scholarly journals “It’s More Than Just Exercise”: Tailored Exercise at a Community-Based Activity Center as a Liminal Space along the Road to Mental Health Recovery and Citizenship

2021 ◽  
Vol 18 (19) ◽  
pp. 10516
Author(s):  
Kjersti Karoline Danielsen ◽  
May Helena Øydna ◽  
Sofia Strömmer ◽  
Kenneth Haugjord
Keyword(s):  
Mental Health ◽  
Poor Mental Health ◽  
Safe Space ◽  
Mental Health Recovery ◽  
Liminal Space ◽  
Community Based ◽  
The Road ◽  
Community Based Programs ◽  
Activity Center ◽  
Mental Health Challenges

Mental health care policies call for health-promoting and recovery-oriented interventions, as well as community-based programs supporting healthier habits. The purpose of this study was to explore how individuals facing mental health challenges experienced participating in tailored exercise at a community-based activity center, and what role tailored exercise could play in supporting an individual’s process of recovery. Data were collected through in-depth interviews with nine adults experiencing poor mental health who engaged in exercise at the activity center. Interviews were audio-recorded, transcribed verbatim and analyzed using systematic text condensation. Participants spoke about the community-based program being a safe space where they could “come as they are” (Theme 1). Taking part in the program was “more than just exercise” and allowed them to connect with others (Theme 2). The experiences they gained from exercise also helped with other areas in life and provided them with a safe space to build their confidence towards the “transition back to the outside” (Theme 3). We summarized the findings into one overall theme: “inside vs. outside”. In conclusion, a community-based activity center acted as a liminal space that aided mental health recovery by allowing participants to feel safe, accepted and supported, as well as experience citizenship. The findings highlight the need to treat mental health challenges as a contextual phenomenon and creating arenas for community and citizenship in society.

Deinstitutionalization and Increased Arrest Rates among the Mentally Disordered

1987 ◽  
Vol 15 (1) ◽  
pp. 117-127 ◽  
Author(s):  
Mark R. Pogrebin ◽  
Eric D. Poole
Keyword(s):  
Mental Health ◽  
Mentally Ill ◽  
Community Based ◽  
Arrest Rates ◽  
Mental Patients ◽  
Mentally Disordered ◽  
Police Decision Making ◽  
Community Based Programs ◽  
Criminal Histories ◽  
Mental Health Programs

Policies of deinstitutionalization, together with a general tightening of civil commitment laws and inadequate funding for community-based programs, have resulted in an increase of mentally ill people on the streets. Growing numbers of former mental patients and individuals whose bizarre behavior might have landed them in a state hospital bed a few years ago are now being arrested and ending up in jail. Four key areas––deinstitutionalization, police decision making, decline of mental health programs, and criminal histories of mental patients—are examined with respect to the shifting of mentally disordered persons from the mental health system to the criminal justice system.

The Creation of “We Are Neighbours”: Participatory Research and Recovery

2009 ◽  
Vol 28 (2) ◽  
pp. 61-72 ◽  
Author(s):  
Alice de Wolff ◽  
Pedro Cabezas ◽  
Linda Chamberlain ◽  
Aldo Cianfarani ◽  
Phillip Dufresne ◽  
...  
Keyword(s):  
Mental Health ◽  
Participatory Research ◽  
Property Values ◽  
Community Based Participatory Research ◽  
Participatory Approach ◽  
Supportive Housing ◽  
Mental Health Recovery ◽  
Health Issues ◽  
Participatory Action ◽  
Community Based

Community-based participatory research is an enabling and empowering practice that is based in principles that overlap with those of mental health recovery. Using a participatory approach, an advocacy group called the Dream Team, whose members have mental health issues and live in supportive housing, planned and conducted a study of the neighbourhood impact of two supportive housing buildings in Toronto. The study found that tenants do not harm neighbourhood property values and crime rates, and that they do make important contributions to the strength of their neighbourhoods. This article demonstrates the strength of a self-directed collective of individuals who are prepared to challenge stigma and discrimination, and documents their use of participatory action research as a proactive strategy to contribute their knowledge to discussions that shape the communities, services, and politics that involve them.

scholarly journals A Peer-Led Electronic Mental Health Recovery App in a Community-Based Public Mental Health Service: Pilot Trial (Preprint)

2018 ◽  
Author(s):  
Amelia Gulliver ◽  
Michelle Banfield ◽  
Alyssa R Morse ◽  
Julia Reynolds ◽  
Sarah Miller ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Service ◽  
Health Service ◽  
Public Mental Health ◽  
Care Staff ◽  
Mental Health Recovery ◽  
Proof Of Concept ◽  
Community Based ◽  
Public Mental Health Service

BACKGROUND There is an increasing need for peer workers (people with lived experience of mental health problems who support others) to work alongside consumers to improve recovery and outcomes. In addition, new forms of technology (tablet or mobile apps) can deliver services in an engaging and innovative way. However, there is a need to evaluate interventions in real-world settings. OBJECTIVE This exploratory proof-of-concept study aimed to determine if a peer worker–led electronic mental health (e-mental health) recovery program is a feasible, acceptable, and effective adjunct to usual care for people with moderate-to-severe mental illness. METHODS Overall, 6 consumers and 5 health service staff participated in the evaluation of a peer-led recovery app delivered at a community-based public mental health service. The peer worker and other health professional staff invited attendees at the drop-in medication clinics to participate in the trial during June to August 2017. Following the intervention period, participants were also invited by the peer worker to complete the evaluation in a separate room with the researcher. Consumers were explicitly informed that participation in the research evaluation was entirely voluntary. Consumer evaluation measures at postintervention included recovery and views on the acceptability of the program and its delivery. Interviews with staff focused on the acceptability and feasibility of the app itself and integrating a peer worker into the health care service. RESULTS Consumer recruitment in the research component of the study (n=6) fell substantially short of the target number of participants (n=30). However, from those who participated, both staff and consumers were highly satisfied with the peer worker and somewhat satisfied with the app. Health care staff overall believed that the addition of the peer worker was highly beneficial to both the consumers and staff. CONCLUSIONS The preliminary findings from this proof-of-concept pilot study suggest that a peer-led program may be a feasible and acceptable method of working on recovery in this population. However, the e-mental health program did not appear feasible in this setting. In addition, recruitment was challenging in this particular group, and it is important to note that these study findings may not be generalizable. Despite this, ensuring familiarity of technology in the target population before implementing e-mental health interventions is likely to be of benefit.

scholarly journals Social Determinants of Mental Health Care Systems: Intensive Community Based Care in The Veterans Health Administration

2020 ◽  
Author(s):  
Ish P Bhalla ◽  
Elina A Stefanovics ◽  
Robert A Rosenheck
Keyword(s):  
Mental Health ◽  
Social Determinants ◽  
Public Mental Health ◽  
Veterans Health Administration ◽  
Outpatient Clinics ◽  
Veterans Health ◽  
Health Administration ◽  
Community Based ◽  
Community Based Programs ◽  
Community Based Services

Abstract Background: Since deinstitutionalization in the 1950s-1970s, public mental health care has changed its focus from asylums to general hospitals, outpatient clinics and specialized community-based programs addressing both clinical and social determinants of mental health. Analysis of the place of community-based programs within a comprehensive health system such as the Veterans Health Administration (VHA) may illuminate the role of social forces in shaping contemporary public mental health systems. Methods: National VHA administrative data were used to compare veterans who exclusively received outpatient clinic care to those receiving four types of specialized community-based services, addressing: 1) functional disabilities from severe mental illness (SMI), 2) justice system involvement, 3) homelessness, and 4) vocational rehabilitation. Bivariate comparisons and multinomial logistic regression analyses compared groups on demographics, diagnoses, service use, and psychiatric prescription fills. Results: An hierarchical classification of 1,386,487 Veterans who received specialty mental health services from VHA in Fiscal Year 2012, showed 1,134,977 (81.8%) were seen exclusively in outpatient clinics; 27,931 (2.0 %) received intensive SMI-related services; 42,985 (3.1%) criminal justice services; 160,273 (11.6%) specialized homelessness services; and 20,921 (1.5%) vocational services. Compared to those seen only in clinics, veterans in the four community treatment groups were more likely to be black, diagnosed with HIV and hepatitis, had more numerous substance use diagnoses and made far more extensive use of mental health outpatient and inpatient care. Conclusions: Almost one-fifth of VHA mental health patients receive community-based services prominently addressing major social determinants of health and multimorbid substance use disorders.

Survivors of Homicide: Mental Health Outcomes, Social Support, and Service Use Among a Community-Based Sample

2015 ◽  
Vol 30 (5) ◽  
pp. 870-883 ◽  
Author(s):  
Alyssa A. Rheingold ◽  
Joah L. Williams
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Health Outcomes ◽  
Service Use ◽  
Poor Mental Health ◽  
Mental Health Outcomes ◽  
Symptom Presentation ◽  
Community Based ◽  
Major Depressive ◽  
Significant Symptom

This study aims to explore rates of bereavement-related mental health outcomes and diagnostic comorbidity along with the associations between mental health outcomes, perceived social support, knowledge of services, and service use among a diverse sample of 47 survivors 2 years postloss. Findings are consistent with prior studies in that homicide is associated with an overlapping of significant symptom presentation of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and complicated grief (CG). Lack of grief-specific social support was demonstrated to be associated with PTSD and MDD but not with CG. Although a significant number of survivors reported poor mental health outcomes, a limited number were using services.

scholarly journals Social Determinants of Mental Health Care Systems: Intensive Community Based Care in The Veterans Health Administration

2020 ◽  
Author(s):  
Ish P Bhalla ◽  
Elina A Stefanovics ◽  
Robert A Rosenheck
Keyword(s):  
Mental Health ◽  
Social Determinants ◽  
Public Mental Health ◽  
Veterans Health Administration ◽  
Outpatient Clinics ◽  
Veterans Health ◽  
Health Administration ◽  
Community Based ◽  
Community Based Programs ◽  
Community Based Services

Abstract Background: Since deinstitutionalization in the 1950s-1970s, public mental health care has changed its focus from asylums to general hospitals, outpatient clinics and specialized community-based programs addressing both clinical and social determinants of mental health. Analysis of the place of community-based programs within a comprehensive health system such as the Veterans Health Administration (VHA) may illuminate the role of social forces in shaping contemporary public mental health systems. Methods: National VHA administrative data were used to compare veterans who exclusively received outpatient clinic care to those receiving four types of specialized community-based services, addressing: 1) functional disabilities from severe mental illness (SMI), 2) justice system involvement, 3) homelessness, and 4) vocational rehabilitation. Bivariate comparisons and multinomial logistic regression analyses compared groups on demographics, diagnoses, service use, and psychiatric prescription fills. Results: An hierarchical classification of 1,386,487 Veterans who received specialty mental health services from VHA in Fiscal Year 2012, showed 1,134,977 (81.8%) were seen exclusively in outpatient clinics; 27,931 (2.0 %) received intensive SMI-related services; 42,985 (3.1%) criminal justice services; 160,273 (11.6%) specialized homelessness services; and 20,921 (1.5%) vocational services. Compared to those seen only in clinics, veterans in the four community treatment groups were more likely to be black, diagnosed with HIV and hepatitis, had more numerous substance use diagnoses and made far more extensive use of mental health outpatient and inpatient care. Conclusions: Almost one-fifth of VHA mental health patients receive community-based services prominantly addressing major social determinants of health and multimorbid substance use disorders.

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