An Integrative Review of Recovery Services to Improve the Lives of Adults Living with Severe Mental Illness.
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SUBMITTER: Badu E
PROVIDER: S-EPMC8393579 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundAlthough national policies in China are comprehensive and instructive, a wide disparity exists between different cities. The current status of public mental health services by region in China remains unclear. This study aimed to investigate policies related to public mental health services, the contact coverage of public mental health services and outcomes of service users.MethodsA cross-sectional study was carried out in Southern China, between April 2021 and March 2022. Considering the geographical location, socioeconomic development levels, and prevalence of severe mental illness, four cities including Wuhan, Changsha, Guangzhou, and Shenzhen were selected. Relevant service providers were asked to report data on mental health policies and facility-related information, including mental health resources, registration rates of patients, management rates of patients, and medication rates of patients. Eligible patients were invited to report service user-related data, including contact coverage of public mental health services and their outcomes. SPSS 26.0 was used for data analysis.ResultsThe four cities in Southern China have made different efforts to develop public mental health services, primarily focusing on socio-economically disadvantaged individuals. Community health centers in Guangzhou and Shenzhen reported having more professional human resources on mental health and higher mental health budgets for patients. The contact coverage rates of most public mental services were higher than 80%. Patients in Changsha (B = 0.3; 95%CI: 0.1-0.5), Guangzhou (B = 0.2; 95%CI: 0.1-0.3), and Shenzhen (B = 0.3; 95%CI: 0.1-0.4) who received social medical assistance services reported higher levels of medication adherence. Patients in Wuhan (B = -6.5; 95%CI: -12.9--0.1), Guangzhou (B = -2.8; 95%CI: -5.5--0.1), and Shenzhen who received community-based rehabilitation services reported lower levels of disability (B = -2.6; 95%CI: -4.6--0.5).ConclusionsThere have been advances in public mental health services in the four Southern cities. The contact coverage rates of most public mental health services were higher than 80%. Patients' utilization of public mental services was associated with better health outcomes. To improve the quality of public mental health services, the government should try to engage service users, their family members, and supporters in the design, delivery, operationalization, and evaluation of these public mental health services in the future.
| S-EPMC11363596 | biostudies-literature
Project description:People with severe mental illness are vulnerable to having other people directly take or misappropriate their disability payments. This study investigated the prevalence of different types of financial victimization and the client characteristics associated with being financially victimized.Adults (N=122) receiving inpatient or intensive outpatient psychiatric treatment who received Social Security disability payments completed assessments about money management and victimization. A path model was used to estimate the association of victimization with participant characteristics.Seventy percent of participants experienced at least one type of financial victimization in the preceding 28 days; 35% ran out of money because of victimization. Victimization was significantly associated with being younger, having had more psychiatric hospitalizations, having more recent alcohol use, and, most robustly, having problems managing money (?=.52, p<.01).Financial victimization of disability recipients in acute care settings is common and more likely among people with recent substance use and difficulty managing their funds.
| S-EPMC4276043 | biostudies-literature
Project description:ObjectiveTo examine whether the receipt of timely mental health services is associated with changes in criminal justice interactions.Data sourcesWe used linked administrative data from Medicaid, mental health, and criminal justice settings in Washington State for persons with severe mental illness released from prison (n = 3086).Study designWe estimate local and average treatment effects to examine measures of criminal justice use in the year following release as a function of timely mental health services.Data extraction methodsMeasures of timely service and criminal justice use within 12 months postrelease were created from administrative data.Principal findingsIndividuals receiving timely mental health services are more likely to experience prison re-incarceration overall and specifically for technical violations 12 months postrelease. The effect of service receipt on incarceration for new charges was negative but not significant.ConclusionsThe finding that mental health services receipt is associated with increased risk of re-incarceration due to technical violations speaks to the complexity of the relationship between mental health and criminal justice services for justice-involved persons with severe mental illness. Further research should examine strategies at the interface of criminal justice and mental health that can improve mental health and criminal justice outcomes for this vulnerable population.
| S-EPMC6505414 | biostudies-literature
Project description:ObjectiveTo examine the literature on how recovery of people with severe mental illness (SMI) is conceptualised in low/middle-income countries (LMICs), and in particular what factors are thought to facilitate recovery.DesignScoping review.Data sources and eligibilityWe searched 14 electronic databases, hand searched citations and consulted with experts during the period May-December 2019. Eligible studies were independently screened for inclusion and exclusion by two reviewers. Unresolved discrepancies were referred to a third reviewer.Data extraction and synthesisAll bibliographical data and study characteristics were extracted using a data charting form. Selected studies were analysed through a thematic analysis emerging from extracted data.ResultsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram offers a summary of the results: 4201 titles, 1530 abstracts and 109 full-text articles were screened. Ten articles were selected for inclusion: two from Turkey, two from India, and one each from China, Swaziland, Indonesia, Egypt, South Africa and Vietnam. Although most studies used qualitative methods, data collection and sampling methods were heterogeneous. One study reported on service provider perspectives while the rest provided perspectives from a combination of service users and caregivers. Three themes emerged from the data analysis. First, studies frame recovery as a personal journey occurring along a continuum. Second, there was an emphasis on social relationships as a facilitator of recovery. Third, spirituality emerged as both a facilitator and an indicator of recovery. These themes were not mutually exclusive and some overlap exists.ConclusionAlthough there were commonalities with how high-income countries describe recovery, we also found differences in conceptualisation. These differences in how recovery was understood reflect the importance of framing the personal recovery concept in relation to local needs and contextual issues found in LMICs. This review highlighted the current sparse evidence base and the need to better understand recovery from SMI in LMICs.
| S-EPMC7993175 | biostudies-literature
Project description:The data was obtained from a field survey aimed at measuring the patterns of utilization of mental healthcare services among people living with mental illness. The data was collected using a standardized and structured questionnaire from People Living with Mental Illness (PLMI) receiving treatment and the care-givers of People Living with Mental Illness. Three psychiatric hospitals in Ogun state, Nigeria were the population from which the samples were taken. Chi-square test of independence and correspondence analysis were used to present the data in analyzed form.
| S-EPMC6141371 | biostudies-literature
Project description:ObjectiveSerious mental illnesses (SMI) commonly emerge during young adulthood. Effective treatments for this population exist; however, engagement in treatment is a persistent challenge. This study examines the impact of Just Do You (JDY), an innovative intake-focused intervention designed to improve engagement in treatment and enhance personal recovery.MethodsThe study used a parallel group randomized trial to examine if and how JDY improved recovery among 121 young adults with SMI from low-resourced communities referred to personalized recovery-oriented services (PROS). Measures of engagement (buy-in and attendance) and personal recovery in this pilot study were assessed at baseline and 3-month follow-up.ResultsParticipants in JDY reported more positive engagement outcomes; that is, relative to the control group they reported higher past two week attendance (b = 0.72, p < 0.05, Cohen's d = 0.56) and higher levels of buy-in to treatment (b = 2.42, p < 0.05, Cohen's d = 0.50). JDY also impacted young adults' personal recovery (b = 0.99, p < 0.05, Cohen's d = 1.15) and did so largely by increasing their level of buy-in to the treatment program.ConclusionThis study suggests that an engagement intervention for young adults that orients, prepares, and empowers them to be active and involved in the larger treatment program makes a difference by improving engagement and enhancing recovery. Data also support conceptualizing and examining engagement beyond treatment attendance; in this study what mattered most for recovery was the level of buy-in to treatment among young adults.
| S-EPMC9742319 | biostudies-literature
Project description:ObjectiveMany adults with serious mental illness have significant medical illness burden and poor illness self-management. In this study, the authors examined Living Well, a group-based illness self-management intervention for adults with serious mental illness that was cofacilitated by two providers, one of whom has lived experience with co-occurring mental health and medical conditions.MethodsAdults with serious mental illness (N=242) were randomly assigned to Living Well or an active control condition. Participants completed assessments of quality of life; health attitudes; self-management behaviors; and symptoms at baseline, posttreatment, and follow-up. Emergency room use was assessed by means of chart review. Mixed-effects models examined group × time interactions on outcomes.ResultsCompared with the control group, adults in Living Well had greater improvements at posttreatment in mental health-related quality of life (t=2.15, p=.032), self-management self-efficacy (t=4.10, p<.001), patient activation (t=2.08, p=.038), internal health locus of control (t=2.01, p=.045), behavioral and cognitive symptom management (t=2.77, p=.006), and overall psychiatric symptoms (t=-2.02, p=.044); they had greater improvements at follow-up in physical activity-related self-management (t=2.55, p=.011) and relationship quality (t=-2.45, p=.015). No effects were found for emergency room use. The control group exhibited greater increases in physical health-related quality of life at posttreatment (t=-2.23, p=.026). Significant group differences in self-management self-efficacy (t=2.86,p=.004) and behavioral and cognitive symptom management (t=2.08, p= .038) were maintained at follow-up.ConclusionsCompared with an active control group, a peer-cofacilitated illness self-management group was more effective in improving quality of life and self-management self-efficacy among adults with serious mental illness.
| S-EPMC6494087 | biostudies-literature
Project description:BACKGROUND:Peer-delivered services potentially provide broad, multifaceted benefits for persons suffering severe mental illness. Most studies to date have been conducted in countries with well-developed outpatient mental health systems. The objective of this study was to examine the feasibility for developing a community-based peer service in China. METHODS:Thirteen peer service providers and 54 consumers were recruited from four communities in Beijing. We initiated the program in two communities, followed by another two in order to verify and add to our understanding of potential scalable feasibility. Semi-structured face-to-face interviews were conducted 12 month after initiation at each site to measure satisfaction and perceived benefits from perspectives of peer service providers, and consumers and their caregivers. RESULTS:Key stakeholders reported that peer support services were satisfying and beneficial. Eleven of 13 peer service providers were willing to continue in their roles. Ten, 8, and 7 of them perceived improvements in working skills, social communication skills, and mood, respectively. Among consumers, 39 of 54 were satisfied with peer services. Improvements in mood, social communication skills, illness knowledge, and illness stability were detected among 23, 18, 13, and 13 consumers, respectively. For caregivers, 31 of 32 expressed a positive view regarding peer services. Caregivers reported improvement in their own mood, confidence in recovery of their family members, and reduction in caretaker burdens. CONCLUSIONS:The findings highlight that peer-delivered services have promise in China for benefiting persons with severe mental illness and their family caregivers, as well as the peer service providers themselves.
| S-EPMC6854628 | biostudies-literature
Project description:INTRODUCTION:The construct of recovery was conceptualised in high-income countries and its applicability in low-income and middle- income countries is underexplored. A scoping review is proposed to synthesise knowledge, review conceptual overlap and map key elements of recovery from severe mental illness in low-income and middle-income countries. We aim to appraise the literature so as to inform future recovery-oriented services that consider the cultural and contextual influences on recovery from severe mental illness. METHODS AND ANALYSIS:The following electronic databases: MEDLINE via PubMed, SCOPUS (which included contents of Embase), PsycINFO, CINAHL, Africa-Wide Information, PsycARTICLES, Health source: Nursing/Academic Edition, Academic Search Premier and SocINDEX all via the EBSCOHOST platform, the Latin American and Caribbean Health Sciences Literature, the Cochrane Centre Register of Controlled Trials) and grey literature sources will be searched between May and December 2019. Eligible studies will be independently screened for inclusion and exclusion by two reviewers using a checklist developed for this purpose. Studies published between January 1993 and November 2019 that focus on recovery from severe mental illness in a low-income and middle-income country will be included. Findings will be compared and discrepancies will be discussed. Unresolved discrepancies will be referred to a third reviewer. All bibliographic data and study characteristics will be extracted and thematically analysed using a tool developed through an iterative process by the research team. Indicators will be classified according to a predefined conceptual framework and categorised and described using qualitative content analysis. ETHICS AND DISSEMINATION:The review aims to synthesise information from available publications, hence it does not require ethical approval. The results will be disseminated through publications, conference presentations and future workshops with stakeholders involved within the recovery paradigm of mental health policy and practice. The scoping review title is registered with the Joanna Briggs Institute.
| S-EPMC7044907 | biostudies-literature
Project description:BackgroundMental health policies outline the need for codesign of services and quality improvement in partnership with service users and staff (and sometimes carers), and yet, evidence of systematic implementation and the impacts on healthcare outcomes is limited.ObjectiveThe aim of this study was to test whether an adapted mental health experience codesign intervention to improve recovery-orientation of services led to greater psychosocial recovery outcomes for service users.DesignA stepped wedge cluster randomized-controlled trial was conducted.Setting and participantsFour Mental Health Community Support Services providers, 287 people living with severe mental illnesses, 61 carers and 120 staff were recruited across Victoria, Australia.Main outcome measuresThe 24-item Revised Recovery Assessment Scale (RAS-R) measured individual psychosocial recovery.ResultsA total of 841 observations were completed with 287 service users. The intention-to-treat analysis found RAS-R scores to be similar between the intervention (mean = 84.7, SD= 15.6) and control (mean = 86.5, SD= 15.3) phases; the adjusted estimated difference in the mean RAS-R score was -1.70 (95% confidence interval: -3.81 to 0.40; p = .11).DiscussionThis first trial of an adapted mental health experience codesign intervention for psychosocial recovery outcomes found no difference between the intervention and control arms.ConclusionsMore attention to the conditions that are required for eight essential mechanisms of change to support codesign processes and implementation is needed.Patient and public involvementThe State consumer (Victorian Mental Illness Awareness Council) and carer peak bodies (Tandem representing mental health carers) codeveloped the intervention. The adapted intervention was facilitated by coinvestigators with lived-experiences who were coauthors for the trial and process evaluation protocols, the engagement model and explanatory model of change for the trial.
| S-EPMC8628597 | biostudies-literature