Objective: This article presents findings from a randomized controlled trial of a peer support mentorship intervention designed for individuals with serious mental illness and frequent, recurrent psychiatric hospitalizations.
Methods: Seventy-six individuals who were diagnosed as having a major psychotic or mood disorder and who had at least two psychiatric hospitalizations or more than three emergency department visits within the 18 months prior to the index hospitalization participated in this trial. Participants were randomly assigned to one of two conditions: standard care or a peer mentor plus standard care.
Objective: The study examined the feasibility and effectiveness of using peer support to reduce recurrent psychiatric hospitalizations.
Methods: A randomized controlled design was used, with follow-up at nine months after an index discharge from an academically affiliated psychiatric hospital. Patients were 18 years or older with major mental illness and had been hospitalized three or more times in the prior 18 months.
Objectives: We examined patient accounts of illness and care among primary care patients whose medical services costs were high in order to illuminate factors associated with high cost.
Methods: Thirty-three primary care patients with multiple chronic illnesses in an urban clinic serving a resource poor neighbourhood were selected from a range of high medical cost patients. Participants were interviewed with open-ended questions to investigate experiences of illnesses and care; their responses were examined for prominent themes using qualitative analysis methodology.
As part of the emerging recovery paradigm, there is an increasing need for psychiatric treatment and rehabilitation to be strengths-based and to be driven by the desires and preferences of the person with mental illness. Yet if mental illness is a brain disease, it is not at all clear how these characteristics contribute to improvement in the person's condition or influence the course and outcome of the disorder. To avoid these aspects being relegated to the role of nonspecific factors, the field must develop an understanding of the role of strengths and interests in recovery.
View Article and Find Full Text PDFPeer support is based on the belief that people who have faced, endured, and overcome adversity can offer useful support, encouragement, hope, and perhaps mentorship to others facing similar situations. While this belief is well accepted for many conditions, such as addiction, trauma, or cancer, stigma and stereotypes about mental illness have impeded attempts on the part of people in recovery to offer such supports within the mental health system. Beginning in the early 1990s with programs that deployed people with mental illness to provide conventional services such as case management, opportunities for the provision and receipt of peer support within the mental health system have proliferated rapidly across the country as part of the emerging recovery movement.
View Article and Find Full Text PDFIn this paper we review qualitative research on recovery from schizophrenia and summarize how persons' daily activities and experiences reflect mechanisms of recovery of the self. We begin by describing examples of persons' daily activities, suggesting that they have in common a stance labeled by E. Corin (1990) as positive withdrawal, representing negotiation of distance from the social milieu.
View Article and Find Full Text PDFObjective: This study examined the frequency with which persons in the community with psychiatric disorders, substance use disorders, and both types of disorders are victims of violence.
Methods: The relationship between diagnosis, gender, and victimization over a one-year period was examined in two cross-sectional data sets, one drawn from a study of adaptation to community life of persons with severe mental illness in Connecticut (N=109) and the other drawn from assessments made by caseworkers in a Connecticut outreach project for persons with psychiatric and substance use disorders (N=197). Analysis of variance was used to evaluate the frequency of victimization across diagnostic categories in each data set.
Espousing an Action Theory approach (Brandstadter, 1998; Lerner, 1982), the authors hypothesized that socially disruptive behaviors committed by people with severe mental illness will be at least partly influenced by incidents of childhood sexual and physical abuse. They further hypothesized that this effect of child abuse on disruptive behaviors in severe mental illness will be mediated by patients' suspiciousness and hostility. Structural equation modeling analyses conducted on data collected from 109 people with severe mental illness provided support for this mediating model.
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