Engagement intervention versus treatment as usual for young adults with serious mental illness: a randomized pilot trial

Aims: Young adults with serious mental illness (SMI) are thought to be socially excluded. However, psychometric measures of social inclusion have not been employed to examine group differences relative to peers from the general community. The aim of this study was to employ such a measure to determine differences in social inclusion between young adults with SMI and peers from the general community. Methods: A cross-sectional hierarchical logistic regression was conducted to identify which dimensions and individual indicators from the Filia Social Inclusion Measure (F-SIM) discriminated between n = 152 young adults aged 18–25 from the general community ( M = 21.36, SD = 2.16) and n = 159 young adults aged 18–25 with SMI ( M = 21.13, SD = 2.21). Results: Group membership was accounted for by Interpersonal Connections (Nagelkerke R2 = .32), Vocational & Financial Security (Nagelkerke R2 = .32) and Healthy Independent Lifestyle (Nagelkerke R2 = .08) dimensions of the F-SIM. Relative to young adults from the general community, those with SMI were five times less likely to feel they had friends who would call on them in a crisis, odds ratio (OR) = .19 (95%CI = .04, .53), p = .04, almost five times more likely to live with their parents, OR = 4.79 (95%CI = 1.98,11.15), p = .004, almost four times less likely to have worked/studied any time over the past 12 months, OR = .27 (95%CI = .11,.64), p < .001, and three-and-a-half times more likely to report unstable accommodation, OR = 3.58 (95%CI = 1.14, 11.15), p = .03. Conclusion: Young adults with SMI are socially excluded relative to peers from the general community in terms of interpersonal connections, vocational engagement, autonomy/independence and housing stability. In addition to the well-established focus on vocational engagement, interventions to improve social inclusion in this population must promote reciprocity within social relationships and healthy autonomy/independence (including stable housing).

Download Full-text

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.

Download Full-text

Effect of lifestyle coaching versus care coordination versus treatment as usual in people with severe mental illness and overweight: Two-years follow-up of the randomized CHANGE trial

PLoS ONE ◽

10.1371/journal.pone.0185881 ◽

2017 ◽

Vol 12 (10) ◽

pp. e0185881 ◽

Cited By ~ 13

Author(s):

Ane Storch Jakobsen ◽

Helene Speyer ◽

Hans Christian Brix Nørgaard ◽

Mette Karlsen ◽

Merete Birk ◽

...

Keyword(s):

Mental Illness ◽

Severe Mental Illness ◽

Care Coordination ◽

Treatment As Usual ◽

Change Trial ◽

Versus Treatment

Download Full-text

Ever onward: The personal strivings of young adults coping with serious mental illness and the hopes of their parents.

American Journal of Orthopsychiatry ◽

10.1037/0002-9432.77.1.104 ◽

2007 ◽

Vol 77 (1) ◽

pp. 104-112 ◽

Cited By ~ 8

Author(s):

Catherine H. Stein ◽

Lissa M. Mann ◽

Marcia G. Hunt

Keyword(s):

Mental Illness ◽

Young Adults ◽

Serious Mental Illness ◽

Personal Strivings

Download Full-text

Peer navigation for individuals with serious mental illness leaving jail: a pilot randomized trial study protocol

10.21203/rs.3.rs-20884/v3 ◽

2020 ◽

Author(s):

Maji Hailemariam ◽

Lauren M Weinstock ◽

Jennifer E. Johnson

Keyword(s):

Mental Health ◽

Mental Illness ◽

Serious Mental Illness ◽

Suicide Attempts ◽

Psychiatric Symptoms ◽

Controlled Trial ◽

Pilot Trial ◽

Public Health Problem ◽

Training Methods ◽

Peer Navigation

Abstract Background: Serious mental illness (SMI) is a prevalent public health problem affecting 25% of individuals in jail. Re-entry to the community following incarceration is a vulnerable time for justice-involved individuals with SMI. SMI requires prompt and ongoing access to mental health and other healthcare services. Methods: The study will: 1) develop a Mentoring And Peer Support (MAPS) intervention for post-release mental health and other service connection among jailed individuals with SMI, and 2) pilot-test the MAPS intervention to determine the feasibility and acceptability of the MAPS intervention. The primary outcomes will be to evaluate the feasibility and acceptability of the proposed recruitment methods and research design, of the intervention training methods, of delivering the enhanced peer-navigator and control interventions. Study samples include (focus groups, open trial), and a randomized pilot trial in a sample of 40 individuals with SMI re-entering the community after jail release. Secondary outcomes will include post-release enrollment in mental health, medical care, and substance use services. We will also evaluate reduction in psychiatric symptoms, improvements in functioning, adherence to psychiatric medications, fewer substance using days, fewer hospitalizations and suicide attempts, nights unstably housed, and time until rearrest. Discussion: This pilot study will evaluate the feasibility and acceptability of a peer navigation intervention for individuals with serious mental illness leaving jails. The study will serve as a formative work for a larger randomized controlled trial assessing the effectiveness of peer navigator intervention for (include the primary outcome) in this population.

Download Full-text

Acceptability and Usability of Mobile Apps for Smoking Cessation Among Young Adults With Psychotic Disorders and Other Serious Mental Illness

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.656538 ◽

2021 ◽

Vol 12 ◽

Author(s):

Minda A. Gowarty ◽

Kelly A. Aschbrenner ◽

Mary F. Brunette

Keyword(s):

Mental Illness ◽

Young Adults ◽

Young Adult ◽

Serious Mental Illness ◽

Psychotic Disorders ◽

Mobile Apps ◽

Initial Study ◽

Task Completion ◽

Post Traumatic Stress ◽

Structured Interviews

Background: Young adults with serious mental illness (SMI) are over twice as likely to smoke cigarettes than those in the general population, but little research has evaluated the efficacy of interventions for this group. While smartphone apps are a promising tool to address this need, their usability should be evaluated among young adults with psychotic disorders, whose symptoms and cognitive impairments may be a barrier to app use.Methods: We compared usability and acceptability of National Cancer Institute apps (QuitGuide and quitSTART) between young adult smokers with SMI psychotic disorders and other SMI diagnoses. We evaluated objective app usability at the initial study visit and following 2 weeks of independent use via a video-recorded task-completion protocol. Perceptions of usability and acceptability were assessed with semi-structured interviews. Engagement was assessed with backend app use data.Results: Participants had a mean age of 29 years old (SD = 4). Of the participants without psychotic disorders (n = 10), all were diagnosed with SMI post-traumatic stress disorder (SMI-PTSD). QuitGuide objective task completion rates were high and similar between diagnosis groups, whereas quitSTART task completion was initially lower among users with psychotic disorder compared to users with SMI-PTSD at Visit 1, and improved by Visit 2. Mean app interactions, mean days of use, and median completed notifications were dramatically higher among quitSTART users compared to QuitGuide users. Compared to quitSTART users with SMI-PTSD, quitSTART users with psychotic disorders had similar daily app interactions over the first week of use (mean 3.8 ± 2.4 interactions), and numerically lower mean daily app interactions during the second week (1.9 ± 1.5 vs. 3.4 ± 2.5), whereas completed notifications remained stable among quitSTART users in both diagnosis groups over time. Qualitative comments indicated general acceptability of both apps among both diagnosis groups.Conclusions: Both QuitGuide and quitSTART were usable and appealing among young adult smokers with psychotic disorders and SMI-PTSD, although quitSTART engendered a dramatically greater level of engagement compared to QuitGuide. Initial coaching to support initiation and app notifications to promote prolonged engagement may be important for young adult smokers with psychotic disorders. Replication and efficacy testing for quitSTART is warranted.

Download Full-text