Importance: People with serious mental illness (SMI), defined as a diagnosis of schizophrenia spectrum disorder, bipolar disorder, or disabling major depressive disorder) die approximately 10 to 25 years earlier than the general population.
Objective: To develop the first-ever lived experience-led research agenda to address early mortality in people with SMI.
Evidence Review: A virtual 2-day roundtable comprising 40 individuals convened on May 24 and May 26, 2022, and used a virtual Delphi method to arrive at expert group consensus.
Examine the unmet needs of people with serious mental illness (SMI) from the perspective of certified peer specialists. 267 certified peer specialists from 38 states completed an online survey (female [73%], 50.9 [SD = 12] years, and non-Hispanic White [79.
View Article and Find Full Text PDFObjective: Discordance between psychiatric care providers' and clients' goals for medication treatment is prevalent and is a barrier to person-centered care. Power statements-short self-advocacy statements prepared by clients in response to a two-part template-offer a novel approach to help clients clarify and communicate their personal goals for using psychiatric medications. This study described the power statement method and examined a sample of power statements to understand clients' goals for medication treatment.
View Article and Find Full Text PDFIndividual involvement in treatment decisions with providers, often through the use of decision support aids, improves quality of care. This study investigates an implementation strategy to bring decision support to community mental health centers (CMHC). Fifty-two CMHCs implemented a decision support toolkit supported by a 12-month learning collaborative using the Breakthrough Series model.
View Article and Find Full Text PDFObjective: Illness management and recovery strategies are considered evidence-based practices. The article describes how a web-based application, CommonGround, has been used to support implementation of such strategies in outpatient mental health services and assess its impact. The specific focus of this article is Personal Medicine, self-management strategies that are a salient component of the CommonGround intervention.
View Article and Find Full Text PDFHealthcare reform emphasizes patient-centered care and shared decision-making. This study examined the impact on psychotropic adherence of a decision support center and computerized tool designed to empower and activate consumers prior to an outpatient medication management visit. Administrative data were used to identify 1,122 Medicaid-enrolled adults receiving psychotropic medication from community mental health centers over a two-year period from community mental health centers.
View Article and Find Full Text PDFPsychiatr Rehabil J
September 2010
Topic: Web-based technology and peer support can be paired to create an enhanced medication visit that supports shared decision making between psychiatrists and people with psychiatric disabilities.
Purpose: The purpose of this paper is to describe an intervention to support recovery and shared decision making in the psychiatric medication visit. We will describe the CommonGround web application and a new role for peer staff in the medication clinic.
This Open Forum describes a vision of comprehensive electronic decision support systems that could provide information and supports to both clients and clinicians in order to facilitate shared decision making and encourage collaborative management of illness and wellness. The authors argue that these systems have the potential to improve mental health care by enhancing and connecting the three elements of evidence-based medicine: client preferences, research evidence, and clinician skills.
View Article and Find Full Text PDFThis column presents preliminary findings of an intervention to support shared decision making in psychopharmacology consultation. The waiting area in an urban psychiatric medication clinic was transformed into a peer-run Decision Support Center featuring a user-friendly, Internet-based software program with which clients could create a one-page computer-generated report for use in the medication consultation. The Decision Support Center was used 662 times by 189 unique users from a young-adult and general adult case management team from October 2006 to September 2007.
View Article and Find Full Text PDFDecision making related to the use of psychiatric medication in the recovery process is complex. This paper describes some of the challenges involved in making decisions about using psychiatric medications. It also details an innovative intervention to support shared decision making in psychiatry.
View Article and Find Full Text PDFPsychiatr Serv
November 2006
Mental health professionals commonly conceptualize medication management for people with severe mental illness in terms of strategies to increase compliance or adherence. The authors argue that compliance is an inadequate construct because it fails to capture the dynamic complexity of autonomous clients who must navigate decisional conflicts in learning to manage disorders over the course of years or decades. Compliance is rooted in medical paternalism and is at odds with principles of person-centered care and evidence-based medicine.
View Article and Find Full Text PDFScand J Public Health Suppl
October 2005
Background: Resilience does not refer to a magical state of invulnerability and the capacity for resilience does not end when one is diagnosed with a prolonged disorder or disease. Despite the enduring legacy of pessimism regarding resilience in the population of people diagnosed with psychiatric disorders, a majority do recover.
Aim: The present study seeks to understand how people with psychiatric disorders demonstrate the capacity for resilience in the ways they use or do not use psychiatric medications in their daily lives.