When Non-Compliance Carries the Day: Evaluating the Effectiveness of an Employment Program for the Severely Mentally Ill

2021 ◽  
pp. 0193841X2110496
Author(s):  
Alberto Martini ◽  
Enrico Rettore ◽  
Gian Paolo Barbetta ◽  
Fabio Sandrolini

Background: Mental disease is increasing worldwide and people who suffer from it show lower employment rates and lower earnings. Various approaches have been tried to increase the employment rate of people with mental disease. In the US, empirical studies show that individual placement and support(IPS)—a rapid transition to the job market, with some external assistance—is effective in increasing the employment rate of the mentally ill. Europe lacks such evidence. Purpose: The study assesses the impact of an IPS-like program undertaken in Italy on the employment rate of people with severe mental illness. Methods: The analysis is based on a RCT that tests whether offering people with severe mental illness the support of a “job coach” increases their chances of being employed. Moreover, using a battery of tests—one of which is made available by the RCT itself—we show that the large non-compliance with the protocol showed by the RCT is ignorable. This motivates estimating the impact of carrying out a traineeship during the experimental period on employment using non-experimental methods. Results and Conclusions: The study finds that the availability of a coach boosts the patients’ chances of finding a traineeship during the experimental period; moreover, undertaking a traineeship almost doubles the likelihood of being at work one year later. JEL CODES: J78, J48, J38

1996 ◽  
Vol 20 (8) ◽  
pp. 461-462 ◽  
Author(s):  
Riadh T. Abed

Since the Health of the Nation government document (Department of Health, 1992) set the target for the reduction of suicide in the severely mentally ill by 33% by the year 2000 it has become necessary to collect the suicide data for this population of patients at district and national level. There are a range of problems concerning the definition and identification of patients with severe mental illness as well as problems concerning the compilation of suicide data for this population at district level.


1995 ◽  
Vol 4 (3) ◽  
pp. 181-186
Author(s):  
Graham Thornicroft

SummaryThis paper argues within the mental health services that people who are most disabled by mental illness, the severely mentally ill (SMI), should be afforded the highest priority, and that services should be provided in relation to need. For this to occur the priority groups need first to be defined. Second, if a service wishes to provide for all prevalent cases of people suffering from severe mental illness, then a systematic method of recording local information about these people is required, and this may draw upon information about patients who are in contact with health services, social services, family health services and who contact voluntary sector and other agencies. One approach to estimating the need for services for people with SMI is by using indicative norms for service requirements. Finally, managerial methods are proposed to monitor how far targeting services to the SMI occurs in clinical practice.


2007 ◽  
Vol 191 (4) ◽  
pp. 343-350 ◽  
Author(s):  
Sheilagh Hodgins ◽  
Jane Alderton ◽  
Adrian Cree ◽  
Andrew Aboud ◽  
Timothy Mak

BackgroundSevere mental illness is associated with increased risk of aggressive behaviour, crime and victimisation. Mental health policy does not acknowledge this evidence. The number of forensic beds has risen dramatically.AimsTo examine the prevalence of aggressive behaviour, victimisation and criminality among people receiving in-patient treatment for severe mental illness in an inner-city area.MethodSelf-reports of aggressive behaviour and victimisation and criminal records were collected for 205 in-patients with severe mental illness.ResultsIn the preceding 6 months 49% of the men and 39% of the women had engaged in aggressive behaviour and 57% of the men and 48% of the women had been victims of assault; 47% of the men and 17% of the women had been convicted of at least one violent crime.ConclusionsAggressive behaviour and victimisation are common among severely mentally ill people requiring hospitalisation in the inner city. Rates of violent crime are higher than in the general population.


2012 ◽  
Vol 82 (4) ◽  
pp. 491-510
Author(s):  
Rochelle Skogen

In this article Rochelle Skogen takes up the subject of university professors diagnosed with severe mental illness and asks why so little is known about these individuals. As an assistant professor who suffers from bipolar disorder, Skogen discusses the impact of stigma on a professor's decision to either disclose or conceal her illness. While it appears that most mentally ill academics choose to hide their diagnoses—perhaps believing that concealment will keep them free of stigma—Skogen argues that such thinking is but an illusion of freedom, because it is based on an emancipation that depends on the “goodwill” of would-be emancipators. Skogen depicts her own journey of “coming into presence” as a process of subjectification rooted in Jacques Rancière's theory of a new logic of emancipation, as interpreted by Bingham and Biesta.


1996 ◽  
Vol 2 (4) ◽  
pp. 158-165 ◽  
Author(s):  
P. Timms

People with mental illness have always been marginalised and economically disadvantaged. Warner (1987) has shown that this is particularly true in times of high unemployment. Poor inner-city areas have excessive rates of severe mental illness, usually without the health, housing and social service provisions necessary to deal with them (Faris & Dunham, 1959). The majority of those who suffer major mental illness live in impoverished circumstances somewhere along the continuum of poverty. Homelessness, however defined, is the extreme and most marginalised end of this continuum, and it is here that we find disproportionate numbers of the mentally ill.


2009 ◽  
Vol 24 (6) ◽  
pp. 373-379 ◽  
Author(s):  
S. Hodgins ◽  
A. Cree ◽  
F. Khalid ◽  
K. Patel ◽  
R. Sainz-Fuentes ◽  
...  

AbstractBackgroundAntisocial behaviour is common among patients with severe mental illness (SMI) requiring hospitalisation.AimTo determine whether differential treatments and services are provided to patients with SMI who engage in antisocial behaviour.MethodA random sample of 161 inpatients with SMI were recruited from general adult wards and assessed at baseline and two years later. Information on symptoms, aggressive behaviour, substance misuse, and service use was obtained from patients and clinical files.ResultsPast antisocial behaviours were not associated with type or intensity of treatments and services. Severity of positive symptoms, aggressive behaviour, and illicit drug use were positively associated with the frequency of CMHT contact, but not with the type of CMHT, type of medication, or other treatments and benefits.ConclusionsWhile the frequency of meetings with CMHTs increased with the severity of antisocial behaviours, no specific treatments were provided to patients with SMI engaging in antisocial behaviours.


2017 ◽  
Vol 3 (3) ◽  
pp. 31
Author(s):  
Andrzej Lipczyński ◽  
Jarosław Kinal ◽  
Institute of Sociology University of Rzeszow

The problem of dual diagnosis described as the first in Poland Lehmann in 1993. He noticed that for people with dual diagnosis is needed different diagnostic and therapeutic-specific approach and that social services (Lehman, 2000; Le hman 1993; Lehman, Myers 1994). Clinical experience suggests the need for a clear separation of this group of patients from both patients and the mentally ill odwykowo. T HAT approach allows to carry out homogeneous diagnostic psychiatric patients. Such ayodrębnienie It is dictated by the difficulties of diagnostic and therapeutic (Siegfried 1998; Sciacca 1991; Lehman, 1998). One clinical term for such a diverse group of patients do not permit a homogeneous diagnostic tests and determine the needs, problems and medical treatment and social services. Interest in this group of patients is not only due to cognitive reasons, but also due to the increasing number of people with dual diagnosis, more effective treatment and social assistance. Another reason is the rapidly growing number of people with PD. This group represents a challenge for physicians, social workers (Crome, Myton 2004; Lehman 2000; Alaja, Sepia1998).Clinical studies confirm the phenomenon of interactivity in which a mentally ill person is at high risk of developing mood-dependent dependence, particularly alcohol and those who are at high risk for mental illness (Lehman 2000).Dual diagnosis is the term defining the clinical coexistence in the same person from one side of a mental disorder, and disorders related to psychoactive substances, mostly drugs and / or alcohol (Abel-Saleh 2004; Crome, Myton 2004). The population of patients with dual diagnosis is large and varies widely in type and severity of the mental illness, the type of psychoactive agents and specific disorders resulting from the adoption of psychoactive substances, psychological and social skills which is obtained support and other factors (Lehman 1996; Ridgely 1987), such as schizophrenia. Severe mental illness (severe mental illness) as a concept which takes into account the clinical diagnosis (diagnosis) the degree of impairment of (disability) and duration of disorder (duration). This criterion includes serious mental breakdowns such as schizophrenia, bipolar affective disorder, depression. These disorders seriously impair people-to-people contact, self-care. Treatment of people with dual diagnosis is a problem because it results from the combination of two extremely different ways of dealing with mental illness and addiction.


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