Relevant training for case managers in severe mental illness

IntroductionUnemployment is common in persons with severe mental illness (SMI) and more in Latino population. Department of Mental Health and Addiction Services (DMHAS) of Connecticut offers a supported employment (SE) Program to help clients get competitive work in integrated settings with nondisabled workers in the community.ObjectiveCapture perspectives of key informant groups to describe barriers for linking Latinos with SMI to employment and adapt SE Services for subpopulations.MethodFour focus groups were conducted (employment specialists, case managers and peer support counselors/employers/two with clients-one in Spanish and other in English). They were conducted during January-February 2015, 70–90 minutes each one. A question guide was developed for each group. Participants per focus group ranged from 3–10, voluntarily. Two new questionnaires to the baseline pack were developed: challenges to Employment Assessment–provider and client version.ResultsThirty individuals participated. Several barriers to employment were reported. Clients and staff reported criminal record, lack of employment history and lack of motivation. Staff described client hygiene, mental status, physical health, substance abuse and discrimination. Clients, staff and employers reported language barrier for Latinos who don’t speak English. Non-adherence to medication was reported by clients and employers. About Spanish-Speaking Latinos with mental illness, medication, discrimination, previous abuse by employers, inappropriate employment, difficulties of the job interview and computer skills appeared as challenges. English-Speaking Latinos with mental illness identified transport, stability, support, keeping apartment and financial needs.ConclusionsFocus groups can help in knowledge about the diversity of Latino communities to improve SE Services and outcomes for Latinos.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Integrating a Mobile Health Device Into a Community Youth Mental Health Team to Manage Severe Mental Illness: Protocol for a Randomized Controlled Trial (Preprint)

10.2196/preprints.19510 ◽

2020 ◽

Author(s):

Simon Byrne ◽

Beth Kotze ◽

Fabio Ramos ◽

Achim Casties ◽

Jean Starling ◽

...

Keyword(s):

Mental Health ◽

Mental Illness ◽

Young Adults ◽

Community Mental Health ◽

Severe Mental Illness ◽

Controlled Trial ◽

Case Manager ◽

Case Managers ◽

Mental Health Team ◽

Health Team

BACKGROUND Symptoms of mental illness are often triggered by stress, and individuals with mental illness are sensitive to these effects. The development of mobile health (mHealth) devices allows continuous recording of biometrics associated with activity, sleep, and arousal. Deviations in these measures could indicate a stressed state requiring early intervention. This paper describes a protocol for integrating an mHealth device into a community mental health team to enhance management of severe mental illness in young adults. OBJECTIVE The aim of this study is to examine (1) whether an mHealth device integrated into a community mental health team can improve outcomes for young adults with severe mental illness and (2) whether the device detects periods of mental health versus deterioration. METHODS This study examines whether physiological information from an mHealth device prevents mental deterioration when shared with the participant and clinical team versus with the participant alone. A randomized controlled trial (RCT) will allocate 126 young adults from community mental health services for 6 months to standard case management combined with an integrated mHealth device (ie, physiological information is viewed by both participant and case manager: unWIRED intervention) or an unintegrated mHealth device (ie, participant alone self-monitors: control). Participants will wear the Empatica Embrace2 device, which continuously records electrodermal activity and actigraphy (ie, rest and activity). The study also examines whether the Embrace2 can detect periods of mental health versus deterioration. A variety of measurements will be taken, including physiological data from the Embrace2; participant and case manager self-report regarding symptoms, functioning, and quality of life; chart reviews; and ecological momentary assessments of stress in real time. Changes in each participant’s Clinical Global Impression Scale scores will be assessed by blinded raters as the primary outcome. In addition, participants and case managers will provide qualitative data regarding their experience with the integrated mHealth device, which will be thematically analyzed. RESULTS The study has received ethical approval from the Western Sydney Local Health District Human Research Ethics Committee. It is due to start in October 2020 and conclude in October 2022. CONCLUSIONS The RCT will provide insight as to whether an integrated mHealth device enables case managers and participants to pre-emptively manage early warning signs and prevent relapse. We anticipate that unWIRED will enhance early intervention by improving detection of stress and allowing case managers and patients to better engage and respond to symptoms. CLINICALTRIAL Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000642987; https://www.anzctr.org.au/ACTRN12620000642987.aspx INTERNATIONAL REGISTERED REPORT PRR1-10.2196/19510

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Community housing: functional outcome of severe mental illness is associated with the personality traits of the case manager

Housing Care and Support ◽

10.1108/hcs-10-2018-0026 ◽

2019 ◽

Vol 22 (2) ◽

pp. 106-113

Author(s):

Mandy Lodder ◽

A.J.P. Schrijvers ◽

J.R.J. de Leeuw ◽

R.M. Brouwer ◽

W. Cahn

Keyword(s):

Mental Illness ◽

Severe Mental Illness ◽

Personality Traits ◽

Functional Outcome ◽

Selection Process ◽

Case Manager ◽

Case Managers ◽

Supported Housing ◽

Content Type ◽

Self Reliance

Purpose The purpose of this paper is to examine whether there is an association between case managers’ personality traits and functional outcome of people with severe mental illness (SMI) living in community housing programs (CHP). Design/methodology/approach Functional outcome is measured by the extent of self-reliance. Self-reliance of people with SMI was measured with the Dutch Self-Sufficiency Matrix. The personality of the case manager was measured with the NEO Five Factor Inventory. Findings Conscientiousness of case managers was associated with an increased self-reliance over a period of two years, in those with SMI living in CHP (OR.2.800 ρ = 0.04). Practical implications When these findings are replicated, they could be used in the case managers selection process and/or training programs. Social implications Conscientiousness of case managers was associated with functional outcome of persons with SMI living in supported housing and that female subjects benefitted the most. This study suggests that conscientious care planning is essential in the recovery process. Originality/value No previous studies have been performed examining the specific relationship between the case manager’s personality traits and functional outcome of people with SMI.

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Integrating a Mobile Health Device Into a Community Youth Mental Health Team to Manage Severe Mental Illness: Protocol for a Randomized Controlled Trial

JMIR Research Protocols ◽

10.2196/19510 ◽

2020 ◽

Vol 9 (11) ◽

pp. e19510

Author(s):

Simon Byrne ◽

Beth Kotze ◽

Fabio Ramos ◽

Achim Casties ◽

Jean Starling ◽

...

Keyword(s):

Mental Health ◽

Mental Illness ◽

Young Adults ◽

Community Mental Health ◽

Severe Mental Illness ◽

Controlled Trial ◽

Case Manager ◽

Case Managers ◽

Mental Health Team ◽

Health Team

Background Symptoms of mental illness are often triggered by stress, and individuals with mental illness are sensitive to these effects. The development of mobile health (mHealth) devices allows continuous recording of biometrics associated with activity, sleep, and arousal. Deviations in these measures could indicate a stressed state requiring early intervention. This paper describes a protocol for integrating an mHealth device into a community mental health team to enhance management of severe mental illness in young adults. Objective The aim of this study is to examine (1) whether an mHealth device integrated into a community mental health team can improve outcomes for young adults with severe mental illness and (2) whether the device detects periods of mental health versus deterioration. Methods This study examines whether physiological information from an mHealth device prevents mental deterioration when shared with the participant and clinical team versus with the participant alone. A randomized controlled trial (RCT) will allocate 126 young adults from community mental health services for 6 months to standard case management combined with an integrated mHealth device (ie, physiological information is viewed by both participant and case manager: unWIRED intervention) or an unintegrated mHealth device (ie, participant alone self-monitors: control). Participants will wear the Empatica Embrace2 device, which continuously records electrodermal activity and actigraphy (ie, rest and activity). The study also examines whether the Embrace2 can detect periods of mental health versus deterioration. A variety of measurements will be taken, including physiological data from the Embrace2; participant and case manager self-report regarding symptoms, functioning, and quality of life; chart reviews; and ecological momentary assessments of stress in real time. Changes in each participant’s Clinical Global Impression Scale scores will be assessed by blinded raters as the primary outcome. In addition, participants and case managers will provide qualitative data regarding their experience with the integrated mHealth device, which will be thematically analyzed. Results The study has received ethical approval from the Western Sydney Local Health District Human Research Ethics Committee. It is due to start in October 2020 and conclude in October 2022. Conclusions The RCT will provide insight as to whether an integrated mHealth device enables case managers and participants to pre-emptively manage early warning signs and prevent relapse. We anticipate that unWIRED will enhance early intervention by improving detection of stress and allowing case managers and patients to better engage and respond to symptoms. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000642987; https://www.anzctr.org.au/ACTRN12620000642987.aspx International Registered Report Identifier (IRRID) PRR1-10.2196/19510

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