Barriers and Facilitators to Behavior Change for Individuals with Severe Mental Illness who Received the Transdiagnostic Intervention for Sleep and Circadian Dysfunction in a Community Mental Health Setting

SummaryAims – Specialist interventions in community psychiatry for severe mental illness are expanding and their place needs to be re-examined. Methods – Recent literature is reviewed to evaluate the advantages and disadvantages of specialist teams. Results – Good community mental health services reduce drop out from care, prevent suicide and unnatural deaths, and reduce admission to hospital. Most of these features have been also demonstrated by assertive community outreach and crisis resolution teams when good community services are not available. In well established community services assertive community teams do not reduce admission but both practitioners and patients prefer this service to other approaches and it leads to better engagement. Crisis resolution teams appear to be more successful than assertive community teams in preventing admission to hospital, although head- to-head comparisons have not yet been made. All specialist teams have the potential of fragmenting services and thereby reducing continuity of care. Conclusions – The assets of improved engagement and greater satisfaction with assertive, crisis resolution and home treatment teams are clear from recent evidence, but to improve integration of services they are probably best incorporated into community mental health services rather than standing alone.Declaration of Interest: The author has been the sole consultant in two assertive outreach teams since 1994 and might there- fore be expected to be in favour of this genre of service. He has received grants for evaluation of different services models from the Department of Health (UK) and the Medical Research Council (UK).

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Metabolic Syndrome Screening in People With Severe Mental Illness: Results From Two Spanish Community Mental Health Centers

Journal of the American Psychiatric Nurses Association ◽

10.1177/1078390319826686 ◽

2019 ◽

Vol 26 (2) ◽

pp. 162-171 ◽

Cited By ~ 1

Author(s):

Sara Fernández Guijarro ◽

Carolina Miguel García ◽

Edith Pomarol-Clotet ◽

Elena Nunilón Egea López ◽

Maria Dolors Burjales Martí ◽

...

Keyword(s):

Mental Health ◽

Risk Factors ◽

Metabolic Syndrome ◽

Mental Illness ◽

Community Mental Health ◽

Physical Health ◽

Severe Mental Illness ◽

Health Centers ◽

Community Mental Health Centers ◽

Mental Health Centers

BACKGROUND: The excess of mortality in people with severe mental illness is due to unnatural causes such as accidents or suicides and natural causes such as metabolic syndrome. The presence of modifiable risk factors like tobacco consumption increases cardiovascular and metabolic risk. AIMS: The purpose of this study was to identify the prevalence of metabolic syndrome and other cardiovascular risk factors in people with severe mental illness. This study also aimed to identify the prevalence of patients receiving treatment for any metabolic syndrome risk factor. METHOD: A cross-sectional descriptive study was performed. A total of 125 participants from two community mental health centers in Spain were recruited. RESULTS: More than half of the participants (58.4%) were active smokers. The prevalence of metabolic syndrome was 60%. A total of 16.8% received previous treatment for hypertension, 17.6% for hypertriglyceridemia, and 11.2% for diabetes. No differences were found between centers (22.7% vs. 18.7%, p = .9). CONCLUSIONS: The findings underscore the importance of monitoring the physical health of patients on antipsychotic therapy. The identification and management of cardiovascular and metabolic risks factors is an essential part of nursing care for people with severe mental illness. Mental health nurses are ideally positioned to carry out this task by performing physical health screening, health education, and lifestyle interventions.

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Introduction to the Special Section on Integrating Community Mental Health and the Criminal Justice Systems for Adults with Severe Mental Illness: Bridges and Barriers

Psychiatric Quarterly ◽

10.1023/b:psaq.0000019806.30099.04 ◽

2004 ◽

Vol 75 (2) ◽

pp. 105-106

Author(s):

Robert L. Weisman

Keyword(s):

Mental Health ◽

Mental Illness ◽

Criminal Justice ◽

Community Mental Health ◽

Severe Mental Illness ◽

Special Section ◽

Criminal Justice Systems ◽

Justice Systems

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Impact of Jointly Using an e–Mental Health Resource (Self-Management And Recovery Technology) on Interactions Between Service Users Experiencing Severe Mental Illness and Community Mental Health Workers: Grounded Theory Study

JMIR Mental Health ◽

10.2196/25998 ◽

2021 ◽

Vol 8 (6) ◽

pp. e25998

Author(s):

Anne Williams ◽

Ellie Fossey ◽

John Farhall ◽

Fiona Foley ◽

Neil Thomas

Keyword(s):

Mental Health ◽

Mental Illness ◽

Grounded Theory ◽

Community Mental Health ◽

Severe Mental Illness ◽

Health Workers ◽

Health Resources ◽

Community Mental Health Services ◽

Discovery Process ◽

Mental Health Resource

Background e–Mental health resources are increasingly available for people who experience severe mental illness, including those who are users of community mental health services. However, the potential for service users (SUs) living with severe mental illness to use e–mental health resources together with their community mental health workers (MHWs) has received little attention. Objective This study aims to identify how jointly using an interactive website called Self-Management And Recovery Technology (SMART) in a community mental health context influenced therapeutic processes and interactions between SUs and MHWs from their perspective. Methods We conducted a qualitative study using a constructivist grounded theory methodology. Data were collected through individual semistructured interviews with 37 SUs and 15 MHWs who used the SMART website together for 2 to 6 months. Data analysis involved iterative phases of coding, constant comparison, memo writing, theoretical sampling, and consultation with stakeholders to support the study’s credibility. Results A substantive grounded theory, discovering ways to keep life on track, was developed, which portrays a shared discovery process arising from the SU-worker-SMART website interactions. The discovery process included choosing to use the website, revealing SUs’ experiences, exploring these experiences, and gaining new perspectives on how SUs did and could keep their lives on track. SUs and MHWs perceived that their three-way interactions were enjoyable, beneficial, and recovery focused when using the website together. They experienced the shared discovery process as relationship building—their interactions when using the website together were more engaging and equal. Conclusions Jointly using an e–mental health resource elicited recovery-oriented interactions and processes between SUs and MHWs that strengthened their therapeutic relationship in real-world community mental health services. Further work to develop and integrate this novel use of e–mental health in community mental health practice is warranted.

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Invited commentary on: Community mental health team management in severe mental illness

The British Journal of Psychiatry ◽

10.1192/bjp.178.6.503 ◽

2001 ◽

Vol 178 (6) ◽

pp. 503-505 ◽

Cited By ~ 8

Author(s):

Frank Holloway

Keyword(s):

Mental Health ◽

Mental Illness ◽

Community Mental Health ◽

Severe Mental Illness ◽

Team Management ◽

Community Mental Health Team ◽

Mental Health Team ◽

Health Team

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HIV-related services for persons with severe mental illness: Policy and practice in new hampshire community mental health

The Journal of Behavioral Health Services & Research ◽

10.1007/bf02291746 ◽

2000 ◽

Vol 27 (3) ◽

pp. 347-353 ◽

Cited By ~ 8

Author(s):

Mary F. Brunette ◽

Carolyn C. Mercer ◽

Catherine L. Carlson ◽

Stanley D. Rosenberg ◽

Benjamin F. Lewis

Keyword(s):

Mental Health ◽

Mental Illness ◽

Community Mental Health ◽

Severe Mental Illness ◽

New Hampshire ◽

Policy And Practice ◽

Related Services

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Multidisciplinary activities in a community mental health service: relationship to Health of the Nation Outcome Scale scores and diagnosis

Psychiatric Bulletin ◽

10.1192/pb.bp.107.019190 ◽

2009 ◽

Vol 33 (5) ◽

pp. 172-175 ◽

Cited By ~ 3

Author(s):

David Meagher ◽

Sinead O'Brien ◽

Ananth Pullela ◽

Anthony Oshun ◽

Pat Brosnan

Keyword(s):

Mental Health ◽

Mental Illness ◽

Community Mental Health ◽

Severe Mental Illness ◽

Multidisciplinary Team ◽

Social Impairment ◽

Severe Illness ◽

Community Mental Health Service ◽

Symptom Profile ◽

Scale Scores

Aims and MethodMultidisciplinary activities of community mental health teams in Ireland are understudied. We explored symptom profile and multidisciplinary team contacts in a complete sector population (n = 504).ResultsThe frequency of attendance was greater in individuals with severe mental illness (P<0.001) and correlated with total Health of the Nation Outcome Scale (HoNOS) scores (P<0.001) and with the sub-scales for social disability (P<0.001) and symptoms (P<0.01). Sixty-two per cent of individuals were receiving shared care and were more likely to have severe mental illness (P<0.001) and higher total HoNOS scores (P<0.001). Frequency of attendance correlated with total HoNOS scores and subscale scores for social impairment and symptoms.Clinical ImplicationsFrequency of service attendance and activities of multidisciplinary team members vary with symptom profile of service attenders but are focused towards individuals with more severe illness and greater problems identified by the HoNOS.

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Methodological challenges in the use of focus groups with people with severe mental illness

Cadernos de Saúde Pública ◽

10.1590/0102-311x00187316 ◽

2017 ◽

Vol 33 (6) ◽

Cited By ~ 4

Author(s):

Rosana Teresa Onocko-Campos ◽

Alberto Rodolfo Giovanello Díaz ◽

Catarina Magalhães Dahl ◽

Erotildes Maria Leal ◽

Octavio Domont de Serpa Junior

Keyword(s):

Mental Health ◽

Mental Illness ◽

Community Mental Health ◽

Focus Groups ◽

Severe Mental Illness ◽

Ethical Issues ◽

Collaborative Work ◽

Mental Healthcare ◽

Community Mental Health Services ◽

Ethical Challenges

Abstract: This study addresses the practical, methodological and ethical challenges that were found in three studies that used focus groups with people with severe mental illness, in the context of community mental health services in Brazil. Focus groups are a powerful tool in health research that need to be better discussed in research with people with severe mental illness, in the context of community mental health facilities. This study is based on the authors’ experience of conducting and analyzing focus groups in three different cities - Campinas, Rio de Janeiro and Salvador - between 2006-2010. The implementation of focus groups with people with severe mental illness is discussed in the following categories; planning, group design, sampling, recruitment, group interview guides, and conduction. The importance of connecting mental healthcare providers as part of the research context is emphasized. Ethical issues and challenges are highlighted, as well as the establishment of a sensitive and empathic group atmosphere, wherein mutual respect can facilitate interpersonal relations and enable people diagnosed with severe mental illness to make sense of the experience. We emphasize the relevance of the interaction between clinical and research teams in order to create collaborative work, achieve inquiry aims, and elicit narratives of mental health users and professionals.

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