Using Smartphone Apps to Promote Psychiatric Rehabilitation in a Peer-led Community Support Program (Preprint)

BACKGROUND Management of severe and persistent mental illness is a complex, resource-intensive challenge for individuals, their families, their treaters, and the healthcare system at large. Community based rehabilitation, in which peer specialists provide support for individuals managing their own condition, has demonstrated effectiveness, but has only been implemented in specialty centers. It remains unclear how the peer based community rehabilitation model could be expanded, given that it requires significant resources to both establish and maintain. OBJECTIVE Here, we describe the results from a study of one such program implemented within Waverley Place, a community support program at McLean Hospital emphasizing psychiatric rehabilitation for individuals with severe and persistent mental illness. Key questions were whether the patients could and would successfully use the app. METHODS The smartphone app offered multiple features relevant to psychiatric rehabilitation, including daily task lists and text messaging with peer specialists. Thirteen patients downloaded the app and used it for up to 90 days. RESULTS Only two patients were not able to complete app installation. Five patients were able to use the app regularly as part of their daily lives. No demographic or clinical features predicted ability to use the app in this way, but receiving a message from the certified peer specialist on the first day after installing the app did. Reasons for success or failure were highly individualistic. CONCLUSIONS Smartphone apps may become a useful tool for psychiatric rehabilitation, addressing both psychiatric and co-occurring medical problems. Individualizing functions to each patient and facilitating connection with a certified peer specialist may be an important feature of useful apps.

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Using Smartphone Apps to Promote Psychiatric Rehabilitation in a Peer-Led Community Support Program: Pilot Study

JMIR Mental Health ◽

10.2196/10092 ◽

2018 ◽

Vol 5 (3) ◽

pp. e10092 ◽

Cited By ~ 9

Author(s):

Nora E Mueller ◽

Trishan Panch ◽

Cathaleene Macias ◽

Bruce M Cohen ◽

Dost Ongur ◽

...

Keyword(s):

Mental Illness ◽

Psychiatric Rehabilitation ◽

Community Support ◽

Support Program ◽

Smartphone Apps ◽

Research Staff ◽

Persistent Mental Illness ◽

Community Support Program ◽

Peer Specialists ◽

Day Program

Background Management of severe and persistent mental illness is a complex, resource-intensive challenge for individuals, their families, treaters, and the health care system at large. Community-based rehabilitation, in which peer specialists provide support for individuals managing their own condition, has demonstrated effectiveness but has only been implemented in specialty centers. It remains unclear how the peer-based community rehabilitation model could be expanded, given that it requires significant resources to both establish and maintain. Objective Here, we describe the results from a study of one such program implemented within Waverley Place, a community support program at McLean Hospital, emphasizing psychiatric rehabilitation for individuals with severe and persistent mental illness, as well as describing the challenges encountered during the implementation of the program. Key questions were whether the patients could, and would, successfully use the app. Methods The smartphone app offered multiple features relevant to psychiatric rehabilitation, including daily task lists, activity tracking, and text messaging with peer specialists. A 90-day program of activities, goals, and content specific to the community support program was created on the basis of a prior pilot, in collaboration between members of the app development team (WellFrame), and peers, clinical, and research staff associated with the program. Hospital research staff recruited patients into the study, monitored peer and patient engagement, and handled all raw data acquired from the study. Results Of 100 people approached for the study, a total of 13 provided consent, of which 10 downloaded and used the app. Two patients were unable to complete the app installation. Five used the app regularly as part of their daily lives for at least 20 days of the 90-day program. We were unable to identify any specific factors (eg, clinical or demographic) that affected willingness to consent or engage with the app platform in the very limited sample, although the individuals with significant app use were generally satisfied with the experience. Conclusions Smartphone apps may become a useful tool for psychiatric rehabilitation, addressing both psychiatric and co-occurring medical problems. Individualizing functions to each patient and facilitating connection with a certified peer specialist may be an important feature of useful apps. Unlike prior reports emphasizing that patients with schizophrenia will adopt smartphone platforms, we found that implementation of digital tools into existing community support programs for severe and persistent mental illness has many challenges yet to be fully overcome to realize the potential benefits such apps could have to promote systematization and cost reduction for psychiatric rehabilitation.

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A Comprehensive Clinical Vocational Assessment: The PACT Approach

Journal of Applied Rehabilitation Counseling ◽

10.1891/0047-2220.22.2.25 ◽

1991 ◽

Vol 22 (2) ◽

pp. 25-28 ◽

Cited By ~ 5

Author(s):

Jana Lane Frey ◽

Michelle Godfrey

Keyword(s):

Mental Illness ◽

Behavioral Assessment ◽

Community Support ◽

Support Program ◽

Vocational Assessment ◽

Persistent Mental Illness ◽

Community Support Program ◽

Vocational Outcomes ◽

Assessment Approach ◽

Model Community

The purpose of this paper is to present an “Integrated Clinical Behavioral Assessment Approach” for use with persons with severe and persistent mental illness. This approach has been viewed as effective in facilitating successful competitive vocational outcomes within a model community support program.

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