scholarly journals Estimating the Prevalence of Serious Mental Illness and Dementia Diagnoses Among Medicare Beneficiaries in the Health and Retirement Study

2017 ◽  
Vol 40 (7) ◽  
pp. 668-686 ◽  
Author(s):  
Maria Teresa Brown ◽  
Douglas A. Wolf

Objective: To estimate the prevalence of serious mental illness and dementia among Medicare beneficiaries in the Health and Retirement Study (HRS). Methods: This study utilizes HRS-linked Medicare claims data sets and inverse probability weighting to estimate overall and age-specific cumulative prevalence rates of dementia and serious mental illnesses among 18,740 Medicare beneficiaries. Two-way tabulations determine conditional probabilities of dementia diagnoses among beneficiaries diagnosed with specific mental illnesses, and binary logistic regressions determine conditional probabilities of dementia diagnoses among beneficiaries diagnosed with specific mental illnesses, controlling for covariates. Results: Weighted prevalence estimates for dementia, schizophrenia (SZP), bipolar disorder (BPD), and major depressive disorder (MDD) are similar to previous studies. Odds of dementia diagnosis are significantly greater for beneficiaries diagnosed with SZP, BPD, or MDD. Conclusions: Co-occurring mental disabilities require further investigation, as in the near future increasing numbers of mentally ill older adults will need appropriate and affordable community-based services and supports.

CNS Spectrums ◽  
2020 ◽  
Vol 25 (5) ◽  
pp. 584-592
Author(s):  
Brendan Daugherty ◽  
Katherine Warburton ◽  
Stephen M. Stahl

Despite medical, technological, and humanitarian advances, the criminalization of those with serious mental illness continues. This is not an isolated phenomenon. The benefits of treatment reform and innovation are difficult to maintain or sometimes outright harmful. Across time and geography, the care of those with serious mental illness tends towards maltreatment, be it criminalization or other forms of harm. We present a social history of serious mental illness, along with the idea that the treatment of serious mental illness is a Sisyphean task—perpetually pushing a boulder up a hill, only for it to roll down and start again. The history is provided as a basis for deeper reflection of treatment, and treatment reform, of those with serious mental illnesses.


Author(s):  
Lauren Mizock ◽  
Erika Carr

Women with Serious Mental Illness: Gender-Sensitive and Recovery-Oriented Care calls attention to a topic and a population that have been overlooked in research and psychotherapy—women with serious mental illnesses (schizophrenia, severe depression, bipolar disorder, and complex post-traumatic stress disorder). The book focuses on the history of mistreatment, marginalization, and oppression women with serious mental illness have encountered, not only from the general public but within the mental health system as well. This book provides an overview of recovery-oriented care for women with serious mental illness—a process of seeking hope, empowerment, and self-determination beyond the effects of mental illness. The authors provide a historical overview of the treatment of women with mental illness, their resilience and recovery experiences, and issues pertaining to relationships, work, class, culture, trauma, and sexuality. This book also offers the new model, the Women’s Empowerment and Recovery-Oriented Care intervention, for working with this population from a gender-sensitive framework. The book is a useful tool for mental health educators and providers and provides case studies, clinical strategies lists, discussion questions, experiential activities, diagrams, and worksheets that can be completed with clients, students, and peers.


2020 ◽  
Author(s):  
Benjamin Buck ◽  
Janelle Nguyen ◽  
Shelan Porter ◽  
Dror Ben-Zeev ◽  
Greg R. Reger

BACKGROUND Veterans with serious mental illnesses (SMI) face barriers to accessing in-person evidence-based interventions that improve illness management. Mobile health (mHealth) has been demonstrated to be feasible, acceptable, effective, and engaging among individuals with serious mental illness in community mental health settings. mHealth for SMI has not been tested within the VA. OBJECTIVE The present study examined the feasibility, acceptability and preliminary effectiveness of an mHealth intervention for serious mental illness in the context of VA outpatient care. METHODS Seventeen (n = 17) veterans with serious mental illnesses enrolled in a one-month pilot trial of FOCUS, a smartphone-based self-management intervention for serious mental illness. At baseline and post-test they completed measures examining symptoms and functional recovery. Participants provided qualitative feedback related to the usability and acceptability of the intervention. RESULTS Veterans completed on average 85.00 (SD = 96.11) interactions with FOCUS over the one-month intervention period. They reported high satisfaction, usability, and acceptability, with nearly all (n = 16, 94.1%) participants reporting that they would recommend the intervention to a fellow veteran. Qualitative feedback indicated that veterans thought mHealth complemented their existing VA services well and described potential opportunities to adapt FOCUS to specific subpopulations (e.g. combat veterans) as well as specific delivery modalities (e.g. groups). In the one-month period, participants experienced small improvements in self-assessed recovery, auditory hallucinations and quality of life. CONCLUSIONS The FOCUS mHealth intervention is feasible, acceptable, and usable among veterans. Future work should develop and examine VA-specific implementation approaches of FOCUS for this population.


2019 ◽  
Vol 12 ◽  
pp. 117863291983762
Author(s):  
Evelyn T Chang ◽  
Merlyn Vinzon ◽  
Amy N Cohen ◽  
Alexander S Young

People with serious mental illness have substantially worse health outcomes than people without mental illness. These patients use primary care less often and fail to receive needed preventive and chronic care. While a variety of care models have been implemented with the goal of improving care for these patients, few have been found to be effective. Young et al describes a specialty patient-centered medical home for patients with serious mental illness. In this model, the primary care provider manages the medical and mental health conditions of patients with stable psychiatric symptoms with assistance from a registered nurse and a consulting psychiatrist. The goal of this integrated model is to engage patients in preventive care by building a relationship with them in primary care and understanding both their medical and psychiatric needs. While this model may improve care and increase patient satisfaction, implementing this type of model may be challenging.


Author(s):  
Kim T. Mueser ◽  
Douglas L. Noordsy ◽  
Robert E. Drake

The high comorbidity between substance use disorders and serious mental illnesses is a significant challenge to traditional treatment systems that have historically treated psychiatric and substance use disorders with different providers and agencies. Defining characteristics of serious mental illness include difficulty with work, performing in school or parenting, social difficulties, and problems caring for oneself. Common serious psychiatric disorders include schizophrenia, schizoaffective disorder, bipolar disorder, and severe major depression, posttraumatic stress disorder, and borderline personality disorder. The epidemiology of substance use disorders in serious mental illness is reviewed, including prevalence, correlates, and onset and course of the disorder. The clinical consequences of substance use disorders in this population are devastating for every possible aspect of the illness. Common factors may increase vulnerability to both substance abuse and psychiatric disorders. The principles of treating co-occurring disorders are based on modern integrated methods, as well as research on the effectiveness of integrated treatment.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Emily B. H. Treichler ◽  
Borsika A. Rabin ◽  
William D. Spaulding ◽  
Michael L. Thomas ◽  
Michelle P. Salyers ◽  
...  

Abstract Background Collaborative decision-making is an innovative decision-making approach that assigns equal power and responsibility to patients and providers. Most veterans with serious mental illnesses like schizophrenia want a greater role in treatment decisions, but there are no interventions targeted for this population. A skills-based intervention is promising because it is well-aligned with the recovery model, uses similar mechanisms as other evidence-based interventions in this population, and generalizes across decisional contexts while empowering veterans to decide when to initiate collaborative decision-making. Collaborative Decision Skills Training (CDST) was developed in a civilian serious mental illness sample and may fill this gap but needs to undergo a systematic adaptation process to ensure fit for veterans. Methods In aim 1, the IM Adapt systematic process will be used to adapt CDST for veterans with serious mental illness. Veterans and Veteran’s Affairs (VA) staff will join an Adaptation Resource Team and complete qualitative interviews to identify how elements of CDST or service delivery may need to be adapted to optimize its effectiveness or viability for veterans and the VA context. During aim 2, an open trial will be conducted with veterans in a VA Psychosocial Rehabilitation and Recovery Center (PRRC) to assess additional adaptations, feasibility, and initial evidence of effectiveness. Discussion This study will be the first to evaluate a collaborative decision-making intervention among veterans with serious mental illness. It will also contribute to the field’s understanding of perceptions of collaborative decision-making among veterans with serious mental illness and VA clinicians, and result in a service delivery manual that may be used to understand adaptation needs generally in VA PRRCs. Trial registration ClinicalTrials.gov Identifier: NCT04324944


2020 ◽  
pp. 089484532094125
Author(s):  
Uma Chandrika Millner ◽  
Erna Sally Rogers ◽  
Philippe Bloch ◽  
William Costa ◽  
Sharon Pritchett ◽  
...  

Individuals diagnosed with serious mental illnesses continue to experience work-related disparities despite the existence of evidence-based practices. Understanding the meaning of work among these individuals is key to developing interventions grounded in career development theory and practice. This qualitative inquiry adapted a consensual qualitative research approach and utilized a participatory component to conduct an in-depth exploration of the meaning of work among a national sample of young adults and older adults living with serious mental illness. The psychology of working perspective was applied to the results after analyses. Results revealed categories that clustered within four overarching domains pertaining to work as central to survival, social connectedness, self-determination, and mental health recovery as proposed by the theory. Implications for services, research, and policy are discussed.


CNS Spectrums ◽  
2020 ◽  
Vol 25 (5) ◽  
pp. 638-650 ◽  
Author(s):  
Joel A. Dvoskin ◽  
James L. Knoll ◽  
Mollie Silva

This article traces the history of the way in which mental disorders were viewed and treated, from before the birth of Christ to the present day. Special attention is paid to the process of deinstitutionalization in the United States and the failure to create an adequately robust community mental health system to care for the people who, in a previous era, might have experienced lifelong hospitalization. As a result, far too many people with serious mental illnesses are living in jails and prisons that are ill-suited and unprepared to meet their needs.


2016 ◽  
Vol 39 (8) ◽  
pp. 960-986 ◽  
Author(s):  
Elizabeth Edmiston Chen ◽  
Edward Alan Miller

This study assessed the odds of dying in hospital associated with enrollment in Medicare Advantage (M-A) versus conventional Medicare Fee-for-Service (M-FFS). Data were derived from the 2008 and 2010 waves of the Health and Retirement Study ( n = 1,030). The sample consisted of elderly Medicare beneficiaries who died in 2008–2010 (34% died in hospital, and 66% died at home, in long-term senior care, a hospice facility, or other setting). Logistic regression estimated the odds of dying in hospital for those continuously enrolled in M-A from 2008 until death compared to those continuously enrolled in M-FFS and those switching between the two plans. Results indicate that decedents continuously enrolled in M-A had 43% lower odds of dying in hospital compared to those continuously enrolled in M-FFS. Financial incentives in M-A contracts may reduce the odds of dying in hospital.


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