scholarly journals Perceived Support for Recovery and Level of Functioning Among People With Severe Mental Illness in Central and Eastern Europe: An Observational Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Catharina Roth ◽  
Michel Wensing ◽  
Jan Koetsenruijter ◽  
Ana Istvanovic ◽  
Antoni Novotni ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Eastern Europe ◽  
Central And Eastern Europe ◽  
Functional Limitations ◽  
Functional Limitation ◽  
Perceived Support ◽  
Service Users ◽  
Level Of Functioning

Background: Many people with severe mental illness experience limitations in personal and social functioning. Care delivered in a person's community that addresses needs and preferences and focuses on clinical and personal recovery can contribute to addressing the adverse impacts of severe mental illness. In Central and Eastern Europe, mental health care systems are transitioning from institutional-based care toward community-based care. The aim of this study is to document the level of functioning and perceived support for recovery in a large population of service users with severe mental illness in Central and Eastern Europe, and to explore associations between perceived support for recovery and the degree of functional limitations.Methods: The implementation of community mental health teams was conducted in five mental health centers in five countries in Central and Eastern Europe. The present study is based on trial data at baseline among service users across the five centers. Baseline data included sociodemographic, the World Health Organization Disability Assessment Schedule (WHODAS 2.0) for functional limitations, and the Recovery Support (INSPIRE) tool for perceived staff support toward recovery. We hypothesized that service users reporting higher levels of perceived support for their recovery would indicate lower levels of functional limitation.Results: Across all centers, the greatest functional limitations were related to participation in society (43.8%), followed by daily life activities (33.3%), and in education or work (35.6%). Service users (N = 931) indicated that they were satisfied overall with the support received from their mental health care provider for their social recovery (72.5%) and that they valued their relationship with their providers (80.3%). Service users who perceived the support they received from their provider as valuable (b = −0.10, p = 0.001) and who reported to have a meaningful relationship with them (b = −0.13, p = 0.003) had a lower degree of functional limitation.Conclusion: As hypothesized, the higher the degree of perceived mental health support from providers, the lower the score in functional limitations. The introduction of the community-based care services that increase contact with service users and consider needs and which incorporate recovery-oriented principles, may improve clinical recovery and functional outcomes of service users with severe mental illness.

scholarly journals Peer support for people with severe mental illness versus usual care: study protocol for a pragmatic multicentre randomised controlled trial (UPSIDES-RCT)

2020 ◽  
Author(s):  
Galia Sharon Moran ◽  
Jasmine Kalha ◽  
Annabel Mueller-Stierlin ◽  
Reinhold Kilian ◽  
Silvia Krumm ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Cost Effectiveness ◽  
Severe Mental Illness ◽  
Peer Support ◽  
Social Inclusion ◽  
Controlled Trial ◽  
Service Users ◽  
Randomised Controlled

Abstract Background: Peer support is an established intervention involving a person in recovery from mental illness being engaged to offering support to others with mental illness. Peers are an under-used resource in global mental health. Building upon comprehensive formative research, this study will rigorously evaluate the impact of peer support at the levels of service users (psychosocial and clinical outcomes), peer support workers (work role, empowerment), services (cost-effectiveness, return on investment), and implementation (adoption, sustainability, organisational change). Methods: UPSIDES-RCT is a pragmatic parallel-group multi-centre randomised controlled trial assessing the effectiveness of UPSIDES at four measurement points over one year (baseline, 4-, 8-, and 12-month follow-up), and embedded process evaluation and cost-effectiveness analysis. Research will take place in a range of high-, middle- and low-income countries (Germany, United Kingdom, Israel, Uganda, Tanzania, India). The primary outcome is social inclusion of service users with severe mental illness (N= 558; N = 93 per site) at 8-month follow-up, measured with the Social Inclusion Scale. Secondary outcomes include empowerment (Empowerment Scale), hope (HOPE scale), recovery (Stages of Recovery), and health and social functioning (Health of the Nations Outcome Scales). Mixed-methods process evaluation will investigate mediators and moderators of effect, and implementation experiences of four UPSIDES stakeholder groups (service users, peer support workers, mental health workers, and policy makers). A cost-effectiveness analysis examining cost-utility and health budget impact will estimate the value for money of UPSIDES peer support. Discussion: By implementing and evaluating a manualized peer support intervention for people with severe mental illness across low-, middle-, and high-income countries, this study will contribute to harmonising core elements of peer support across different cultural and organisational dimensions. The UPSIDES-RCT will explore the essential components necessary to create a peer support model in mental health care, while providing the evidence required to sustain and eventually scale-up the intervention. Performance of mental health services will be maximised by actively involving and empowering service users, generating system changes towards user-centeredness, recovery orientation, community participation, and realising mental health as a human right. Trail registration: ISRCTN, ISRCTN26008944. Registered 30 October 2019, http://www.isrctn.com/ISRCTN26008944.

Comparing needs assessed by staff and by service users: paternalism or partnership in mental health?

2002 ◽  
Vol 11 (3) ◽  
pp. 186-191 ◽  
Author(s):  
Graham Thornicroft ◽  
Mike Slade
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Service Users ◽  
Camberwell Assessment Of Need ◽  
Assessment Of Need

This paper examines two questions. Do staff and service users agree when rating the needs of those with severe mental illness? If not, what is the meaning of these differences? To put these questions in context, we shall define needs, examine one particular way in which needs can be measured in a standardised way, using the Camberwell Assessment of Need, and shall discuss three somewhat similar studies which have compared user and staff rated needs.

Individual care packages for people with severe mental illness: a description of their implementation in an English County

2013 ◽  
Vol 30 (2) ◽  
pp. 125-130
Author(s):  
R. Macpherson ◽  
N. Hovey ◽  
A. Khan ◽  
G. Riley ◽  
K. Taralipoyina
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Community Mental Health ◽  
Severe Mental Illness ◽  
Mental Health Problems ◽  
Service Users ◽  
Supported Accommodation ◽  
Individual Care ◽  
New Form

BackgroundThis paper includes a brief review of the historical and policy background to a new form of supported accommodation, the Individual Care Package (ICP). This is a co-ordinated, individualised and flexible method to support people with complex mental health problems in the community.MethodThe study aimed to describe the implementation of this new form of care in Gloucestershire, England, over a 5-year period. We aimed to audit the quality of care in the packages against six care standards, derived by a project steering group. Staff working in community mental health services and staff providing ICPs were asked to report their levels of satisfaction with care provision.ResultsA total of 35 ICPs were developed, mostly relating to service users with severe mental illness. Only 60% of the community mental health team key workers were aware of the expected level of care. In many cases, service users were accessing support from day services or family alongside the ICP. Four service users were admitted, and four moved accommodation after going into ICPs. Overall, levels of care provided within ICPs tended to remain static. Trust key workers were mostly satisfied with the support provided in ICPs, but a range of concerns were expressed. ICP staff reported mostly positive views about the support that they received from statutory services, but also reported some concerns.ConclusionsICPs appeared to be successful in enabling a number of service users with complex difficulties to obtain and maintain tenancies in the community. There were some concerns about the quality of monitoring of the ICPs and some uncertainty about whether ICP staff would have the skills, support and training to promote recovery and increasing independence of service users. There was little evidence of service users moving on or reduction in care over time. There is a need for good inter-agency working for the successful deployment of this new form of service. There is also a need for more research, comparing ICPs with other forms of supported accommodation and considering the service user experience through qualitative research.

Community Families: Bridging the gap between mental health services and civil society – A qualitative study from users’ perspective

2017 ◽  
Vol 63 (2) ◽  
pp. 132-138 ◽  
Author(s):  
Ulla Væggemose ◽  
Stina Lou ◽  
Michal Frumer ◽  
Nanna Limskov Stærk Christiansen ◽  
Jørgen Aagaard ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Health Workers ◽  
Qualitative Interviews ◽  
Mental Health Workers ◽  
Service Users ◽  
Social Interventions ◽  
The Social

Background: Social interventions to support people with severe mental illness are important to improving the quality of life. The perspectives of users are essential in this process. This article explores users’ experiences, investments and concerns of a befriending programme. Material: Focus group and individual qualitative interviews with service users. Discussion: Overall, the experiences with the programme were positive, and the social interaction was highly valued. However, that the relationships were arranged and facilitated by mental health workers remained an unresolved concern even after several years. Conclusion: People with severe mental illness benefit from relationships despite the need of professional assistant.

scholarly journals Cost Analysis of a High Support Housing Initiative for Persons with Severe Mental Illness and Long-Term Psychiatric Hospitalization

2018 ◽  
Vol 63 (7) ◽  
pp. 492-500 ◽  
Author(s):  
David Rudoler ◽  
Claire de Oliveira ◽  
Binu Jacob ◽  
Melonie Hopkins ◽  
Paul Kurdyak
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Cost Saving ◽  
Cost Analysis ◽  
Severe Mental Illness ◽  
Inpatient Care ◽  
Cost Savings ◽  
Support Housing ◽  
High Support

Objective: The objective of this article was to conduct a cost analysis comparing the costs of a supportive housing intervention to inpatient care for clients with severe mental illness who were designated alternative-level care while inpatient at the Centre for Addiction and Mental Health in Toronto. The intervention, called the High Support Housing Initiative, was implemented in 2013 through a collaboration between 15 agencies in the Toronto area. Method: The perspective of this cost analysis was that of the Ontario Ministry of Health and Long-Term Care. We compared the cost of inpatient mental health care to high-support housing. Cost data were derived from a variety of sources, including health administrative data, expenditures reported by housing providers, and document analysis. Results: The High Support Housing Initiative was cost saving relative to inpatient care. The average cost savings per diem were between $140 and $160. This amounts to an annual cost savings of approximately $51,000 to $58,000. When tested through sensitivity analysis, the intervention remained cost saving in most scenarios; however, the result was highly sensitive to health system costs for clients of the High Support Housing Initiative program. Conclusions: This study suggests the High Support Housing Initiative is potentially cost saving relative to inpatient hospitalization at the Centre for Addiction and Mental Health.

scholarly journals A Taxonomy for Homework Used by Mental Health Case Managers When Working with Individuals Diagnosed with Severe Mental Illness

2007 ◽  
Vol 43 (6) ◽  
pp. 565-581 ◽  
Author(s):  
Peter J. Kelly ◽  
Frank P. Deane ◽  
Robert King ◽  
Nikolaos Kazantzis ◽  
Trevor P. Crowe
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Case Managers

scholarly journals Access to public mental health services among older adults with severe mental illness

2009 ◽  
Vol 24 (3) ◽  
pp. 313-318 ◽  
Author(s):  
Todd P. Gilmer ◽  
Victoria D. Ojeda ◽  
Dahlia Fuentes ◽  
Viviana Criado ◽  
Piedad Garcia
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Severe Mental Illness ◽  
Public Mental Health ◽  
Public Mental Health Services

Cultural competence in multi-family psychoeducation groups: The experiences of Russian-speaking immigrant mothers of adults with severe mental illness

2021 ◽  
pp. 136346152110583
Author(s):  
Evgeny Knaifel
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Cultural Competence ◽  
Severe Mental Illness ◽  
Former Soviet Union ◽  
Health Knowledge ◽  
Qualitative Content Analysis ◽  
Family Psychoeducation ◽  
Family Coping ◽  
Immigrant Mothers

The successful integration of cultural competence with evidence-based practices in mental health services is still limited for particular cultural populations. The current study explored culturally adapted family psychoeducation intervention for immigrants from the former Soviet Union (FSU) in Israel who care for a family member with severe mental illness (SMI). Semi-structured in-depth interviews were conducted with 18 immigrant mothers about their experience of taking part in Russian-speaking multi-family psychoeducation groups (MFPGs). Qualitative content analysis revealed five salient processes and changes that participants attributed to their engagement in the intervention: 1) from a language barrier to utilization of and satisfaction with services; 2) from a lack of information to acquiring new mental health knowledge; 3) from harboring a family secret to exposure and sharing; 4) from social isolation to cultural belonging and support; 5) from families blurring boundaries to physical and emotional separation. The results showed that these changes—linguistic, cognitive, emotional, socio-cultural and relational—improved family coping and recovery. Implications for cultural adaptation of family psychoeducation for Russian-speaking immigrants are discussed.

The health service contact patterns of people with psychotic and non-psychotic forms of severe mental illness in New South Wales, Australia: A record-linkage study

2021 ◽  
pp. 000486742110314
Author(s):  
Rachael C Cvejic ◽  
Preeyaporn Srasuebkul ◽  
Adrian R Walker ◽  
Simone Reppermund ◽  
Julia M Lappin ◽  
...  
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Mental Illness ◽  
Health Service ◽  
Confidence Interval ◽  
Physical Health ◽  
Severe Mental Illness ◽  
New South ◽  
Service Utilisation ◽  
South Wales

Objective: To describe and compare the health profiles and health service use of people hospitalised with severe mental illness, with and without psychotic symptoms. Methods: We conducted a historical cohort study using linked administrative datasets, including data on public hospital admissions, emergency department presentations and ambulatory mental health service contacts in New South Wales, Australia. The study cohort comprised 169,306 individuals aged 12 years and over who were hospitalised at least once with a mental health diagnosis between 1 July 2002 and 31 December 2014. Of these, 63,110 had a recorded psychotic illness and 106,196 did not. Outcome measures were rates of hospital, emergency department and mental health ambulatory service utilisation, analysed using Poisson regression. Results: People with psychotic illnesses had higher rates of hospital admission (adjusted incidence rate ratio (IRR) 1.26; 95% confidence interval [1.23, 1.30]), emergency department presentation (adjusted IRR 1.17; 95% confidence interval [1.13, 1.20]) and ambulatory mental health treatment days (adjusted IRR 2.90; 95% confidence interval [2.82, 2.98]) than people without psychotic illnesses. The higher rate of hospitalisation among people with psychotic illnesses was driven by mental health admissions; while people with psychosis had over twice the rate of mental health admissions, people with other severe mental illnesses without psychosis (e.g. mood/affective, anxiety and personality disorders) had higher rates of physical health admissions, including for circulatory, musculoskeletal, genitourinary and respiratory disorders. Factors that predicted greater health service utilisation included psychosis, intellectual disability, greater medical comorbidity and previous hospitalisation. Conclusion: Findings from this study support the need for (a) the development of processes to support the physical health of people with severe mental illness, including those without psychosis; (b) a focus in mental health policy and service provision on people with complex support needs, and (c) improved implementation and testing of integrated models of care to improve health outcomes for all people experiencing severe mental illness.

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