Treatment Network Typologies and the Working Alliance of Clients with Serious Mental Illness

2021 ◽  
pp. 215686932110014
Author(s):  
George S. Usmanov ◽  
Eric R. Wright ◽  
Raeda K. Anderson
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Working Alliance ◽  
Serious Mental Illness ◽  
Weighted Least Squares ◽  
Local Treatment ◽  
Psychiatric Hospitals ◽  
Local Network ◽  
Care Providers

The climate and culture of treatment for clients with serious mental illness (SMI) are complex. In this study, we aim to cultivate a deeper understanding of the treatment environment using a network typological approach to measure the local treatment context and assess its implications on the perceived quality of clients’ relationships with their care providers. We use in-depth egocentric network data from clients with SMI in community mental health centers and state psychiatric hospitals from the Indiana Mental Health Services and HIV Risk Study ( N = 417). Clustering analysis identifies five unique and distinct network types: supportive, sparse, diverse, clinical, and treatment-focused. Weighted least squares regressions reveal clients in networks with high amounts of support predict a more trusting working alliance, whereas care-oriented networks predict a less trusting alliance. Our findings underscore the need to consider the local network context in studies of the quality of care provided to people with SMI.

scholarly journals Creating a ‘reverse’ integrated primary and mental healthcare clinic for those with serious mental illness

2015 ◽  
Vol 17 (05) ◽  
pp. 421-427 ◽  
Author(s):  
Alexandros Maragakis ◽  
Ragavan Siddharthan ◽  
Jill RachBeisel ◽  
Cassandra Snipes
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Illness ◽  
Quality Of Care ◽  
Serious Mental Illness ◽  
Mental Healthcare ◽  
Policy Reforms ◽  
Mental Health Settings ◽  
Primary Care Practitioners

Individuals with serious mental illness (SMI) are more likely to experience preventable medical health issues, such as diabetes, hyperlipidemia, obesity, and cardiovascular disease, than the general population. To further compound this issue, these individuals are less likely to seek preventative medical care. These factors result in higher usage of expensive emergency care, lower quality of care, and lower life expectancy. This manuscript presents literature that examines the health disparities this population experiences, and barriers to accessing primary care. Through the identification of these barriers, we recommend that the field of family medicine work in collaboration with the field of mental health to implement ‘reverse’ integrated care (RIC) systems, and provide primary care services in the mental health settings. By embedding primary care practitioners in mental health settings, where individuals with SMI are more likely to present for treatment, this population may receive treatment for somatic care by experts. This not only would improve the quality of care received by patients, but would also remove the burden of managing complex somatic care from providers trained in mental health. The rationale for this RIC system, as well as training and policy reforms, are discussed.

Psychiatric Rehabilitation Outcomes Among Hispanics with Co-Occurring Serious Mental Illness and Substance Use Disorders: A Systematic Review

2017 ◽  
Vol 48 (1) ◽  
pp. 40-49 ◽  
Author(s):  
Jennifer Sánchez ◽  
Veronica Muller ◽  
Magdalena E. Garcia ◽  
Stephany N. Martinez ◽  
Scott T. Cool ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Substance Use ◽  
Serious Mental Illness ◽  
Psychiatric Rehabilitation ◽  
Treatment Strategies ◽  
Rehabilitation Outcomes ◽  
Psychiatric Hospitalizations ◽  
Evidenced Based

Purpose: To conduct a systematic literature review relating to psychiatric rehabilitation (PsyR) outcomes of Hispanics with co-occurring serious mental illness (SMI) and substance use disorder (SUD) and to identify the most appropriate evidenced-based practices (EBPs) to facilitate treatment strategies for this population. Method: The following electronic databases were used to search multiple keywords and keyword combinations: MEDLINE/PubMed, SpringerLink, and Education Resources Information Center (ERIC). The initial search resulted in a total of 911 articles. Next, 906 articles from the initial search were excluded because they did not meet inclusion criteria for the following reasons: duplicates (n = 50), not relating to PsyR outcomes (n = 718) or to co-occurring SMI and SUD (n = 53), and not including Hispanics (n = 85). Five articles were retained for this study. Results: The included studies were classified by intervention into three categories: Integrated Mental Health and Substance Abuse Treatments (3), Motivational Interviewing (1), and Psychosocial Resources (1). Outcomes included reduction in mental health and PTSD symptoms, increased abstinence, decrease in substance use and psychiatric hospitalizations, improved self-efficacy for recovery, and better quality of life (QOL). Conclusion: This review identified several successful PsyR outcomes for Hispanics with co-occurring SMI and SUD; however, it also highlighted the limited availability of extant literature focused on EBPs for Hispanics with co-occurring SMI and SUD. As the Hispanic population increases, their specific needs should be addressed.

scholarly journals PREDICTORS OF HEALTH-RELATED QUALITY OF LIFE AND RECOVERY AMONG OLDER ADULTS WITH SERIOUS MENTAL ILLNESS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S877-S877
Author(s):  
Anjana Muralidharan ◽  
Clayton H Brown ◽  
Richard W Goldberg
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Older Adults ◽  
Mental Illness ◽  
Physical Health ◽  
Serious Mental Illness ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Abstract Older adults with serious mental illness (i.e., schizophrenia spectrum disorders and affective psychoses) exhibit marked impairments across medical, cognitive, and psychiatric domains. The present study examined predictors of health-related quality-of-life and mental health recovery in this population. Participants (N=211) were ages 50 and older with a chart diagnosis of serious mental illness and a co-occurring medical condition, engaged in outpatient mental health services at a study site. Participants completed a battery of assessments including subtests from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the 24-Item Behavior and Symptom Identification Scale (BASIS-24), the 12-Item Short-Form Health Survey (SF-12), and the Maryland Assessment of Recovery Scale (MARS). Multiple linear regression analyses, with age, race, gender, and BMI as covariates, examined number of current medical conditions, RBANS, and BASIS as predictors of quality-of-life and recovery. Significant predictors of physical health-related quality-of-life (R-squared=.298, F(9,182)=8.57, p<.0001) were number of medical conditions (β=-1.70, p<.0001), BASIS-Depression/Functioning (β=-4.84, p<.0001), and BASIS-Psychosis (β=2.39, p<.0008). Significant predictors of mental health-related quality-of-life (R-squared=.575, F(9,182)=27.37, p<.0001) were RBANS (β=0.03, p=.05), BASIS-Depression/Functioning (β=-6.49, p<.0001), BASIS-Relationships (β=-3.17, p<.0001), and BASIS-Psychosis (β=-1.30, p=.03). Significant predictors of MARS (R-squared=.434, F(9,183)=15.56, p<.0001) were BASIS-Depression/Functioning (β=-4.68, p=.002) and BASIS-Relationships (β=-9.44, p<.0001). To promote holistic recovery among older adults with serious mental illness, integrated interventions are required. For example, to improve physical health-related quality-of-life, one should target depression and psychotic symptoms as well as medical illness burden. To improve mental health-related quality-of-life, depression symptoms and interpersonal functioning may be key targets, as well as neurocognitive function.

scholarly journals Social Determinants of Health for People With Serious Mental Illness After Transitioning to the Community

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 32-33
Author(s):  
Kathy Kellett ◽  
Kaleigh Ligus ◽  
Kristin Baker ◽  
Julie Robison
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Social Determinants ◽  
Community Context ◽  
Improve Quality ◽  
Social Community

Abstract Approximately 10 million, or 6 percent, of the U.S. population experience serious mental illness (SMI) (NAMI, 2019). Social determinants of health (SDOH) associated with this population can provide important information for targeted innovations with the potential to reduce disease burden and improve quality of life. Using secondary data from Connecticut’s Money Follows the Person Rebalancing Demonstration, this research compares people age 50+ who transitioned out of an institution onto the Medicaid HCBS Mental Health Waiver (MHW) (n= 271) to those receiving Mental Health services through the Medicaid State Plan (MHSP) (n=278). Analyses examine SDOH in both groups and are organized around five broad domains: Finances; education; social/community context, health/health care, and neighborhood/built environment. MHSP participants were significantly more likely to report not having enough money at the end of the month at 6 (42% vs. 21%), 12 (37% vs. 20%), and 24 (37% vs. 17%) months. Significantly more MHSP than MHW participants did not like where they lived at 6 (12% vs. 1%) and 24 (24% vs. 5%) months. Significantly more MHSP than MHW participants were unhappy with the help they received in the community at 6 (22% vs. 8%), 12 (23% vs. 7%), and 24 (19% vs. 5%) months. Groups did not differ by education, social/community context, health/health care, feelings of safety where they live, or on post-transition hospitalizations, ED use or reinstitutionalization. To improve quality of life in the community, MHSP participants could benefit from greater assistance with finances, housing, and community services.

Utilization of an Innovative Psychoeducational Group for Veterans With Severe Mental Illness: A Program Evaluation of a Quality Improvement Initiative

2020 ◽  
pp. 107839032097063
Author(s):  
Wendi L. Koonce Morse ◽  
Sasha Mankowski ◽  
S. Akeya Harrold
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Quality Improvement ◽  
Health Care Providers ◽  
Serious Mental Illness ◽  
Nurse Practitioner ◽  
Quality Improvement Initiative ◽  
Treatment Team ◽  
Care Providers ◽  
Collaborative Interactions

INTRODUCTION Cognitive impairments—episodes of mania or psychosis, paranoia, and substance use—are common effects of serious mental illness, which can lead to stigmatization, social isolation, and a decrease in interaction with health care providers. These consequences can obstruct a person with serious mental illness ability to comprehend diagnosed mental disorders and to fully participate in treatment. Consistent with the Substance Abuse and Mental Health Services Administration Recovery Model for Disease Management, nurse practitioner residents in a mental health nurse practitioner residency program developed an interactive psychoeducation series to improve veteran health self-efficacy and self-management. OBJECTIVE The overall purpose of this sequential quality improvement initiative was to develop and deliver a psychoeducational series, which is both veteran centric and recovery oriented. METHODS Series I of the project produced psychoeducational sessions based on collaborative interactions among veterans and members of the treatment team, with a focus on neurobiology, pharmacology, and evidence-based treatment recommendations. Through an innovative and interactive framework, Plan–Do–Study–Act cycles were utilized to bring about foundational themes and inherent changes in the psychoeducation delivery. With veterans’ feedback and collaboration, Series II of the project was developed within the continuous improvement evaluations from Series I. RESULTS Treatment collaboration between veterans and providers was fostered as veterans experienced learning, symptom recognition, and empowerment. CONCLUSION This project is unique in that it is the first known review of a quality improvement initiative to incorporate concurrent changes in psychoeducational session delivery, involving veterans and their providers to foster collaboration.

Quality of Care for Florida Nursing Home Residents With Serious Mental Illness

2006 ◽  
Author(s):  
Kathy Hyer ◽  
Christopher Johnson ◽  
Victor A. Molinari ◽  
Marion Becker
Keyword(s):  
Mental Illness ◽  
Nursing Home ◽  
Quality Of Care ◽  
Serious Mental Illness ◽  
Nursing Home Residents

Occupational Stress, Mental Health and Attitude Towards Mental Illness of Nursing Staff Working in General and Psychiatric Hospital: A Comparative Study

2015 ◽  
Vol 4 (4) ◽  
Author(s):  
Suresh Lukose ◽  
Abdul Azeez E.P.
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Occupational Stress ◽  
Nursing Staff ◽  
Demographic Data ◽  
General Health Questionnaire ◽  
Psychiatric Hospitals ◽  
Working Environment ◽  
Stress Index ◽  
Role Overload

Nurses are identified as one of the professional groups with high level of job related stress and related issues. The magnitude of the problem this segment faces is very intensive as a large number of them are women. They are victimized for multiple roles in the home and hospital. Stressors for nurses are always been identified with workload, dual role and pressures which are associated with demands of the existing working environment. The nature of illness/diseases a nurse dealing with has significant effects on the stress and mental health level. Healthcare professionals dealing with psychiatric illness and other chronic/traumatic conditions faces more stress while comparing to the other domains of healthcare. The present study is a cross sectional hospital based study carried out at four centres and 100 samples were collected by judgmental sampling method which consisted of 50 female nursing staff from general hospital and same number from psychiatric hospitals. A socio-demographic data sheet along with General Health Questionnaire was administered and those who have satisfactory health have been considered as further samples. Mental health, stress level, and attitude towards mental illness were analyzed. The results shows that psychiatric nursing staff scored higher in overall occupational stress index and in the subs-domains of role overload, role ambiguity, role conflict, role unreasonable group and political pressure compared to general nursing staff. Also the mental health inventory total score is negatively correlated with role overload sub-domain of occupational stress index scale. Present study implicates the need of comprehensive psycho-social management plans for the professionals working in psychiatric hospitals.

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