Browsing by Subject "severe mental illness"

Now showing 1 - 10 of 10
  • Thumbnail Image
    Item
    An Analysis of Readmissions to a Mental Health Court
    (Oxford University Press, 2018-09-01) Kondrat, David C.; Linhorst, Donald M.; Dirks-Linhorst, P. Ann; Horning, Emily
    Mental health courts (MHCs) have emerged as one option to address the needs of people with severe mental illness who enter the criminal justice system. Little is known about defendants having multiple referrals to MHCs or the outcomes of subsequent admissions. This study included a sample of 1,084 defendants referred to municipal MHC. During the 13-year study period, 14.3% of defendants had a second admission, with an estimated probability of readmission of 17.4%. Key factors associated with readmission included being eligible to participate in the court but choosing not to do so, being rearrested during court supervision, and having a negative termination from supervision. Defendants who had a second admission during the study period had poorer outcomes than those with one admission. When defendants are referred for readmission to MHCs, careful assessment is required to ensure that these courts are the best alternative for them.
  • Thumbnail Image
    Item
    Employment specialists' competencies as predictors of employment outcomes.
    (2010-05-25T20:16:20Z) Taylor, Amanda Christine; Bond, Gary R.; McGrew, John H., 1953-; Rand, Kevin; Devine, Dennis J. (Dennis John)
    Employment specialist competencies were examined as predictors of employment outcomes for consumers with severe mental illness participating in supported employment. Using a cross-sectional correlational design a variety of self-report and supervisor-rated performance measures were examined for their association with three consumer employment outcomes (e.g., the percentage of consumers on an employment specialist's caseload that were competitively employed, the percentage of consumers on an employment specialist's caseload that were employed 90 consecutive days, and the rate in which consumers dropped out of employment services). Six mental health agencies with a total of 57 employment specialists and 14 supervisors from across the nation participated in the study. Competitive employment rates ranged among employment specialists from 0% to 80%. Higher supervisor-rated job performance, supervisor-rated employment specialist efficacy, percentage of work time spent in the community during the past month, and number of contacts with consumers during the past month were related to improved consumer employment outcomes. However, employment specialist attitudes, knowledge of supported employment, conscientiousness, and self-efficacy were unrelated to employment outcomes. This study is one of the first of its kind to examine employment specialist competencies as they relate to supported employment for consumers with severe mental illness. While supported employment is a great improvement over traditional vocational programs, further examination of employment specialist competencies could hold the key to unlocking employment success for many more consumers.
  • Thumbnail Image
    Item
    Facilitators and Barriers to Illness Management and Recovery Implementation
    (Office of the Vice Chancellor for Research, 2013-04-05) White, Dominique A.; McGuire, Alan B.; Salyers, Michelle P.
    Illness Management and Recovery (IMR) is an evidence-based program designed to help people with severe mental illness better manage their illness and achieve personally meaningful goals. IMR has shown improved outcomes including better coping and reduced psychiatric symptoms. There have been some difficulties implementing IMR, even within programs that have received IMR training. The purpose of the current study was to examine the differences between facilitators and barriers for implementing IMR as perceived by providers of IMR and non-providers of IMR in order to identify potential targets for implementation strategies. A national online survey was conducted with VA Medical Centers (VAMCs), resulting in 151 responses representing 107 VAMCs nationwide. Survey respondents included local recovery coordinators (LRCs) and staff referred by the LRC for being knowledgeable regarding IMR. The current analyses focused on two open-ended questions pertaining to facilitators and barriers to implementation. The authors independently developed codes through an iterative process to categorize responses. We then established overall consensus on codes and applied those codes to each open-ended response. Chi-square tests were performed on each category to determine differences between provider and non-provider perceived facilitators and barriers. Differences in identified facilitators and barriers were discovered between the providers and non-providers respondents. Overall barriers and facilitators to implementation are described. Identifying facilitators and barriers that differ between providers and non-providers can provide insight into areas that may impact implementation. By understanding these differences we can provide carefully targeted interventions to increase implementation, for example, gaining support from individuals who do not directly provide IMR, could reinforce the experiences of direct service providers.
  • Thumbnail Image
    Item
    Helping Behaviors and Recovery in Severe Mental Illness
    (Office of the Vice Chancellor for Research, 2014-04-11) Firmin, Ruth L.; Luther, Lauren; Salyers, Michelle P.
    Background: Despite recent interest in peer-support workers in recovery-oriented services, little is known about how helping behaviors may affect recovery from severe mental illness (SMI). The current study is a mixed-methods approach to understanding self-motivated helping behaviors and their relationship with recovery outcomes among persons with SMI. Method: Forty-six participants with schizophrenia-spectrum disorders completed a narrative interview and standardized measures of recovery, positive and negative symptoms, hope, patient activation, and illness management. Interviews were coded using modified grounded theory. We compared individuals who (unprompted) mentioned helping behaviors in their interview to those who did not on recovery-related outcomes. Results: Sixteen participants (35%) reported unprompted self-motivated helping behaviors, including a desire to tell others their story, teach others recovery-promoting tools, become a peer-support worker, give back to society, and be more active family members. Those who discussed helping others in narrative interviews scored significantly higher on scales assessing recovery, illness management, patient activation, hope, functioning, insight and lower overall symptom severity, negative symptoms, and thought disorder than those who did not discuss helping behaviors. Discussion: Findings suggest that helping others may contribute to recovery from SMI. Implications include focusing on meaningful work/volunteerism and expanding roles for peer-support in recovery-oriented services.
  • Thumbnail Image
    Item
    Housing Preferences and Choices Among Adults with Mental Illness and Substance Use Disorders: A Qualitative Study
    (2010-08) Tsai, Jack; Bond, Gary R.; Salyers, Michelle P.; Godfrey, Jenna L.; Davis, Kristin E.
    Housing is a crucial issue for adults with severe mental illness and co-occurring substance use disorders, as this population is particularly susceptible to housing instability and homelessness. We interviewed 40 adults with dual disorders, living in either supervised or independent housing arrangements, to examine housing preferences, decision making processes surrounding housing choices, and perceived barriers to housing. We found that many clients indicated their housing preferences had changed over time, and some clients related housing preferences to recovery. Although the majority of clients preferred independent housing, many also described benefits of supervised housing. Clients' current living situations appeared to be driven primarily by treatment provider recommendations and availability of housing. Common barriers to obtaining desired housing were lack of income and information. These findings have implications for supported housing models and approaches to providing housing for clients.
  • Thumbnail Image
    Item
    Illness Management and Recovery: A Review of the Literature
    (2014) McGuire, Alan B.; Kukla, Marina; Green, Amethyst; Gilbride, Daniel; Mueser, Kim T.; Salyers, Michelle P.
  • Thumbnail Image
    Item
    Managing physical and mental health conditions: Consumer perspectives on integrated care
    (Taylor & Francis, 2017) Rollins, Angela L.; Wright-Berryman, Jennifer; Henry, Nancy H.; Quash, Alicia M.; Benbow, Kyle; Bonfils, Kelsey A.; Hedrick, Heidi; Miller, Alex P.; Firmin, Ruth L.; Salyers, Michelle P.; Department of Psychology, School of Science
    Despite the growing trend of integrating primary care and mental health services, little research has documented how consumers with severe mental illnesses (SMI) manage comorbid conditions or view integrated services. We sought to better understand how consumers perceive and manage both mental and physical health conditions and their views of integrated services. We conducted semi-structured interviews with consumers receiving primary care services integrated in a community mental health setting. Consumers described a range of strategies to deal with physical health conditions and generally viewed mental and physical health conditions as impacting one another. Consumers viewed integration of primary care and mental health services favorably, specifically its convenience, friendliness, and knowledge of providers, and collaboration between providers. Although integration was viewed positively, consumers with SMI may need a myriad of strategies and supports to both initiate and sustain lifestyle changes that address common physical health problems.
  • Thumbnail Image
    Item
    Parenthood and severe mental illness: Relationships with recovery
    (2014) Bonfils, Kelsey A.; Adams, Erin L.; Firmin, Ruth L.; White, Laura M.; Salyers, Michelle P.
  • Thumbnail Image
    Item
    The Relationship Between Provider Competence, Content Exposure, and Consumer Outcomes in Illness Management and Recovery Programs
    (Springer, 2015) McGuire, Alan B.; White, Dominique A.; Bartholomew, Tom; Flanagan, Mindy E.; McGrew, John H.; Rollins, Angela L.; Mueser, Kim T.; Salyers, Michelle P.; Department of Psychology, School of Science
    Provider competence may affect the impact of a practice. The current study examined this relationship in sixty-three providers engaging in Illness Management and Recovery with 236 consumers. Improving upon previous research, the present study utilized a psychometrically validated competence measure in the ratings of multiple Illness Management and Recovery sessions from community providers, and mapped outcomes onto the theory underlying the practice. Provider competence was positively associated with illness self-management and adaptive coping. Results also indicated baseline self-management skills and working alliance may affect the relationship between competence and outcomes.
  • Thumbnail Image
    Item
    Why are you here again? Concordance between consumers and providers about the primary concern in recurring psychiatric visits
    (Elsevier, 2014-12) Bonfils, Kelsey A.; Fukui, Sadaaki; Adams, Erin L.; Hedrick, Heidi M.; Salyers, Michelle P.; Department of Psychology, IU School of Science
    Patient-centered care has become increasingly important over the last decade, both in physical and mental health care. In support of patient-centered care, providers need to understand consumers׳ primary concerns during treatment visits. The current study explored what primary concerns were brought to recurring psychiatric visits for a sample of adults with severe mental illness (N=164), whether these concerns were concordant with those recognized by providers, and which factors predicted concordance. We identified 17 types of primary concerns, most commonly medications and symptoms, with only 50% of visits showing evidence of at least partial agreement between consumers and providers. Contrary to expectations, consumer demographics, activation, trust, and perceptions of patient-centeredness were not predictive, while greater preferences for autonomy predicted poorer agreement. Our findings highlight the need for interventions to promote a shared understanding of primary concerns in recurring psychiatric visits. Further attention is needed to ensure the provision of patient-centered care such that consumer concerns are acknowledged and addressed within recurring psychiatric visits.