Habits and other Anchors of Everyday Life That People with Psychiatric Disabilities May Not Take for Granted

This article argues for the adoption of action theory as the foundation for rethinking psychiatric research and practice as it relates to individuals with serious mental illnesses. Action theory involves viewing human beings as agents who are active in creating their experiences and environments at the same time as they are shaped by them. Rather than following from insight, actions are viewed as preceding and generating insight. When viewed in this manner, the chronicity formerly associated with psychosis is reinterpreted as habits stemming from institutionalization, while recovery is understood as developing new habits based on the person's need to establish caring relationships and focus on being grounded in the present. What results is a strengths-based approach to practice that shares many basic principles with occupational science and therapy, leading us to call for a renewed interest in mental illness among investigators and practitioners within this discipline and profession.

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A social history of serious mental illness

CNS Spectrums ◽

10.1017/s1092852920001364 ◽

2020 ◽

Vol 25 (5) ◽

pp. 584-592

Author(s):

Brendan Daugherty ◽

Katherine Warburton ◽

Stephen M. Stahl

Keyword(s):

Mental Illness ◽

Social History ◽

Serious Mental Illness ◽

Mental Illnesses ◽

History Of ◽

Reform And Innovation ◽

Serious Mental Illnesses

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.

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A brief history of the criminalization of mental illness

CNS Spectrums ◽

10.1017/s1092852920000103 ◽

2020 ◽

Vol 25 (5) ◽

pp. 638-650 ◽

Cited By ~ 2

Author(s):

Joel A. Dvoskin ◽

James L. Knoll ◽

Mollie Silva

Keyword(s):

Mental Health ◽

United States ◽

Mental Illness ◽

Community Mental Health ◽

Mental Disorders ◽

The United States ◽

Mental Illnesses ◽

The People ◽

History Of ◽

Serious Mental Illnesses

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.

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Women with Serious Mental Illness

10.1093/med-psych/9780190922351.001.0001 ◽

2020 ◽

Author(s):

Lauren Mizock ◽

Erika Carr

Keyword(s):

Mental Health ◽

Mental Illness ◽

Serious Mental Illness ◽

Severe Depression ◽

Mental Illnesses ◽

Post Traumatic Stress ◽

Class Culture ◽

History Of ◽

Serious Mental Illnesses ◽

Work Class

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.

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Pilot trial of the FOCUS mHealth intervention for veterans with serious mental illness in an outpatient VA setting (Preprint)

10.2196/preprints.26049 ◽

2020 ◽

Author(s):

Benjamin Buck ◽

Janelle Nguyen ◽

Shelan Porter ◽

Dror Ben-Zeev ◽

Greg R. Reger

Keyword(s):

Mental Illness ◽

Serious Mental Illness ◽

Pilot Trial ◽

Mental Illnesses ◽

Management Intervention ◽

Mhealth Intervention ◽

Qualitative Feedback ◽

The One ◽

Specific Implementation ◽

Serious Mental Illnesses

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.

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Forensic Psychiatry

10.1093/med/9780190610999.003.0017 ◽

2017 ◽

Author(s):

Sheku Magona ◽

Tara Straka

Keyword(s):

Mental Illness ◽

Justice System ◽

Mental Illnesses ◽

The Public ◽

People With Mental Illness ◽

Fitness To Stand Trial ◽

Criminal Procedure Law ◽

Serious Mental Illnesses ◽

Public Psychiatrists

Law enforcement, lawmakers, and the public are increasingly concerned about how people with mental illness are treated within the criminal justice system. This chapter focuses on the role of public psychiatrists in the provision of timely evaluation, expertise, and care for individuals in custody—particularly for individuals with serious mental illnesses. A case-based discussion illuminates important aspects of the legal and health care challenges facing individuals at the time of arrest, arraignment, incarceration, trial, and community re-entry. The chapter discusses mental hygiene law, criminal procedure law, advocacy, and the formation of policy with an emphasis on fitness to stand trial. Appropriate diversion of individuals with mental illness from incarceration, and its role in helping these individuals to achieve recovery, is explored in detail.

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Acceptance of Mental Illness

10.1093/med:psych/9780190204273.001.0001 ◽

2016 ◽

Author(s):

Lauren Mizock ◽

Zlatka Russinova

Keyword(s):

Mental Health ◽

Mental Illness ◽

Severe Depression ◽

Mental Illnesses ◽

Recovery Movement ◽

People With Mental Illness ◽

The Face ◽

Mental Wellness ◽

Serious Mental Illnesses ◽

Diverse Groups

The book covers a topic that is often overlooked in the literature: How people with serious mental illnesses (i.e., schizophrenia, bipolar disorder, severe depression) come to recognize and deal with the symptoms of a mental illness in order to promote recovery. Per the recovery movement in mental health, recovery is understood as not simply symptom elimination, but the process of living a meaningful and satisfying life in the face of mental illness. Acceptance of Mental Illness draws from research to provide educators, clinicians, researchers, and consumers with an understanding of the multidimensional process of acceptance of mental illness in order to support people across culturally diverse groups to experience empowerment, mental wellness, and growth. Chapters focus on providing a historical overview of the treatment of people with mental illness, examining the acceptance process, and exploring the experience of acceptance among women, men, racial–ethnic minorities, and LGBT individuals with serious mental illnesses. The book is a useful tool for mental health educators and providers, with each chapter containing case studies, clinical strategies lists, discussion questions, experiential activities, diagrams, and worksheets that can be completed with clients, students, and peers.

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

Research on Aging ◽

10.1177/0164027517728554 ◽

2017 ◽

Vol 40 (7) ◽

pp. 668-686 ◽

Cited By ~ 2

Author(s):

Maria Teresa Brown ◽

Douglas A. Wolf

Keyword(s):

Mental Illness ◽

Serious Mental Illness ◽

Mental Illnesses ◽

Health And Retirement Study ◽

Data Sets ◽

Conditional Probabilities ◽

Medicare Beneficiaries ◽

Services And Supports ◽

Serious Mental Illnesses ◽

Retirement Study

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.

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Effective Models Urgently Needed to Improve Physical Care for People With Serious Mental Illnesses

Health Services Insights ◽

10.1177/1178632919837628 ◽

2019 ◽

Vol 12 ◽

pp. 117863291983762

Author(s):

Evelyn T Chang ◽

Merlyn Vinzon ◽

Amy N Cohen ◽

Alexander S Young

Keyword(s):

Primary Care ◽

Mental Illness ◽

Serious Mental Illness ◽

Psychiatric Symptoms ◽

Mental Illnesses ◽

Patient Centered ◽

Care Models ◽

Effective Models ◽

Serious Mental Illnesses ◽

To Receive

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.

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From the Editor's desk

The British Journal of Psychiatry ◽

10.1192/bjp.207.5.467 ◽

2015 ◽

Vol 207 (5) ◽

pp. 467-468 ◽

Cited By ~ 1

Author(s):

Kamaldeep Bhui

Keyword(s):

Mental Health ◽

Mental Illness ◽

Life Sciences ◽

Mental Illnesses ◽

Psychiatric Research ◽

Medical Illness ◽

Positive Outcomes ◽

Brain Disorder ◽

Diagnostic Practice ◽

Emotionally Intelligent

Is medical illness a myth?The National Institute of Health's (NIH's) emphasis on mental illness as a brain disorder has transformed psychiatric research and attitudes towards mental illness. Despite the departure of the Director of the National Institute of Mental Health, Thomas Insel, to join Google Life Sciences (http://www.nih.gov/about/director/09152015_statement_insel.htm), the move away from symptom-based diagnoses in favour of more neuroscientific rationales for diagnosis is necessary and likely to be sustained. The absence of demonstrable organic pathology in mental illnesses motivated the NIH programmes, yet essentially all behaviours and adaptations to context will have physiological correlates; Google and other software and technology companies may well offer better and more powerful methods for assessing pathophysiology and making diagnoses in the future. Such shifts in diagnostic practice require much disciplined research, and seem to not obviate the need for compassionate, caring and emotionally intelligent clinicians who are able to contain and negotiate meanings and experiences, and transform conversations and care packages to positive outcomes for patients.

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Serious Mental Illness

10.1093/oxfordhb/9780199381708.013.009 ◽

2014 ◽

Author(s):

Kim T. Mueser ◽

Douglas L. Noordsy ◽

Robert E. Drake

Keyword(s):

Mental Illness ◽

Substance Use ◽

Psychiatric Disorders ◽

Substance Use Disorders ◽

Serious Mental Illness ◽

Integrated Treatment ◽

Mental Illnesses ◽

Clinical Consequences ◽

Social Difficulties ◽

Serious Mental Illnesses

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.

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