An Investigation of Employment Hope as a Key Factor Influencing Perceptions of Subjective Recovery among Adults with Serious Mental Illness Seeking Community Work.

Introduction: Employment is an important contributor to recovery in people with serious mental illness (SMI), yet studies have not explored how subjective elements of employment hope contribute to perceptions of global recovery in this population.

Methods: The current study examined the relationship between employment hope and subjective recovery in 276 unemployed adults with SMI participating in a multi-site clinical trial of a cognitive behavioral group intervention tailored toward work and combined with vocational rehabilitation. Participants had diagnoses of schizophrenia spectrum, bipolar, depressive, and posttraumatic stress disorders, and were receiving services at three Veterans Affairs healthcare facilities in the United States.

Results From the POINT Pragmatic Randomized Trial: An Emergency Department-Based Peer Support Specialist Intervention to Increase Opioid Use Disorder Treatment Linkage and Reduce Recurrent Overdose.

Background: People with opioid use disorder (OUD) frequently present at the emergency department (ED), a potentially critical point for intervention and treatment linkage. Peer recovery support specialist (PRSS) interventions have expanded in US-based EDs, although evidence supporting such interventions has not been firmly established.

Methods: Researchers conducted a pragmatic trial of POINT (Project Planned Outreach, Intervention, Naloxone, and Treatment), an ED-initiated intervention for harm reduction and recovery coaching/treatment linkage in 2 Indiana EDs.

Latent class analysis of emergency department patients engaged in telehealth peer recovery support services and associations of identified classes with post-discharge outcomes.

Background: People with substance use disorders (SUDs) frequently use emergency department (ED) services. Despite evidence demonstrating that post-discharge SUD treatment linkage effectively reduces the number of ED re-presentations, relatively few hospitals have implemented interventions to identify and connect patients with SUDs to appropriate care. ED-based peer recovery support specialist (PRSS) interventions have emerged as a promising approach for hospitals, but more research is needed to understand the extent to which these interventions meet the needs of patients who present to the ED for different reasons and with various underlying concerns.

eHealth Use on Acute Inpatient Mental Health Units: Implementation Processes, Common Practices, and Barriers to Use.

Information technology to promote health (eHealth) is an important and growing area of mental healthcare, yet little is known about the use of patient-facing eHealth in psychiatric inpatient settings. This quality improvement project examined the current practices, barriers, implementation processes, and contextual factors affecting eHealth use across multiple Veteran Health Administration (VHA) acute mental health inpatient units. Staff from units serving both voluntary and involuntary patients (n = 49 from 37 unique sites) completed surveys regarding current, desired, and barriers to use of Veteran-facing eHealth technologies.

Exploring Factors Impacting the Implementation of Recovery-Oriented Treatment Planning on Acute Inpatient Mental Health Units.

Purpose: The current literature on operationalizing and implementing recovery-oriented inpatient care in diverse settings remains limited. The present study systematically examined factors affecting the implementation of one aspect of recovery-oriented care in a large and diverse national sample of Veterans Health Administration (VHA) inpatient mental health units.

Method: VHA inpatient mental health units were scored on the Recovery-Oriented Acute Inpatient scale (RAIN).

Recovery-oriented inpatient mental health care and readmission.

Objective: This article examines the relationship between inpatient mental health units' adherence to recovery-oriented care and 30-day patient readmission.

Method: The sample included patients admitted to one of 34 Veterans Health Administration inpatient mental health units. Recovery-oriented care was assessed using interviews and site visits.

Inpatient Mental Healthcare before and during the COVID-19 Pandemic.

Prior studies have demonstrated disruption to outpatient mental health services after the onset of the COVID-19 pandemic. Inpatient mental health services have received less attention. The current study utilized an existing cohort of 33 Veterans Health Affairs (VHA) acute inpatient mental health units to examine disruptions to inpatient services.

Introduction to the special section on recovery-oriented services in crisis settings.

While substantial progress has been made in integrating recovery-oriented services into traditional outpatient settings, similar progress has lacked in settings which commonly serve persons experiencing mental health crises. This special section includes three studies that highlight promising, recovery-oriented practices that divert persons in crisis from the criminal justice system and traditional emergency medical services, as well as improve the recovery orientation of inpatient services. These promising studies also highlight the substantial work still needed in this area.

Recovery-oriented acute inpatient mental health care: Operationalization and measurement.

Objective: The current article describes efforts to develop and test a measure of recovery-oriented inpatient care.

Method: The Recovery-oriented Acute INpatient (RAIN) scale was based on prior literature and current Veterans Health Administration (VHA) policy and resources and further revised based on data collection from 34 VHA acute inpatient units.

Results: A final scale of 23, behaviorally anchored items demonstrated a four-factor structure including the following factors: inpatient treatment planning, outpatient treatment planning, group programming, and milieu.

Peer Support for Self-Management of Chronic Pain: the Evaluation of a Peer Coach-Led Intervention to Improve Pain Symptoms (ECLIPSE) Trial.

Background: Pain self-management is an effective, evidence-based treatment for chronic pain. Peer support, in which patients serve as coaches for other patients, has been effective in other chronic conditions and is a potentially promising approach to implementing pain self-management programs using fewer clinical resources.

Objective: To test a peer coach-delivered pain self-management program for chronic pain.

Exploring peer coaches' outcomes: Findings from a clinical trial of patients with chronic pain.

Objective: Although peer coaching can help patients manage chronic conditions, few studies have evaluated the effects of peer coaching on coaches, and no studies have systematically examined these effects in the context of chronic pain coaching.

Methods: Peer coach outcomes were assessed as part of a randomized trial of peer coaching for chronic pain. In this exploratory analysis, linear mixed models were used to evaluate changes in peer coaches' pain and related outcomes from baseline to 6 and 9 months.

Emergency department-based peer support for opioid use disorder: Emergent functions and forms.

Emergency department (ED)-based peer support programs aimed at linking persons with opioid use disorder (OUD) to medication for addiction treatment and other recovery services are a promising approach to addressing the opioid crisis. This brief report draws on experiences from three states' experience with such programs funded by the SAMHSA Opioid State Targeted Repose (STR) grants. Core functions of such programs include: Integration of peer supports in EDs; Alerting peers of eligible patients and making the patient aware of peer services; and connecting patients with recovery services.

Evaluation of a peer coach-led intervention to improve pain symptoms (ECLIPSE): Rationale, study design, methods, and sample characteristics.

Chronic pain is prevalent, costly, and a leading cause of disability. Pain self-management (i.e.

Facilitators and Barriers to Implementation of a Peer Support Intervention for Patients with Chronic Pain: A Qualitative Study.

Objective: Pain self-management information and support, delivered by peers, are a potentially useful approach to help patients who are struggling to manage their chronic pain. Before implementation into clinical settings, it is important to understand factors that may influence the success of implementation. The purpose of this study was to explore facilitators and barriers to implementation of peer support for chronic pain.

Helping veterans achieve work: A Veterans Health Administration nationwide survey examining effective job development practices in the community.

Objective: Veterans Health Administration vocational services assist veterans with mental illness to acquire jobs; one major component of these services is job development. The purpose of this study was to characterize the nature of effective job development practices and to examine perceptions and intensity of job development services.

Method: A national mixed-methods online survey of 233 Veterans Health Administration vocational providers collected data regarding frequency of employer contacts, perceptions of job development ease/difficulty, and effective job development practices when dealing with employers.

Consumer factors predicting level of treatment response to illness management and recovery.

Objective: This study aims to identify consumer-level predictors of level of treatment response to illness management and recovery (IMR) to target the appropriate consumers and aid psychiatric rehabilitation settings in developing intervention adaptations.

Method: Secondary analyses from a multisite study of IMR were conducted. Self-report data from consumer participants of the parent study (n = 236) were analyzed for the current study.

Comparing the Costs and Acceptability of Three Fidelity Assessment Methods for Assertive Community Treatment.

Successful implementation of evidence-based practices requires valid, yet practical fidelity monitoring. This study compared the costs and acceptability of three fidelity assessment methods: on-site, phone, and expert-scored self-report. Thirty-two randomly selected VA mental health intensive case management teams completed all fidelity assessments using a standardized scale and provided feedback on each.

How Do Patients with Chronic Pain Benefit from a Peer-Supported Pain Self-Management Intervention? A Qualitative Investigation.

Objective: Peer support is a novel and under-studied approach to the management of chronic pain. This study's purpose was to uncover the elements of a peer-supported self-management intervention that are perceived by participants as essential to achieving positive changes.

Design: Qualitative, semi-structured interviews.

Integrating Self-Determination and Job Demands-Resources Theory in Predicting Mental Health Provider Burnout.

Limited progress has been made in reducing burnout in mental health professionals. Accordingly, we identified factors that might protect against burnout and could be productive focal areas for future interventions. Guided by self-determination theory, we examined whether supervisor autonomy support, self-efficacy, and staff cohesion predict provider burnout.

Veterans' pain management goals: Changes during the course of a peer-led pain self-management program.

Objective: Goal setting is a common element of self-management support programs; however, little is known about the nature of patients' goals or how goals change during pain self-management. The purpose of the current study is to explore how patients' goals and views of goal setting change over the course of a peer-led pain self-management program.

Methods: Veterans (n=16) completing a 4-month peer-led pain self-management program completed semi-structured interviews at baseline and follow-up regarding their goals for their pain.

Illness management and recovery in community practice.

Objective: To examine provider competence in providing Illness Management and Recovery (IMR), an evidence-based self-management program for people with severe mental illness, and the association between implementation supports and IMR competence.

Method: IMR session recordings, provided by 43 providers/provider pairs, were analyzed for IMR competence using the IMR Treatment Integrity Scale. Providers also reported on receipt of commonly available implementation supports (e.

Rural and urban supported employment programs in the Veterans Health Administration: Comparison of barriers and facilitators to vocational achievement for veterans experiencing mental illnesses.

Objective: The purpose of this mixed-methods study was to compare urban and rural supported employment programs on barriers and facilitators with employment for veterans experiencing mental illnesses.

Method: A national sample of 114 supported employment staff, supervisors, and upper level managers employed by the Veteran's Health Administration were recruited. Participants completed an online survey of work barriers and facilitators, including open-ended questions regarding additional factors that impact the work success of veterans.

Barriers and Facilitators Related to Work Success for Veterans in Supported Employment: A Nationwide Provider Survey.

Objective: Veterans with mental illness are at serious risk of poor work outcomes and career stagnation. Supported employment (SE) is an evidence-based model of vocational services that assists persons with mental illness to obtain competitive employment. The purpose of this study was to gain a rich understanding of barriers and facilitators related to competitive work success from the perspective of a nationwide sample of U.