Browsing by Subject "serious mental illness"

Now showing 1 - 6 of 6
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    Comorbidity Profile and Health Care Utilization in Elderly Patients with Serious Mental Illnesses
    (Elsevier, 2013-12) Hendrie, Hugh C.; Hay, Don; Lane, Kathleen A.; Gao, Sujuan; Purnell, Christianna; Munger, Stephanie; Smith, Faye; Dickens, Jeanne; Boustani, Malaz A.; Callahan, Christopher M.; Department of Psychiatry, IU School of Medicine
    Objectives Patients with serious mental illness are living longer. Yet there remain few studies that focus on health care utilization and its relationship to comorbidities in these elderly mentally ill patients. Design Comparative study. Information on demographics, comorbidities and health care utilization were taken from an electronic medical record system. Setting Wishard Health Services senior care and community mental health clinics. Participants Patients age 65 years and over-255 patients with serious mental illness (schizophrenia, major recurrent depression and bipolar illness) attending a mental health clinic and a representative sample of 533 non-demented patients without serious mental illness attending primary care clinics. Results Patients having serious mental illness had significantly higher rates of medical emergency room visits (p=0.0027) and significantly longer lengths of medical hospitalizations (p<0.0001) than did the primary care control group. The frequency of medical comorbidities such as diabetes, coronary artery disease, congestive heart failure, chronic obstructive pulmonary disease, thyroid disease, and cancer were not significantly different between the groups. Hypertension was lower in the mentally ill group (p<0.0001). Reported falls (p<0.0001), diagnoses of substance abuse (p=0.02), and alcoholism (p=0.0016) were higher in the seriously mentally ill. The differences in health care utilization between the groups remained significant after adjusting for comorbidity levels, lifestyle factors, and attending primary care. Conclusions Our findings of higher rates of emergency care, longer hospitalizations, and increased frequency of falls, substance abuse, and alcoholism suggest the elderly seriously mentally ill remain a vulnerable population requiring an integrated model of health care.
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    Correlates of observer-rated active involvement in psychiatric treatment visits
    (Elsevier, 2017-10) Bonfils, Kelsey A.; Luther, Lauren; Fukui, Sadaaki; Adams, Erin L.; Dreison, Kimberly C.; Firmin, Ruth L.; Salyers, Michelle P.; Department of Psychology, School of Science
    Among people with serious mental illness, increased patient activation has been linked to a range of key recovery outcomes. To date, patient activation has been measured largely through self-report. The present study investigated correlates of a new tool that assesses active involvement through rating audio-recordings of treatment visits. The key domains of patient activation assessed in visits included: patients asking questions, discussing with providers instances of being active in managing illness outside the session, talking about goals, bringing up concerns, making evaluative statements about treatment, setting the agenda for the visit, and making requests about the course of treatment. The new coding scheme proved to be a feasible and reliable method for identifying multi-faceted behavioral indicators of patient activation. Contrary to our hypotheses, in a sample of 166 people diagnosed with severe mental illnesses, self-reported activation and observer-rated indices of activation were often not correlated or correlated in unexpected directions with the new behavioral measure of patient activation. This suggests the nature of patient activation may be complex and work is needed to understand how observer-rated and self-rated activation may predict differential recovery outcomes.
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    Living with Serious Mental Illness, Police Encounters, and Relationships of Power: A Critical Phenomenological Study
    (2021-12) Quiring, Stephanie Q.; Kim, Hea-Won; Starnino, Vincent; Sullivan, Patrick; Kennedy, Sheila
    The criminalization of mental illness has drawn and kept a disproportionate number of people living with mental illness in jails and prisons across the United States. The criminal legal system is ill-equipped or unequipped to provide meaningful mental health care. Police often serve as gatekeepers to the criminal legal system in the midst of encounters involving people living with serious mental illness. The literature that examines police decision-making amid these highly discretionary encounters has been primarily situated in post-positivist, quantitative methodologies focused on police perspectives. There is a dearth of research with the direct involvement of people living with serious mental illness that employs more advanced qualitative methodologies. The purpose of this study was to understand the lived experience of police encounters from the perspective of people living with serious mental illness through multi-level analysis of the interpersonal and structural contexts which underpin these encounters. This critical phenomenological study used interpretative phenomenological analysis as process. A sample of 16 adults were recruited using purposive and snowball sampling and completed semi-structured interviews. The findings reported two descriptive areas for participants—aspects of serious mental illness and contemplations of power. The findings also included the interpretive analysis organized around six themes that emerged regarding the lived experience of police encounters: (a) significant context, to include serious mental illness, was made invisible, (b) the carceral response to serious mental illness and interpersonal issues, (c) law enforcement’s power to force submission, (d) facets of escalation, (e) law enforcement encounters lacked essential care, and (f) law enforcement encounters served as a microcosm of the criminal legal system. The implications of the study’s findings on police encounters as they are currently framed in the largely post-positivist, quantitative body of research are discussed. In addition, the current wave of national police response models and reform are considered and connected to implications for social work practice. Finally, culminating in the findings’ implications for a growing edge of critical phenomenology that incorporates intersectionality and disciplinary power and the central role of an abolition feminist praxis at the nexus of mental health, crisis response, and collective care.
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    Recovery and serious mental illness: a review of current clinical and research paradigms and future directions
    (Taylor & Francis, 2017) Leonhardt, Bethany L.; Huling, Kelsey; Hamm, Jay A.; Roe, David; Hasson-Ohayon, Ilanit; McLeod, Hamish J.; Lysaker, Paul H.; Psychiatry, School of Medicine
    Introduction: Recovery from serious mental illness has historically not been considered a likely or even possible outcome. However, a range of evidence suggests the courses of SMI are heterogeneous with recovery being the most likely outcome. One barrier to studying recovery in SMI is that recovery has been operationalized in divergent and seemingly incompatible ways: as an objective outcome versus a subjective process. Areas covered: This paper offers a review of recovery as a subjective process and recovery as an objective outcome; contrasts methodologies utilized by each approach to assess recovery; reports rates and correlates of recovery; and explores the relationship between objective and subjective forms of recovery. Expert commentary: There are two commonalities of approaching recovery as a subjective process and an objective outcome: (i) the need to make meaning out of one’s experiences to engage in either type of recovery and (ii) there exist many threats to engaging in meaning making that may impact the likelihood of moving toward recovery. We offer four clinical implications that stem from these two commonalities within a divided approach to the concept of recovery from SMI.
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    Social Network Decay as Potential Recovery from Homelessness: A Mixed Methods Study in Housing First Programming
    (MDPI, 2017-09) Golembiewski, Elizabeth; Watson, Dennis P.; Robison, Lisa; Coberg, John W.; Social and Behavioral Sciences, School of Public Health
    The positive relationship between social support and mental health has been well documented, but individuals experiencing chronic homelessness face serious disruptions to their social networks. Housing First (HF) programming has been shown to improve health and stability of formerly chronically homeless individuals. However, researchers are only just starting to understand the impact HF has on residents’ individual social integration. The purpose of the current study was to describe and understand changes in social networks of residents living in a HF program. Researchers employed a longitudinal, convergent parallel mixed method design, collecting quantitative social network data through structured interviews (n = 13) and qualitative data through semi-structured interviews (n = 20). Quantitative results demonstrated a reduction in network size over the course of one year. However, increases in both network density and frequency of contact with network members increased. Qualitative interviews demonstrated a strengthening in the quality of relationships with family and housing providers and a shedding of burdensome and abusive relationships. These results suggest network decay is a possible indicator of participants’ recovery process as they discontinued negative relationships and strengthened positive ones.
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    Use of Smartphones, Computers and Social Media Among People with SMI: Opportunity for Intervention
    (Springer, 2019) Brunette, M. F.; Achtyes, E.; Pratt, S.; Stilwell, K.; Opperman, M.; Guarino, S.; Kay‑Lambkin, F.; Psychiatry, School of Medicine
    Mobile technology provides a unique opportunity to expand access to evidence-based interventions. The objective of this study was to provide an update regarding use of technology in people with serious mental illness (SMI). In 2017, 403 people in treatment for SMI were surveyed. Technology use was common: 65.8% used a smartphone, 53.6% used the Internet on a computer or tablet in the past 6 months, and over two thirds (67.9%) used social media. Rates of technology and Facebook use were similar to rates among low-income Americans. Approximately three quarters were willing to use a device to access interventions for stress, health and mental health. Younger adults were more likely to use most forms of technology and social media compared to older adults, but willingness to try technology-delivered interventions did not vary by age. This survey supports the rationale for ongoing development and testing of digital interventions for people with SMI.