Poverty transitions in severe mental illness: longitudinal analysis of social drift in China, 1994–2015

2021 ◽  
pp. 1-9
Author(s):  
Yue-Hui Yu ◽  
Wei Luo ◽  
Bo Liu ◽  
Wei-Hong Kuang ◽  
Larry Davidson ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Poverty Rate ◽  
International Classification Of Disease ◽  
Fast Change ◽  
The Social ◽  
Poverty Transitions ◽  
Icd 10 ◽  
Persistent Poverty

Abstract Background Although poverty associated with severe mental illness (SMI) has been documented in many studies, little long-term evidence of social drift exists. This study aimed to unravel the poverty transitions among persons with SMI in a fast change community in China. Methods Two mental health surveys, using the International Classification of Disease (ICD-10), were conducted in the same six townships of Xinjin county, Chengdu, China in 1994 and 2015. A total of 308 persons with SMI identified in 1994 were followed up in 2015. The profiles of poverty transitions were identified and regression modelling methods were applied to determine the predictive factors of poverty transitions. Results The poverty rate of persons with SMI increased from 39.9% to 49.4% in 1994 and 2015. A larger proportion of them had fallen into poverty (27.3%) rather than moved out of it (17.8%). Those persons with SMI who had lost work ability, had physical illness and more severe mental disabilities in 1994, as well as those who had experienced negative changes on these factors were more likely to live in persistent poverty or fall into poverty. Higher education level and medical treatment were major protective factors of falling into poverty. Conclusions This study shows long-term evidence on the social drift of persons with SMI during the period of rapid social development in China. Further targeted poverty alleviation interventions should be crucial for improving treatment and mental recovery and alleviating poverty related to SMI.

scholarly journals Cost Analysis of a High Support Housing Initiative for Persons with Severe Mental Illness and Long-Term Psychiatric Hospitalization

2018 ◽  
Vol 63 (7) ◽  
pp. 492-500 ◽  
Author(s):  
David Rudoler ◽  
Claire de Oliveira ◽  
Binu Jacob ◽  
Melonie Hopkins ◽  
Paul Kurdyak
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Cost Saving ◽  
Cost Analysis ◽  
Severe Mental Illness ◽  
Inpatient Care ◽  
Cost Savings ◽  
Support Housing ◽  
High Support

Objective: The objective of this article was to conduct a cost analysis comparing the costs of a supportive housing intervention to inpatient care for clients with severe mental illness who were designated alternative-level care while inpatient at the Centre for Addiction and Mental Health in Toronto. The intervention, called the High Support Housing Initiative, was implemented in 2013 through a collaboration between 15 agencies in the Toronto area. Method: The perspective of this cost analysis was that of the Ontario Ministry of Health and Long-Term Care. We compared the cost of inpatient mental health care to high-support housing. Cost data were derived from a variety of sources, including health administrative data, expenditures reported by housing providers, and document analysis. Results: The High Support Housing Initiative was cost saving relative to inpatient care. The average cost savings per diem were between $140 and $160. This amounts to an annual cost savings of approximately $51,000 to $58,000. When tested through sensitivity analysis, the intervention remained cost saving in most scenarios; however, the result was highly sensitive to health system costs for clients of the High Support Housing Initiative program. Conclusions: This study suggests the High Support Housing Initiative is potentially cost saving relative to inpatient hospitalization at the Centre for Addiction and Mental Health.

scholarly journals Smoking cessation in severe mental illness: combined long-term quit rates from the UK SCIMITAR trials programme

2019 ◽  
pp. 1-3 ◽  
Author(s):  
Simon Gilbody ◽  
Emily Peckham ◽  
Della Bailey ◽  
Catherine Arundel ◽  
Paul Heron ◽  
...  
Keyword(s):  
Mental Illness ◽  
Smoking Cessation ◽  
Severe Mental Illness ◽  
Short Term ◽  
Cessation Intervention ◽  
Term Trial ◽  
Short And Long Term ◽  
The Uk ◽  
Full Trial

Summary Smoking contributes to health inequalities for people with severe mental illness (SMI). Although smoking cessation interventions are effective in the short term, there are few long-term trial-based estimates of abstinence. The SCIMITAR trials programme includes the largest trial to date of a smoking cessation intervention for people with SMI, but this was underpowered to detect anticipated long-term quit rates. By pooling pilot and full-trial data we found that quit rates were maintained at 12 months (OR = 1.67, 95% CI 1.02–2.73, P = 0.04). Policymakers can now be confident that bespoke smoking cessation interventions produce successful short- and long-term quitting.

scholarly journals Household poverty in people with severe mental illness in rural China: 1994–2015

BJPsych Open ◽  
2020 ◽  
Vol 6 (5) ◽  
Author(s):  
Yue-Hui Yu ◽  
Wei Luo ◽  
Man-Xi He ◽  
Xin Yang ◽  
Bo Liu ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Socioeconomic Development ◽  
Rural China ◽  
Work And Family ◽  
Factors Associated ◽  
Household Poverty ◽  
Poor Households ◽  
Icd 10

Background Little is known about poverty trends in people with severe mental illness (SMI) over a long time span, especially under conditions of fast socioeconomic development. Aims This study aims to unravel changes in household poverty levels among people with SMI in a fast-changing rural community in China. Method Two mental health surveys, using ICD-10, were conducted in the same six townships of Xinjin county, Chengdu, China. A total of 711 and 1042 people with SMI identified in 1994 and 2015, respectively, participated in the study. The Foster-Greer-Thorbecke poverty index was adopted to measure the changes in household poverty. These changes were decomposed into effects of growth and equity using a static decomposition method. Factors associated with household poverty in 1994 and 2015 were examined and compared by regression analyses. Results The proportion of poor households, as measured by the headcount ratio, increased significantly from 29.8% in 1994 to 39.5% in 2015. Decomposition showed that poverty in households containing people with SMI had worsened because of a redistribution effect. Factors associated with household poverty had also changed during the study period. The patient's age, ability to work and family size were of paramount significance in 2015. Conclusions This study shows that the levels of poverty faced by households containing people with SMI has become more pressing with China's fast socioeconomic development. It calls for further integration of mental health recovery and targeted antipoverty interventions for people with SMI as a development priority.

scholarly journals The Social–Environmental Context of Violent Behavior in Persons Treated for Severe Mental Illness

2002 ◽  
Vol 92 (9) ◽  
pp. 1523-1531 ◽  
Author(s):  
Jeffrey W. Swanson ◽  
Marvin S. Swartz ◽  
Susan M. Essock ◽  
Fred C. Osher ◽  
H. Ryan Wagner ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Violent Behavior ◽  
Environmental Context ◽  
The Social ◽  
Social Environmental

Long-Term Outcomes of Unlocking Chinese Patients with Severe Mental Illness

2018 ◽  
Vol 89 (3) ◽  
pp. 757-763
Author(s):  
Yun-Shu Zhang ◽  
Ke-Qing Li ◽  
Jian-Hua Sun ◽  
Wei Li ◽  
Zhi-Hua Tong ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Chinese Patients ◽  
Long Term Outcomes

scholarly journals Social exclusion of people with severe mental illness in Switzerland: results from the Swiss Health Survey

2017 ◽  
Vol 28 (04) ◽  
pp. 427-435 ◽  
Author(s):  
D. Richter ◽  
H. Hoffmann
Keyword(s):  
Mental Illness ◽  
General Population ◽  
Severe Mental Illness ◽  
Social Exclusion ◽  
Health Survey ◽  
Social Situation ◽  
Physical Illness ◽  
Swiss Health Survey ◽  
Swiss Health ◽  
The Social

Aims.People with severe mental illness (SMI) have a high risk of living socially excluded from the mainstream society. Policy initiatives and health systems aim to improve the social situation of people who suffer from mental health disabilities. The aim of this study was to explore the extent of social exclusion (employment and income, social network and social activities, health problems) of people with SMI in Switzerland.Methods.Data from the Swiss Health Survey 2012 were used to compare the social exclusion magnitude of people with SMI with those suffering from severe physical illness, common mental illness and the general population.Results.With the exception of Instrumental Activities of Daily Living, we found a gradient of social exclusion that showed people with SMI to be more excluded than the comparison groups. Loneliness and poverty were widespread among people with SMI. Logistic regression analyses on each individual exclusion indicator revealed that people with SMI and people with severe physical illness were similarly excluded on many indicators, whereas people with common mental illness and the general population were much more socially included.Conclusions.In contrast to political and health system goals, many people with SMI suffer from social exclusion. Social policy and clinical support should increase the efforts to counter exclusionary trends, especially in terms of loneliness and poverty.

scholarly journals Diagnose, indicate, and treat severe mental illness (DITSMI) as appropriate care: A three-year follow-up study in long-term residential psychiatric patients on the effects of re-diagnosis on medication prescription, patient functioning, and hospital bed utilization

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
H. M. Veereschild ◽  
E. O. Noorthoorn ◽  
H. L. I. Nijman ◽  
C. L. Mulder ◽  
M. Dankers ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Psychosocial Functioning ◽  
Psychiatric Patients ◽  
Control Group ◽  
Chi Square ◽  
Medication Prescription ◽  
Appropriate Care ◽  
Severely Mentally Ill

Abstract Background. While polypharmacy is common in long-term residential psychiatric patients, prescription combinations may, from an evidence-based perspective, be irrational. Potentially, many psychiatric patients are treated on the basis of a poor diagnosis. We therefore evaluated the DITSMI model (i.e., Diagnose, Indicate, and Treat Severe Mental Illness), an intervention that involves diagnosis (or re-diagnosis) and appropriate treatment for severely mentally ill long-term residential psychiatric patients. Our main objective was to determine whether DITSMI affected changes over time regarding diagnoses, pharmacological treatment, psychosocial functioning, and bed utilization. Methods. DITSMI was implemented in a consecutive patient sample of 94 long-term residential psychiatric patients during a longitudinal cohort study without a control group. The cohort was followed for three calendar years. Data were extracted from electronic medical charts. As well as diagnoses, medication use and current mental status, we assessed psychosocial functioning using the Health of the Nations Outcome Scale (HoNOS). Bed utilization was assessed according to length of stay (LOS). Change was analyzed by comparing proportions of these data and testing them with chi-square calculations. We compared the numbers of diagnoses and medication changes, the proportions of HoNOS scores below cut-off, and the proportions of LOS before and after provision of the protocol. Results. Implementation of the DITSMI model was followed by different diagnoses in 49% of patients, different medication in 67%, some improvement in psychosocial functioning, and a 40% decrease in bed utilization. Conclusions. Our results suggest that DITSMI can be recommended as an appropriate care for all long-term residential psychiatric patients.

scholarly journals The social adjustment of people with severe mental illness in São Paulo, Brazil

2005 ◽  
Vol 27 (4) ◽  
pp. 309-314 ◽  
Author(s):  
André Gulinelli ◽  
Lilian R C Ratto ◽  
Paulo Rossi Menezes
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Social Functioning ◽  
Social Adjustment ◽  
Psychiatric Symptoms ◽  
Sao Paulo ◽  
Mental Illnesses ◽  
São Paulo ◽  
The Social

OBJECTIVE: To investigate the social adjustment of individuals with severe mental illness living in the community in a large urban center of a developing country, and the characteristics associated with poor social functioning. METHOD: A cross-sectional study was performed in the city of Sao Paulo. Eligible subjects were residents of a defined geographic area, aged between 18 and 65, with a diagnosis of functional psychosis who had had contact with any public psychiatric service during a defined period. Structured assessments were used to obtain information on social-demographic characteristics, diagnosis (ICD-10), psychiatric symptoms (PANSS), and social adjustment (DAS). RESULTS: One hundred and eighty-eight subjects were included, of whom, 120 (63.8%) had some degree of impairment in social functioning. The most frequently affected areas of social functioning were work performance and sexual role. Twenty-four patients (12.8%) showed poor or very poor social adjustment in the month prior to the interview. Negative symptoms, number of previous admissions and general symptoms showed statistically significant associations with global social adjustment scores. CONCLUSIONS: The proportion of patients showing any degree of impairment in social adjustment was as high as in more developed societies. In order to successfully implement the new mental health policy in Brazil, better provision of community-based mental health services for those with severe mental illnesses is needed.

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