major depression (50.0%), or bipolar disorder (26.5%), and wore Fitbits most of the days (M=86.2%; SD=18.4%) they were enrolled in the study. At 6-months, higher average daily step count was associated with greater weight loss (F=5.07; df=1,32; p=0.0314), but not improved fitness (F=1.92; df=1,31; p=0.176). These findings demonstrate that encouraging participants with serious mental illness enrolled in lifestyle interventions to collect more steps may contribute to greater weight loss. This suggests that wearable devices may offer a feasible and potentially effective strategy for supporting behavioral weight loss in community mental health settings. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A comparison of adherence to hypoglycemic medications between Type 2 diabetes patients with and without serious mental illness

PubMed Central

Kreyenbuhl, Julie; Leith, Jaclyn; Medoff, Deborah R.; Fang, LiJuan; Dickerson, Faith B.; Brown, Clayton H.; Goldberg, Richard W.; Potts, Wendy; Dixon, Lisa B.

2011-01-01

Inadequate self-management of chronic medical conditions like Type 2 diabetes may play a role in the poor health status of individuals with serious mental illnesses. We compared adherence to hypoglycemic medications and blood glucose control between 44 diabetes patients with a serious mental illness and 30 patients without a psychiatric illness. The two groups did not differ in their ability to manage a complex medication regimen as assessed by a performance-based measure of medication management capacity. However, significantly fewer patients with a mental illness self-reported nonadherence to their hypoglycemic regimens compared to those without a mental illness. Although individuals with mental illnesses also had better control of blood glucose, this metabolic parameter was not correlated with adherence to hypoglycemic medications in either patient group. The experience of managing a chronic mental illness may confer advantages to individuals with serious mental illnesses in the self-care of co-occurring medical conditions like Type 2 diabetes. PMID:21459458

Children's understanding of mental illness: an exploratory study.

PubMed

Fox, C; Buchanan-Barrow, E; Barrett, M

2008-01-01

This study aimed to investigate children's thinking about mental illness by employing a well-established framework of adult illness understanding. The study adopted a semistructured interview technique and a card selection task to assess children's responses to causes, consequences, timeline and curability of the different types of mental illness. The children were aged between 5 and 11 years. Results indicated a developmental trend in the children's thinking about mental illness; there was an increase in the children's understanding of the causes, consequences, curability and timeline of mental illness with age. The older children demonstrated a more sophisticated and accurate thinking about mental illness compared with the younger children, who tended to rely on a medical model in order to comprehend novel mental illnesses. Furthermore, the girls exhibited more compassion, showing greater social acceptance compared with the boys. The Leventhal model provides a useful framework within which to investigate children's knowledge and understanding of mental illness. Limitations of the study and implications for future research are discussed.

Attitudes of U.S. Psychiatry Residents and Fellows towards Mental Illness and its Causes: a Comparison Study with Medical Students.

PubMed

Chiles, Catherine; Stefanovics, Elina; Rosenheck, Robert

2018-01-13

Stigma towards people with mental illness remains a burden for patients and healthcare providers. This study at a large US university examined the attitudes of psychiatry residents and fellows towards mental illness and its causes, and whether their attitudes differed from the medical student attitudes previously studied utilizing the same survey method. An electronic questionnaire examining attitudes toward people with mental illness, causes of mental Illness, and treatment efficacy was used to survey the attitudes of psychiatry residents and fellows. Exploratory factor analysis derived from the authors' medical student survey was used to examine attitudinal factors. The study response rate was 54.2% (n = 94). Factor analysis employed three factors previously identified reflecting social acceptance of mental illness, belief in supernatural causes, and belief in biopsychosocial causes. Residents and fellows reporting more personal experiences with mental illness, both as a group and when compared with medical students, were significantly more willing to socialize with the mentally ill. Respondents who had more professional (work) experience other than medical school or post-graduate training were less likely to believe in supernatural causes of mental illness. Female residents and fellows were more willing to socialize with the mentally ill, and were less likely to believe in supernatural causes for mental illness than their male counterparts. In our study, increased social acceptance of the mentally ill relates to having personal experiences, advanced training in psychiatry, and female gender. Both professional experiences outside of training and female gender reduced the belief in supernatural causes.

Community Attitude and Associated Factors towards People with Mental Illness among Residents of Worabe Town, Silte Zone, Southern Nation’s Nationalities and People’s Region, Ethiopia

PubMed Central

Bedasso, Kufa; Feyera, Fetuma

2016-01-01

Background Mental illnesses worldwide are accompanied by another pandemic, that of stigma and discrimination. Public understanding about mental illnesses and attitudes towards people with mental illness play a paramount role in the prevention and treatment of mental illness and the rehabilitation of people with mental illness. Objective To assess community attitude and associated factors towards people with mental illness. Methods Community based cross-sectional study was conducted from April 28 to May 28, 2014. Quantitative data were collected through interview from 435 adults selected using simple random sampling. Data were collected using community attitude towards mentally ill (CAMI) tool to assess community attitude towards people with mental illness and associated factors. Multiple linear regression analysis was performed to identify predictors of community attitude towards people with mental illness and the level of significance association was determined by beta with 95% confidence interval and P less than 0.05. Results The highest mean score was on social restrictiveness subscale (31.55±5.62). Farmers had more socially restrictive view (β = 0.291, CI [0.09, 0.49]) and have less humanistic view towards mentally ill (β = 0.193, CI [-0.36, -0.03]). Having mental health information had significantly less socially restrictive (β = -0.59, CI [-1.13, -0.05]) and less authoritarian (β = -0.10, CI [-1.11, -0.06]) view towards mentally ill but respondents who are at university or college level reported to be more socially restrictive (β = 0.298, CI [0.059, 0.54]). Respondents whose age is above 48 years old had significantly less view of community mental health ideology (β = -0.59, CI [-1.09, -0.08]). Conclusion and Recommendation Residents of Worabe town were highly socially restrictive but less authoritarian. There was high level of negative attitude towards people with mental illness along all the subscales with relative variation indicating a need to develop strategies to change negative attitude attached to mental illness in Worabe town at community level. PMID:26930591

Perspectives of Treatment Providers and Clients with Serious Mental Illness Regarding Effective Therapeutic Relationships.

PubMed

Easter, Alison; Pollock, Michele; Pope, Leah Gogel; Wisdom, Jennifer P; Smith, Thomas E

2016-07-01

This study explores the nature of clinical therapeutic relationships between mental health treatment providers and high-need clients with serious mental illness who had recently discontinued treatment. Semi-structured qualitative interviews of 56 clients with serious mental illness who had recently discontinued care and 25 mental health treatment providers were completed. Both clients with serious mental illness and treatment providers emphasized the importance of client-focused goal setting, time and availability of treatment providers, a caring approach, and trust and honesty in the relationship. However, clients with serious mental illness placed greater emphasis on goals involving tangible services, a notable area of discord between the two groups. Individuals with serious mental illness and treatment providers agreed regarding several key elements to a positive clinical relationship. Further attention to client goals related to tangible services may serve to improve relationships between treatment providers and high-need clients with serious mental illness.

Stigma associated with mental illness: perspectives of university students in Qatar.

PubMed

Zolezzi, Monica; Bensmail, Nawal; Zahrah, Farah; Khaled, Salma Mawfek; El-Gaili, Tayseer

2017-01-01

Stigma in relation to mental illness is one of the main factors inhibiting people from seeking help. Studies have been undertaken looking into the knowledge, attitudes, and beliefs (KAB) about mental illness among residents in Qatar; however, none have looked specifically at students in higher education. The aim of this study was to understand the KAB toward mental illness among students at a Qatari university and determine if there are any differences based on gender, nationality, and college type. A convenience sample of students from all genders, colleges, and nationalities was approached to participate in a survey that consisted of four sections: demographic, beliefs, attitudes, and help-seeking and treatment preferences associated with mental illness. Chi-square testing was performed to test for differences in the distribution of proportions of our primary outcomes (students' beliefs, attitudes, and help-seeking and treatment preferences). A total of 282 students completed the survey. The majority of the participating students were females (59.3%), non-Qataris (64.3%), and enrolled in science-based colleges (62.7%). Beliefs reflecting poor mental health literacy, such as "medications to treat mental illness can cause addiction", "mental illness is not like any other illness", or that "mental illness is a punishment from God", were reported by a majority of students (84.4%, 56.7%, and 50.2%, respectively). Stigmatizing attitudes that were endorsed by a majority of students included believing that people with mental illness cannot have regular jobs (60.2%), that people with mental illness are dangerous (65.7%), and that they would not marry someone with a mental illness (88.9%). Additionally, 33.6% of students indicated they would be ashamed to mention if someone in their family or they themself, had a mental illness. A vast majority of students (86.3%) indicated to prefer family and friend's support as treatment options. Significant differences in KAB about mental illness between genders, colleges, and college type were found only for a few items. The findings of this study suggest that a high percentage of students reported KAB about mental illness, that are considered stigmatizing. Students' KAB about mental illness was consistent with that reported by the general population in Qatar. Nevertheless, the sample was small and as such, larger studies from a randomly selected population are needed to confirm these findings.

One Year Later: Mental Illness Prevalence and Disparities Among New Orleans Residents Displaced by Hurricane Katrina

PubMed Central

VanLandingham, Mark

2009-01-01

Objectives. We examined whether there were high levels of mental illness among displaced New Orleans, LA, residents in the fall of 2006, 1 year after Hurricane Katrina. Methods. We used data from the Displaced New Orleans Residents Pilot Study, which measured the prevalence of probable mild or moderate and serious mental illness among a representative sample of people who resided in New Orleans at the time of the hurricane, including people who evacuated the city and did not return. We also analyzed disparities in mental illness by race, education, and income. Results. We found high rates of mental illness in our sample and major disparities in mental illness by race, education, and income. Severe damage to or destruction of an individual's home was a major covariate of mental illness. Conclusions. The prevalence of mental illness remained high in the year following Hurricane Katrina, in contrast to the pattern found after other disasters. Economic losses and displacement may account for this finding as well as the disparity in mental illness between Blacks and Whites. PMID:19890178

Childhood risk factors for criminal justice involvement in a sample of homeless people with serious mental illness.

PubMed

Desai, R A; Lam, J; Rosenheck, R A

2000-06-01

It has been suggested that criminal justice involvement among the homeless, particularly those with mental illness, is largely situational. The objective of this study was to assess, in a sample of homeless seriously mentally ill people, the prevalence of childhood conduct disorder behaviors as a risk factor for adult criminal activity as well as the extent and types of adult criminal justice contact. Data were taken from the national ACCESS program, which conducted extensive baseline interviews with 7,222 homeless seriously mentally ill adults. The interview assessed demographics, childhood risk factors for criminal activity such as conduct disorder behaviors, foster care, and parental abuse, as well as current illness severity and recent criminal justice contact. The 2-month arrest rate in this sample was much higher than national rates (11% compared with 1% annually in the general population). Although most arrests were for minor crimes (10.8%), there were also substantial rates of arrest for major (2.7%) and substance-related charges (2.0%). The prevalence of a history of conduct disorder behavior was also substantial (55% in male subjects, 40% in female subjects), and conduct disorder was a strong predictor of recent criminal justice involvement, even after controlling for other predictors of arrest (odds ratio = 1.76 for major crimes, 1.49 for minor crimes, and 1.98 for substance-related crimes). Recent literature has criticized a trend to criminalize homeless mentally ill persons for attempting to get needed food, shelter, or medical attention. However, these data indicate that at least some proportion of arrests in this population are of people who have been exhibiting antisocial behavior since early adolescence, and that early antisocial behavior is a strong predictor of all types of recent arrests in this population.

Trends in Smoking Among Adults With Mental Illness and Association Between Mental Health Treatment and Smoking Cessation

PubMed Central

Lê Cook, Benjamin; Wayne, Geoff Ferris; Kafali, E. Nilay; Liu, Zimin; Shu, Chang; Flores, Michael

2017-01-01

IMPORTANCE Significant progress has been made in reducing the prevalence of tobacco use in the United States. However, tobacco cessation efforts have focused on the general population rather than individuals with mental illness, who demonstrate greater rates of tobacco use and nicotine dependence. OBJECTIVES To assess whether declines in tobacco use have been realized among individuals with mental illness and examine the association between mental health treatment and smoking cessation. DESIGN, SETTING, AND PARTICIPANTS Use of nationally representative surveys of noninstitutionalized US residents to compare trends in smoking rates between adults with and without mental illness and across multiple disorders (2004–2011 Medical Expenditure Panel Survey [MEPS]) and to compare rates of smoking cessation among adults with mental illness who did and did not receive mental health treatment (2009–2011 National Survey of Drug Use and Health [NSDUH]).The MEPS sample included 32 156 respondents with mental illness (operationalized as reporting severe psychological distress, probable depression, or receiving treatment for mental illness) and 133 113 without mental illness. The NSDUH sample included 14 057 lifetime smokers with mental illness. MAIN OUTCOME SAND MEASURES Current smoking status (primary analysis; MEPS sample) and smoking cessation, operationalized as a lifetime smoker who did not smoke in the last 30 days (secondary analysis; NSDUH sample). RESULTS Adjusted smoking rates declined significantly among individuals without mental illness (19.2% [95% CI, 18.7–19.7%] to 16.5% [95% CI, 16.0%–17.0%]; P < .001) but changed only slightly among those with mental illness (25.3% [95% CI, 24.2%–26.3%] to 24.9% [95% CI, 23.8%–26.0%]; P = .50), a significant difference in difference of 2.3% (95% CI, 0.7%–3.9%) (P = .005). Individuals with mental illness who received mental health treatment within the previous year were more likely to have quit smoking (37.2% [95% CI, 35.1%–39.4%]) than those not receiving treatment (33.1% [95% CI, 31.5%–34.7%]) (P = .005). CONCLUSIONS AND RELEVANCE Between 2004 and 2011, the decline in smoking among individuals with mental illness was significantly less than among those without mental illness, although quit rates were greater among those receiving mental health treatment. This suggests that tobacco control policies and cessation interventions targeting the general population have not worked as effectively for persons with mental illness. PMID:24399556

Mental Illness in Blacks: An Overview, and Treatment Approaches

PubMed Central

Davis, Elizabeth B.

1979-01-01

Provisions for inner city mental health services must recognize the association between poverty, discrimination, and related social and physical conditions and disproportionately high rates of severe mental disorder—a transcultural phenomenon. Program emphasis should therefore be on the prevention, early recognition, prompt and effective treatment and rehabilitative care of psychosis. The total spectrum of psychiatric services is required for this, and thus an opportunity is afforded for necessary training and research. Poverty has negative impact on general health and cognitive development as well as on self-esteem, self-care, and the ability to utilize medical and health services. This contributes to a vicious, intergenerational poverty cycle. Primary prevention of mental illness, where possible, depends at present on socioeconomic change. Secondary prevention, ie, timely, appropriate treatment, is effective, but requires patient access to and acceptance of all indicated modalities of care. PMID:537113

Physical activity preferences, motivators, barriers and attitudes of adults with mental illness.

PubMed

Chapman, Justin J; Fraser, Sarah J; Brown, Wendy J; Burton, Nicola W

2016-10-01

Adults with mental illness may have specific attitudes toward physical activity (PA). To assess the PA attitudes of non-institutionalised adults with mental illness, and associations with psychological distress. Participants completed questionnaires on activity preferences (type, context and sources of support), motivators, barriers and attitudes toward personal training (PT). Relationships between responses and distress were assessed using logistic regressions. One-hundred forty-two participants completed the questionnaires. PA context preferences included activities done close to home, outdoors, with professional instruction, with people of the same ability, as part of a healthy lifestyle program and with a social component. The most commonly endorsed source of support was an exercise instructor. Most respondents had never received PT; however, PT had high acceptability. Common barriers included poor physical and mental health, and lack of money. Distress was positively associated with barriers of poor mental health, tiredness, disorganisation, exhaustion and being shy/embarrassed (p ≤ 0.001). Local outdoor walking groups that include social and healthy lifestyle components, and that are led by an exercise instructor who can provide support for overcoming barriers, may best meet PA interests of this group. PT could be an acceptable method for offering individualised support.

[An explanatory model of behavior toward mental illness].

PubMed

García-Sílberman, Sarah

2002-01-01

To evaluate a theoretical model designed to explain behaviors toward mental illness, considering some variables related to the construct. A survey was conducted in 1996 on mental disorder beliefs, attitudes, and behavioral intentions. The sample population was stratified by socioeconomic status, age, and gender. Study subjects were 800 individuals from Mexico City's general population. A data collection instrument was constructed and validated, consisting of 120 Likert-type items with five options each. Data were coded and analyzed with the software package SPSS. Internal consistency of the scales was assessed using Cronbach's alpha and construct validity with factorial analysis. Student's t test and ANOVA were used to compare the groups in the different strata. The model allowed to confirm the predictive capacity of the causal chain connecting beliefs, attitudes, and intentions; nevertheless, other study variables did not contribute to explain it, and behavior was scarcely influenced by intentions, depending mainly on experimented necessity. Study findings constitute a basis to understand the attitudes of shame and fear usually related to mental illnesses, to plan efficient actions aimed at modifying them, and to design programs to promote mental health. The English version of this paper is available at: http://www.insp.mx/salud/index.html.

[The stigma of mental illness: concepts, forms, and consequences].

PubMed

Rüsch, Nicolas; Angermeyer, Matthias C; Corrigan, Patrick W

2005-07-01

Persons with mental illness frequently encounter public stigma and may suffer from self-stigma. We aim to clarify the concept of mental illness stigma and discuss important consequences for people with mental illness. A search of scientific literature on mental illness stigma was conducted with a focus on conceptually relevant empirical studies. After giving a conceptual overview of stigma, we elaborate on the consequences of stigma, focussing on self-stigma/empowerment, coping behaviour, fear of stigma as a barrier to using health services, and on structural discrimination. Main strategies to reduce stigma -- protest, education, and contact -- are discussed. Stigma is of central importance to persons with mental illness, both to how they experience their illness and its consequences and whether they use available health services. Well-designed anti-stigma initiatives will help to diminish the impact of mental illness stigma.

Quetiapine

MedlinePlus

... tablets are used to treat the symptoms of schizophrenia (a mental illness that causes disturbed or unusual ... a treatment program to treat bipolar disorder and schizophrenia in children and teenagers. Quetiapine is in a ...

Program Evaluation of Services for the Homeless: Challenges and Strategies.

ERIC Educational Resources Information Center

Mercier, Celine; And Others

1992-01-01

Research strategies, including types of evaluations, designs, and indicators, developed to assess programs for chronic alcoholics and mentally ill homeless people in Canada are reviewed. Findings from previous evaluations are summarized, and the implications for evaluation practice are considered. (SLD)

Beyond attributions: Understanding public stigma of mental illness with the common sense model.

PubMed

Mak, Winnie W S; Chong, Eddie S K; Wong, Celia C Y

2014-03-01

The present study applied the common sense model (i.e., cause, controllability, timeline, consequences, and illness coherence) to understand public attitudes toward mental illness and help-seeking intention and to examine the mediating role of perceived controllability between causal attributions with public attitudes and help seeking. Based on a randomized household sample of 941 Chinese community adults in Hong Kong, results of the structural equation modeling demonstrated that people who endorsed cultural lay beliefs tended to perceive the course of mental illness as less controllable, whereas those with psychosocial attributions see its course as more controllable. The more people perceived the course of mental illness as less controllable, more chronic, and incomprehensible, the lower was their acceptance and the greater was mental illness stigma. Furthermore, those who perceived mental illness with dire consequences were more likely to feel greater stigma and social distance. Conversely, when people were more accepting, they were more likely to seek help for psychological services and felt a shorter social distance. The common sense model provides a multidimensional framework in understanding public's mental illness perceptions and stigma. Not only should biopsychosocial determinants of mental illness be advocated to the public, cultural myths toward mental illness must be debunked.

Alcohol consumption and use of health care services in people with severe mental illness and stressful childhood experiences.

PubMed

Schneeberger, Andres R; Huber, Christian G; Seixas, Azizi; Muenzenmaier, Kristina H; Lang, Undine E; Castille, Dorothy; Larkin, Stefan; Link, Bruce G

2017-01-01

People who suffer from severe mental illness often present with histories of abuse during childhood. Alcohol use disorders is a common co-morbidity of survivors of childhood abuse and neglect. This study analyzes the effects of stressful childhood experiences, a proxy for trauma, on the frequency of alcohol consumption and the utilization of health care services in a population of people with severe mental illness. There were 111 men (mean age: 35 years) and 72 women (mean age: 40.0 years) with severe mental illness that were recruited from psychiatric outpatient clinics in New York City. The analysis focused on lifetime prevalence of stressful childhood experiences, alcohol consumption, and utilization of health care services over time. The longitudinal data were analyzed over 12 months with a level-2 model (multilevel modeling). Out of the participants, 41.5% reported a history of more than four types of abusive experiences. There were 33.3% that had a DSM-IV diagnosis of alcohol abuse and 27.3% qualified for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of alcohol dependence throughout their lives. Stressful childhood experiences predicted an increased frequency of alcohol consumption over time. People with histories of childhood abuse had more often been to outpatient clinics and 12-step programs, but at the same time showed lower frequency rates of psychiatrist visits and visits to outpatient clinics. Childhood abuse is prevalent in people with severe mental illness and is related to an increased alcohol consumption. Despite an increased need of health care services, affected persons might encounter more barriers to access them.

Influence of southern spiritual beliefs on perceptions of mental illness.

PubMed

Morrison, E F; Thornton, K A

1999-01-01

Cultural religious beliefs influence perceptions of mental illness, and any clinician interested in treating mentally ill people and their families must consider these beliefs so that he or she can develop culturally specific interventions. This article reports on the results of interviews with African American experts, mentally ill persons, and nurses caring for the mentally ill. A case study is used to illustrate the influence of southern religious beliefs on perceptions of mental illness and the behaviors of people who are mentally ill. Although many issues are considered in this analysis (i.e., ethnicity, geographic location, and religion), it is the influence of three religious traditions in the South--voodoo, slave religion, and evangelical Protestantism--that takes precedence in the analysis. Mental health professionals, especially psychiatric nurses, will find this information helpful when assisting hospitalized patients.

Attitudes Towards Seeking Psychological Help: An Integrative Model Based on Contact, Essentialist Beliefs About Mental Illness, and Stigma.

PubMed

Hantzi, Alexandra; Anagnostopoulos, Fotios; Alexiou, Eva

2018-06-16

Based on intergroup contact theory, a proposed comprehensive model of attitudes towards seeking professional psychological help was tested, including both potential barriers to mental health help-seeking (i.e., public stigma and self-stigma of seeking help, prejudicial and essentialist beliefs about mental illness, intergroup anxiety) and potential facilitators (i.e., direct and extended contact with persons with mental illness). Relevant measures were completed by 119 community-dwelling participants. Path analysis showed that direct (but not extended) contact with mental illness, by reducing intergroup anxiety, led to less negative beliefs about mental illness and weaker essentialist beliefs about mental illness (the latter being directly and positively associated with negative beliefs about mental illness). Moreover, less negative beliefs about mental illness, by reducing perceptions of self (but not public) stigma of seeking psychological help, were related to more positive attitudes towards help-seeking. Results are discussed in the context of the (unintentional) adverse effects of biogenetic (essentialist) explanations of mental disorders, and the clinical implications regarding interventions that aim at improving help-seeking attitudes.

Analysis of causes of death for all decedents in Ohio with and without mental illness, 2004-2007.

PubMed

Sherman, Marion E; Knudsen, Kraig J; Sweeney, Helen Anne; Tam, Kwok; Musuuza, Jackson; Koroukian, Siran M

2013-03-01

This study compared causes of death, crude mortality rates, and standardized mortality ratios (SMRs) between decedents with mental illness in Ohio's publicly funded mental health system ("mental illness decedents") and all Ohio decedents. Ohio death certificates and Ohio Department of Mental Health service utilization data were used to assess mortality among decedents from 2004 to 2007. Age-adjusted SMRs and age-adjusted mortality rates were calculated across race and sex strata. Mental illness decedents accounted for 3.3% of all 438,749 Ohio deaths. Age-adjusted SMRs varied widely across the race and sex strata and by cause of death. Nonblacks with or without mental illness showed higher SMRs than blacks. Nonblack females with mental illness showed the highest SMRs in injury-related deaths. Higher SMRs were found for deaths associated with substance abuse; mental illness; diabetes; issues related to the nervous, cardiovascular, or respiratory systems; and injury. With and without mental illness, the top cause of death was violence for youths and cardiovascular disease for adults >35. Deaths from injury and violence, especially among those <35, should be specifically addressed to reduce excess mortality for persons with mental illness. Mental health care should be integrated with primary care to better manage chronic disease, especially cardiovascular disease. Methodological contributions included use of linked files to compare SMR and leading causes of death between mental illness decedents and all Ohio decedents. More research is needed on patterns in cause of death and any interactions from demographic characteristics and mental illness. Health care data silos must be bridged between private and public sectors and the Departments of Veterans Affairs and Defense.

Mental illness and reduction of gun violence and suicide: bringing epidemiologic research to policy.

PubMed

Swanson, Jeffrey W; McGinty, E Elizabeth; Fazel, Seena; Mays, Vickie M

2015-05-01

This article describes epidemiologic evidence concerning risk of gun violence and suicide linked to psychiatric disorders, in contrast to media-fueled public perceptions of the dangerousness of mentally ill individuals, and evaluates effectiveness of policies and laws designed to prevent firearms injury and mortality associated with serious mental illnesses and substance use disorders. Research concerning public attitudes toward persons with mental illness is reviewed and juxtaposed with evidence from benchmark epidemiologic and clinical studies of violence and mental illness and of the accuracy of psychiatrists' risk assessments. Selected policies and laws designed to reduce gun violence in relation to mental illness are critically evaluated; evidence-based policy recommendations are presented. Media accounts of mass shootings by disturbed individuals galvanize public attention and reinforce popular belief that mental illness often results in violence. Epidemiologic studies show that the large majority of people with serious mental illnesses are never violent. However, mental illness is strongly associated with increased risk of suicide, which accounts for over half of US firearms-related fatalities. Policymaking at the interface of gun violence prevention and mental illness should be based on epidemiologic data concerning risk to improve the effectiveness, feasibility, and fairness of policy initiatives. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Increased prevalence of chronic physical health disorders in Australians with diagnosed mental illness.

PubMed

Scott, David; Burke, Karena; Williams, Susan; Happell, Brenda; Canoy, Doreen; Ronan, Kevin

2012-10-01

To compare chronic physical health disorder prevalence amongst Australian adults with and without mental illness. Total n=1,716 participants (58% female) with a mean age of 52 ± 13 years (range: 18 to 89 years) completed an online survey of Australian adults in 2010. Outcome measures including prevalence of chronic physical conditions and self-reported body mass index (BMI) in n=387 (23%) with a self-reported mental illness diagnosis were compared to respondents without mental illness. A significantly higher proportion of participants with mental illness were obese (BMI ≥ 30; 31 vs 24%, p=0.005). Adjusted odds ratios (OR) for coronary heart disease, diabetes, chronic bronchitis or emphysema, asthma, irritable bowel syndrome, and food allergies or intolerances (OR range: 1.54-3.19) demonstrated that chronic physical disorders were significantly more common in participants with a mental illness. Australian adults with a diagnosis for mental illness have a significantly increased likelihood of demonstrating chronic physical health disorders compared to persons without mental illness. Health professionals must be alert to the increased likelihood of comorbid chronic physical disorders in persons with a mental illness and should consider the adoption of holistic approaches when treating those with either a mental or physical illness. © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.

Mental illness and reduction of gun violence and suicide: bringing epidemiologic research to policy

PubMed Central

Swanson, Jeffrey W.; McGinty, E. Elizabeth; Fazel, Seena; Mays, Vickie M.

2015-01-01

Purpose This article describes epidemiologic evidence concerning risk of gun violence and suicide linked to psychiatric disorders, in contrast to media-fueled public perceptions of the dangerousness of mentally ill individuals, and evaluates effectiveness of policies and laws designed to prevent firearms injury and mortality associated with serious mental illnesses and substance use disorders. Methods Research concerning public attitudes toward persons with mental illness is reviewed and juxtaposed with evidence from benchmark epidemiologic and clinical studies of violence and mental illness and of the accuracy of psychiatrists' risk assessments. Selected policies and laws designed to reduce gun violence in relation to mental illness are critically evaluated; evidence-based policy recommendations are presented. Results Media accounts of mass shootings by disturbed individuals galvanize public attention and reinforce popular belief that mental illness often results in violence. Epidemiologic studies show that the large majority of people with serious mental illnesses are never violent. However, mental illness is strongly associated with increased risk of suicide, which accounts for over half of US firearms–related fatalities. Conclusions Policymaking at the interface of gun violence prevention and mental illness should be based on epidemiologic data concerning risk to improve the effectiveness, feasibility, and fairness of policy initiatives. PMID:24861430

Stigma towards people with mental illness in developing countries in Asia.

PubMed

Lauber, Christoph; Rössler, Wulf

2007-04-01

There is a wide range of literature on stigmatization and discrimination of people with mental illness. Most studies, however, derive from Western countries. This review aims at summarizing results from developing countries in Asia published between 1996-2006. Medline search focusing on English-speaking literature. Comparable to Western countries, there is a widespread tendency to stigmatize and discriminate people with mental illness in Asia. People with mental illness are considered as dangerous and aggressive which in turn increases the social distance. The role of supernatural, religious and magical approaches to mental illness is prevailing. The pathway to care is often shaped by scepticism towards mental health services and the treatments offered. Stigma experienced from family members is pervasive. Moreover, social disapproval and devaluation of families with mentally ill individuals are an important concern. This holds true particularly with regards to marriage, marital separation and divorce. Psychic symptoms, unlike somatic symptoms, are construed as socially disadvantageous. Thus, somatisation of psychiatric disorders is widespread in Asia. The most urgent problem of mental health care in Asia is the lack of personal and financial resources. Thus, mental health professionals are mostly located in urban areas. This increases the barriers to seek help and contributes to the stigmatization of the mentally ill. The attitude of mental health professionals towards people with mental illness is often stigmatizing. This review revealed that the stigmatization of people with mental illness is widespread in Asia. The features of stigmatization-beliefs about causes of and attitudes towards mental illness, consequences for help-seeking-have more commonalities than differences to Western countries.

Dual Recovery among People with Serious Mental Illnesses and Substance Problems: A Qualitative Analysis

PubMed Central

Green, Carla A.; Yarborough, Micah T.; Polen, Michael R.; Janoff, Shannon L.; Yarborough, Bobbi Jo H.

2014-01-01

Objective Individuals with serious mental illnesses are more likely to have substance-related problems than those without mental health problems. They also face more difficult recovery trajectories as they cope with dual disorders. Nevertheless, little is known about individuals’ perspectives regarding their dual recovery experiences. Methods This qualitative analysis was conducted as part of an exploratory mixed-methods study of mental health recovery. Members of Kaiser Permanente Northwest (a group-model, not-for-profit, integrated health plan) who had serious mental illness diagnoses were interviewed four times over two years about factors affecting their mental health recovery. Interviews were recorded, transcribed, and coded with inductively-derived codes. Themes were identified by reviewing text coded “alcohol or other drugs.” Results Participants (N = 177) were diagnosed with schizophrenia/schizoaffective disorder (n = 75, 42%), bipolar I/II disorder (n = 84, 48%), or affective psychosis (n = 18, 10%). At baseline, 63% (n = 112) spontaneously described addressing substance use as part of their mental health recovery. When asked at follow-up, 97% (n = 171) provided codeable answers about substances and mental health. We identified differing pathways to recovery, including through formal treatment, self-help groups or peer support, “natural” recovery (without the help of others), and continued but controlled use of alcohol. We found three overarching themes in participants’ experiences of recovering from serious mental illnesses and substance-related problems: Learning about the effects of alcohol and drugs provided motivation and a foundation for sobriety; achieving sobriety helped people to initiate their mental health recovery processes; and achieving and maintaining sobriety built self-efficacy, self-confidence, improved functioning and a sense of personal growth. Non-judgmental support from clinicians adopting chronic disease approaches also facilitated recovery. Conclusions Irrespective of how people achieved sobriety, quitting or severely limiting use of substances was important to initiating and continuing mental health recovery processes. Substance abuse treatment approaches that are flexible, reduce barriers to engagement, support learning about effects of substances on mental health and quality of life, and adopt a chronic disease model of addiction may increase engagement and success. Peer-based support like Alcoholics or Narcotics Anonymous can be helpful for people with serious mental illnesses, particularly when programs accept use of mental health medications. PMID:25491440

Preexisting mental illness and risk for developing a new disorder after hurricane Katrina.

PubMed

Sullivan, Greer; Vasterling, Jennifer J; Han, Xiaotong; Tharp, Andra Teten; Davis, Teri; Deitch, Elizabeth A; Constans, Joseph I

2013-02-01

To investigate predisaster mental illness as a risk factor of poor postdisaster mental health outcomes, veterans with (n = 249) and without (n = 250) preexisting mental illness residing in the Gulf Coast during Hurricane Katrina were surveyed after Katrina and screened for posttraumatic stress disorder (PTSD), depression, generalized anxiety disorder, and panic. Logistic regression examined the association between preexisting mental disorders and positive screens after the hurricane, adjusting for demographics and exposure to hurricane-related stressors. The odds of screening positive for any new mental disorder were 6.8 times greater for those with preexisting mental illness compared with those without preexisting mental illness. Among those with preexisting PTSD, the odds of screening positive for any new mental illness were 11.9 times greater; among those with schizophrenia, 9.1 times greater; and among those with affective disorders, 4.4 times greater. Persons with preexisting mental illnesses, particularly PTSD, should be considered a high-risk group for poor outcomes after a disaster.

Competency courts: a creative solution for restoring competency to the competency process.

PubMed

Finkle, Michael J; Kurth, Russell; Cadle, Christopher; Mullan, Jessica

2009-01-01

It is well accepted that jail is a poor setting for treating the acutely mentally ill, yet the number of mentally ill persons in jail has increased such that Los Angeles County Jail and Riker's Island in New York house more mentally ill than any psychiatric hospital. The number of mentally ill persons charged with a crime whose competency to stand trial is in question has also increased dramatically. Inefficiencies within the competency process result in mentally ill persons charged with crimes remaining in jail longer than necessary. One solution is "competency court", a specialty court within a mental health court. The same judges, attorneys, and mental health professionals staff both courts. By combining their Mental Health Court experience, they can work with the mentally ill using their expertise in competency law and processes, and thereby improve the competency process and reduce the unnecessary time that mentally ill persons spend in jail. (c) 2009 John Wiley & Sons, Ltd.

Children's conceptions of mental illness: a naïve theory approach.

PubMed

Fox, Claudine; Buchanan-Barrow, Eithne; Barrett, Martyn

2010-09-01

This paper reports two studies that investigated children's conceptions of mental illness using a naïve theory approach, drawing upon a conceptual framework for analysing illness representations which distinguishes between the identity, causes, consequences, curability, and timeline of an illness. The studies utilized semi-structured interviewing and card selection tasks to assess 6- to 11-year-old children's conceptions of the causes and consequences (Study 1) and the curability and timeline (Study 2) of different mental and physical illnesses/ailments. The studies revealed that, at all ages, the children held coherent causal-explanatory ideas about the causes, consequences, curability, and timeline of both mental and physical illnesses/ailments. However, while younger children tended to rely on their knowledge of common physical illnesses when thinking about mental illnesses, providing contagion and contamination explanations of cause, older children demonstrated differences in their thinking about mental and physical illnesses. No substantial gender differences were found in the children's thinking. It is argued that children hold coherent conceptions of mental illness at all ages, but that mental illness only emerges as an ontologically distinct conceptual domain by the end of middle childhood.

Stigma associated with mental illness: perspectives of university students in Qatar

PubMed Central

Zolezzi, Monica; Bensmail, Nawal; Zahrah, Farah; Khaled, Salma Mawfek; El-Gaili, Tayseer

2017-01-01

Background Stigma in relation to mental illness is one of the main factors inhibiting people from seeking help. Studies have been undertaken looking into the knowledge, attitudes, and beliefs (KAB) about mental illness among residents in Qatar; however, none have looked specifically at students in higher education. The aim of this study was to understand the KAB toward mental illness among students at a Qatari university and determine if there are any differences based on gender, nationality, and college type. Methods A convenience sample of students from all genders, colleges, and nationalities was approached to participate in a survey that consisted of four sections: demographic, beliefs, attitudes, and help-seeking and treatment preferences associated with mental illness. Chi-square testing was performed to test for differences in the distribution of proportions of our primary outcomes (students’ beliefs, attitudes, and help-seeking and treatment preferences). Results A total of 282 students completed the survey. The majority of the participating students were females (59.3%), non-Qataris (64.3%), and enrolled in science-based colleges (62.7%). Beliefs reflecting poor mental health literacy, such as “medications to treat mental illness can cause addiction”, “mental illness is not like any other illness”, or that “mental illness is a punishment from God”, were reported by a majority of students (84.4%, 56.7%, and 50.2%, respectively). Stigmatizing attitudes that were endorsed by a majority of students included believing that people with mental illness cannot have regular jobs (60.2%), that people with mental illness are dangerous (65.7%), and that they would not marry someone with a mental illness (88.9%). Additionally, 33.6% of students indicated they would be ashamed to mention if someone in their family or they themself, had a mental illness. A vast majority of students (86.3%) indicated to prefer family and friend’s support as treatment options. Significant differences in KAB about mental illness between genders, colleges, and college type were found only for a few items. Conclusion The findings of this study suggest that a high percentage of students reported KAB about mental illness, that are considered stigmatizing. Students’ KAB about mental illness was consistent with that reported by the general population in Qatar. Nevertheless, the sample was small and as such, larger studies from a randomly selected population are needed to confirm these findings. PMID:28533684

World survey of mental illness stigma.

PubMed

Seeman, Neil; Tang, Sabrina; Brown, Adalsteinn D; Ing, Alton

2016-01-15

To obtain rapid and reproducible opinions that address mental illness stigma around the world. Random global Web users were exposed to brief questions, asking whether they interacted daily with someone with mental illness, whether they believed that mental illness was associated with violence, whether it was similar to physical illness, and whether it could be overcome. Over a period of 1.7 years, 596,712 respondents from 229 countries completed the online survey. The response rate was 54.3%. China had the highest proportion of respondents in daily contact with a person with mental illness. In developed countries, 7% to 8% of respondents endorsed the statement that individuals with mental illness were more violent than others, in contrast to 15% or 16% in developing countries. While 45% to 51% of respondents from developed countries believed that mental illness was similar to physical illness, only 7% believed that mental illness could be overcome. To test for reproducibility, 21 repeats of the same questions were asked monthly in India for 21 months. Each time, 10.1 ± 0.11% s.e., of respondents endorsed the statement that persons who suffer from mental illness are more violent than others, indicating strong reproducibility of response. This study shows that surveys of constructs such as stigma towards mental illness can be carried out rapidly and repeatedly across the globe, so that the impact of policy interventions can be readily measured. The method engages English speakers only, mainly young, educated males. Copyright © 2015 Elsevier B.V. All rights reserved.

The Impact of Illness Identity on Recovery from Severe Mental Illness.

PubMed

Yanos, Philip T; Roe, David; Lysaker, Paul H

2010-04-01

The impact of the experience and diagnosis of mental illness on one's identity has long been recognized; however, little is known about the impact of illness identity, which we define as the set of roles and attitudes that a person has developed in relation to his or her understanding of having a mental illness. The present article proposes a theoretically driven model of the impact of illness identity on the course and recovery from severe mental illness and reviews relevant research. We propose that accepting a definition of oneself as mentally ill and assuming that mental illness means incompetence and inadequacy impact hope and self-esteem, which further impact suicide risk, coping, social interaction, vocational functioning, and symptom severity. Evidence supports most of the predictions made by the model. Implications for psychiatric rehabilitation services are discussed.

Major Mental Illness in Those Who Sexually Abuse.

PubMed

Moulden, Heather M; Marshall, Liam E

2017-11-09

There is evidence showing an increasing prevalence of mental illness in those in conflict with the law. However, there are many factors affecting the detection, treatment, and management of criminals who are mentally ill. Sex offenders with major mental illness present many challenges to those providing treatment and management services. For example, it is important to consider whether sexually offensive behavior is the cause of criminal behavior or whether it is reflective of an antisocial orientation. Recent evidence suggests it may help better understand and inform risk assessment and management. This paper will review the literature on mental illness among sexual offenders, present a typology to aid in the assessment, treatment, and management of sexual offender with mental illness, and highlight important considerations when providing treatment to sexual offenders with mental illness.

Understanding Mental Illness Stigma Toward Persons With Multiple Stigmatized Conditions: Implications of Intersectionality Theory.

PubMed

Oexle, Nathalie; Corrigan, Patrick W

2018-05-01

People with mental illness are often members of multiple stigmatized social groups. Therefore, experienced disadvantage might not be determined solely by mental illness stigma. Nevertheless, most available research does not consider the effects and implications of membership in multiple stigmatized social groups among people with mental illness. Reflecting on intersectionality theory, the authors discuss two intersectional effects determining disadvantage among people with mental illness who are members of multiple stigmatized social groups, namely double disadvantage and prominence. To be effective, interventions to reduce disadvantage experienced by people with mental illness need to be flexible and targeted rather than universal in order to address the implications of intersectionality. Whereas education-based approaches usually assume homogeneity and use universal strategies, contact-based interventions consider diversity among people with mental illness.

Changing Knowledge and Attitudes with a Middle School Mental Health Education Curriculum

PubMed Central

Wahl, Otto F.; Susin, Janet; Kaplan, Lorraine; Lax, Amy; Zatina, Dayna

2011-01-01

Purpose This research tested the effectiveness of a widely used mental health education curriculum in changing knowledge and attitudes about mental illness. Method Middle school students from four schools were provided the Breaking the Silence: Teaching the Next Generation About Mental Illness mental health instruction while students from other classes at the same schools received usual class instruction. Students completed questionnaires assessing knowledge, attitudes, and social distance preferences before, immediately after, and six weeks after the instruction was given. Results Students given the Breaking the Silence instruction showed improvements in knowledge about mental illness, attitudes toward mental illness, and willingness to interact with people with mental illnesses. Students in the comparison classes showed no changes. Conclusions Breaking the Silence was an effective means of improving the knowledge and attitudes of middle school students about mental illness. Implications An easy-to-administer and effective curriculum, Breaking the Silence is available to teachers and schools to help improve understanding and acceptance of people with mental illness. Such a curriculum, introduced during childhood and adolescence, may help to prevent the negative attitudes and misunderstanding that characterize adult perceptions of mental illness. PMID:21731851

Training frontline workforce on psychosis management: a prospective study of training effects.

PubMed

Sørlie, Tore; Borg, Marit; Flage, Karin B; Kolbjørnsrud, Ole-Bjørn; Haugen, Gunnar B; Benth, Jūratė Šaltytė; Ruud, Torleif

2015-01-01

The care situation for persons experiencing severe mental illness is often complex and demands good coordination, communication, and interpersonal relationships among those involved from the primary and specialized mental health care systems. For 15 years, professional care providers from different service levels within the same geographical areas in Norway have been trained together in a 2-year local onsite training program with the aim of increasing skills, joint understanding, and collaboration in their work with individuals experiencing severe mental illness. The key aspects of competence addressed by the training program were measured at baseline, after 1 year, and at the end of the training period. Professional education and experience were also rated at baseline. Data were collected between 1999 and 2005 and were analyzed by estimating a linear mixed model. Results showed a significant increase in participants' experienced competence in all training goals, especially for the understanding of psychosis and relationship building. There was no significant variance at the program level, indicating consistent implementation of local programs. This prospective study indicates that the training program was successful in increasing perceived competence in the areas addressed, and training staff from different service levels together probably contributed to more collaboration. This training model still operates in Norway.

Mental illness--stigma and discrimination in Zambia.

PubMed

Kapungwe, A; Cooper, S; Mwanza, J; Mwape, L; Sikwese, A; Kakuma, R; Lund, C; Flisher, A J

2010-07-01

The aim of this qualitative study was to explore the presence, causes and means of addressing individual and systemic stigma and discrimination against people with mental illness in Zambia. This is to facilitate the development of tailor-made antistigma initiatives that are culturally sensitive for Zambia and other low-income African countries. This is the first in-depth study on mental illness stigma in Zambia. Fifty semi-structured interviews and 6 focus group discussions were conducted with key stakeholders drawn from 3 districts in Zambia (Lusaka, Kabwe and Sinazongwe). Transcripts were analyzed using a grounded theory approach. Mental illness stigma and discrimination is pervasive across Zambian society, prevailing within the general community, amongst family members, amid general and mental health care providers, and at the level of government. Such stigma appears to be fuelled by misunderstandings of mental illness aetiology; fears of contagion and the perceived dangerousness of people with mental illness; and associations between HIV/AIDS and mental illness. Strategies suggested for reducing stigma and discrimination in Zambia included education campaigns, the transformation of mental health policy and legislation and expanding the social and economic opportunities of the mentally ill. In Zambia, as in many other low-income African countries, very little attention is devoted to addressing the negative beliefs and behaviours surrounding mental illness, despite the devastating costs that ensue. The results from this study underscore the need for greater commitment from governments and policy-makers in African countries to start prioritizing mental illness stigma as a major public health and development issue.

The Station Community Mental Health Centre Inc: nurturing and empowering.

PubMed

Taylor, Judy; Jones, Rosalind M; O'Reilly, Peta; Oldfield, Wayne; Blackburn, Anne

2010-01-01

Consumer-driven community mental health services play an important role in rehabilitation, recovery, and advocacy in rural and remote Australia. The origins of services often lie in the need to provide options for people with mental illness and their carers when there is a lack of on-the-ground support. This article adds to the information about the strengths and limitations of consumer-driven mental health services by presenting the findings of an evaluation of The Station Inc. in rural South Australia. This consumer-driven mental health service provides a safe and supportive environment, social connections, and activities for its members (those with a lived experience of mental illness). Using a realist evaluation approach, the evaluation identified the contextual factors and the program mechanisms that produce positive outcomes for members. The evaluation was conducted as participatory action research with The Station members, volunteers, management committee members, and staff involved in all phases of the research process. Because of the complexity of The Station's functioning a realist evaluation using qualitative data was conducted to identify how the program worked, for whom, and in what circumstances. Twenty-five in-depth interviews were conducted with participants who were randomly selected from within the groups identified above. Interviews focused on The Station's role in assisting recovery from mental illness, the limitations and strengths of the program, and relationships with the mental health system. The Station's goals, policies and procedures, and the role of stakeholders were analysed in order to identify any links among these contextual factors, program mechanisms, and program outcomes. Qualitative data were entered into descriptive categories in N6 software (QSR; www.qsr.international.com). Data from the stakeholder analysis were entered into Microsoft Excel. Using an iterative approach to include the three data sets, a model was developed that identified important contextual factors that linked with two groups of program mechanisms that produced positive outcomes for members. Program mechanisms are categorised by descriptive themes referred to as 'nurturing' and 'empowering'. Nurturing' is experienced as feeling of belonging and being accepted 'as one is' and 'empowerment' mechanisms engender a belief in oneself. Respondents identified features of The Station's program, policies, atmosphere, connections and networks, stakeholder relationships, and staff and volunteers that are nurturing and empowering. Five key contextual factors enable the program mechanisms to work. The Station's coordinators ensure that nurturing and empowerment processes are highlighted through careful facilitation. The governance arrangements, policies, and administrative systems at The Station are well developed but flexibly implemented so that they support the nurturing and empowerment processes. Support and legitimacy for the program is obtained from the mental health system at state and local levels. The Station obtains resources and connections to its rural community through key stakeholders and a peak organisation One Voice Network acts as an advocate. Information about the benefits and limitations of consumer-driven mental health services in rural and remote Australia is in short supply. Increasing the available information about the contribution these services make may result in services being legitimised, understood, and resourced within mental health systems thus making the services sustainable. The benefits of consumer-driven services are that they provide flexibility and adaptation, an ability to capture the energy and passion of rural communities to improve the wellbeing of community members, and they overcome the power differential that exists between professionals and 'patients' or 'clients'.

Assessing the Relationship between Physical Illness and Mental Health Service Use and Expenditures among Older Adults from Racial/Ethnic Minority Groups

PubMed Central

Jimenez, Daniel E; Cook, Benjamin; Kim, Giyeon; Reynolds, Charles F.; Alegria, Margarita; Coe-Odess, Sarah; Bartels, Stephen J.

2015-01-01

Objective The association of physical illness and mental health service use in older adults from racial/ethnic minority groups is an important area of study given the mental and physical health disparities and the low use of mental health services in this population. The purpose of this study is to describe the impact of comorbid physical illness on mental health service use and expenditures in older adults; and to evaluate disparities in mental health service use and expenditures among a racially/ethnically diverse sample of older adults with and without comorbid physical illness. Methods Data were obtained from the Medical Expenditure Panel Survey (years 2004–2011). The sample included 1563 whites, 519 African-Americans, and 642 Latinos and (N=2,724) aged 65+ with probable mental illness. Using two-part generalized linear models, we estimated and compared mental health service use among those with and without a comorbid physical illness. Results Mental health service use was greater for older adults with comorbid physical illness compared to those without a comorbid physical illness. Once mental health services were accessed, no differences in mental health expenditures were found. Comorbid physical illness increased the likelihood of mental health service use in older whites and Latinos. However, the presence of a comorbidity did not impact racial/ethnic disparities in mental health service use. Conclusions This study highlighted the important role of comorbid physical illness as a potential contributor to using mental health services and suggests intervention strategies to enhance engagement in mental health services by older adults from racial/ethnic minority groups. PMID:25772763

Symptoms of Mental Illness and Their Impact on Managing Type 2 Diabetes in Adults.

PubMed

Cimo, Adriana; Dewa, Carolyn S

2017-11-08

People with mental illnesses are more likely to experience diabetes-related complications that can reduce life expectancy by 10 to 15 years. Diabetes management and outcomes can be improved when lifestyle interventions addressing healthful eating habits and physical activity use content tailored to the learning needs of individuals or groups. Understanding the challenges that prevent adherence to diabetes recommendations can start to inform the design of tailored diabetes education care. The purpose of this pilot study was to explore the perspectives of clients with mental illnesses and type 2 diabetes with regard to challenges faced when engaging in diabetes self-care behaviours. Focus groups were held with 17 people who had type 2 diabetes and mental illnesses, including depressive disorder, bipolar disorder, anxiety disorder, schizophrenia and schizoaffective disorder. In the groups, participants were asked to share their experiences with diabetes self-care and access to diabetes-education services. Data were transcribed verbatim, assessed for quality and saturation and coded to identify relationships and meanings among identified themes. Participants identified many challenges and unmet needs that created multidimensional and interrelated barriers to care, ultimately resulting in poor diabetes self-care behaviours. Some challenges were psychological in nature and related to emotional states, lifestyles and food habits, perceptions of affordability, health literacy and value of health information. Other challenges included the physical states of health and social environments. Multidimensional diabetes education programs that consider psychological, physical and social challenges are needed to address the needs of people with mental illnesses. Copyright © 2017. Published by Elsevier Inc.

Development and validation of the Chinese Version of Indiana Job Satisfaction Scale (CV-IJSS) for people with mental illness.

PubMed

Tsang, Hector W H; Wong, Alvin

2005-06-01

Job satisfaction has been increasingly regarded as an important outcome of vocational rehabilitation programs among people with mental illness. Chinese measures of job satisfaction for individuals with mental illness are however extremely scarce. The aim of this study was to translate the 32-item Indiana Job Satisfaction Scale to Chinese. By means of the expert panel method, the culturally relevant 28-item Chinese Version of Indiana Job Satisfaction Scale (CV-IJSS) was then finalized. A validation study among a group of 125 individuals with mental illness showed that the scale had acceptable psychometric properties. Coefficient alpha of the total score was 0.81 with subscales ranging from 0.63 to 0.87. Test re-test reliability as measured by ICC was 0.77 for the total score and ranged from 0.54 to 0.72 for the subscales. Factorial analysis yielded a four factor solution (general satisfaction, job ambiguity and stress, advancement and security, and job recognition) accounting for 44% of the total variance. The factor solution had similarities as well as differences when compared with the Indiana Job Satisfaction Scale. The differences are discussed in the light of cultural differences. Relationship between scores of CV-IJSS and work performance, quality of life and self-esteem was positive in general which may act as evidence to its concurrent validity. The Chinese Version of Indiana Job Satisfaction Scale is ready for use by rehabilitation professionals to assess vocational rehabilitation outcome for individuals with mental illness in Hong Kong and other Chinese societies. Directions for further studies are suggested.

Effects of a Crisis Intervention Team (CIT) training program upon police officers before and after Crisis Intervention Team training.

PubMed

Ellis, Horace A

2014-02-01

In communities across the United States and internationally, police officers frequently come into contact with individuals experiencing mental health crisis despite not having the skills to safely intervene. This often results in officers resorting to excessive or even deadly force. The Crisis Intervention Team (CIT) is heralded as a revolutionary and transformative intervention to correct this gap in practice. Several previous interdisciplinary national and international studies, including criminology and sociology, have examined these concepts using quantitative and qualitative methodological designs, however, no prior nursing studies have been done on this topic. The purpose of this study was to determine the effect of CIT training on police officers' knowledge, perception, and attitude toward persons with mental illness. Twenty five police officers participated. An explorative, quasi experimental, descriptive design was used to collect the data on the three major concepts. Results on knowledge about mental illness improved at p<.0125 (p<.05 after Bonferroni correction). Perception scores improved at p<.0125 (p<.05 after Bonferroni correction), and attitudes were more favorable at p<.0125 (p<.05 after Bonferroni correction). The results of this study validated the CIT program as an innovative community health program that benefits law enforcement, consumers, mental health professionals, and stakeholders. © 2013 Elsevier Inc. All rights reserved.

Jail Diversion for Persons with Serious Mental Illness Coordinated by a Prosecutor's Office

PubMed Central

2017-01-01

Persons with serious mental illnesses (SMI) are involved in the criminal justice system at a disproportionately higher rate than the general population. While the exact causes remain unclear, it is accepted that a comprehensive strategy including mental health treatment is needed to reduce recidivism. This paper describes a unique jail diversion program coordinated by a county prosecutor's office in which individuals were diverted towards mental health services including case management, community-based services, and housing supports. Outcomes were studied over a five-year period, beyond the typical 12- to 24-month follow-up in other studies. Individuals who completed the program, compared to those who did not complete it, were at lower risk for being rearrested, arrested fewer times, and incarcerated fewer days. Gains were moderated by previous criminal justice involvement and substance use but, nevertheless, were maintained despite severity of history. The strongest gains were seen while the individual was still actively enrolled in the diversion services and these outcomes were maintained for up to four years. These findings suggest that completion of a jail diversion program facilitated by a prosecutor's office can lower recidivism and days incarcerated. Further research is needed to assess the unique contribution of prosecutor office facilitation. PMID:29333452

Mobile Health for All: Public-Private Partnerships Can Create a New Mental Health Landscape

PubMed Central

2016-01-01

Research has already demonstrated that different mHealth approaches are feasible, acceptable, and clinically promising for people with mental health problems. With a robust evidence base just over the horizon, now is the time for policy makers, researchers, and the private sector to partner in preparation for the near future. The Lifeline Assistance Program is a useful model to draw from. Created in 1985 by the U.S. Federal Communications Commission (FCC), Lifeline is a nationwide program designed to help eligible low-income individuals obtain home phone and landline services so they can pursue employment, reach help in case of emergency, and access social services and healthcare. In 2005, recognizing the broad shift towards mobile technology and mobile-cellular infrastructure, the FCC expanded the program to include mobile phones and data plans. The FCC provides a base level of federal support, but individual states are responsible for regional implementation, including engagement of commercial mobile phone carriers. Given the high rates of disability and poverty among people with severe mental illness, many are eligible to benefit from Lifeline and research has shown that a large proportion does in fact use this program to obtain a mobile phone and data plan. In the singular area of mobile phone use, the gap between people with severe mental illness and the general population in the U.S. is vanishing. Strategic multi-partner programs will be able to grant access to mHealth for mental health programs to those who will not be able to afford them—arguably, the people who need them the most. Mobile technology manufacturing costs are dropping. Soon all mobile phones in the marketplace, including the more inexpensive devices that are made available through subsidy programs, will have “smart” capabilities (ie, internet connectivity and the capacity to host apps). Programs like Lifeline could be expanded to include mHealth resources that capitalize on “smart” functions, such as secure/encrypted clinical texting programs and mental health monitoring and illness-management apps. Mobile phone hardware and software development companies could be engaged to add mHealth programs as a standard component in the suite of tools that come installed on their mobile phones; thus, in addition to navigation apps, media players, and games, the new Android or iPhone could come with guided relaxation videos, medication reminder systems, and evidence-based self-monitoring and self-management tools. Telecommunication companies could be encouraged to offer mHealth options with their data plans. Operating system updates pushed out by the mobile carrier companies could come with optional mHealth applications for those who elect to download them. In the same manner in which the Lifeline Assistance Program has helped increase access to fundamental opportunities to so many low-income individuals, innovative multi-partner programs have the potential to put mHealth for mental health resources in the hands of millions in the years ahead. PMID:27268283

Mobile Health for All: Public-Private Partnerships Can Create a New Mental Health Landscape.

PubMed

Ben-Zeev, Dror

2016-06-06

Research has already demonstrated that different mHealth approaches are feasible, acceptable, and clinically promising for people with mental health problems. With a robust evidence base just over the horizon, now is the time for policy makers, researchers, and the private sector to partner in preparation for the near future. The Lifeline Assistance Program is a useful model to draw from. Created in 1985 by the U.S. Federal Communications Commission (FCC), Lifeline is a nationwide program designed to help eligible low-income individuals obtain home phone and landline services so they can pursue employment, reach help in case of emergency, and access social services and healthcare. In 2005, recognizing the broad shift towards mobile technology and mobile-cellular infrastructure, the FCC expanded the program to include mobile phones and data plans. The FCC provides a base level of federal support, but individual states are responsible for regional implementation, including engagement of commercial mobile phone carriers. Given the high rates of disability and poverty among people with severe mental illness, many are eligible to benefit from Lifeline and research has shown that a large proportion does in fact use this program to obtain a mobile phone and data plan. In the singular area of mobile phone use, the gap between people with severe mental illness and the general population in the U.S. is vanishing. Strategic multi-partner programs will be able to grant access to mHealth for mental health programs to those who will not be able to afford them-arguably, the people who need them the most. Mobile technology manufacturing costs are dropping. Soon all mobile phones in the marketplace, including the more inexpensive devices that are made available through subsidy programs, will have "smart" capabilities (ie, internet connectivity and the capacity to host apps). Programs like Lifeline could be expanded to include mHealth resources that capitalize on "smart" functions, such as secure/encrypted clinical texting programs and mental health monitoring and illness-management apps. Mobile phone hardware and software development companies could be engaged to add mHealth programs as a standard component in the suite of tools that come installed on their mobile phones; thus, in addition to navigation apps, media players, and games, the new Android or iPhone could come with guided relaxation videos, medication reminder systems, and evidence-based self-monitoring and self-management tools. Telecommunication companies could be encouraged to offer mHealth options with their data plans. Operating system updates pushed out by the mobile carrier companies could come with optional mHealth applications for those who elect to download them. In the same manner in which the Lifeline Assistance Program has helped increase access to fundamental opportunities to so many low-income individuals, innovative multi-partner programs have the potential to put mHealth for mental health resources in the hands of millions in the years ahead.

A Mixed-Methods Study of the Recovery Concept, "A Meaningful Day," in Community Mental Health Services for Individuals with Serious Mental Illnesses.

PubMed

Myers, Neely A L; Smith, Kelly; Pope, Alicia; Alolayan, Yazeed; Broussard, Beth; Haynes, Nora; Compton, Michael T

2016-10-01

The recovery concept encompasses overcoming or managing one's illness, being physically and emotionally healthy, and finding meaningful purpose through work, school, or volunteering, which connects one to others in mutually fulfilling ways. Using a mixed-methods approach, we studied the emphasis on "a meaningful day" in the new Opening Doors to Recovery (ODR) program in southeast Georgia. Among 100 participants, we measured the meaningful day construct using three quantitative items at baseline (hospital discharge) and at 4-, 8-, and 12-month follow-up, finding statistically significant linear trends over time for all three measures. Complementary qualitative interviews with 30 individuals (ODR participants, family members, and ODR's Community Navigation Specialists and program leaders) revealed themes pertaining to companionship, productivity, achieving stability, and autonomy, as well as the concern about insufficient resources. The concept of "a meaningful day" can be a focus of clinical attention and measured as a person-centered outcome for clients served by recovery-oriented community mental health services.

The Effects of Religion and Locus of Control on Perception of Mental Illness.

PubMed

Amedome, Sedem Nunyuia; Bedi, Innocent Kwame

2018-06-23

The study investigated the influence of religion and locus of control on perception of mental illness. Specifically, the study explored the relationship between religiosity and perception of mental illness, differences in perception by internals and externals, the effect of knowledge on perception of mental illness and the interactive effect of religiosity and locus of control on perception of mental illness. Data were collected from 200 participants in the Volta Region of Ghana. Three hypotheses were tested in the study using a battery of tests. It was observed that people with internal locus of control perceive mental patients positively than those with external locus of control. A significant interactive effect between religiosity and locus of control on perception of mental illness was observed. Religiosity significantly relates to perception of mental illness. The results and implications are discussed for further studies.

Preliminary evidence for the basis of self-concept in Chinese people with mental illness.

PubMed

Tam, Sing-Fai; Tsang, Hector W H; Chan, Yee-Chiu I P; Chan, Cap S C

2004-03-01

The Adult Source of Self-Esteem Inventory (ASSEI) (A.C. Elovson and J.S. Fleming, unpublished manuscript. California: California State University, 1989), open-ended questions on self-evaluation, and interviewing were adopted as the major procedures for identifying the sources and basis of the self-concepts of people with mental illness. One hundred and twenty three Hong Kong Chinese adults with mental illness participated in this study. From the results, the basis of the self-concepts of people with mental illness was explored and compared through probing, comparing, and contrasting their perceptions of different aspects of life. A hierarchical multidimensional self-concept model of the population with mental illness was thus suggested. This model includes five major self-concept factors, named as interpersonal relationship, social integrity, personal competency, personal quality, and external achievement. The self-concept of people with mental illness was also compared to that of people without mental illness. This paper discusses the implications of the findings for psychiatric rehabilitation practice for people with mental illness.

Trends In News Media Coverage Of Mental Illness In The United States: 1995–2014

PubMed Central

McGinty, Emma E.; Kennedy-Hendricks, Alene; Choksy, Seema; Barry, Colleen L.

2016-01-01

The United States is engaged in ongoing dialogue around mental illness. To assess trends in this national discourse, we studied the volume and content of a random sample of 400 news stories about mental illness from the period 1995–2014. Compared to news stories in the first decade of the study period, those in the second decade were more likely to mention mass shootings by people with mental illnesses. The most frequently mentioned topic across the study period was violence (55 percent overall) divided into categories of interpersonal violence or self-directed (suicide) violence, followed by stories about any type of treatment for mental illness (47 percent). Fewer news stories, only 14 percent, described successful treatment for or recovery from mental illness. The news media’s continued emphasis on interpersonal violence is highly disproportionate to actual rates of violence among those with mental illnesses. Research suggests that this focus may exacerbate social stigma and decrease support for public policies that benefit people with mental illnesses. PMID:27269031

'teen Mental Health First Aid': a description of the program and an initial evaluation.

PubMed

Hart, Laura M; Mason, Robert J; Kelly, Claire M; Cvetkovski, Stefan; Jorm, Anthony F

2016-01-01

Many adolescents have poor mental health literacy, stigmatising attitudes towards people with mental illness, and lack skills in providing optimal Mental Health First Aid to peers. These could be improved with training to facilitate better social support and increase appropriate help-seeking among adolescents with emerging mental health problems. teen Mental Health First Aid (teen MHFA), a new initiative of Mental Health First Aid International, is a 3 × 75 min classroom based training program for students aged 15-18 years. An uncontrolled pilot of the teen MHFA course was undertaken to examine the feasibility of providing the program in Australian secondary schools, to test relevant measures of student knowledge, attitudes and behaviours, and to provide initial evidence of program effects. Across four schools, 988 students received the teen MHFA program. 520 students with a mean age of 16 years completed the baseline questionnaire, 345 completed the post-test and 241 completed the three-month follow-up. Statistically significant improvements were found in mental health literacy, confidence in providing Mental Health First Aid to a peer, help-seeking intentions and student mental health, while stigmatising attitudes significantly reduced. teen MHFA appears to be an effective and feasible program for training high school students in Mental Health First Aid techniques. Further research is required with a randomized controlled design to elucidate the causal role of the program in the changes observed.

Attitudes towards mental illness of nursing students in a Baccalaureate programme in Jamaica: a questionnaire survey.

PubMed

Bennett, J; Stennett, R

2015-10-01

There is longstanding evidence of nurses demonstrating negative attitudes towards people with mental illness. Student nurses' fear or discomfort with mentally ill patients results in poorer outcomes for patients and students' dissatisfaction with their experience of mental health nursing. There is evidence of negative attitudes towards mental illness in the Jamaican society; however, no studies have explored whether these attitudes are held by nursing students. The aim of the study was to examine the attitudes of nursing students towards mental illness. A questionnaire survey was conducted with a convenience sample of 143 third-year nursing students who were enrolled in a baccalaureate programme. Data were collected using the Attitudes Towards Acute Mental Health Scale (ATAMHS). A response rate of 71% was achieved for the survey. The findings indicated that the student nurses held an overall negative attitude towards mental illness, with a general perception that mentally ill people are dangerous. The student nurses were divided in their opinions in a number of areas, suggesting a possible conflict of opinions. Negative attitudes towards mental illness impact client outcomes and the career choices made by nurses. This study provides baseline data within the Jamaican context that adds to the evidence on nursing students' attitude to mental illness. Further research is needed to explore whether nursing education and clinical experience enables student nurses in Jamaica to develop a more positive attitude towards mental illness and mental health nursing and whether cultural factors contribute to negative attitudes. © 2015 John Wiley & Sons Ltd.

The stigma of mental illness in Arab families: a concept analysis.

PubMed

Dardas, L A; Simmons, L A

2015-11-01

The stigma of mental illness varies significantly from culture to culture and from person to person. To date, little is known about how mental illness stigma manifests within the Arab community. This study aimed at bringing clarity to the concept of 'mental illness stigma' as it applies to Arab families. Nursing's holistic and patient-centered approach is integral to helping Arab patients and their families appropriately incorporate individual values, beliefs, and cultural perspectives into treatment plans. This study establishes a scientific alert for professionals at all levels to avoid making false generalizations about a specific culture that are not based on specific research findings from that culture. Accessing mental health services is a critical step towards reducing the burden of mental illness. The stigma of mental illness is one of the most common reasons for not seeking mental health care leading to negative health consequences and undue suffering for many individuals and their families. Stigma is embedded in its social context. What may be considered acceptable in one society may be considered unacceptable and open to stigmatization in other societies. Arabs have a shared set of values, beliefs, and traditions that are substantially different from those of Westerners. Further, in most Arab countries, formal mental health resources are scarce and people with mental illness experience the compounded disadvantages of poverty and illness stigma. To date, little is known about how mental illness stigma manifests within the Arab community making it difficult to design and test interventions that support Arab individuals with mental illness and their families in treatment seeking and adherence. Using Rodger's concept analysis method, we examined how 'mental illness stigma' operates within an Arab context as a first step towards elucidating culturally competent approaches to treatment. This analysis provides a foundation for future work in the areas of mental illness diagnosis, education, and treatment that reflect the unique characteristics of Arab culture. © 2015 John Wiley & Sons Ltd.

How do homeless adults change their lives after completing an intensive job-skills program? A prospective study.

PubMed

Gray, Heather M; Nelson, Sarah E; Shaffer, Howard J; Stebbins, Patricia; Farina, Andrea Ryan

2017-09-01

Among people experiencing homelessness, difficulty securing housing is often compounded by concurrent challenges including unemployment, chronic illness, criminal justice involvement, and victimization. The Moving Ahead Program (MAP) is a vocational rehabilitation program that seeks to help adults facing these challenges to secure competitive employment. We prospectively studied how MAP graduates (N = 97) changed from the beginning of MAP to about six months after graduation. We observed a variety of positive outcomes not just in employment and housing but also in health, substance use, and criminal justice involvement. However, these gains were not universal; for instance, participants were less likely to report positive outcomes at follow-up if they started MAP with a serious mental illness, made relatively small gains in work skills, or did not seek mental health treatment during the six months after they completed MAP. These findings might encourage program staff to devote additional resources toward supporting at-risk students.

Comparative study of forensic psychiatric system between China and America.

PubMed

Li, Gangqin; Gutheil, Thomas G; Hu, Zeqing

2016-01-01

Laws and regulations about the forensic psychiatric systems in China and America were compared, and suggestions for improving the forensic psychiatric system of China were provided. There are many differences regarding the role of the forensic psychiatrist, the initiation of the assessment and the admission of expert opinion because of elements in the legal systems in China and America. The Chinese system has the advantages of objectivity, cost saving and high efficiency; but it has deficiencies in procedural justice and the admission of expert opinion. China can persist with the current system while taking measures to give more rights to the litigants to participate in their assessment, and while improving the quality and utility of the expert opinion; however, this review article will compare broadly the two systems without addressing human rights issues or procedural justice issues, nor will it presume to address the entirety of Chinese systems. In addition, China is developing its legal system for dealing with the mentally ill defendant in situations involving the criminal justice system and civil commitment. Although China enacted new laws regarding the mandatory treatment for the mentally ill, both in criminal and civil systems, there remain many aspects to be improved, including but not limited to a system of review of the decision to detain a patient on psychiatric grounds, and the need for provisions in the laws preventing indefinite detention. From this viewpoint, America's laws and regulations are instructive for us, in matters such as the method of dealing with the mentally ill defendant who is "incompetent to stand trial", "not guilty only by reason of insanity" or "guilty but mentally ill". The conditional release of the committed mentally ill person and the special programs in the forensic security hospital are all worthy of study by China in order to manage the mentally ill offender and to reduce the recidivism rate. Copyright © 2016 Elsevier Ltd. All rights reserved.

Mental illness stigma: concepts, consequences, and initiatives to reduce stigma.

PubMed

Rüsch, Nicolas; Angermeyer, Matthias C; Corrigan, Patrick W

2005-12-01

Persons with mental illness frequently encounter public stigma and may suffer from self-stigma. This review aims to clarify the concept of mental illness stigma and discuss consequences for individuals with mental illness. After a conceptual overview of stigma we discuss two leading concepts of mental illness stigma and consequences of stigma, focussing on self-stigma/empowerment and fear of stigma as a barrier to using health services. Finally, we discuss three main strategies to reduce stigma -- protest, education, and contact -- and give examples of current anti-stigma campaigns. Well-designed anti-stigma initiatives will help to diminish negative consequences of mental illness stigma.

Stigmatization of people with mental illness among inhabitants of a rural community in northern Nigeria.

PubMed

Audu, Ishaq A; Idris, Suleiman H; Olisah, Victor O; Sheikh, Taiwo L

2013-02-01

Despite the fact that mental illness is a common problem in society, people's perception of the mentally ill and community attitude towards them is still rather poor, making their rehabilitation and reintegration into society an uphill task. To examine the stigmatization of people with mental illness within a rural community and identify the socio-demographic variables involved. A cross-sectional descriptive study using a multi-stage random sampling technique to obtain data through an interviewer-administered questionnaire to 325 adult inhabitants of a rural community in Nigeria. The results showed widespread ignorance about causation, mode of transmission and remedies available for mental illness, with only 0.9% of respondents attributing mental illness to brain disease. The others attributed it to spiritual attack, punishment for evil doing and illicit psychoactive substance use, among other things. Negative views about the mentally ill were also widely expressed resulting in discriminatory practices. Stigmatization of people with mental illness is still rampant in our community. There is a need for adequate public education about the causes and mode of transmission of mental illness and the treatment options available in the community.

Fifteen-month follow up of an assertive community treatment program for chronic patients with mental illness.

PubMed

Kim, Tae-Won; Jeong, Jong-Hyun; Kim, Young-Hee; Kim, Yura; Seo, Ho-Jun; Hong, Seung-Chul

2015-09-16

The aim of this study was to evaluate the effect of an Assertive Community Treatment (ACT) program on psychiatric symptoms, global functioning, life satisfaction, and recovery-promoting relationships among individuals with mental illness. Participants were patients at the Suwon Mental Health Center. Thirty-two patients were part of the ACT program and 32 patients matched for age, sex, and mental illness were in a standard case-management program and served as a control group. Follow-up with patients occurred every 3 months during the 15 months after a baseline interview. Participants completed the Brief Psychiatric Rating Scale (BPRS), Global Assessment of Functioning (GAF) Scale, Life Satisfaction Scale, and Recovery-Promoting Relationship Scale (RPRS). No significant differences were noted in the sociodemographic characteristics of the ACT and the case-management group. According to the BPRS, the ACT group showed a significant reduction in symptom severity, but the ACT program was not significantly more effective at reducing psychiatric symptoms from baseline to the 15-month follow-up compared to the case-management approach. The ACT group showed more significant improvement than the control group in terms of the GAF Scale. Both groups showed no significant differences in the change of life satisfaction and in the change of recovery-promoting relationships. We observed a significant increase in recovery-promoting relationships in the control group, but the degree of change of recovery-promoting relationships through time flow between groups was not significantly different. In this study, we observed that ACT was significantly better at improving the GAF than case management and that participation in ACT was associated with a significant decrease in BPRS scores. However, ACT did not demonstrate an absolute superiority over the standard case-management approach in terms of the BPRS and the measures of life satisfaction and recovery-promoting relationships. ACT may have some advantages over a standard case management approach.

Moving beyond the illness: factors contributing to gaining and maintaining employment.

PubMed

Cunningham, K; Wolbert, R; Brockmeier, M B

2000-08-01

The work presented here, exploratory in nature, uses a comparative and qualitative approach to understand the factors associated with the ability of individuals with severe and persistent mental illness to successfully gain and maintain employment. Based on open-ended interviews with individuals in an Assertive Community Treatment (ACT) program, we compare the experiences of those who have been successful gaining and maintaining employment, with those who have been successful gaining but not maintaining work, and those who have been unsuccessful gaining employment. The three groups seemed to differ in three significant ways: (1) in the ways the individuals talked about their illness, (2) in the ways the individuals talked about work, and (3) in the strategies they described for coping with bad days. In each of these areas individuals' awareness of and attitude toward their illness was significant. The findings have clear implications for agencies working to help people with severe and persistent mental illness obtain and maintain employment.

Self-Stigma, Identity, and Co-Occurring Disorders.

PubMed

Al-Khouja, Maya A; Corrigan, Patrick W

2017-01-01

A four stage regressive model that links public stigma to self-stigma is applied to mental illness and substance use disorder. We assess this four stage model in those with co-occurring disorders versus those who have mental illness or substance use disorder alone. 366 people who self-identified as having either a mental illness or co-occurring mental illness with substance use disorder were recruited from MTurk and completed measures on identity and self-stigma. Higher group identity predicted lower selfstigma in those with mental illness while this effect was not present for participants with co-occurring disorders. Limitations include that this study only looked at mental illness identity for those with both mental illness and substance use disorder; sample limitations are also discussed. Those with co-occurring disorders may identify more with certain groups over others.

Pediatric and adolescent mental health emergencies in the emergency medical services system.

PubMed

Dolan, Margaret A; Fein, Joel A

2011-05-01

Emergency department (ED) health care professionals often care for patients with previously diagnosed psychiatric illnesses who are ill, injured, or having a behavioral crisis. In addition, ED personnel encounter children with psychiatric illnesses who may not present to the ED with overt mental health symptoms. Staff education and training regarding identification and management of pediatric mental health illness can help EDs overcome the perceived limitations of the setting that influence timely and comprehensive evaluation. In addition, ED physicians can inform and advocate for policy changes at local, state, and national levels that are needed to ensure comprehensive care of children with mental health illnesses. This report addresses the roles that the ED and ED health care professionals play in emergency mental health care of children and adolescents in the United States, which includes the stabilization and management of patients in mental health crisis, the discovery of mental illnesses and suicidal ideation in ED patients, and approaches to advocating for improved recognition and treatment of mental illnesses in children. The report also addresses special issues related to mental illness in the ED, such as minority populations, children with special health care needs, and children's mental health during and after disasters and trauma.

Community Perceptions of Mental Illness in Jharkhand, India.

PubMed

Sangeeta, S J; Mathew, K J

2017-09-01

Understanding and perceptions about mental illness vary among individuals based on their experience with the illness or their contact with the people affected by it. These may be further influenced by the individuals' sociocultural background. This study aimed to understand the differences in the beliefs about, understanding of, and explanations for mental illness between different population groups of Jharkhand, India. During July 2014 to February 2016, we recruited the following 3 groups of individuals aged between 18 and 60 years: individuals with mental illness (group 1, n = 240), relatives of individuals with mental illness (group 2, n = 240), and the general public (group 3, n = 240). Qualitative and quantitative findings were combined in this study, and participants were asked about their beliefs about, understanding of, and explanations about mental illness. Individuals with mental illness and their relatives shared similar beliefs whereas the general public held a different opinion in various domains. There were significant differences among all groups in their understanding of various aspects of mental illnesses including the definition, causes, signs and symptoms, treatment, and outcomes. Individuals' perception towards different aspects of mental illness varies, despite they are sharing the same sociocultural milieu. Differences in beliefs, understanding, and explanations may lead to conflicts in treatment goals and expectations, and hamper the intervention strategies that promote mental health and patient care. Focused strategies to develop uniformity in beliefs and explanations about various aspects of mental illness may help to develop collaboration with different community groups that may in turn help in developing effective interventions and treatment.

Perceived reasons for loss of housing and continued homelessness among homeless persons with mental illness.

PubMed

Mojtabai, Ramin

2005-02-01

The objective of this study was to examine the reasons for the most recent loss of housing and for continued homelessness as perceived by homeless persons with mental illness. A total of 2,974 currently homeless participants in the 1996 National Survey of Homeless Assistance Providers and Clients (NSHAPC) were asked about the reasons for their most recent loss of housing and continued homelessness. The responses of participants who had mental illness, defined both broadly and narrowly, were compared with responses of those who were not mentally ill. The broad definition of mental illness was based on a set of criteria proposed by NSHAPC investigators. The narrow definition included past psychiatric hospitalization in addition to the NSHAPC criteria. A total of 1,620 participants (56 percent) met the broad definition of mental illness, and 639 (22 percent) met the narrow definition; 1,345 participants (44 percent) did not meet any of these criteria and were categorized as not having a mental illness. Few differences in reasons for the most recent loss of housing were noted between the participants with and without mental illness. Both groups attributed their continued homelessness mostly to insufficient income, unemployment, and lack of suitable housing. Homeless persons with mental illness mostly report the same reasons for loss of housing and continued homelessness as those who do not have a mental illness. This finding supports the view that structural solutions, such as wider availability of low-cost housing and income support, would reduce the risk of homelessness among persons with mental illness, as among other vulnerable social groups.

Experiencing Community: Perspectives of Individuals Diagnosed as Having Serious Mental Illness

PubMed Central

Bromley, Elizabeth; Gabrielian, Sonya; Brekke, Benjamin; Pahwa, Rohini; Daly, Kathleen A.; Brekke, John S.; Braslow, Joel T.

2013-01-01

Objective Community integration is recognized as a crucial component of recovery from serious mental illness. Although the construct of community integration can be measured with structured instruments, little is known about the subjective and experiential meaning of community and community involvement for persons with serious mental illness. Methods In 2010, 30 individuals with serious mental illness treated in two public mental health clinics completed semistructured interviews that elicited the places and people that they associate with the experience of community and the larger meaning of community in their lives. Results Participants described four experiences as integral to their concepts of community: receiving help, minimizing risk, avoiding stigma, and giving back. Participants looked for communities that provide reliable support, and they described the need to manage community contact in order to protect themselves and others from their symptoms and from discrimination. Most participants experienced communities centered on mental health treatment or mentally ill peers as providing opportunities for positive engagement. Conclusions The experience of having a serious mental illness shapes preferences for and perceptions of community in pervasive ways. Participants describe community involvement not as a means to move away from illness experiences and identities but as a process that is substantially influenced by them. Mental health communities may help individuals with serious mental illness to both manage their illness and recognize and enjoy a sense of community. The findings indicate the need for further research on the relationship between community integration and outcome in serious mental illness. PMID:23545784

Motor skills, cognition, and work performance of people with severe mental illness.

PubMed

Lipskaya-Velikovsky, Lena; Elgerisi, Dikla; Easterbrook, Adam; Ratzon, Navah Z

2018-01-12

Employment offers many benefits to people with mental illness, yet their employment rate is much lower than that of the general population. We investigated the effect of work-related motor skills, neurocognition, and job attitudes on the work performance of people with mental illness, comparing those working in sheltered workshops, with controls working in similar jobs. Twenty-nine adults with severe mental illness and 27 controls matched by gender and age were enrolled into the study using convenience sampling. They were assessed for gross and fine motor hand functioning, job attitudes, work performance, and cognition. People with mental illness scored lower on work performance, cognitive functioning, and hand dexterity while sitting and working with tools. They were assigned lower job loads than were controls, and perceived the physical environment at work as more constraining than did controls. Assembling motor skills significantly explained the work performance of people with mental illness. The results expand our understanding of the complexities involved in the employment of people with severe mental illness, and point to new paths for improving vocational outcomes of people with severe mental illness, taking into account their motor skills and job attitudes. Implications for rehabilitation Therapists should be aware that employed people with severe mental illness may have various unmet needs, affecting their work performance and experience of stress. This study results demonstrate importance of motor skills and perception of the work environment for the promotion of vocational outcomes among individuals with severe mental illness. Employment of people with severe mental illness should be viewed from holistic perspective as with general population, rather than focused on traditionally illness-related factors.

Australian Rotary Health: a major contributor to mental illness research and mental health awareness in Australia.

PubMed

Jorm, Anthony; Sawyer, Michael; Gillett, Joy

2012-08-01

Australian Rotary Health (ARH) was established in 1981 with the goal of supporting family health research in Australia. Since 2000, ARH has supported research relevant to mental health and mental illness. This article describes the early history of the fund, the reasons for the move to mental illness research, some examples of research projects that have had a beneficial impact and the branching out into mental health community awareness raising and stigma reduction. ARH has emerged as a major non-government supporter of mental illness research. It has also effectively engaged Rotary clubs at a local level to increase community awareness of mental illness and to reduce stigma.

The Stigma of Mental Illness as a Barrier to Self Labeling as Having a Mental Illness.

PubMed

Stolzenburg, Susanne; Freitag, Simone; Evans-Lacko, Sara; Muehlan, Holger; Schmidt, Silke; Schomerus, Georg

2017-12-01

The aim of this study was to investigate whether personal stigma decreases self-identification as having a mental illness in individuals with untreated mental health problems. We interviewed 207 persons with a currently untreated mental health problem as confirmed by a structured diagnostic interview. Measures included symptom appraisal, self-identification as having a mental illness (SELFI), self-labeling (open-ended question on the nature of their problem) stigma-related variables (explicit and implicit), as well as sociodemographics, current symptom severity, and previous treatment. Support for discrimination and implicit stigmatizing attitude were both associated with lower likelihood of self-identification. More social distance and support for discrimination were associated with less self-labeling. Previous treatment was the strongest predictor of symptom appraisal, SELFI, and self-labeling. Destigmatizing mental illness could increase awareness of personal mental health problems, potentially leading to lower rates of untreated mental illness.

The attitudes of psychiatrists toward people suffering from mental illnesses.

PubMed

Kochański, Artur; Cechnicki, Andrzej

2017-02-26

Stigmatizing convictions, emotions and behaviors toward the mentally ill have impact on the social distance and more acute course of the illness. Research shows that the sufferers are the object of stigmatization also by representatives of medical professionals, including psychiatrists. The aim of the study was to examine the opinions of Polish psychiatrists regarding the mentally ill and to compare them with similar studies in the general population. Polish psychiatrists were the investigated group. A diagnostic survey was conducted with a self-completion questionnaire. 232 questionnaires were analyzed. The results were compared with the general population. 61.5% of the respondents (59% in the general population) believe that a person who is mentally ill has a chance of recovery and 79% (vs. 77%) that coercion in Polish psychiatry is used frequently enough. 95% (vs. 75%) consider mental illness a health problem which is concealed from the others. 43% (vs. 56%) believe that mental illness significantly reduces the ability of regular employment, 13.5% (vs. 30%) believe that it reduces the ability to work in a team and 33% (vs. 71%) that it reduces the ability to do work which requires a lot of self-reliance. 16% (vs. 22%) is opposed to having institutions for the mentally ill near their place of residence. Psychiatrists more often declared a close friendship with people suffering from mental illness (87.5% vs. 32%), and a positive attitude toward the mentally ill and their participation in social life (86.5% vs. 65%). 1. A relatively large group of the investigated psychiatrists compared with the general population has a family member suffering from a mental illness or they themselves suffer from mental illness. 2. Despite their education and professional mission, Polish psychiatrists present similarly stigmatizing attitudes toward the mentally ill as does the general population. 3. Through their attitudes, Polish psychiatrists co-create a support system, but also participate in the process of stigmatization.

Gender differences in the knowledge, attitude and practice towards mental health illness in a rapidly developing Arab society.

PubMed

Bener, Abdulbari; Ghuloum, Suhaila

2011-09-01

Mental disorders are common in all countries and cause immense suffering. Both gender and low socioeconomic status have been related to depression and other common mental disorders, but their possible relationship to mental health literacy remains uncertain. The aim of this study was to determine the gender differences in knowledge, attitudes and practices towards mental illness in a sample of Qatari and other Arab expatriates residing in the State of Qatar. This is a cross-sectional survey. Primary healthcare centres in the State of Qatar. A multi-stage sampling design was used and a representative sample of 3,300 Qatari and other Arab expatriates above 20 years of age were surveyed during the period from October 2008 to June 2009. Of the study sample of 3,300, 2,514 subjects (76.2%) expressed their consent to participate. A questionnaire was designed to assess the gender difference in knowledge, attitudes and practice towards mental illness.This questionnaire was administered to the Arab adult population above 20 years of age who were attending primary healthcare centres for various reasons other than mental illness. Face-to-face interviews were based on this questionnaire, which included variables on socio-demographic characteristics, knowledge, attitude and practice towards mental illness. Of the study sample, 49.2% were men and 50.8% were women. Overall, the studied women held more to the cultural beliefs related to some aspects of mental illness. For example, more women than men believed that mental illness is due to possession by evil spirits. Also, nearly half of the women thought traditional healers can treat mental illness; this belief was significantly lower in men. Some of the women considered people with mental illness as dangerous; a belief also significantly lower in men. Men had a better attitude towards mental illness than women. Men were more willing to visit a psychiatrist for their emotional problems, while women preferred a traditional healer. Women were more afraid than men to talk to the mentally ill. Knowledge of common mental illnesses was generally poor, and it seemed to be lower among women. Men obtained more information than women from the media; women favoured healthcare staff more than men did. The study reveals that men had better knowledge, beliefs and attitudes towards mental illness than women. Most of the women were afraid and not willing to keep friendships with the mentally ill. The results of this study underline the importance of information in changing people's attitude towards mental illness. Recognition of common mental disorders was very poor in men and women.

Mental ill-health among adult patients at healthcare centres in Sweden: district nurses experiences.

PubMed

Janlöv, Ann-Christin; Johansson, Linda; Clausson, Eva K

2017-11-13

Mental ill-health among the general population is increasing in Sweden. Primary Health Care (PHC) and Healthcare Centres (HCC), where district nurses (DNs) work, bear the basic responsibility for treatment of mental ill-health, while severe mental ill-health fall under the responsibility of psychiatric specialist care. The increased prevalence of mental ill-health in the community means that DNs increasingly encounter people with mental health problems - not least as a comorbidity. How well DNs are equipped to deal with mental ill-health is currently unclear. The purpose of this study was to explore district nurses' experience of encountering and dealing with mental ill-health among adult patients at healthcare centres. A qualitative explorative approach was used to capture the experiences of the phenomena under study. Individual interviews were conducted with 10 DNs working at six HCCs. The interviews were transcribed and analysed by qualitative content analysis. The result emerged as several subcategories captured by three categories: (i) having competence - a prerequisite for feeling confident; (ii) nursing mental ill-health requires time and commitment; and (iii) working in an organisation without preparedness, encompassed by the synthesising theme; nursing mental ill-health requires specific competence and organisational support. Working as a DN requires formal and informal competence when encountering patients with complex health needs. The findings revealed that the DNs could feel insecure regarding how to deal with patients with mental ill-health due to lack of knowledge. Assessment of patients with mental ill-health is time- and energy-consuming and calls for improved teamwork at HCCs as well as effective collaboration with psychiatric specialist care and other care givers. The DNs responsibility to fulfil their work considering the increasing number of mental ill-health among people that seeks help at HCCs needs to be acknowledged and met by the PHC organisation. © 2017 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

Exploring experiences of and attitudes towards mental illness and disclosure amongst health care professionals: a qualitative study.

PubMed

Waugh, William; Lethem, Claudia; Sherring, Simon; Henderson, Claire

2017-10-01

The literature suggests that many health professionals hold stigmatising attitudes towards those with mental illness and that this impacts on patient care. Little attention has been given to how these attitudes affect colleagues with a mental illness. Current research demonstrates that stigma and discrimination are common in the UK workplace and impact on one's decision to disclose mental illness. This study aims to explore health professionals' experiences of and attitudes towards mental illness and disclosure in the workplace. This qualitative study involved semi-structured interviews with 24 health professionals employed by an NHS (National Health Service) trust. 13 of these worked in mental health, and 11 in other health fields. Interviews were transcribed and thematic analysis was used to identify themes. Five key themes were identified from the data: personal experiences and their effect in changing attitudes; perceived stigmatising views of mental illness in other staff members; hypothetical disclosure: factors affecting one's decision; attitudes towards disclosure; support in the workplace after disclosure; and, applying only to those working outside of the mental health field, mental illness is not talked about. The results indicated that participants had a great deal of experience with colleagues with a mental illness and that support in the workplace for such illnesses is variable. Attitudes of participating health professionals towards colleagues with a mental illness appeared to be positive, however, they did report that other colleagues held negative attitudes. Deciding to disclose a mental illness was a carefully thought out decision with a number of advantages and disadvantages noted. In particular, it was found that health professionals' fear stigma and discrimination from colleagues and that this would dissuade participants from disclosing a mental illness. In many respects, this research supports the findings in other workplaces. Such findings need to be investigated further to identify the degree to which these experiences and attitudes can be applied to other health professionals in other healthcare settings to determine what intervention is necessary. Importantly, this study has also indicated that the level of support available to NHS health professionals with a mental illness is variable, suggesting the need to identify and replicate positive practice.

On the Self-Stigma of Mental Illness: Stages, Disclosure, and Strategies for Change

PubMed Central

Corrigan, Patrick W.; Rao, Deepa

2012-01-01

People with mental illness have long experienced prejudice and discrimination. Researchers have been able to study this phenomenon as stigma and have begun to examine ways of reducing this stigma. Public stigma is the most prominent form observed and studied, as it represents the prejudice and discrimination directed at a group by the larger population. Self-stigma occurs when people internalize these public attitudes and suffer numerous negative consequences as a result. In this article, we more fully define the concept of self-stigma and describe the negative consequences of self-stigma for people with mental illness. We also examine the advantages and disadvantages of disclosure in reducing the impact of stigma. In addition, we argue that a key to challenging self-stigma is to promote personal empowerment. Lastly, we discuss individual and societal level methods for reducing self-stigma, programs led by peers as well as those led by social service providers. PMID:22854028

Investigating the relationship between neighborhood experiences and psychiatric distress for individuals with serious mental illness.

PubMed

Kloos, Bret; Townley, Greg

2011-03-01

The present study examined the relationships between how research participants experienced their neighborhood, their neighborhood social climate, and psychological well-being. Participants (n = 525) were residents of supported housing programs who used mental health services at one of 17 community mental health centers in South Carolina. Hierarchical regression and mediation analyses were employed to answer research questions. Results suggest that neighbor relations, perceptions of neighborhood safety, and neighborhood satisfaction were significantly associated with perceptions of neighborhood social climate; and neighborhood social climate accounted for a significant amount of the variance in psychiatric distress. Of particular interest, perceptions of neighborhood social climate fully mediated the relationship between the specific reported neighborhood experiences and psychiatric distress. These findings have implications for interventions and policy aimed at promoting integration of individuals with serious mental illness into community settings.

Recovery orientation of treatment, consumer empowerment, and satisfaction with services: a mediational model.

PubMed

Barrett, Blake; Young, M Scott; Teague, Gregory B; Winarski, James T; Moore, Kathleen A; Ochshorn, Ezra

2010-01-01

This study explores the relationship between the recovery orientation of treatment and subjective experiences of consumer empowerment and satisfaction with services for individuals with severe and persistent mental illness. Instruments measuring perceptions of empowerment, recovery orientation of treatment, and satisfaction with services were administered to 45 participants enrolled in two demographically similar mental health treatment programs in Tampa, Florida - a community mental health center and an Assertive Community Treatment team. Analyses were conducted according to traditional mediation models. Empowerment was expected to mediate the relationship between the recovery orientation of treatment and consumer satisfaction with services. A recovery-based treatment orientation significantly predicted both consumer empowerment and satisfaction with services. Empowerment mediated the relationship between treatment orientation and consumer satisfaction. These preliminary findings highlight the impact of the recovery orientation of treatment on empowerment and satisfaction with services among individuals with severe and persistent mental illness.

Attitudes of Malaysian general hospital staff towards patients with mental illness and diabetes

PubMed Central

2011-01-01

Background The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent of mental health training and clinical experience, are associated with different attitudes and behaviours towards a patient with mental illness than towards a patients with a general health problem - diabetes. Methods General hospital health professionals in Malaysia were randomly allocated one of two vignettes, one describing a patient with mental illness and the other a patient with diabetes, and invited to complete a questionnaire examining attitudes and health care practices in relation to the case. The questionnaires completed by respondents included questions on demographics, training in mental health, exposure in clinical practice to people with mental illness, attitudes and expected health care behaviour towards the patient in the vignette, and a general questionnaire exploring negative attitudes towards people with mental illness. Questionnaires with complete responses were received from 654 study participants. Results Stigmatising attitudes towards persons with mental illness were common. Those responding to the mental illness vignette (N = 356) gave significantly lower ratings on care and support and higher ratings on avoidance and negative stereotype expectations compared with those responding the diabetes vignette (N = 298). Conclusions Results support the view that, in the Malaysian setting, patients with mental illness may receive differential care from general hospital staff and that general stigmatising attitudes among professionals may influence their care practices. More direct measurement of clinician behaviours than able to be implemented through survey method is required to support these conclusions. PMID:21569613

Relationship Between General Illness and Mental Health Service Use and Expenditures Among Racially-Ethnically Diverse Adults ≥65 Years.

PubMed

Jimenez, Daniel E; Cook, Benjamin Lê; Kim, Giyeon; Reynolds, Charles F; Alegría, Margarita; Coe-Odess, Sarah; Bartels, Stephen J

2015-07-01

The association of general medical illness and mental health service use among older adults from racial-ethnic minority groups is an important area of study given the disparities in mental health and general medical services and the low use of mental health services in this population. The purpose of this report is to describe the impact of comorbid general medical illness on mental health service use and expenditures among older adults and to evaluate disparities in mental health service use and expenditures in a racially-ethnically diverse sample of older adults with and without comorbid general medical illness. Data were obtained from the Medical Expenditure Panel Survey (years 2004-2011). The sample included 1,563 whites, 519 African Americans, and 642 Latinos (N=2,724) age ≥65 with probable mental illness. Two-part generalized linear models were used to estimate and compare mental health service use among adults with and without a comorbid general medical illness. Mental health service use was more likely for older adults with comorbid general medical illness than for those without it. Once mental health services were accessed, no differences in mental health expenditures were found. Comorbid general medical illness increased the likelihood of mental health service use by older whites and Latinos. However, the presence of comorbidity did not affect racial-ethnic disparities in mental health service use. This study highlighted the important role of comorbid general medical illness as a potential contributor to using mental health services and suggests intervention strategies to enhance engagement in mental health services by older adults from racial-ethnic minority groups.

Perceptions of mental illness and related stigma among Vietnamese populations: findings from a mixed method study.

PubMed

Do, Mai; Pham, Nhu Ngoc K; Wallick, Stacy; Nastasi, Bonnie Kaul

2014-12-01

Mental-illness-related (MIR) stigma is recognized as a major barrier to health care. Yet very little is known about mental illness and stigma among Vietnamese populations, or how emigration and acculturation processes might affect traditional views. Focus group discussions were conducted with Vietnamese Americans in New Orleans (Louisiana) and Vietnamese nationals in Bui Chu (Vietnam), who shared historical and cultural backgrounds, in 2010 to assess differences in their perceptions of mental illness and stigma. Results show several significant differences in mental illness perceptions between Vietnamese Americans and Vietnamese nationals, while MIR stigma seemed prevalent and understanding of mental illness was low among both groups.

Automatically activated shame reactions and perceived legitimacy of discrimination: A longitudinal study among people with mental illness

PubMed Central

Rüsch, Nicolas; Todd, Andrew R.; Bodenhausen, Galen V.; Olschewski, Manfred; Corrigan, Patrick W.

2009-01-01

Perceived legitimacy of discrimination shapes reactions to mental illness stigma among stigmatized individuals. We assessed deliberately endorsed versus automatic shame-related reactions to mental illness as predictors of change in perceived legitimacy of discrimination over six months among 75 people with mental illness. Automatically activated shame-related associations with mental illness were measured using the Brief Implicit Association Test, deliberately endorsed beliefs via self-report. Controlling for depression and perceived stigma, stronger baseline automatic shame-related associations, but not deliberately endorsed beliefs, predicted higher perceived legitimacy of discrimination after six months. Automatically activated shame reactions may increase vulnerability to mental illness stigma. PMID:19897173

“I’m not sure that I can figure out how to do that”: Pursuit of work among people with mental illnesses leaving jail1

PubMed Central

Baron, Richard C.; Draine, Jeffrey; Salzer, Mark S.

2013-01-01

Restoring people with mental illnesses to community life after detention in jail is fraught with significant challenges. Many of these challenges mirror those faced by anyone else who has been detained in jail. Among these are the particular challenge of seeking gainful employment and financial support for day-to-day life. This challenge is intensified when individuals return from jail to impoverished communities where employment prospects are already limited for residents, and where either a criminal record or a mental illness creates still additional barriers to work. To understand these barriers more fully, this study examined the process of seeking employment among people with mental illnesses leaving jail. Seventeen individuals with a history of mental health problems and with recent jail incarcerations were recruited from either a community based employment program or a mental health service setting. The informants were interviewed using life history interview techniques. Results show that connections to the paid workforce were tenuous at best for these respondents, both before and after their jail detention. While psychiatric symptoms, addiction, and the lack of productive social connections were individual-level factors that affected employment, the most pernicious impediments were rooted in policy, community structures, stigma and other social and economic realities.. If employment interventions are to have any traction at all in these settings, interventionists need to dig for innovative ways to address these factors, which are not complications, but bedrock realities that undergird all else. PMID:23935455

The Forgotten Plague: Psychiatric Manifestations of Ebola, Zika, and Emerging Infectious Diseases.

PubMed

Tucci, Veronica; Moukaddam, Nidal; Meadows, Jonathan; Shah, Suhal; Galwankar, Sagar C; Kapur, G Bobby

2017-01-01

The media and public health generally focus on the biological and physical ramifications of epidemics. Mental health issues that coincide with emerging diseases and epidemics are rarely examined and sometimes, even eschewed due to cultural considerations. Psychiatric manifestations of various infectious diseases, especially with a focus on Ebola Virus disease (EVD) and Zika Virus, are discussed in this commentary to illustrate the continued need of care after the resolution of the actual illness. Various infectious diseases have associations with mental illness, such as an increased risk of obsessive-compulsive disorders and Tourette syndrome in children with Group B streptococcal infection. Current EVD literature does not demonstrate a strong association of mental illness symptoms or diseases but there is a necessity of care that extends beyond the illness. Patients and their families experience depression, anxiety, trauma, suicidal ideation, panic and other manifestations. Zika virus has been associated neuronal injury, genetic alteration that affects fetal development and detrimental maternal mental health symptoms are being documented. While funding calls from the international community are present, there are no specific epidemiological data or fiscal estimates solely for mental health during or after infectious diseases epidemics or disasters that support health care providers and strengthen policies and procedures for responding to such situations. Therefore, those on the frontlines of epidemics including emergency physicians, primary care providers and infectious disease specialists should serve communicate this need and advocate for sustained and increased funding for mental health programs to heighten public awareness regarding acute psychiatric events during infectious diseases outbreaks and offer treatment and support when necessary.

Regulating a health insurance exchange: implications for individuals with mental illness.

PubMed

McGuire, Thomas G; Sinaiko, Anna D

2010-11-01

Under the newly enacted health reform law, millions of lower- and middle-income Americans will purchase individual or family health insurance through state-based markets for private health insurance called insurance "exchanges," which consolidate and regulate the market for individual and small-group health insurance. The authors consider options for structuring choice and pricing of health insurance in an exchange from the perspective of efficiently and fairly serving persons with mental illness. Exchanges are intended to foster choice and competition. However, certain features-open enrollment, individual choice, and imperfect risk adjusters-create incentives for "adverse selection," especially in providing coverage for persons with mental illness, who have higher overall health care costs. The authors review the experience of persons with mental illness in insurance markets similar to the exchanges, such as the Massachusetts Connector and the Federal Employees Health Benefit Program, and note that competition among health plans for enrollees who are "good risks" can undermine coverage and efficiency. They review the possible approaches for contending with selection-related incentives, such as carving out all or part of mental health benefits, providing reinsurance for some mental health care costs, or their preferred option, running the exchange in the same way that an employer runs its employee benefits and addressing selection and cost control issues by choice of contractor. The authors also consider approaches an exchange could use to promote effective consumer choice, such as passive and active roles for the exchange authority. Regulation will be necessary to establish a foundation for success of the exchanges.

Increasing physical activity in patients with mental illness--A randomized controlled trial.

PubMed

Göhner, Wiebke; Dietsche, Christine; Fuchs, Reinhard

2015-11-01

The objective of the study was to evaluate whether a motivational-volitional intervention program offered in addition to an existing sport program during stationary treatment is capable of establishing a post-stationary increase in physical activity in persons with mental illness. N=112 in-patients were initially randomly assigned to the control group (CG; standard rehabilitation) or intervention group (IG; standard rehabilitation plus intervention). Assessments were conducted at four measurement points. At 6 months follow up, the level of exercise in the IG was 95 min/week higher than in the CG (p=.02). The participants of the IG were able to increase their level of goal intention until 6 months follow up (t2: p=.03; t4: p=.005); levels of self-efficacy of the IG increased during intervention (t2: p=.001). Changes in volitional aspects were significant over time (t1-t3), but not specifically for the IG. The intervention was effective at increasing the level of physical activity in patients with mental illness who were initially minimally active. Our results suggest that it could be of great use to place the emphasis of a physical activity-enhancing intervention on its motivational effect since volitional aspects are already taken into sufficient account in standard rehabilitation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Social status determinants of control in individuals' accounts of their mental illness.

PubMed

Maher, Erin J; Kroska, Amy

2002-09-01

We examine the determinants of patients' accounts of their own mental illness. In particular, we examine the factors that affect the likelihood of attributing one's own mental illness to controllable factors rather than non-controllable factors. Our quantitative measure of attributional control is derived from the coding of in-depth interviews with people with severe mental illness seeking treatment for the first time (N = 144). We find that those who occupy positions of social disadvantage (particularly African-American males and those who receive public assistance) are less likely to attribute their illness to controllable sources, suggesting that personal mental illness attributions are systematically related to a person's social location. We outline the significance of these findings for research on the psychological consequences of mental illness attributions.

Coping and resilience of children of a mentally ill parent.

PubMed

Pölkki, Pirjo; Ervast, Sari-Anne; Huupponen, Marika

2004-01-01

This paper examines the needs and stress reactions of children of mentally ill parents, as well as coping and resilience. The study is based on the interviews of six 9-11 years old children and narratives of seventeen female grown up children of mentally ill parents. The younger and older children of the mentally ill parents had not been informed about their parent's illness. The illness of the parent aroused a variety of emotions in them. The children used both practical problem solving and emotional coping mechanisms. Informal social support was available to them but seldom from the public services. It is recommended that professionals in mental health and child welfare services clarify their roles when working with mentally ill parents. The best interest of the child and the parenting they need should be carefully assessed. Open care measures should be offered to families early enough to prevent serious child welfare and mental problems.

Development and psychometric validation of the Task-Specific Self-Efficacy Scale for Chinese people with mental illness.

PubMed

Chou, Chih Chin; Cardoso, Elizabeth Da Silva; Chan, Fong; Tsang, Hector W H; Wu, Mingyi

2007-12-01

The aim of this study was to validate a Task-Specific Self-Efficacy Scale for Chinese people with mental illness. The study included 79 men and 77 women with chronic mental illness. The Task-Specific Self-Efficacy Scale for People with Mental Illness (TSSES-PMI) and Change Assessment Questionnaire for People with Severe and Persistent Mental Illness were used as measures for the study. Factor analysis of the TSSES-PMI resulted in four subscales: Symptom Management Skills, Work-Related Skills, Help-Seeking Skills, and Self-Emotional-Regulation Skills. These community living skills were found to be related to the level of readiness for psychiatric rehabilitation among Chinese people with mental illness. In conclusion the results support the construct validity of the TSSES-PMI for the Chinese population and the TSSES-PMI can be a useful instrument for working with Chinese people with mental illnesses.

Racial and ethnic disparities in mental illness stigma.

PubMed

Rao, Deepa; Feinglass, Joseph; Corrigan, Patrick

2007-12-01

The present study sought to examine whether racial/ethnic differences exist in stigmatizing attitudes towards people with mental illness among community college students. Multiple regression models were used to investigate racial/ethnic differences in students' perceived dangerousness and desire for segregation from persons with mental illness both before and after participation in an antistigma intervention. At baseline, African Americans and Asians perceived people with mental illness as more dangerous and wanted more segregation than Caucasians, and Latinos perceived people with mental illness as less dangerous and wanted less segregation than Caucasians. Similar patterns emerged postintervention, except that Asians' perceptions changed significantly such that they tended to perceive people with mental illness as least dangerous of all the racial/ethnic groups. These findings suggest that racial/ethnic background may help to shape mental illness stigma, and that targeting antistigma interventions to racial/ethnic background of participants may be helpful.

The Variability of Nursing Attitudes Toward Mental Illness: An Integrative Review

PubMed Central

de Jacq, Krystyna; Norful, Allison Andreno; Larson, Elaine

2016-01-01

Mental illnesses are common worldwide, and nurses’ attitudes toward mental illness have an impact on the care they deliver. This integrative literature review focused on nurses’ attitudes toward mental illness. Four databases were searched between January 1, 1995 to October 31, 2015 selecting studies, which met the following inclusion criteria: 1) English language; and 2) Research in which the measured outcome was nurses’ attitudes toward mental illness. Fifteen studies conducted across 20 countries that 4,282 participants met the inclusion criteria. No study was conducted in the United States (U.S.). Studies reported that nurses had mixed attitudes toward mental illness, which were comparable to those of the general public. More negative attitudes were directed toward persons with schizophrenia. Results indicate the need for further research to determine whether attitudes among nurses in the U.S. differ from those reported from other countries and to examine potential gaps in nursing curriculum regarding mental illness. PMID:27888976

Mental illness stigma in the Israeli context: deliberations and suggestions.

PubMed

Tal, Amir; Roe, David; Corrigan, Patrick W

2007-11-01

In this paper we deliberate mental illness stigma in the Israeli context and suggest ways to reduce it, emphasizing the community's role in the rehabilitation of persons with mental illness. A literature review of Israeli and international literature of mental illness stigma. Community mental health, in addition to its traditional focus on developing community-based services, should focus also on community-based interventions such as the delivery of anti-stigma interventions. Providing individualized rehabilitation services in the community while addressing stigma-induced social barriers may create a better recovery ground for Israelis with mental illness.

Providing Tobacco Treatment in a Community Mental Health Setting: A Pilot Study.

PubMed

Okoli, Chizimuzo T C; Mason, Dia A; Brumley-Shelton, Angela; Robertson, Heather

Individuals with mental illnesses (MIs) are disproportionately affected by tobacco-related disease burden because of higher tobacco use prevalence and poor tobacco treatment outcomes. This pilot study examines the outcomes of delivering an evidence-based tobacco treatment program (the Cooper-Clayton program) in a community mental health setting. A prospective nonequivalent group design was used to assess outcomes. This study included 47 participants, of which 19 were in a community mental health setting and 28 were from two non-mental-health settings. Information on sociodemographic (gender, age, educational level, and current life stressors) and medical, MI, substance use, and tobacco use and cessation histories were obtained. Program completion and smoking cessation at the end of treatment (verified with expired carbon monoxide monitoring) were assessed. The program consists of combining behavioral counseling with nicotine replacement therapy for 12 weeks. Participants from the mental health setting were significantly less educated, had greater medical comorbidities, had greater psychiatric and mental health histories, and had greater perceived secondhand tobacco smoke exposure as compared with those from the non-mental-health settings. Thirty-two percent of the participants (6/19) completed the program in the mental health site as compared with 68% (19/28) from the non-mental-health site. None of those from the mental health site achieved cessation as compared with 68% of those from non-mental-health sites. The differential outcomes of evidence-based tobacco treatment programs in non-mental-health versus mental health settings may suggest the need to modify existing tobacco treatment approaches for those with MIs in community settings.

Supporting patients with mental illness: Deconstructing barriers to community pharmacist access.

PubMed

Calogero, Samantha; Caley, Charles F

To discuss the barriers faced by individuals with mental health conditions attempting to access their community pharmacists and to propose solutions toward deconstructing those barriers. Given the prevalence of mental illness and the frequency at which psychotropic medications are dispensed, community pharmacists have a daily opportunity to engage patients with mental illness and be active participants in community-based mental health care. Yet multiple barriers affect patient access to community pharmacists. Some barriers, such as heavy dispensing workload, can be considered as "external" to the pharmacist. Other barriers, such as negative attitudes about mental illness, are considered to be "internal." Research about mental illness stigma in pharmacy often reports that community pharmacists are uncomfortable with, or have little time for, mental health patients. Patients also report experiencing stigma from pharmacists and pharmacy staff. Expanded efforts are needed by the pharmacy profession to deconstruct barriers that patients with mental illness are faced with in community pharmacy, especially related to stigma. Specifically, these efforts should include critically evaluating and addressing the quality of didactic and experiential opportunities in psychiatric pharmacotherapy for pharmacy students, transforming the physical layout of community pharmacies to offer true counseling privacy, educating community pharmacists and pharmacy staff about mental illness, and educating patients about what to expect from community pharmacists. There are opportunities for community pharmacy to improve its impact on mental health treatment outcomes by resolving mental illness stigma and other barriers that prevent patients with mental illness from accessing their community pharmacist. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Learning what matters for patients: qualitative evaluation of a health promotion program for those with serious mental illness

PubMed Central

Shiner, Brian; Whitley, Rob; Van Citters, Aricca D.; Pratt, Sarah I.; Bartels, Stephen J.

2008-01-01

Sedentary lifestyle, poor dietary behaviors and metabolic alterations associated with psychiatric medications contribute to poor health and high rates of obesity among individuals with serious mental illness (SMI). Interventions that increase engagement in physical exercise, dietary modifications, lifestyle changes and preventive health care can provide health benefits across the lifespan. These interventions have led to substantial physical improvements in some persons with SMI, while others have not improved or have experienced worsening physical health. We set out to identify characteristics of a health promotion program that persons with SMI associated with physical health improvements. Interviews were conducted with eight participants from the In SHAPE health-promotion program who lost at least 10 pounds or diminished their waist circumference by at least 10 cm. Interviews aimed to determine which aspects of the program were perceived to be most helpful in promoting physical health improvement. Among successful participants, three themes emerged, highlighting the importance of: (i) individualized interventions promoting engagement in the program; (ii) relationships with health-promotion program employees and (iii) self-confidence resulting from program participation. Health-promotion programs that target these areas may have better success in achieving health benefits for persons with SMI. PMID:18552363

Mental Health: Overcoming the Stigma of Mental Illness

MedlinePlus

... difference. StigmaFree me. National Alliance on Mental Illness. https://www.nami.org/Get-Involved/Take-the-stigmafree- ... it a problem? National Alliance on Mental Illness. https://www.nami.org/stigmafree. Accessed April 25, 2017. ...

Mind-language in the age of the brain: is "mental illness" a useful term?

PubMed

Pies, Ronald

2015-01-01

The term "mental illness" has been criticized on a variety of grounds, most notably by those who have argued that the term is merely a "myth" or a "metaphor." Some have argued that if and when so-called mental illnesses are exhaustively explained by disturbed brain function or structure, we will no longer need the term "mental illness," on the supposition that neuropathology and psychopathology are mutually exclusive constructs. The author argues that, on the contrary, the locution "mental illness" is not rendered useless or unnecessary when neuropathology is discovered, nor is the term "mental illness" a metaphor. Rather, it is an instance of "ordinary language" that we apply quite literally to certain types of suffering and incapacity in the realm of thought, emotion, cognition, and behavior. Although its use carries the risk of perpetuating mind-body dualism and it may be misused as a pejorative label, "mental illness" is likely to remain a useful and meaningful descriptive term, even as we discover the neurobiological underpinnings of psychiatric illness.