scholarly journals Improving health outcomes for adults with severe mental illness and comorbid diabetes: is supporting diabetes self-management the right approach?

2016 ◽  
Vol 23 (5) ◽  
pp. 322-330 ◽  
Author(s):  
J. Taylor ◽  
N. Siddiqi
Keyword(s):  
Mental Illness ◽  
Health Outcomes ◽  
Severe Mental Illness ◽  
Self Management ◽  
The Right

scholarly journals Identifying the minimal important difference in patient-reported outcome measures in the field of people with severe mental illness: a pre–post-analysis of the Illness Management and Recovery Programme

2021 ◽  
Author(s):  
Titus A. A. Beentjes ◽  
Steven Teerenstra ◽  
Hester Vermeulen ◽  
Peter J. J. Goossens ◽  
Maria W. G. Nijhuis-van der Sanden ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Minimal Important Difference ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Self Management ◽  
Illness Management ◽  
Meaningful Change ◽  
Illness Management And Recovery ◽  
Patient Reported

Abstract Purpose Complementary interventions for persons with severe mental illness (SMI) focus on both personal recovery and illness self-management. This paper aimed to identify the patient-reported outcome measures (PROMs) associated with the most relevant and meaningful change in persons with SMI who attended the Illness Management and Recovery Programme (IMR). Methods The effect of the IMR was measured with PROMs concerning recovery, illness self-management, burden of symptoms and quality of life (QoL). From the QoL measures, an anchor was chosen based on the most statistically significant correlations with the PROMs. Then, we estimated the minimal important difference (MID) for all PROMs using an anchor-based method supported by distribution-based methods. The PROM with the highest outcome for effect score divided by MID (the effect/MID index) was considered to be a measure of the most relevant and meaningful change. Results All PROMs showed significant pre–post-effects. The QoL measure ‘General Health Perception (Rand-GHP)’ was identified as the anchor. Based on the anchor method, the Mental Health Recovery Measure (MHRM) showed the highest effect/MID index, which was supported by the distribution-based methods. Because of the modifying gender covariate, we stratified the MID calculations. In most MIDs, the MHRM showed the highest effect/MID indexes. Conclusion Taking into account the low sample size and the gender covariate, we conclude that the MHRM was capable of showing the most relevant and meaningful change as a result of the IMR in persons with SMI.

scholarly journals Oral health inequality in people with severe mental illness: a cross-sectional study using National Health and Nutrition Examination Survey 1999-2016

2021 ◽  
Author(s):  
Jing Kang ◽  
Jianhua Wu ◽  
Vishal Aggarwal ◽  
David Shiers ◽  
Tim Doran ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mental Illness ◽  
Oral Health ◽  
General Population ◽  
Health Outcomes ◽  
Severe Mental Illness ◽  
Tooth Loss ◽  
List Type ◽  
Cross Sectional ◽  
Oral Health Outcomes

AbstractOBJECTIVETo explore whether people with severe mental illness (SMI) experience worse oral health compared to the general population, and the risk factors for poor oral health in people with SMI.METHODThis study used cross-sectional data from the National Health and Nutrition Examination Survey (1999-2016) including on self-rated oral health, ache in mouth, tooth loss, periodontitis stage, and number of decayed, missing, and filled teeth. Candidate risk factors for poor oral health included demographic characteristics, lifestyle factors, physical health comorbidities, and dental hygiene behaviours. The authors used ordinal logistic regression and zero-inflated negative binomial models to explore predictors of oral health outcomes.RESULTS53,348 cases were included in the analysis, including 718 people with SMI. In the fully adjusted model, people with SMI were more likely to suffer from tooth loss (OR 1.40, 95% CI: 1.12-1.75). In people with SMI, the risk factors identified for poor oral health outcomes were older age, white ethnicity, lower income, smoking history, and diabetes. Engaging in physical activity and daily use of dental floss were associated with better oral health outcomes.CONCLUSIONSPeople with SMI experience higher rates of tooth loss than the general population, and certain subgroups are particularly at risk. Having a healthy lifestyle such as performing regular physical exercise and flossing may lower the risk of poor oral health. These findings suggest opportunities for targeted prevention and early intervention strategies to mitigate adverse oral health outcomes.Significant outcomes (x3)People with severe mental illness were at 40% higher risk of tooth loss when compared to the general population.Older adults, smokers and people with diabetes were at particularly high risk of poor oral health.Physical exercise and daily use of dental floss were associated with better oral health outcomes.Limitations (x3)The number of cases with data on periodontal disease was limited.The study was cross-sectional so causation could not be inferred.The analysis used prescriptions of antipsychotic and mood stabilising medication as a proxy measure of severe mental illness, as clinical diagnoses were not available in the dataset.Data availability statementThe NHANES 1999-2016 data is available at CDC website: https://www.cdc.gov/nchs/nhanes/index.htm, and is accessible and free to download for everyone.

scholarly journals Self-management interventions for people with severe mental illness: systematic review and meta-analysis

2019 ◽  
Vol 214 (5) ◽  
pp. 260-268 ◽  
Author(s):  
Melanie Lean ◽  
Miriam Fornells-Ambrojo ◽  
Alyssa Milton ◽  
Brynmor Lloyd-Evans ◽  
Bronwyn Harrison-Stewart ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Meta Analysis ◽  
Health Problems ◽  
Self Management ◽  
Management Interventions

BackgroundSelf-management is intended to empower individuals in their recovery by providing the skills and confidence they need to take active steps in recognising and managing their own health problems. Evidence supports such interventions in a range of long-term physical health conditions, but a recent systematic synthesis is not available for people with severe mental health problems.AimsTo evaluate the effectiveness of self-management interventions for adults with severe mental illness (SMI).MethodA systematic review of randomised controlled trials was conducted. A meta-analysis of symptomatic, relapse, recovery, functioning and quality of life outcomes was conducted, using RevMan.ResultsA total of 37 trials were included with 5790 participants. From the meta-analysis, self-management interventions conferred benefits in terms of reducing symptoms and length of admission, and improving functioning and quality of life both at the end of treatment and at follow-up. Overall the effect size was small to medium. The evidence for self-management interventions on readmissions was mixed. However, self-management did have a significant effect compared with control on subjective measures of recovery such as hope and empowerment at follow-up, and self-rated recovery and self-efficacy at both time points.ConclusionThere is evidence that the provision of self-management interventions alongside standard care improves outcomes for people with SMI. Self-management interventions should form part of the standard package of care provided to people with SMI and should be prioritised in guidelines: research on best methods of implementing such interventions in routine practice is needed.Declaration of interestsNone.

Childhood Abuse as a Precursor to Homelessness for Homeless Women With Severe Mental Illness

1996 ◽  
Vol 11 (2) ◽  
pp. 129-142 ◽  
Author(s):  
Sally Davies-Netzley ◽  
Michael S. Hurlburt ◽  
Richard L. Hough
Keyword(s):  
Mental Health ◽  
Posttraumatic Stress Disorder ◽  
Mental Illness ◽  
Sexual Abuse ◽  
Health Outcomes ◽  
Severe Mental Illness ◽  
Childhood Abuse ◽  
Stress Disorder ◽  
Homeless Women ◽  
Physical And Sexual Abuse

Previous studies of childhood abuse levels among homeless women have typically focused either on single homeless women or female heads of families; almost none have focused specifically on homeless women with severe mental illness. This study explores rates of childhood physical and sexual abuse among 120 homeless women with severe mental illness. Correlates of experiencing childhood abuse are considered, including mental health outcomes and when women first become homeless. The prevalence of childhood abuse in this sample of women was substantially higher than among homeless women in general. The experience of childhood abuse was related to increased suicidality, and resulted in symptoms of posttraumatic stress disorder for some women. Women who had suffered abuse were also much more likely to become homeless during childhood and it is suggested that this is an important precursor to homelessness for many homeless women with chronic and severe mental illness.

scholarly journals Self-management interventions for type 2 diabetes in adult people with severe mental illness

2014 ◽  
Author(s):  
Hayley McBain ◽  
Kathleen Mulligan ◽  
Mark Haddad ◽  
Chris Flood ◽  
Julia Jones ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Self Management ◽  
Management Interventions

Self-Management Support Needs From the Perspectives of Persons With Severe Mental Illness: A Systematic Review and Thematic Synthesis of Qualitative Research

2019 ◽  
Vol 26 (5) ◽  
pp. 464-482 ◽  
Author(s):  
Titus A. A. Beentjes ◽  
Betsie G. I. van Gaal ◽  
Theo van Achterberg ◽  
Peter J. J. Goossens
Keyword(s):  
Systematic Review ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Essential Element ◽  
Self Management ◽  
Support Needs ◽  
Management Support ◽  
Thematic Synthesis ◽  
Management Interventions ◽  
Important Others

BACKGROUND: The development of de-hospitalization policies in mental health has resulted in a growing emphasis on self-management. In the chronic care model, self-management support is an essential element. Because of the episodic nature of severe mental illness (SMI) and its high relapse rates, we assume that the extent of self-management support needs of individuals with an SMI is considerable. However, a clear overview of the nature of the self-management support needs of persons with SMI is missing. AIMS: This study aimed to identify self-management support needs from the perspective of individuals with SMI. METHOD: A systematic review was conducted using the method of thematic synthesis of qualitative studies. After searching the databases MEDLINE, PsycINFO, CINAHL, and EMBASE, we screened the papers for the eligibility criteria: individuals with an SMI, adequately representing the voice of persons with SMI and describing their self-management support needs. Thirty-one papers were included. RESULTS: The main findings showed that participants in the studies described the need for informational support, emotional support, acknowledgment, encouragement, and guidance to make sense of their illness experiences, ease suffering, obtain validation and recognition, execute self-management tasks, and be led through unfamiliar territory. CONCLUSION: The perspectives of persons with SMI can provide a road map for constructing a self-management support intervention for persons with SMI. Important others have an essential role in fulfilling support needs. Independently managing an SMI is difficult. Therefore, it is preferable to let important others participate in self-management interventions and to introduce peer support.

scholarly journals The DIAMONDS intervention to support self-management of type 2 diabetes in people with severe mental illness: study protocol for a single-group feasibility study

2021 ◽  
Author(s):  
Jennifer V E Brown ◽  
Ramzi Ajjan ◽  
Sarah Alderson ◽  
Jan R Böhnke ◽  
Claire Carswell ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Mental Illness ◽  
Data Collection ◽  
Severe Mental Illness ◽  
Feasibility Study ◽  
Controlled Trial ◽  
Self Management ◽  
Intervention Delivery ◽  
Intervention Session

AbstractIntroductionThe DIAMONDS programme aims to evaluate a novel supported diabetes self-management intervention for people with severe mental illness (the “DIAMONDS intervention”). The purpose of this study is to test the feasibility of intervention delivery and data collection procedures to inform a definitive randomised controlled trial (RCT).MethodsAdults aged 18 years or over with a diagnosis of type 2 diabetes and severe mental illness (schizophrenia, schizoaffective disorder, or bipolar disorder) will be eligible for inclusion. Individuals with other types of diabetes or non-psychotic mental illness and those lacking capacity to consent will not be eligible. Participants will be recruited from NHS mental health trusts and general practices across the North of England. All participants will receive the DIAMONDS intervention: weekly one-to-one sessions with a trained facilitator (“DIAMONDS Coach”) to support goal setting, action planning, and diabetes education; ongoing self-management supported by a paper-based workbook and optional digital application (app); and monthly peer-support group sessions with other participants. The primary outcomes are: 1. Recruitment rate, measured as proportion of the recruitment target (N=30) achieved at 5 months from start of recruitment, 2. Attrition measured as the proportion of missing outcomes data at the end of the recruitment period (5 months from start of recruitment) for physiological and self-reported data items, 3. Intervention delivery rate recorded as the proportion of planned sessions delivered (measured by the number of completed intervention session logs per participant within 15 weeks of the first intervention session). Secondary outcomes include completeness of data collection at baseline and of process evaluation data at follow-up as well as the feasibility and acceptability of the intervention and of wearing a blinded continuous glucose monitoring device. An intervention fidelity framework will also be developed. Recruitment started in July 2021. The study was prospectively registered: ISRCTN15328700 (12th March 2021).DiscussionThe results of this feasibility study will inform the refinement of the content and delivery of the DIAMONDS intervention, as well as research procedures, including recruitment and data collection, in preparation for the main DIAMONDS RCT.

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