Measuring recovery as an outcome

2015 ◽  
Vol 12 (03) ◽  
pp. 174-179 ◽  
Author(s):  
V. A. Noel ◽  
P. E. Deegan ◽  
R. E. Drake
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Mental Health Treatment ◽  
Mental Health Problems ◽  
Service Users ◽  
Meaningful Life ◽  
Health Treatment ◽  
History Of ◽  
Premorbid Functioning

Summary Background: As the concept of recovery has become increasingly popular in mental health treatment settings, professionals have attempted to measure recovery as an outcome. Aims: This article reviews the history of the concept of recovery and recent attempts to measure recovery as an outcome. Results: The concept of recovery, as developed by people who experienced mental health problems, emphasizes the process of learning to live a meaningful life in spite of vulnerabilities and symptoms. Traditional outcome studies assess recovery as cure or return to premorbid functioning, not in this new sense of developing quality of life. Newer measures attempt to assess the process and outcomes of recovery, but with minimal consistency, reflecting the heterogeneity of definitions, populations, and programs. Attempts to measure recovery may, nevertheless, move the mental health system, programs, and professionals closer to understanding and honoring the ideals of recovery that are so meaningful to service users.

Barriers to Practitioners' Endorsement of a Recovery Perspective

2021 ◽  
pp. 861-879
Author(s):  
Debra Kram-Fernandez
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Treatment ◽  
Behavioral Theory ◽  
Meaningful Life ◽  
Health Treatment ◽  
Surgeon General ◽  
History Of ◽  
Cognitive Behavioral Theory ◽  
The Impact

This chapter is concerned with the impact of practitioner biases on the experience of a meaningful life for individuals who live with serious mental illness (SMI). Professional biases, systemic biases that originate in societal fear and lack of knowledge, and internalized stigma taken on by the consumer affect life decisions. Following a history of treatment initiatives experienced by consumers as abusive, it is important to understand how a system envisioned to protect and treat was often experienced as harmful. In the 1980s a movement emerged to transform the nature of mental health treatment to a client-centered, recovery-oriented model. In 1999, the Surgeon General proclaimed that all agencies serving this population should be recovery oriented. Yet, the shift to this approach to understanding people with SMI has not been complete. While there are many explanations why practitioners may not fully embrace this perspective, this chapter introduces the concept of “schemas” from cognitive behavioral theory as a way of examining professional biases in the field of SMI.

Barriers to Practitioners' Endorsement of a Recovery Perspective

2018 ◽  
pp. 108-132 ◽  
Author(s):  
Debra Kram-Fernandez
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Treatment ◽  
Behavioral Theory ◽  
Meaningful Life ◽  
Health Treatment ◽  
Surgeon General ◽  
History Of ◽  
Cognitive Behavioral Theory ◽  
The Impact

This chapter is concerned with the impact of practitioner biases on the experience of a meaningful life for individuals who live with serious mental illness (SMI). Professional biases, systemic biases that originate in societal fear and lack of knowledge, and internalized stigma taken on by the consumer affect life decisions. Following a history of treatment initiatives experienced by consumers as abusive, it is important to understand how a system envisioned to protect and treat was often experienced as harmful. In the 1980s a movement emerged to transform the nature of mental health treatment to a client-centered, recovery-oriented model. In 1999, the Surgeon General proclaimed that all agencies serving this population should be recovery oriented. Yet, the shift to this approach to understanding people with SMI has not been complete. While there are many explanations why practitioners may not fully embrace this perspective, this chapter introduces the concept of “schemas” from cognitive behavioral theory as a way of examining professional biases in the field of SMI.

Unmet mental health needs in patients with advanced B-cell lymphomas

2021 ◽  
pp. 1-6
Author(s):  
Chrystal Marte ◽  
Login S. George ◽  
Sarah C. Rutherford ◽  
Daniel Jie Ouyang ◽  
Peter Martin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Mental Health Service ◽  
B Cell ◽  
Mental Health Treatment ◽  
Health Service Utilization ◽  
Mental Health Service Utilization ◽  
B Cell Lymphomas ◽  
Health Treatment

Abstract Context Existing research on psychological distress and mental health service utilization has focused on common types of solid tumor cancers, leaving significant gaps in our understanding of patients experiencing rare forms of hematologic cancers. Objective To examine distress, quality of life, and mental health service utilization among patients with aggressive, refractory B-cell lymphomas. Method Patients (n = 26) with B-cell lymphomas that relapsed after first- or second-line treatment completed self-report measures of distress (Hospital Anxiety and Depression Scale) and quality of life (Short-Form Health Survey, SF-12). Patients also reported whether they had utilized mental health treatment since their cancer diagnosis. Results Approximately 42% (n = 11) of patients reported elevated levels of psychological distress. Of patients with elevated distress, only one quarter (27.2%; n = 3) received mental health treatment, while more than half did not receive mental health treatment (54.5%; n = 6), and 18.1% (n = 2) did not want treatment. Patients with elevated distress reported lower mental quality of life than patients without elevated distress [F (1, 25) = 15.32, p = 0.001]. Significance of the results A significant proportion of patients with advanced, progressive, B-cell lymphomas may experience elevated levels of distress. Yet, few of these distressed patients receive mental health treatment. Findings highlight the need to better identify and address barriers to mental health service utilization among patients with B-cell lymphoma, including among distressed patients who decline treatment.

scholarly journals The Relation between Perceived Need for Mental Health Treatment, DSM Diagnosis, and Quality of Life: A Canadian Population-Based Survey

2005 ◽  
Vol 50 (2) ◽  
pp. 87-94 ◽  
Author(s):  
Jitender Sareen ◽  
Murray B Stein ◽  
Darren W Campbell ◽  
Thomas Hassard ◽  
Verena Menec
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Suicidal Ideation ◽  
Mental Health Treatment ◽  
Population Based ◽  
Health Treatment ◽  
Need For Treatment ◽  
Perceived Need ◽  
Perceived Need For Treatment

Objectives: Prevalence estimates of mental disorders were designed to provide an indirect estimate of the need for mental health services in the community. However, recent studies have demonstrated that meeting criteria for a DSM-based disorder does not necessarily equate with need for treatment. The current investigation examined the relation between self-perceived need for mental health treatment and DSM diagnosis, with respect to quality of life (QoL) and suicidal ideation. Methods: Data came from an Ontario population-based sample of 8116 residents (aged 15 to 64 years). The University of Michigan Composite International Diagnostic Interview was used to diagnose mood, anxiety, substance use, and bulimia disorder according to DSM-III-R criteria. We categorized past-year help seeking for emotional symptoms and (or) perceiving a need for treatment without seeking care as self-perceived need for treatment. We used a range of variables to measure QoL: self-perception of mental health status, a validated instrument that measured well-being, and restriction of activities (current, past 30 days, and long-term). Results: Independent of subjects' meeting criteria for a DSM-III-R diagnosis, self-perceived need for treatment was significantly associated with poor QoL (on all measures) and past-year suicidal ideation. Conclusions: Self-perceived need for mental health treatment, in addition to DSM diagnosis, may provide valuable information for estimating the number of people in the population who need mental health services. The relation between self-perceived need for treatment and objective measures of treatment need requires future study.

scholarly journals Effectiveness and cost effectiveness of interpersonal community psychiatric treatment (ICPT) for people with long-term severe non-psychotic mental disorders: a multi-Centre randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mark van Veen ◽  
Bauke Koekkoek ◽  
Steven Teerenstra ◽  
Eddy Adang ◽  
Cornelis L. Mulder
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Cost Effectiveness ◽  
Community Mental Health ◽  
Mental Health Treatment ◽  
Psychiatric Treatment ◽  
Illness Management ◽  
Illness Management And Recovery ◽  
Perceived Difficulty

Abstract Background Long-term community mental health treatment for non-psychotic disorder patients with severe mental illness (SMI) who are perceived as difficult by clinicians, is poorly developed and lacks a structured, goal-centred approach. This study compares (cost-)effectiveness of Interpersonal Community Psychiatric Treatment (ICPT) with Care As Usual (CAU) on quality of life and clinician perceived difficulty in the care for non-psychotic disorder SMI-patients. A multi-centre cluster-randomized clinical tria was conducted in which Community Mental Health Nurses (Clinicians) in three large community mental health services in the Netherlands were randomly allocated to providing either ICPT or CAU to included patients. A total of 56 clinicians were randomized, who treated a total of 93 patients (59 in ICPT-group and 34 in CAU-group). Methods Primary outcome measure is patient-perceived quality of life as measured by the Manchester Short Assessment of Quality of Life (MANSA). Secondary outcome measures include clinician-perceived difficulty, general mental health, treatment outcomes, illness management and recovery, therapeutic relationship, care needs and social network. Patients were assessed at baseline, during treatment (6 months), after treatment (12 months) and at 6 months follow-up (18 months). Linear mixed-effects models for repeated measurements were used to compare mean changes in primary and secondary outcomes between intervention and control group of patients over time on an intention to treat basis. Potential efficiency was investigated from a societal perspective. Economic evaluation was based on general principles of a cost-effectiveness analysis. Outcome measures for health economic evaluation, were costs, and Quality Adjusted Life Years (QALYs). Results Half of the intended number of patients were recruited. There was no statistically significant treatment effect found in the MANSA (0.17, 95%-CI [− 0.058,0.431], p = 0.191). Treatment effects showed significant improvement in the Different Doctor-Patient Relationship Questionnaire-scores and a significant increase in the Illness Management and Recovery–scale Client-version scores). No effects of ICPT on societal and medical costs nor QALYs were found. Conclusions This is the first RCT to investigate the (cost)-effectiveness of ICPT. Compared with CAU, ICPT did not improve quality of life, but significantly reduced clinician-perceived difficulty, and increased subjective illness management and recovery. No effects on costs or QALY’s were found. Trial registration NTR 3988, registered 13 May 2013.

scholarly journals Quality of Life in Persons with Intellectual Disabilities and Mental Health Problems: An Explorative Study

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Filip Morisse ◽  
Eleonore Vandemaele ◽  
Claudia Claes ◽  
Lien Claes ◽  
Stijn Vandevelde
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Social Inclusion ◽  
Mental Health Problems ◽  
Health Problems ◽  
Positive Outcomes ◽  
Support Strategies ◽  
Professional Network ◽  
Universal Properties

The field of intellectual disability (ID) is strongly influenced by the Quality of Life paradigm (QOL). We aimed at investigating whether or not the QOL paradigm also applies to clients with ID and cooccurring mental health problems. This paper aims at stimulating a debate on this topic, by investigating whether or not QOL domains are universal. Focus groups with natural and professional network members were organized to gather qualitative data, in order to answer two questions: (1) Are the QOL dimensions conceptualized in the model of Schalock et al. applicable for persons with ID and mental health problems? (2) What are indicators relating to the above-mentioned dimensions in relation to persons with ID and mental health problems? The results offer some proof for the assumption that the QOL construct seems to have universal properties. With regard to the second question, the study revealed that the natural and professional network members are challenged to look for the most appropriate support strategies, taking specific indicators of QOL into account. When aspects of empowerment and regulation are used in an integrated manner, the application of the QOL paradigm could lead to positive outcomes concerning self-determination, interdependence, social inclusion, and emotional development.

scholarly journals Exploring the quality of life and psychological symptoms of university students in Cyprus during the Covid-19 pandemic

2021 ◽  
Vol 17 ◽  
pp. 110-121
Author(s):  
Hadjicharalambous Demetris ◽  
Loucia Demetriou ◽  
Koulla Erotocritou
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Family Income ◽  
Mental Health Problems ◽  
Psychological Symptoms ◽  
Negative Impact ◽  
General Health Questionnaire ◽  
Well Being ◽  
Idioms Of Distress

The onset of the infectious disease Covid19 originating in Wuhan, China, took over the world in December 2019 and was declared a pandemic in January 2020.  Empirical evidence resulting from relevant research illustrated that the effects of the pandemic itself but also of the strict measures to contain the spread of the virus on the mental health and well-being of affected populations were just as unanticipated as the pandemic itself. Data led to the identification of six idioms of distress: (1) Demoralization and pessimism towards the future, (2) anguish and stress, (3) self-depreciation, (4) social withdrawal and isolation, (5) somatization, (6) withdrawal into oneself. Our research explores the psychological impact of the Covid19 pandemic on college students and their quality of life. The study took place in Cyprus with 356 young participants, whereas 256 were female (72%) and 100 were male (28%). They all completed the General Health Questionnaire-28 and the Life Satisfaction Inventory (LSI). The present study's findings revealed that six factors, including residence without family, the deterioration of the financial situation of the family, the loss of employment, the deterioration of social relationships, young age, and gender, have significantly affected in a negative way the mental health and quality of life of young people. Research findings revealed that the strict lockdown and physical/social isolation measures had a significant adverse effect on our sample, whereas participants showed increased symptoms of anxiety and insomnia, social dysfunction, and somatization. Young adults who lost their jobs during the pandemic or had a significant decrease in their family income, and students who stayed away from their families, experienced a negative impact on their quality of life and had to cope with more mental health problems.

scholarly journals IPS in Supported Housing: Fidelity and Employment Outcomes Over a 4 Year Period

2021 ◽  
Vol 11 ◽  
Author(s):  
Diana Roeg ◽  
Lars de Winter ◽  
Cris Bergmans ◽  
Chrisje Couwenbergh ◽  
Peter McPherson ◽  
...  
Keyword(s):  
Mental Health ◽  
The Netherlands ◽  
Mental Health Treatment ◽  
Mental Health Problems ◽  
Employment Outcomes ◽  
Supported Housing ◽  
Competitive Employment ◽  
Health Treatment ◽  
Housing Services ◽  
Team Integration

Background: People with severe mental illness have difficulties finding and maintaining competitive employment. This is particularly so for those living in supported housing who, by definition, have significant day-to-day support needs: in the Netherlands only 3 to 5% of people with serious mental health problems who live in supported housing are competitively employed. To support these people in finding and maintaining competitive employment, Individual Placement, and Support (IPS) was introduced within supported housing services in the Netherlands in 2015. As this is the first country that broadly implemented IPS in supported housing settings, this paper will focus on the first results regarding feasibility and effects on employment in clients of IPS in this sector.Methods: We investigated the feasibility and employment outcomes of delivering IPS in supported housing services using fidelity assessments and quarterly employment outcomes on IPS program level within eight supported housing organizations, and compared these with 21 mental health treatment organizations in the Netherlands over a 4 year period. We investigated possible reasons for our findings and their implications through qualitative evaluations of the IPS fidelity assessors' notes and additional focus groups with IPS specialists and coordinators from supported housing services and fidelity assessors.Results: The overall fidelity scores indicated reasonable implementation of the IPS model within both supported housing services and mental health services. However, there were differences between services with regard to specific fidelity items; mental health treatment organizations scored higher for team integration, whereas supported housing services scored higher for rapid job search and caseload size, diversity of jobs, and employers. Our qualitative data suggested that the difference in team integration between the two sectors was due to differences in their organizational and financial structures, as well as in the specific needs of their clients. Conversely, supported housing services had better connections with employers which facilitated more rapid job searching and greater diversity in employment opportunities. The average total client employment rate did not significantly differ; and was 25.8% per quarter in supported housing services and 29.6% in mental health treatment services.Conclusion: Implementing IPS in supported housing settings is both feasible and effective.

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