scholarly journals Barriers to and Facilitators of Vocational Development for Black Young Adults with Serious Mental Illnesses

2021 ◽  
Author(s):  
Jonathan Delman ◽  
Leslie B. Adams
Keyword(s):  
Young Adults ◽  
Critical Race Theory ◽  
Black People ◽  
Ecological Model ◽  
Psychiatric Rehabilitation ◽  
Qualitative Interviews ◽  
Mental Illnesses ◽  
Black Communities ◽  
Vocational Goals ◽  
Serious Mental Illnesses

Objective: Black young adults with serious mental illnesses (SMI) have low rates of employment and school completion. Racial disparities exist in the delivery of vocational services, with Black people less likely to be screened in, and if screened in less likely to receive job training. This qualitative exploratory study examined how Black young adults with SMI perceive the barriers and facilitators to achieving their vocational goals. Method: Our conceptual model for this study is the Social-Ecological Model, which contains four domains of analysis (intrapersonal, interpersonal, community, and societal), informed by Critical Race Theory. We completed semi-structured, qualitative interviews with 28 Black young adults with SMI. We analyzed data using qualitative content and inductive analyses. Results: Numerous respondents were experiencing racial discrimination in their vocational pursuits and their lives overall, and had doubts about achieving vocational success in racially imbalanced environments. Facilitating their vocational growth was trusting relationships with non-judgmental and understanding vocational counselors who provided supports reflecting client preferences. As college students, respondents benefited from the presence and accessibility of Black faculty and students. As employees, they valued workplace supervisors who provided direct support and feedback. Conclusions: Black young adults with SMI face high and racialized barriers to pursing work and education at multiple socioecological levels. The field of psychiatric rehabilitation should prepare vocational counselors to understand and address the needs and expressed preferences of Black young adults with SMI. Also called for is research, centered on and directed by Black communities, on the effectiveness of race-conscious vocational practices.

“To fill the emptiness”: The importance of work in life history narratives of older adults with schizophrenia-spectrum diagnoses

2017 ◽  
Vol 17 (4) ◽  
pp. 556-576 ◽  
Author(s):  
Lydia P Ogden
Keyword(s):  
Older Adults ◽  
Life History ◽  
Vocational Rehabilitation ◽  
Psychiatric Rehabilitation ◽  
Mental Illnesses ◽  
Negative Consequences ◽  
Schizophrenia Spectrum ◽  
Vocational Goals ◽  
History Narratives ◽  
Serious Mental Illnesses

Objective: This study’s purpose was to develop an understanding of the importance and meaning of vocational histories, present-time employment status, and vocational goals for older adults who were in treatment for schizophrenia-spectrum diagnoses. Methods: The theory of cumulative adversity and advantage focused 35 semistructured interviews and 43 field observation points that developed life history narratives of seven older adults in treatment for schizophrenia-spectrum diagnoses. Thematic narrative analysis was the primary analytic strategy. Results: Five shared themes within the life history narratives connected to vocational histories: “Purpose is provided by work,” “identity in work,” “perseverance toward value-based vocational goals,” “the importance of an income,” and “illness symptoms and their treatment disrupted work.” Discussion: Findings connect to practice implications for vocational programs for persons with serious mental illnesses, suggesting that vocational services for older adults could be rehabilitative and that vocational assessments should be holistic and values oriented. Psychiatric rehabilitation programs developed specifically for older adults might benefit from the inclusion of vocational rehabilitation options that do not rule out competitive employment. Social workers must be aware of bias in the profession toward persons on the basis of age and serious mental illnesses. Conclusion: In line with current vocational rehabilitation literature, the study concludes that psychiatric rehabilitation treatment that inhibits work can have unintended negative consequences for all persons with serious mental illnesses. Those negative consequences have to potential extend into later life challenges that range from identity challenges to challenges in day-to-day survival.

scholarly journals Building a therapeutic relationship between probation officers and probationers with serious mental illnesses

CNS Spectrums ◽  
2020 ◽  
Vol 25 (5) ◽  
pp. 723-733
Author(s):  
Matthew W. Epperson ◽  
Leon Sawh ◽  
Sophia P. Sarantakos
Keyword(s):  
Mental Health ◽  
Focus Groups ◽  
Therapeutic Relationship ◽  
Qualitative Interviews ◽  
Implementation Process ◽  
Probation Officers ◽  
Mental Illnesses ◽  
Service Engagement ◽  
Probation Supervision ◽  
Serious Mental Illnesses

ObjectiveThe purpose of this study was to engage in a collaborative process with a variety of stakeholders to develop the Brief Intervention to Promote Service Engagement (BIPSE), which aims to enhance the therapeutic relationship between probation officers and probationers with serious mental illnesses (SMI).MethodsThe BIPSE intervention was developed through a multistage “design for implementation” process, including a series of stakeholder meetings, observations of probation supervision sessions, incorporating existing intervention approaches, and workshopping initial BIPSE components with three randomly selected officers from a specialized mental health probation unit. Acceptability and feasibility of BIPSE components were assessed through focus groups with probation officers, additional observations of probation sessions, and qualitative interviews with probationers with SMI.ResultsTwo foundational components of the BIPSE intervention were identified during the stakeholder meetings and observations: (1) engagement and (2) shared decision-making. These two components inform and undergird the intervention’s third component, strategic case management. During focus groups, probation officers expressed interest in using the modified tools they were given and also saw the benefit of structuring their sessions. Probationers expressed their appreciation for the caring and collaborative nature with which their probation officers approached their sessions.ConclusionBuilding a therapeutic relationship between probation officers and probationers with SMI is an essential task toward improving mental health and criminal justice outcomes. The BIPSE development and refinement process demonstrates that interventions targeting the therapeutic relationship are acceptable to officers and clients, and can be tailored and feasibly structured into standard probation practices.

Prospectively identifying adults with serious mental illness at risk for poor physical health: The role of person reported outcomes

2020 ◽  
Author(s):  
Limor Hochman ◽  
Galia S Moran ◽  
Marc Gelkopf ◽  
David ROE ◽  
Efrat Shadmi
Keyword(s):  
Physical Health ◽  
Outcome Measures ◽  
Psychiatric Rehabilitation ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Mental Illnesses ◽  
Poor Physical Health ◽  
Patient Reported ◽  
Self Reports ◽  
Serious Mental Illnesses

Abstract Objective Persons with serious mental illnesses are at increased risk for co-occurring physical comorbidities. Patient-reported outcome measures are increasingly used in routine assessments of persons with serious mental illnesses, yet the relation of patient-reported outcome measures to physical health outcomes has not been comprehensively investigated. We examined the association between patient-reported outcome measures and self-reported physical health at 1-year follow-up. Design A retrospective cohort study. Setting Data were collected as part of the Israeli Psychiatric Rehabilitation Patient-Reported Outcome Measurement program in Israel. Participants A total of 2581 psychiatric rehabilitation service users assessed between April 2013 and January 2016. Main Outcome Measures Self-reports on two consecutive years of physical health dichotomized as poor versus good. Results More than one-third of participants reported having poor physical health. Multivariate regression analysis showed that quality of life (odds ratio [OR] = 0.71; 95% confidence interval [CI]: 0.60–0.84) and lack of effect of symptoms on functioning (OR = 0.81; 95%CI: 0.74–0.89) predict subsequent physical health, controlling for all other factors. Compared to a multivariate model with personal characteristics and self-reports on physical health at baseline (Model A), the model which also included patient-reported outcome measures (Model B) showed slightly better discrimination (c-statistic: 0.74 vs. 0.76, respectively). Conclusions These results suggest that patient-reported outcome measures contribute to the prediction of poor physical health and thus can be useful as an early screening tool for people with serious mental illnesses living in the community, who are at risk of physical health problems.

scholarly journals An Examination of the Community Participation Interests of Young Adults with Serious Mental Illnesses

2019 ◽  
Vol 47 (4) ◽  
pp. 526-543
Author(s):  
Elizabeth C. Thomas ◽  
Gretchen Snethen ◽  
Amber O’Shea ◽  
John Suarez ◽  
Irene Hurford ◽  
...  
Keyword(s):  
Young Adults ◽  
Community Participation ◽  
Mental Illnesses ◽  
Serious Mental Illnesses

scholarly journals The ideal victim: A critical race theory (CRT) approach

2021 ◽  
pp. 026975802199333
Author(s):  
Lisa J Long
Keyword(s):  
Critical Race Theory ◽  
Qualitative Interviews ◽  
Mixed Race ◽  
Black Communities ◽  
Critical Race ◽  
Migrant Status ◽  
Race Theory ◽  
The Relationship ◽  
Future Practice ◽  
The Ideal

Using a critical race theory (CRT) framework, this paper analyses Black and Black mixed- race people’s experiences of reporting crime. It is based on qualitative interviews with 20 participants. The analysis finds that the process of becoming the (un)victim is mediated through the intersection of race with gender and masculinity, class and migrant status. Ultimately, Black and Black mixed-race men are the ‘ideal offender’ rather than the ‘ideal victim’ (Christie, 1986). The research finds that the (un)victim experiences racial re-victimization and develops an altered perception of the police as a trusted body. The racialized affect of being the (un)victim is greater than the effects of minor crime on the victim. The challenges that this poses to the relationship between Black communities and the police are explored and the implications for future practice discussed.

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