scholarly journals The future of mental health care: peer-to-peer support and social media

2016 ◽  
Vol 25 (2) ◽  
pp. 113-122 ◽  
Author(s):  
J. A. Naslund ◽  
K. A. Aschbrenner ◽  
L. A. Marsch ◽  
S. J. Bartels

Aims:People with serious mental illness are increasingly turning to popular social media, including Facebook, Twitter or YouTube, to share their illness experiences or seek advice from others with similar health conditions. This emerging form of unsolicited communication among self-forming online communities of patients and individuals with diverse health concerns is referred to as peer-to-peer support. We offer a perspective on how online peer-to-peer connections among people with serious mental illness could advance efforts to promote mental and physical wellbeing in this group.Methods:In this commentary, we take the perspective that when an individual with serious mental illness decides to connect with similar others online it represents a critical point in their illness experience. We propose a conceptual model to illustrate how online peer-to-peer connections may afford opportunities for individuals with serious mental illness to challenge stigma, increase consumer activation and access online interventions for mental and physical wellbeing.Results:People with serious mental illness report benefits from interacting with peers online from greater social connectedness, feelings of group belonging and by sharing personal stories and strategies for coping with day-to-day challenges of living with a mental illness. Within online communities, individuals with serious mental illness could challenge stigma through personal empowerment and providing hope. By learning from peers online, these individuals may gain insight about important health care decisions, which could promote mental health care seeking behaviours. These individuals could also access interventions for mental and physical wellbeing delivered through social media that could incorporate mutual support between peers, help promote treatment engagement and reach a wider demographic. Unforeseen risks may include exposure to misleading information, facing hostile or derogatory comments from others, or feeling more uncertain about one's health condition. However, given the evidence to date, the benefits of online peer-to-peer support appear to outweigh the potential risks.Conclusion:Future research must explore these opportunities to support and empower people with serious mental illness through online peer networks while carefully considering potential risks that may arise from online peer-to-peer interactions. Efforts will also need to address methodological challenges in the form of evaluating interventions delivered through social media and collecting objective mental and physical health outcome measures online. A key challenge will be to determine whether skills learned from peers in online networks translate into tangible and meaningful improvements in recovery, employment, or mental and physical wellbeing in the offline world.

2020 ◽  
Vol 1 ◽  
pp. 263348952094320
Author(s):  
Kelly A Aschbrenner ◽  
Gary R Bond ◽  
Sarah I Pratt ◽  
Kenneth Jue ◽  
Gail Williams ◽  
...  

Background: Limited empirical evidence exists on the impact of adaptations that occur in implementing evidence-based practices (EBPs) in real-world practice settings. The purpose of this study was to measure and evaluate adaptations to an EBP (InSHAPE) for obesity in persons with serious mental illness in a national implementation in mental health care settings. Methods: We conducted telephone interviews with InSHAPE provider teams at 37 (95%) of 39 study sites during 24-month follow-up of a cluster randomized trial of implementation strategies for InSHAPE at behavioral health organizations. Our team rated adaptations as fidelity-consistent or fidelity-inconsistent. Multilevel regression models were used to estimate the relationship between adaptations and implementation and participant outcomes. Results: Of 37 sites interviewed, 28 sites (76%) made adaptations to InSHAPE ( M = 2.1, SD = 1.3). Sixteen sites (43%) made fidelity-consistent adaptations, while 22 (60%) made fidelity-inconsistent adaptations. The number of fidelity-inconsistent adaptations was negatively associated with InSHAPE fidelity scores (β = −4.29; p < .05). A greater number of adaptations were associated with significantly higher odds of participant-level cardiovascular risk reduction (odds ratio [ OR] = 1.40; confidence interval [CI] = [1.08, 1.80]; p < .05). With respect to the type of adaptation, we found a significant positive association between the number of fidelity-inconsistent adaptations and cardiovascular risk reduction ( OR = 1.59; CI = [1.01, 2.51]; p < .05). This was largely explained by the fidelity-inconsistent adaptation of holding exercise sessions at the mental health agency versus a fitness facility in the community (a core form of InSHAPE) ( OR = 2.52; 95% CI = [1.11, 5.70]; p < .05). Conclusions: This research suggests that adaptations to an evidence-based lifestyle program were common during implementation in real-world mental health practice settings even when fidelity was monitored and reinforced through implementation interventions. Results suggest that adaptations, including those that are fidelity-inconsistent, can be positively associated with improved participant outcomes when they provide a potential practical advantage while maintaining the core function of the intervention. Plain language abstract: Treatments that have been proven to work in research studies are not always one-size-fits-all. In real-world clinical settings where people receive mental health care, sometimes there are good reasons to change certain things about a treatment. For example, a particular treatment might not fit well in a specific clinic or cultural context, or it might not meet the needs of specific patient groups. We studied adaptations to an evidence-based practice (InSHAPE) targeting obesity in persons with serious mental illness made by teams implementing the program in routine mental health care settings. We learned that adaptations to InSHAPE were common, and that an adaptation that model experts initially viewed as inconsistent with fidelity to the model turned out to have a positive impact on participant health outcomes. The results of this study may encourage researchers and model experts to work collaboratively with mental health agencies and clinicians implementing evidence-based practices to consider allowing for and guiding adaptations that provide a potential practical advantage while maintaining the core purpose of the intervention.


Diabetes Care ◽  
2014 ◽  
Vol 37 (8) ◽  
pp. 2261-2267 ◽  
Author(s):  
Judith A. Long ◽  
Andrew Wang ◽  
Elina L. Medvedeva ◽  
Susan V. Eisen ◽  
Adam J. Gordon ◽  
...  

2008 ◽  
Vol 59 (8) ◽  
pp. 921-924 ◽  
Author(s):  
Amy L. Drapalski ◽  
Jaime Milford ◽  
Richard W. Goldberg ◽  
Clayton H. Brown ◽  
Lisa B. Dixon

Author(s):  
Lauren Mizock ◽  
Zlatka Russinova

Chapter 2 offers an overview of the recovery movement in the provision of mental health care for serious mental illness. Within the recovery movement in mental illness treatment, recovery is understood as a process of living a satisfying life of well-being and autonomy, as opposed to mere symptom elimination. Early theory of the recovery paradigm is outlined, highlighting the process of acceptance of serious mental illness within this model. Applications of the recovery paradigm to mental health care are discussed, as well as the various types of recovery from a serious mental illness. Acceptance is examined as the neglected paradox of recovery. Other parts of the chapter include discussion questions, activities, the “Personal Recovery Processes Worksheet,” and diagrams.


Author(s):  
Charles L. Scott ◽  
Brian Falls

An increasing number of individuals with mental illness are now treated in correctional environments instead of community settings. In the incarcerated population, prevalence estimates of serious mental illness (SMI) range from 9 to 20% compared to 6% in the community. More astonishingly, over three times more persons with serious mental illness in the United States are located in jails and prisons than in hospitals. It was not always like this. How did U.S. correctional systems become de facto mental health institutions for so many? Scholars point to a number of reasons for the increasing prevalence of mental illness among incarcerated individuals, including deinstitutionalization and limited community resources, prominent court decisions and legislative rulings, and the ‘revolving door’ phenomenon. There are many similarities between correctional and community mental health care services. Both systems typically provide appropriate medications, emergency care, hospitalization, medication management, and follow-up care. However, key differences often exist in correctional systems, including restricted formularies due to concerns of medication abuse or cost, alternative involuntary medication procedures, restricted access by visitors, and the inability of mental health providers to control the treatment environment. This chapter summarizes the historical context of correctional versus community mental health; factors resulting in the increasing management of people with mental illness in correctional settings; and similarities and differences between the provision of mental health care in correctional versus community settings.


2013 ◽  
Vol 64 (12) ◽  
pp. 1203-1210 ◽  
Author(s):  
Carla A. Green ◽  
Nancy A. Perrin ◽  
Michael C. Leo ◽  
Shannon L. Janoff ◽  
Bobbi Jo H. Yarborough ◽  
...  

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