Books, Articles and Research
This section of the Wellness Recovery Action Plan (WRAP) website presents a range of resources to help people recover from mental and physical health problems and addictions, primarily through WRAP. WRAP is an evidence-based practice in which people identify resources, learn about wellness tools, and use these resources and tools to create a personal action plan for recovery. This part of the WRAP website includes links to articles on topics including wellness tools, trauma, and using WRAP for specific health issues. It also features links to more than 30 webinars on topics such as writing grant proposals for WRAP, WRAP for kids, and how WRAP can be used in work with veterans and military personnel. The section also includes links to information on crisis and post-crisis planning and to a WRAP blog.
Integrated Behavioral Health Teams: Synchronicity and Health Reform
In this post to the blog of the National Council for Behavioral Health, the author looks at key features of behavioral healthcare centers of excellence and top-quality community behavioral health organizations (CBHOs). He quotes from a white paper by Dick Dougherty, a psychologist and consultant, in which Dougherty argues that healthcare teams in CBHOs should be what he calls integrated behavioral health teams (IBHTs), with each team specialized in working with people with specific diagnoses, such as schizophrenia, or clusters of diagnoses, such as anxiety disorders. Dougherty writes that IBHTs should be composed of mental health and substance use clinicians, people with lived experience, and support staff, and should be integrated with other health care, peer support, and employment and housing services and providers.
Addressing Spirituality in Healthcare
In this June 2014 eSolutions newsletter from the SAMHSA-HRSA Center for Integrated Health Solutions, the author, a reverend and licensed professional counselor, discusses how spirituality can play an important role in an individual's path of recovery. He explores spirituality and its place in models of health, and he notes that in his own county, he and others have worked to make sure their health programs support all dimensions of wellness in part by including behavioral health professionals in the system of care. He also offers an example of how a therapist worked with one client to address spiritual issues that were standing in the way of recovery.
Empowerment Exchange Uses Peer Support Toward Meaningful Outcomes
This E-News Bulletin from the New York Association of Psychiatric Rehabilitation Services, Inc. (NYAPRS) discusses findings from a recent outcome measurement study of the Empowerment Exchange, a peer-run nonprofit program that works to increase self-help and recovery activities across the country. The study demonstrated the importance of connection to others and trust in overcoming emotional challenges and addressing these challenges before they become crises, while also creating stepping stones for individuals in recovery.
Improving the Physical Health of Adults with Serious Mental Illness
This 3-year study looked at the impact of 56 programs funded by the Substance Abuse and Mental Health Services Administration's Primary and Behavioral Health Care Integration grants. One type of impact this study examined was how the 56 programs through their use of integrated primary care and behavioral health services made a difference in the physical health of people with mental health problems like schizophrenia, bipolar disorder, and major depression. The study found mixed success in each location's ability to successfully integrate behavioral health and primary care services, but that, once people were enrolled in the program, they were more likely to receive primary care services. Investigators found that health outcomes did improve for some chronic conditions, including diabetes, cholesterol, and hypertension, but outcomes did not improve for obesity and smoking. Researchers found that three traits were associated with greater access to care among program participants: co-location of services, integration of practices, and staff perception of themselves as being part of a team.
Evidence-Based Tools Improve Functioning of People with Bipolar Disorder
This press release announces findings from a study of an evidence-based clinical program, Advancing Standards of Care for People with Bipolar Disorder. Program participants at 10 pilot sites experienced significant improvements in their productivity, social networking skills, coping skills, health practices, communication, money management, problem solving, and leisure enjoyment. The program involves two components: a group curriculum to give participants better understanding and information on independent management of their mental health issues, and a functional assessment tool that measures everyday functioning. The study had an attrition rate of 50 percent.
Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis
This article describes a systematic review of published descriptions and models of personal recovery that researchers conducted to create a synthesized conceptual framework of people's experiences of recovery. Their goal was to increase understanding of common elements of recovery to be used in recovery-oriented research and practice. They used 97 papers to create this framework, which, according to the article abstract, includes "(a) 13 characteristics of the recovery journey; (b) five recovery processes comprising: connectedness; hope and optimism about the future; identity; meaning in life; and empowerment (giving the acronym CHIME); and (c) recovery stage descriptions which mapped onto the transtheoretical model of change." Additionally, researchers found that studies focused on certain ethnicities were more likely to show a greater emphasis on spirituality and discrimination, along with other culturally specific aspects of recovery.
Recovery Movement Endorsed by United Nations
This White House Blog post announces that a United Nations (UN) resolution, Supporting Recovery from Substance Use Disorders, was approved by the UN's Commission on Narcotic Drugs on March 21, 2014. This landmark resolution makes recovery a top priority by recognizing that substance use disorders should be treated like other chronic health conditions and that recovery support initiatives are vital to helping prevent relapse and facilitate long-term recovery for individuals. The resolution also makes an appeal for nations to be accepting, supportive, and inclusive of people in recovery and promotes the exchange of information on best practices and evidence-based support initiatives.
Consumer and Family Psychoeducation: Assessing the Evidence
This literature review sought to examine the body of research assessing the impact of individual, group, and family psychoeducation models on various aspects of recovery including treatment adherence, relapse, and hospitalization rates. There was significant evidence to demonstrate that psychoeducation models, which are based on providing information regarding mental health and recovery to consumers, were effective in helping to promote positive recovery outcomes. The authors reviewed several studies that focused on multifamily psychoeducation groups, which they found to be linked to positive outcomes including greater problem-solving ability and lessened burden on families. The authors used these studies to make the case for psychoeducation services to be covered by insurance.
The Police-Based Crisis Intervention Team (CIT) Model: I. Effects on Officers? Knowledge, Attitudes, and Skills
This study sought to determine the officer-level outcomes of Crisis Intervention Training (CIT), which is designed to help police officers improve their responses to individuals experiencing mental health crises. Officers who took the CIT training were compared to officers who had not taken the training and were found, according to the abstract, to have "consistently better scores on knowledge, diverse attitudes about mental illnesses and their treatments, self-efficacy for interacting with someone with psychosis or suicidality, social distance stigma, deescalation skills, and referral decisions."
The Affordable Care Act: Overview and implications for county and city behavioral health and intellectual/developmental disability programs
Ron Manderscheid discusses how the Affordable Care Act (ACA) may shape the future of the behavioral health services as the insurance market is reformed. The author presents five key reform areas of the ACA: insurance, coverage, quality, performance, and information technology. He then examines how consumers and service programs may change as a result of these reforms. Suggestions are made for what city and county programs can do in the process to work towards ideal outcomes.
Social integration in global mental health: What is it and how can it be measured?
This article examines the need for a global measurement of social inclusion as an outcome for ongoing mental health campaigns and initiatives. While many programs seek to increase social inclusion of individuals with mental health issues into their communities, there are not yet measurements which are suitable for global, cross-cultural application. The authors discuss the four main conceptual frameworks of social inclusion which have emerged in the field and analyze challenges as well as potential methods for how a global measurement of social inclusion may be created.
Psychiatry Embraces Patient-Centered Care
This article discusses the changing face of the medical field and psychiatry in particular as it shifts to embrace patient-centered approaches to care. As the authors note, "This model of care places greater emphasis on the patient's involvement in determining the goals of treatment that are meaningful to them and the nature of their care. Meaningful goals for patients generally go beyond symptoms to include quality of life, functioning, and a sense of hope and self-efficacy." This shifts the responsibility and authority in patient-doctor relationships and empowers individuals to be more involved in treatment decisions through shared decision making with their practitioners. This approach seeks to increase effectiveness and productivity of appointments; but will also present challenges for practitioners as it will initially require more time and investment since many individuals receiving treatment will need to be educated about their diagnoses and those very diagnoses may interfere with cognitive and decision-making abilities. Despite these challenges, the authors see great benefits to this approach and encourage practitioners to enhance patient involvement and work to talk and listen to those in treatment in new ways.
Telehealth Therapy Stacks Up When Compared to Standard Care
This blog post introduces telehealth therapy and discusses the promising findings of a study done to compare this therapy to standard care in its ability to reduce depressive symptoms. The study was a meta-analysis, a kind of study in which researchers review other similar studies that have been done and look at overall findings. Telehealth therapy uses technology, such as video or telephone conferencing, to connect consumers and providers for therapy sessions. This allows individuals access to treatment that may have been difficult to attain otherwise due to lack of time or considerable geographical distance between consumers and providers. It is especially valuable in reaching rural areas, which generally have more limited mental healthcare resources. The study found that there was no significant difference in treatment outcomes for those in telehealth therapy and those in therapy conducted in person in traditional settings. The author hopes that this method of utilizing technology may prove to be a valuable means of meeting the demands for increased access to mental health care.
Mental Health Crisis May Be Better Served in Homelike Environment Instead of Traditional ER, Says Study
This article describes a new concept in psychiatric emergency treatment through the Living Room, a program funded by the Illinois Department of Mental Health and provided as an alternative to utilizing a hospital emergency room for support during emotional distress. This drop-in support center is set up like a living room in a person's house and is staffed by a licensed professional counselor, registered nurse, and trained peer counselors who create a calm and respectful environment, focusing on recovery for the individual in crisis. In a study, they found that individuals came to the center for psychiatric issues similar to those for which they might otherwise have visited an emergency room. However, this setting was shown to be much more effective in providing needed support in comparison to typically hectic emergency room settings and received more positive feedback from consumers using the service.
National Study Of Peer-Run Organizations And Consumer-Operated Services
This webpage describes a study being conducted by Lived Experience Research Network staff at the Johns Hopkins School of Public Health. The study involves a nationwide survey of peer-run organizations and consumer-operated service programs. Its goal is to learn more about how these organizations can be integrated into local community mental health systems and what impact this integration may have. The study describes management practices of the models on which these organizations and programs are based, and uses this information to educate key stakeholders working to improve their local systems of care. Two reports were created from this survey. The first report presents a description of peer-run organizations' operations and their underlying characteristics in comparison to other, more traditional care models. The second report covers the ability and willingness of these organizations to accept Medicaid reimbursements.
Changing Knowledge and Attitudes with a Middle School Mental Health Education Curriculum
This study sought to examine the effectiveness of the Breaking the Silence: Teaching the Next Generation About Mental Illness curriculum, which was created to help increase youth's understanding and acceptance of people with mental health issues. Because many social attitudes are formed in the early years of life and rates of children diagnosed with mental health issues have risen, it is vital now more than ever that teachers, families, providers, and communities at large ensure that attitudes towards these issues are positive and recovery-oriented as opposed to negative and discriminatory. Researchers found that utilizing this curriculum with middle school students improved their knowledge of signs of and treatment for mental health issues, their attitudes toward these issues, and their overall willingness to interact with a person with a mental health issue.
How You Can Help Prevent Discrimination Against People with Mental Illness
This issue of Recovery to Practice Highlights, a weekly e-newsletter, discusses six ways in which mental health providers and practitioners can help to promote greater respect, understanding, and social inclusion for people with mental health issues with whom they work in therapy. In an effort to prevent discrimination and perpetuation of negative stereotypes, the author outlines common pitfalls for providers. He also outlines strategies and attitudes to avoid these pitfalls while helping to better convey positive messages of recovery and capability for individuals whom they serve as therapists.
Integrated Care: Wellness-Oriented Peer Approaches: A Key Ingredient for Integrated Care
This column defines whole health and wellness and provides an overview of the wellness and peer movement, peer wellness coaching, the role and potential roles of peers in integrated healthcare systems, and the differences between the wellness model and the traditional medical model. Implications of the Affordable Care Act and the changing face of the healthcare system are discussed alongside how these changes will redefine the experience of individuals in recovery and also bring new opportunities for peers working in the healthcare system.
Self-Help and Serious Mental Illness
This literature review looks at the concept of self-help groups and how they differ from client-patient therapy models. The author discusses six studies that looked at the effects over time of self-help groups. These groups often got very good feedback from participants, who found they were empowered by these self-run and personally motivated groups, as they got to share and foster connections based on common experiences of mental health diagnoses and isolation resulting from prejudice and discrimination they have faced as a result. These groups become powerful support networks and allow people to find self-worth by not only helping themselves, but also getting to help others in the process.
NIH and NFL Tackle Concussion Research
This press release announces the selection by the National Institutes of Health (NIH) of eight research projects to support. Funded by the Sports and Health Research Program, a collaboration of the NIH, the National Football League, and the Foundation for the National Institutes of Health, these studies will work toward a better understanding of traumatic brain injuries. They will examine such areas as the long-term effects of repeated head injuries, short- and long-term outcomes, and factors for individual prognoses during recovery. The eight projects and the program structure are introduced.
The Path Forward: Investing in the Illinois Community Mental Health System; Improving Lives, Saving Money
In this November 2013 policy brief, Illinois' largest mental health recovery provider, Thresholds, outlines the economic value of investing in community mental health services that provide a safety net and would help to lower emergency room visits for psychiatric or substance use crises. By investing the money in prevention services up front, the State could provide better mental healthcare services to community members while also significantly reducing the cost to the public of psychiatric emergency room visits, which between 2009 and 2011 was higher than the amount of money saved in budget cuts to prevention services. Recommendations are made for how these investments could be made to maximize services and cost effectiveness.
'Peers' May Ease Mental Health Worker Shortage under Obamacare
Published in September 2013 in USA Today, this article introduces the concept of peer specialists working in mental health and discusses the growing recognition of their value in the field, particularly in light of the implementation of the Affordable Care Act (ACA). There has been a long-standing shortage of mental health care providers, the article notes, and implementation of the ACA will bring about greater need to fill in the gaps as more people get insurance and seek treatment for previously undiagnosed or untreated mental health and substance use conditions. The use of peer specialists has been shown not only to help lower the overall costs of treatment, but also to help people achieve improved overall health and sustain their recovery over the long term.
Building Partnerships: Conversations with the Hmong about Mental Health Needs and Community Strengths
This resource from the UC Davis Center for Reducing Health Disparities discusses mental health needs and unique requirements that providers and policymakers need to address to ensure that healthcare systems best address the needs of Hmong communities in the United States, many of which were formed by refugees who fled Southeast Asia starting in 1975 as a result of the Vietnam War or during a second wave of immigration starting in 2004. This publication outlines findings from a project that engaged a spectrum of underserved populations in California to gain community perspectives as to what the mental health system could do to more effectively reach out to Hmong people in the United States and their communities. For these communities, these issues revolve around severe social disadvantages as a result of their resettlement in a completely new culture and society. These disadvantages include low levels of education, high poverty rates, and low English proficiency. The publication includes direct quotes and considerations gathered from project participants.
Building Partnerships: Conversations with Native Americans about Mental Health Needs and Community Strengths
Produced by the UC Davis Center for Reducing Health Disparities, this report discusses mental health needs and unique cultural considerations that providers and policymakers need to address to ensure that healthcare systems can more effectively serve Native American populations. Based on findings from a California project to engage underserved populations, the greatest concerns for Native Americans were the loss of their cultural roots, violence, substance use, depression, and suicide. The publication includes direct quotes and considerations gathered from project participants.
Building Partnerships: Conversations with African Americans about Mental Health Needs and Community Strengths
This report produced by the UC Davis Center for Reducing Health Disparities discusses mental health concerns and unique requirements that providers and policymakers need to address to ensure that healthcare systems can better serve African American communities. Researchers partnered with agencies, individuals, and advocates within the African American community to give them an opportunity to express their view of what is needed in their community with the goal of helping counties develop their plans and programs for the prevention of mental disorders. The greatest concerns voiced revolved around experiences of violence, family disruption, substance use, suicide, and homelessness.
Building a Community-Academic Partnership: Implementing a Community-Based Trial of Telephone Cognitive Behavioral Therapy for Rural Latinos
This paper discusses the shortage of evidence-based practices for ethnic minorities within community healthcare systems and the reasons for this shortage. It proposes that partnerships be built between researchers and community practitioners to help run clinical trials and further develop and implement culturally relevant programs. The paper also reports on the process involved in building such partnerships, as well as the results of a pilot test implemented by a community-academic partnership. In this randomized clinical trial, cognitive behavioral therapy by telephone was adapted to serve a primarily Spanish-speaking patient base. The development and outcomes of the program are presented.
American Indian and Alaska Native Mental Health: Diverse Perspectives on Enduring Disparities
This review provides an overview of the state of mental health and substance use issues within the American Indian and Alaska Native populations in the United States. Specifically, the review discusses the disproportionate burden of substance use disorders, posttraumatic stress, violence, and suicide that these populations face and the disparities in health services, which are often underfunded and understaffed for these populations, relative to other U.S. groups. The increasing interest in research on these issues is discussed, along with the growing initiative within these populations to advocate for appropriate alternatives that are more culturally relevant.
NIMH Director Rethinks Standard Psychiatric Treatment for Schizophrenia
While the reform movement within the mental health field has been long underway, it has been making landmark strides in recent years as more and more agencies are recognizing the merits of recovery- and wellness-based practices. This article discusses the August 2013 statement from the Director of the National Institute of Mental Health in recognizing that individuals diagnosed with schizophrenia have varied responses to treatments and can have drastically different paths to recovery. The article discusses the industry that has been built around a standardized treatment protocol that has been unable to bring recovery to many. Diverse approaches are discussed, including Open Dialogue therapy, which has strong long-term outcomes.
The Process of Recovery of People with Mental Illness: The Perspectives of Patients, Family Members and Care Providers; Part 1
This qualitative design study, part of a larger study on recovery, sought to examine common themes within the process of recovery from the viewpoints of people with mental health challenges, their family members and friends, and their care providers. Two significant themes emerged in the analysis. They emphasized the importance of looking to the specific story of the individual and of addressing relationship issues in the recovery process. The findings suggest that recovery relies upon bringing meaning to people's particular experiences with their mental health problems and basing their recovery processes around their unique circumstances.
When Doctors Discriminate
The author discusses her experiences with having medical problems overlooked by doctors who dismissed these problems because she has a mental health problem. She writes about the issues of being given wrong diagnoses and receiving poor treatment, or no treatment, as a result of these misconceptions. She also notes that many individuals are reluctant to see doctors for physical issues when they have also been diagnosed with a mental health problem. Finally, she presents solutions such as integration of mental and physical health care.
Mentally Ill Patients Deserve Equality
In this live chat, the host and four mental health service providers discuss discrimination and injustice faced by people with mental health issues as they seek medical treatment for general health concerns. These issues make it difficult for people with serious mental illnesses to get needed medical attention, which is reflected in the fact that these individuals live on average 25 years less than those in the general population, often as a result of preventable illnesses. Chat participants note the need for sensitivity and diversity training in the medical industry, as well as the improvement in treatment when doctors are able to become aware of each individual's personal narrative and provide medical care tailored to that narrative, rather than to the individual's mental health diagnosis.
Mental Illness At Work: My Schizophrenia Helped Me Find A Job (Video)
In these excerpts from her interview with mental health blogger Natasha Tracy, Lisa Halpern, the Director of Recovery Services at Vinfen, a nonprofit mental health services provider, discusses the onset of her schizophrenia, her path to recovery, and how her experiences led her to her current position in which she supervises 18 peer recovery supporters and oversees peer services at Vinfen.
Person Centered Recovery Planning Implementation
This Web page introduces the Person Centered Recovery Planning implementation project, as well as the philosophy behind it and the shift in mental health care practice required to implement it. This program allows individuals to decide the course of their treatment, empowering and encouraging them to take control of their own health and wellness. The implementation project is currently in its pilot stage and expanding to new locations in Texas. Links to a forum with additional tools and resources used in this program are available via this Web page.
Behavioral Health—Prevention, Early Identification, and Intervention: A Pathways Policy Brief
This policy brief developed by the American Public Human Services Association explores the role that prevention and early detection play in enhancing behavioral health. In addition to the potential benefits of prevention to communities, this brief also discusses challenges like decreases in funding that impact mental health agencies. Some of the recommendations proposed to address these issues include encouraging collaboration between public and private agencies and supporting information-sharing efforts between agencies and programs.
Prevention is Primary: Strategies for Community Wellbeing, Second Edition
The Prevention Institute's Prevention is Primary: Strategies for Community Wellbeing text presents effective methods and tools for preventing mental health and substance use problems, as well as other health problems, and improving the health of communities. It serves as a resource for health care providers and educators, as well as community-based organizations. This text discusses various social issues and also addresses mental health needs of returning veterans.
Changing Course: New Directions in Mental Health and Recovery
In this 2012 Webinar, author and journalist Robert Whitaker and mental health educator Mary Ellen Copeland discuss mental health issues. Whitaker explores issues such as recovery, the long-term effects of psychiatric medications on one's health, and the growing rate of people with mental health problems in the United States. Copeland describes the Wellness Recovery Action Plan and her vision of people turning first to their own resources to address mental health challenges.
In this article, Mary Ellen Copeland discusses how introducing someone to the Wellness Recovery Action Plan (WRAP) can help in that person's understanding of his or her own recovery journey and wellness. She describes how "'Living WRAP'" everyday, and sometimes moment to moment, has helped her to manage life stress. Also, she explores the importance of a strong Wellness Toolbox.
Wellness and Recovery Programs: A Model of Self-Advocacy for People Living with Mental Illness
This article examines definitions of wellness and recovery and how they relate to mental health disorders and provides an overview of both peer-led programs and other tools that promote wellness and recovery. These are discussed with an eye toward creating mental health systems that are more recovery oriented. The authors conclude that when psychiatrists develop a better understanding of wellness and recovery and how people living with mental health problems work toward these goals, this understanding can lead to more effective treatment relationships and recommendations regarding a broader range of helpful supports, both of which can lead to more positive outcomes.
The Evolving Understanding of Recovery: What the Sociology of Mental Health Has to Offer
In this article, the author notes how central the concept of recovery has become to modern mental health policy. He attributes this shift to work by sociologists looking at mental health several decades ago, though he notes that sociology in the intervening decades did little work on the study of recovery. He discusses mental health recovery in depth, its role in policy and practice today, and recovery from the perspective of sociologists.
The Roots of the Recovery Movement in Psychiatry: Lessons Learned
This book explores various fields, including psychology, social welfare, and civil rights, to help in describing the concept of recovery and what has been learned over the years about mental health practice. The authors discuss community-based care, the role of social inclusion in recovery, and recovery as a civil rights movement.
Entry on mental illness is added to AP Stylebook
This press release announces that, as of March 7, 2013, the Associated Press (AP) had added an entry on mental illness to the AP Stylebook to help address how journalists handle questions of mental illness in their coverage. This addition is a significant positive step for public education efforts around mental health that will help reduce negative perceptions and promote social inclusion of people with mental health problems.
A Wellness Recovery Action Plan (WRAP) is an empowering approach to one's recovery journey from mental health disorders that encourages peers to utilize their strengths and other self-help skills while in treatment. This book describes an approach to WRAP designed specifically for youth, encouraging them to overcome life's challenges and move into new opportunities.
Health homes: What healthcare's "one stop shopping" models mean for behavioral health-Medicaid health homes: Care coordination in the States
This article describes Section 2703 of the Affordable Care Act, which allows States to provide additional support, by way of the Medicaid "health home" option, to beneficiaries with two or more chronic conditions, including a mental or substance use disorder. The Medicaid "health home" option is based on the patient-centered medical home model, which supports recovery-oriented approaches including self-management support and shared decisionmaking.
Converting partial hospitals to community integrated recovery centers
In this paper, researchers emphasize the effectiveness of community-integrated recovery and other community activities in helping individuals in their recovery. This paper also explores how the transition of partial hospitals into recovery-oriented programs has become a part of systems transformation and some of the steps involved, such as technical assistance and strengths-based assessment of resources and needs.
NAMI in our own voice and NAMI smarts for advocacy: Self-narrative as advocacy tool
In this column, the author examines the need for advocacy among mental health professionals and researchers and the role it could play in issues related to mental health disorders and other mental health professionals. The author discusses sharing one's recovery story as a means of raising awareness and educating others about mental disorders. He mentions two programs of the National Alliance on Mental Illness (NAMI), NAMI In Our Own Voice and NAMI Smarts for Advocacy.
Social inclusion: Its importance to mental health
This Mental Health Coordinating Council document outlines the importance of social inclusion for people with mental disorders and the role that community-based organizations can play in establishing a socially inclusive community. In addition to emphasizing the importance of a meaningful community connection, this publication also focuses on the need for supportive family and caregivers, strong consumer networks, and access to clinical services as a way of reaching social inclusion.
Meeting the behavioral health needs of veterans: Operation Enduring Freedom and Operation Iraqi Freedom
With 30 percent of the 2 million active duty and reserve military personnel deployed since 2001 in need of mental health treatment, the challenge of addressing the mental health needs of veterans is a significant one. In this article, the National Council discusses different ways this challenge is being addressed. Although a number of approaches, including evidence-based care and cognitive behavioral therapy, have been shown to be effective in addressing posttraumatic stress disorder and major depression, the focus has also turned to increasing the number of veterans utilizing care and ensuring the availability of care for veterans. This article also explores the benefits of community-based mental health care investments in veterans and the potential economic benefits of addressing veterans' mental health needs.
Hyde: Health care reform to offer new opportunities for consumers
This article at the Web site of Peers Envisioning and Engaging in Recovery Services (P.E.E.R.S.) covers the opening keynote at the 2012 Alternatives conference. The keynote was presented by Pamela Hyde, the Administrator for the Substance Abuse and Mental Health Services Administration. In her talk, she shared her view on the Affordable Care Act and ways it will help support individuals with mental and substance use disorders in their recovery. Hyde discussed the importance of integrating behavioral and primary health care, emphasizing the impact that mental health issues can have on physical health. Beginning in 2014, the Affordable Care Act will mandate that mental and substance use disorder services be included in non-grandfathered individual insurance plans. Along with many other expectations of this new law, it is estimated that the law will provide access to coverage for 32 million uninsured Americans. Hyde shared her belief that this Act represents a significant shift in the way mental health treatment is viewed, in recognizing that individuals with mental and substance use disorders can take responsibility for their symptoms and make good treatment decisions for themselves.
Barriers and facilitators to mental health help-seeking for young elite athletes: a qualitative study
Oftentimes, adolescents and young adults do not seek help with mental disorders. Research has found many barriers and facilitators to getting help for young adults. In this study, researchers worked to identify specific factors that impact help-seeking among elite athletes. They found that negative and harmful attitudes and beliefs related to mental disorders were key in deterring youth from seeking support, as were negative past experiences of help-seeking. Positive feedback from and attitudes of others, including coaches, and positive encounters with providers were identified as important ways of getting young adults to seek mental health support.
Morbidity and mortality in people with serious mental illness
With individuals with serious mental illnesses dying 25 years earlier than individuals from the general population, this report explores contributing causes to this disparity, like smoking, obesity, and inadequate access to medical care. It also outlines recommendations for improvement. Some suggested solutions for addressing this public health problem include the implementation of care standards for prevention, screening, and treatment; better access and integration with physical healthcare services; and ongoing support for educational resources, such as toolkits, to encourage healthy choices and promote personal responsibility. This report also addresses provider agencies directly, highlighting the important role of a hopeful message of recovery and the support of wellness and personal empowerment to help promote individual recovery efforts.
Second in a series of three policy briefs on peer supports in mental health delivery systems. Policy issue #2: Introducing and supporting peer providers in traditional mental health provider networks
This issue brief is the second of three policy briefs from Independent Living Research Utilization in collaboration with the Human Services Research Institute. The series covers peer supports in mental health delivery systems. This issue brief discusses ways the concept of peer providers could be introduced to agencies, methods of addressing staff perceptions of peer providers, risk management, and other specific issues that could impact the employment of peer providers in agencies.
Third in a series of three policy briefs on peer supports in mental health delivery systems. Policy issue #3: Financing peer provided services
This issue brief comes from Independent Living Research Utilization in collaboration with the Human Services Research Institute and shares information on ways peer services can be financed, such as in-kind resources and State and Federal programs. It also discusses other key financial factors, including personnel costs, administrative costs, and billing for peer support services. Additionally, this brief provides examples from other States and explores approaches to funding that States can use for consumer-operated service programs (COSPs) and peer providers in traditional mental health agencies.
Under the microscope. Peer support: A valued part of recovery, wellness and health reform
This article by the National Association of County Behavioral Health and Developmental Disability Directors (NACBHDD) discusses the value of peer support and its role in demonstrating that recovery is attainable. This article recognizes peer support as not only a movement but also as a form of delivering care and an evidence-based practice. It also discusses the importance of expanding the ways peer support is utilized and incorporating peer support services into various types of reform, such as insurance and quality reform. In addition, it lists potential action steps to help advance peer support services, provides recommendations and solutions for what can be done at the national and State level to address health disparities, and discusses the importance of integrating behavioral health and primary care services, including the challenges and opportunities involved.
Recovery of evidence-based practice
This research paper explores various aspects of evidence-based practice (EBP), including methodologies, outcomes measures, and evidence standards, from a consumer recovery point of view. Through their examination, researchers worked to critique, inform, and support the expansion of EBP and reshape the study of EBP with the goal of encouraging service providers to provide recovery-oriented support for individuals with mental disorders.
Prevention, treatment, and recovery supports for those with substance use problems: Opportunities for enhanced access and quality of care
While recognizing the negative impact that substance use disorders can have on an individual, one's family, and community, this article explores ways to improve access to prevention and care for substance use disorders.
The mental health recovery movement and family therapy, part I: Consumer-led reform of services to persons diagnosed with severe mental illness
This article outlines key concepts of mental health recovery for marriage and family therapists. It provides a history and practical means of implementing a recovery-oriented approach with clients. The introduction of this approach comes as a result of a 2004 consensus statement from the U.S. Department of Health and Human Services that called for public mental health organizations to incorporate a recovery approach to their work with individuals with mental and substance use disorders.
An examination of the integration of Certified Peer Specialists into community mental health centers
In this report, researchers describe the formal role of Certified Peer Specialists (CPSs) in the mental health field. They explore the experience, responsibilities, and activities of a CPS. The recent incorporation of CPSs in community mental health centers is also examined. Researchers found overall that CPSs have been received well in mental health centers and are satisfied with their role within this setting.
Reaching out to the LGBT population
In this article, the Executive Director of Rainbow Heights Club, a New York program for individuals with mental disorders who identify with the lesbian, gay, bisexual, and transgender (LGBT) community, shares his thoughts on what they have learned about providing support to LGBT people. He cites the U.S. Surgeon General's estimate that 2.6 percent of adults in general are living with a serious mental disorder and adds that this estimate combined with other statistics suggests that 11,000 LGBT adults with mental disorders live in New York City alone. The author goes on to describe the negative attitudes and harmful beliefs that Rainbow Heights Club members have faced, their use of support groups to address these obstacles, and the overall success of the Rainbow Heights approach to supporting LGBT people with mental disorders. Many of these successes involve high levels of consumer appreciation reflected in satisfaction surveys, increases in funding, and decreases in the need for hospitalization among Rainbow Heights Club members.
100 ways to support recovery: A guide for mental health professionals
This report was developed through the collaboration of Rethink and Mike Slade, a clinical psychologist who researched recovery practices throughout Europe, the U.S., and Australia. It includes recommendations to help mental health professionals incorporate recovery-oriented services into their work with individuals with mental disorders. The report outlines the foundations of recovery-oriented mental health services transforming the mental health system, and ways mental health staff can help individuals develop an action plan and recovery goals. The goal of the report is to translate the concept of the Personal Recovery Framework into practice.
Personal recovery and mental illness: A guide for mental health professionals
Personal Recovery and Mental Illness: A Guide for Mental Health Professionals explores recovery for individuals with mental disorders by way of 26 case studies from around the world. This book describes the shift from a traditional clinical approach of managing risk and relapse to a recovery focus that incorporates taking responsibility for one's life and developing goals. This guide for professionals describes ways to support recovery and outlines ideas to help professionals develop action plans to incorporate recovery-oriented practice approaches into their work. It also describes the concept of the Personal Recovery Framework, which emphasizes the person instead of the illness.
Governments discover need for mental health first aid
This article describes the collaborative efforts of the National Council, the Maryland Department of Health and Mental Hygiene, and the Missouri Department of Mental Health to bring Mental Health First Aid (MHFA) to the United States. Just as traditional first aid works to prepare people to help others in emergency situations, the MHFA course teaches individuals how to recognize signs and symptoms of mental disorders and how to provide support. This article describes the widespread use of MHFA throughout the country. Since 2008, over 50,000 people have been trained in over 47 States and the District of Columbia, many of whom are public workers and citizens completing training for their jobs. The article also describes costs of this course and cost-effective ways employers can train employees.
Integrated care for Asian American, Native Hawaiian and Pacific Islander communities: A blueprint for action; Consensus statements and recommendations
This report covers a meeting in August 2011 of 40 stakeholders committed to enhancing the lives of Asian American, Native Hawaiian, and Pacific Islander (AANHPI) communities. The stakeholders met to discuss how to create a national agenda to review benefits of integrated care for AANHPIs. The group included providers, consumers, policy makers, and healthcare administrators in primary health care, integrated care, mental health, substance use, and disabilities. The Blueprint for Action discusses the need for integrated care to have a holistic, public health approach that works across the life span, as well as the need to have research and data that include AANHPIs. The blueprint includes recommendations to inform both governmental and non-governmental partners of culturally and linguistically responsive approaches and models of care.
Laker star gives mental health assist
Ron Artest, now known as Metta World Peace, of the Los Angeles Lakers took a bold step a few years ago when he thanked his psychiatrist on national television in an interview after a big win that led his team to the NBA championship. He has worked to manage his mental health issues for years through therapy with a sports psychiatrist, and he decided that, when he made his mental disorder public, that many people could benefit from knowing about his experience. His openness was a big step in helping increase knowledge and understanding of mental disorders, and acceptance and inclusion of people who experience them, in society.
The price of being strong: Risks to the mental health of athletes
This article explores how susceptible athletes are to psychological strain as they endure great pressure during competitions and throughout their careers. The prevalence of chronic trauma and traumatic brain injury in athletes is also discussed, as depression, suicide ideation, and loss of focus are common symptoms associated with these types of trauma. The likelihood of facing some forms of posttraumatic stress disorder (PTSD) as athletic careers come to a close for some is also explored, as PTSD has the potential to trigger depression or feelings of grief in retiring athletes. As a means of countering many of these risks, the author emphasizes the need for people to change the negative and harmful attitudes, assumptions, and beliefs held about mental disorders and embrace the idea of help as available and attainable. The support roles of family, friends, coaches, and teammates in identifying symptoms and encouraging athletes to seek help are also highlighted.
Surfacing from depression
This USA Today article tells the story of Tiffany Clay, who at 18 received a swim scholarship to attend the University of Tennessee. Soon after she started college she began to feel overwhelmed and depressed. The many pressures of being a student-athlete while also adjusting to a new environment took a toll on her. She received support from her coach and a clinical social worker in the athletic department at her school. With major depression so prevalent among student-athletes, this article highlights the importance of building a support system on campus through which students can get the support they need.
The NSDUH report: Physical health conditions among adults with mental illnesses
This report highlights the connections between physical and mental health and makes recommendations for improving care coordination to bring about better health outcomes for people with mental and substance use disorders. Data collected and reported on by the National Survey on Drug Use and Health (NSDUH) in this report provides further insight into the higher rates of high blood pressure, heart disease, and stroke among individuals with mental disorders. The report shares specifics on chronic health conditions, the use of health care, and the need for improved screening in both physical and mental health settings to ensure both mental health and physical health problems are identified and addressed regardless of which of these settings is the point of entry. The report also suggests the importance of communication among all members of an individual's healthcare team to help with mental and physical health symptoms experienced.
Resolution on APA endorsement of the concept of recovery for people with serious mental illness
A significant body of data now shows a rise in numbers of individuals with mental disorders improving over time, leading full, independent lives. With Federal and State agencies recommending a shift to treatment that is less symptom-oriented, the concept of recovery is expanding. In this resolution, a rationale for the concept of recovery is explored and recommendations on promoting this concept through the American Psychological Association (APA) are discussed.
Service providers' experiences and perspectives on recovery-oriented mental health system reform
This research article discusses the results of a qualitative study in which researchers gathered information about service providers' experience with and views of a recovery-oriented approach. Positive attitudes toward recovery-oriented reform, as well as challenges associated with this approach, are discussed, as well as recommendations for ways to support implementation of recovery-oriented practice.
Prevalence and risk of violence against adults with disabilities: A systematic review and meta-analysis of observational studies
In this article, researchers report on findings from a review of prior studies examining the prevalence and risk of violence against individuals with disabilities in comparison to people who are not disabled. Although the types of disability and violence explored in the earlier studies varied, the authors of this article found that "adults with disabilities are at a higher risk of violence than are non-disabled adults, and those with mental illnesses could be particularly vulnerable."
WRAP® for the effects of trauma
Mary Ellen Copeland, Ph.D. developed the Wellness Recovery Action Plan (WRAP) as a tool to help people in recovery feel empowered, enhance their quality of life, and support them as they work toward life goals. In this book, she focuses on the role that trauma plays in the onset of various mental health conditions. She adapts the WRAP program for individuals who attribute their mental disorders to trauma, discusses what it means to be a trauma survivor, and shares examples of symptoms related to trauma, as well as ideas for wellness tools and action plans that work.
Supported education for adults with psychiatric disabilities
This article reports on the results of a study undertaken to assess the effectiveness of the Bridge Program, a 12-session supported education program for adults with mental health conditions. Study results showed that participation in this program, which includes a combination of skill development sessions and one-on-one mentoring, helped participants' academic skill levels improve, along with their social skills and levels of professionalism. At a 6-month followup, 63 percent of those who had completed the program had enrolled in an educational program or job training, had obtained employment, or were applying to a specific program in the next year.
WRAP Plus (formerly Living Without Depression and Manic Depression)
The Wellness Recovery Action Plan (WRAP) was developed by Mary Ellen Copeland, Ph.D., as a tool for individuals in recovery to help them feel empowered, better their quality of life, support them as they work toward life goals, and decrease negative feelings or behaviors throughout the recovery journey. In this book, WRAP Plus (formerly Living Without Depression and Manic Depression), she shares findings on mental health recovery, guidance on how to create a WRAP, and recovery stories from individuals who have thrived as a result of their own WRAPs.
In this position paper, Collaborative Support Programs of New Jersey (CSPNJ) discusses issues relating to the use of psychiatric medications and consumer choice in these matters. The paper addresses the importance of viewing medication as one treatment option among many, and of shared decisionmaking regarding medication use and choices. It also covers benefits and side effects of psychotropic medications and presents recommendations for psychiatric and psychological policy and practice including the use of alternative wellness approaches to support individuals with mental disorders. This position paper includes the story of the current Governing Board President of CSPNJ in which she shares her experience with depression and twelve hospitalizations and how her relationship with a particular psychiatrist helped in her recovery.
A permanent home that allows drinking helps homeless drink less
This article discusses the successful approach of one supportive housing program for people who have experienced long-term homelessness. The program allows residents to continue to drink alcohol while working towards their recovery from alcoholism. The author identified several factors which contributed to the program's success, including easier rules to follow, support from fellow residents and staff, and an overall attitude that does not look down on residents for drinking but rather invites them to be more open about it.
The role of treatment relationships in service engagement (Center on Adherence and Self-Determination Research and Practice Brief no. 5)
This brief discusses research to date examining the role of the therapeutic relationship in the treatment process and the various ways in which a strong working partnership between the consumer and his/her service provider can be established and maintained. It highlights the value of this relationship; how it helps consumers' decisions, wants, and needs to be heard during treatment; and how the elements of this relationship can positively or negatively impact treatment.
The lived experience of using psychiatric medication in the recovery process and a shared decision-making program to support it
This article describes a new approach that supports shared decisionmaking between individuals with mental disorders and their psychiatrists regarding psychiatric medication options and use. Researchers discuss challenges involved in making decisions regarding medications, the peer-run decision support center and associated software program components of this new intervention designed to support shared decisionmaking, and the intervention's impact on the recovery process.
Shared decision-making in mental health care: Practice, research, and future directions
This report discusses the overall concept and value of the practice of shared decision-making (SDM) in the treatment of mental disorders. SDM is an approach that recognizes the importance of consumers' assuming an active role in communicating with care providers about their needs and preferences and ultimately assuming responsibility for making decisions about their own care. Researchers describe SDM as having the potential to enhance care and recovery. Research on SDM is explored in depth, and future steps and recommendations for policy and practice are discussed.
Building partnerships: Conversations with communities about mental health needs and community strengths
This report produced by the UC Davis Center for Reducing Health Disparities examines the needs of underserved communities, strategies to prevent mental disorders, and ways to address mental health needs specifically while also identifying strengths within the community. Researchers partnered with agencies, members, and advocates within specific communities to give them an opportunity to express their view of what is needed in their community with the goal of helping counties develop their plans and programs for the prevention of mental disorders. Participants' responses highlighted a number of key factors within these communities, including the prevalence of violence and trauma, the role of social conditions such as poverty and unemployment as being a hindrance to community well-being, and the lack of affordable services available in communities.
Idaho suicide prevention hotline: Analysis of options for decision making
With the current suicide rate in Idaho at 11th in the nation, this report was prepared as a means of helping decisionmakers understand the need for a suicide hotline and identifying ways a suicide hotline might be created. Some key topics this report discusses include potential hotline costs, hotline benefits and effectiveness, training standards, confidentiality, and a marketing plan.
Integration of mental health, substance use, and primary care services: Embracing our values from a client and family member perspective
The focus of this paper is to provide perspectives of clients and family members about the integration of treatment of mental and substance use disorders within primary care settings. This paper discusses core values such as wellness-focused and person-centered treatment, the importance of involving persons with lived experience and family members in local planning efforts, and recommendations for stakeholders and for self-advocacy/self-management support. It also provides information, resources, and tools to support wellness, recovery, and hope.
Adults traumatized by child abuse: What survivors need from community-based mental health professionals
In this study, researchers seek to gain an in-depth understanding of the impact of childhood abuse from the adults who have experienced it. They then describe the interventions and trauma treatment approaches that are the most effective. Study participants highlighted the need for trauma-based treatment that is easily accessible and for community-based therapists who are informed about trauma issues.
Models for developing trauma-informed behavioral health systems and trauma-specific services
This report explores some history of trauma-informed services in State mental health systems, describes guidelines for establishing a trauma-informed mental health service system, and also describes the variety of trauma-informed service models and approaches for State systems and providers. It includes a broad range of models including trauma-informed models for parenting, for working with child abuse survivors, and for developing trauma-informed service systems and organizations.
Risking connection: Helping agencies embrace relational work with trauma survivors
This paper describes the Risking Connection approach to working with trauma survivors, an approach that promotes hope, empowerment, and recovery. It discusses how this program has helped improve providers' own awareness and understanding of traumatized individuals. It provides a history of the Risking Connection Model, the role that the relational process had on the development of this model, and a brief outline of how a Risking Connection training would be conducted.
The Trauma Recovery and Empowerment Model (TREM): Conceptual and practical issues in a group intervention for women
This article covers TREM, a group intervention approach designed for women trauma survivors with severe mental disorders. A trauma-informed treatment approach, TREM is attuned to the needs of survivors of physical and sexual abuse. It focuses on the present and helps survivors develop recovery skills. Also, TREM groups are guided by what is known about how women experience and address the challenges of trauma.
Psychiatry and recovery-oriented practice: A situational analysis
This report provides an overview of a collaborative project of the American Psychiatric Association, the American Association of Community Psychiatrists, and an advisory group comprising psychiatrists, other mental health professionals, and consumers. This project worked to develop and share educational materials for psychiatrists to encourage their use of recovery-oriented practices. SAMHSA's 10 recovery components are discussed and barriers, strengths, and opportunities associated with this approach are examined. Also, in this report, psychiatrists' current understanding and use of recovery-oriented practices is explored.
Population mental health: Evidence, policy, and public health practice
This book explores the evidence base for including issues related to mental disorders as a priority in the public health agenda. It discusses the connection between physical and mental disorders, the impact of health policies on the care of people with mental disorders, some of the barriers to developing a revised public health approach to mental disorders, and the use of public health intervention models.
Jail diversion & trauma recovery - Priority to veterans
This article describes the Jail Diversion and Trauma Recovery initiative, which works to offset the increased risk of returning service members becoming involved in the justice system as a result of posttraumatic stress disorder. This initiative has also positively influenced how communities address mental and substance use disorder needs of veterans involved in the justice system. This article explores pilot site activities of grant awardees working at the community and State level to address service and other training needs necessary for successful jail diversion efforts.
Mental health and social inclusion: Making psychiatry and mental health services fit for the 21st century
For this publication, a group employed by the Royal College of Psychiatrists of the United Kingdom set out to examine social inclusion among individuals with mental disorders. It not only describes social exclusion, psychiatry, and current treatment of consumer/survivors in the UK but it expands on the importance of psychiatrists making an effort to adapt their skills to become more socially inclusive. This publication also discusses social inclusion of individuals with mental disorders and how it relates to recovery, treatment services, policy, and specific challenges for the 21st century.
Designing healthy communities
This book discusses tools for individuals looking to bring about positive change within their communities. It explores ways in which the design of an environment influences the health of individuals and also discusses issues relating to social and environmental justice. Obesity and a variety of additional preventable diseases are addressed, while the author also takes time to emphasize best practices for countering these conditions.
Promoting mental well-being and social inclusion through art: Evaluation of an arts and mental health project
Researchers in this study review the benefits reported by consumers following their participation in introductory art courses offered by an arts and mental well-being project. Questionnaires used at the start and end of courses showed that participants recognized improvements in well-being and social inclusion.
Effectiveness of peer support in reducing readmissions of persons with multiple psychiatric hospitalizations
This study explored the feasibility and effectiveness of employing peer support as a means of decreasing reoccuring psychiatric hospitalizations. Based on study results, researchers concluded that using peer mentors is an effective approach to reducing both the frequency and length of hospitalizations for individuals with high likelihoods of being readmitted.
Mental health crisis: What do service users need when in crisis?
Researchers in this study explored the crisis needs of individuals seeking support services for mental disorders. One goal of the study was to learn whether there was strong support for the development of residential crisis services, an alternative to hospitalization. Study results indicated that 93 percent of both consumers and providers supported the idea of residential crisis services. In addition, participants' responses suggested that being able to express concerns and participating in decisions during treatment were also important.
What do consumers say they want and need during a psychiatric emergency?
This article is based on results of a survey seeking consumer perspectives and recommendations on enhancing emergency psychiatric care. Most participants had had negative experiences in hospital emergency rooms and suggested that specialized psychiatric emergency services be developed. Additional recommendations from consumer participants for improving emergency care included the incorporation of verbal interventions, taking a collaborative approach where consumers would be treated with respect and involved in treatment decisions, and an increase in the use of peer support services.
A case study of the peer-run crisis respite organizing process in Massachusetts
This case study examined the experiences of a group of consumers working to implement peer-run crisis respites (PRCRs) in Massachusetts. It includes information on the evidence base supporting PRCRs and different models of PRCRs as well as the grassroots organizing process used by the group to advocate for implementation of PRCRs in Massachusetts. The goal is to help inform groups in other communities interested in gaining support for and implementing PRCRs.
Reintegration problems and treatment interests among Iraq and Afghanistan combat veterans receiving VA medical care
This study sought to describe the frequency and types of community integration issues among Iraq and Afghanistan combat veterans receiving medical care from the U.S. Department of Veterans Affairs (VA). Researchers also set out to learn more about the connection between probable PTSD and reintegration problems and interests in treatment, as well as identifying interests in interventions to assist with readjustment to community life. Results estimate that 25% to 56% of combat veterans who use VA services experienced "some" to "extreme" difficulty in social functioning, productivity, and community involvement, with about 96% of participants expressing an interest in receiving servics to assistance with readjustment to civilian life.
Tenemos Voz National Latino Consumer Network
This network is comprised of Latinos with mental and substance use disorders who work to promote holistic approaches to health and wellness in recovery through equal access to treatment. The network engages in advocacy to influence policy, eliminate disparities, and improve treatment outcomes. It also provides educational and networking opportunities and support for consumer/survivors.
The Community Defined Evidence Project (CDEP)
This project is a collaborative effort between the National Latino Behavioral Health Association (NLBHA) and National Network to Eliminate Disparities in Behavioral Health (NNED) to advance understanding of effective community-based practices for Latinos. The project plans to develop an evidence base that uses key cultural and community indicators and to use this information to influence research, evaluation, policymakers, and funders to support efforts to implement and use community-based practices to reduce disparities and improve both access and quality of care for Latinos..
Policy Responses to Social Exclusion: Towards Inclusion?
This article defines social exclusion and addresses various aspects of life related to the concept including the labor market, education, health, housing, and access to services. This publication goes on to describe policy responses to social exclusion and identifies themes and issues influencing policy initiatives. The ways in which past policy interventions have created or contributed to current issues are discussed as well as recommendations for developing effective policies to reduce exclusionary practices and evaluate these efforts.
Reaching Out: An Action Plan on Social Exclusion
The Action Plan described in this article works to counter the experiences of many who have been socially excluded in the UK. The plan shifts from focusing on treatment to focusing on prevention to break the cycle of disadvantage. This plan has five key guiding principles: to develop better identification and earlier intervention; to systematically identify successful approaches; to promote collaboration among agencies; to tailor programs of support developed based on those in need; and to support achievement and manage underperformance.
What Are Peer Recovery Support Services?
This paper is an introduction to peer recovery support services, which are designed and delivered by individuals who have experienced substance use disorders and recovery. It describes ways these services engage people in their recovery process and reduce the chance of a relapse. Other aspects of peer recovery support services discussed are the types of peer support, its adaptability, the value of these services, and key principles on which these services are based.
The Imperative of a New Approach to Warrior and Veteran Care
Recognizing the alarming rates of depression, brain injury, and suicide among active service members and veterans, this policy brief describes the need for: a new model for dispersing federal funds; changes to the relationship between the Department of Defense (DOD) and Department of Veterans Affairs (VA); and inclusion of private-sector stakeholders, such as nonprofit organizations, in addressing these issues. It provides current statistics on service member and veteran mental and substance use disorders and recommendations for the White House, the DOD, and the VA to improve care.
Introduction to "Building communities from the inside out: A path toward finding and mobilizing a community's assets"
This publication is an introduction to a guide on rebuilding troubled communities that emphasizes identifying and building upon community strengths rather than focusing on deficits within the community. It includes success stories of communities that have thrived and the role that the asset-based community development strategy has played in developing steps toward community growth. This introduction explores ways the traditional approach has failed communities, identifies problems, and discusses solutions and assets of a community, including those of individuals, associations, and institutions.
Building the capacity of the homeless service workforce
This article discusses the importance of addressing the professional development needs of homeless service providers to strengthen this workforce and thereby facilitate improvement in the delivery of services to individuals who are homeless. Challenges of work in homeless services such as low wage environments and the need to confront negative public attitudes are discussed. Researchers also describe the role of developing supportive organizations, providing competency-based training, and encouraging collaboration among Federal agencies in enhancing and developing careers in homeless services.
GLBTQI Mental Health: Recommendations for Policies and Services
Gay, lesbian, bisexual, transgender, questioning, or intersex (GLBTQI) individuals are often reported to have limited access to behavioral health services or to experience unwelcoming environments where behavioral health programs and rehabilitative care is provided. This publication makes recommendations for policy makers and service providers to ensure equal access to and quality services for GLBTQI individuals and to promote recovery and community integration. It includes an assessment of barriers experienced by GLBTQI individuals seeking behavioral health care and suggestions for ways to address these barriers.
Strategies for Strengthening Substance Use Prevention, Treatment, and Recovery Systems: Provider Networks and Impact on the Workforce
Due to diminished resources and high outcome demands, current trends of today suggest that addiction agencies must find new methods of collaborating in order to maximize resources, retain staff, and provide higher quality services based on evidence-based practices. This report explores the various collaborative efforts of nine successful addictions provider networks across the U.S. These nine case studies examined demonstrate strategies and solutions for addressing common challenges thoughout the addictions system. This report also includes recommendations viewed as important to consider in forming a network.
Leading Change: A Plan for SAMHSA's Roles and Actions 2011-2014
This publication describes SAMHSA's plans for 2011 through 2014 to help people with behavioral health problems and their families. Their main focus is to help in developing strong communities, prevent behavioral health problems, and promote better health for all Americans. This plan is outlined by the eight new Strategic Initiatives that will guide SAMHSA's work, each Initiative with its own purpose, specific goal, action step, and measure for determining success.
Recovery Begins with Hope
This report focuses on how to make significant change in behavioral health services and policies. It describes the journey of two mental health trusts that have implemented the recovery approach in their policies and are working to put it into practice. The recovery approach is based on three key principles: hope, respect, and opportunity. This report does not suggest recovery as an alternative to clinical treatment but rather a more positive method of supporting behavioral health consumers that values collaboration and individuals' ability to learn to relate and reorganize their lives.
Successfully exiting homelessness: Experiences of formerly homeless mentally ill individuals
This study sought to identify and describe the processes of change which contribute to homeless individuals obtaining and maintaining stable housing. The researchers examined the impact of a number of factors including employment difficulties, behavioral health problems, and relationships with family, friends, and service providers. A key finding was that relationships with family, friends and service providers were central to achieving stable housing.
"A disease like any other?" A decade of change in public reactions to schizophrenia, depression, and alcohol dependence
Over the last 15 years, behavioral health conditions have increasingly been described as medical diseases by behavioral health professionals, advocates, and policy makers as a way to counter lack of service use and negative and harmful attitudes and misconceptions. This study examined the effects that this neurobiological explanation has had on the rate of those seeking treatment and on the general public's attitude toward people with mental health challenges during the period of 1996-2006. Results suggest that this medical disease approach to understanding behavioral health problems has led to increased support for services but has not significantly reduced negative and harmful beliefs and attitudes. Researchers suggest that to reduce negative attitudes and discrimination, providers and advocates must shift to an emphasis on competence and inclusion.
Americans believe in prevention and recovery from addictions
This SAMHSA report discusses the findings of a survey regarding the general public's perceptions relating to prevention and recovery from substance use disorders and their attitudes towards people who have substance use problems. The report found that a majority of Americans have positive feelings about prevention and recovery from substance use problems, with three-fourths of the population believing that recovery is possible from addiction to alcohol, prescription drugs, and marijuana.
No health without mental health
This document from the United Kingdom discusses an outcome strategy for behavioral health, highlighting the significant influence behavioral health has on all other aspects of life. It describes ways in which quality behavioral health and wellness translate into social and economic benefits for society as a whole, stressing the need for both government and community support to ensure these outcomes. Some agreed-upon goals developed through collaboration of governmental departments, local organizations, and behavioral health professionals are that more people will have positive experiences while provided care and support, that there will be a reduction in negative and harmful attitudes towards people with behavioral health issues, and that more of those with behavioral health problems will have good physical health.
Researching recovery from psychosis
In this article, researchers explore individuals' experiences of recovery from behavioral health problems. They identify three key trends in the process of recovery: rebuilding self, rebuilding life, and hope for a better future. These key elements lend support to a definition of recovery as a gradual process of learning to cope and regain control of one's life instead of an absolute cure. This article also describes implications for behavioral health professionals and future practice.
Ending chronic homelessness: Cost-effective opportunities for interagency collaboration
This article explores the opportunity for Federal policies and programs to change the approach to assisting people who are homeless. It discusses both cost savings that could be realized and improved outcomes in maintaining housing stability, outcomes that would benefit both individuals and the community. It suggests new ideas and approaches to directing policies and practices as a means of enhancing the current approach to addressing homelessness.
Long-term care fundamentals No. 5: Implementing Olmstead in California
This brief provides background information on the 1999 U.S. Supreme Court Olmstead decision which found that the unnecessary institutionalization of people with disabilities is a violation of the Americans with Disabilities Act of 1990. Implications of this decision are discussed, as well as States' efforts toward expanding home- and community-based options for individuals with disabilities including a detailed discussion of efforts undertaken within the State of California.
Joint Statement of the Department of Housing and Urban Development and the Department of Justice: Reasonable accommodations under the Fair Housing Act
This statement outlines the responsibilities of the Department of Justice (DOJ) and the Department of Housing and Urban Development (HUD) in enforcing the federal Fair Housing Act, which prohibits housing discrimination based on race, color, religion, sex, national origin, familial status, and disability. It describes some of the common complaints that HUD and DOJ respond to regarding the Fair Housing Act as well as common questions and answers regarding the rights and duties of people with disabilities and housing providers under the Act relating to reasonable accommodations.
A common purpose: Recovery in future mental health services
This paper seeks to define recovery and discuss what recovery means for the development of future behavioral health services. It addresses ways the recovery approach can be beneficial for individuals' overall health and for social care services, i.e. services which address needs associated with the health and welfare of the population. The paper encourages mental health professionals, consumers, and friends and family of consumers to work toward enhancing current standards and making recovery a key component of developing services.
Peer-run supportive housing for families
This article describes the approach of Housing Options Made Easy, (HOME) Inc., a consumer-run supportive housing program. The article discusses the service approach HOME's peer providers use to support residents in achieving personal recovery and the positive outcomes experienced by residents including fewer and shorter hospital stays and reduced use of crisis services. The article also discusses system-level benefits realized through this program including cost savings, a reduction in negative attitudes, and improved overall effectiveness of the area's mental health delivery system.
Does the scientific evidence support the recovery model?
The recovery model is a social movement that has continued to impact the development of mental health services worldwide. Some of its basic principles include optimism about outcome from psychosis, empowerment of individuals with behavioral health problems, and collaborative decision-making regarding treatment. This editorial highlights data that suggest positive outcomes for consumers with schizophrenia when optimism is incorporated into recovery. The editorial discusses how empowering individuals throughout recovery can enhance the process. The research shows that employment helps people recover from psychosis and demonstrates the importance of addressing the negative, internalized perceptions of behavioral health problems during recovery. This editorial goes on to address other ways in which these basic recovery model principles are supported by scientific research.
Involving patients in decisions during psychiatric consultations
This research study examined the level to which psychiatrists involve consumers in therapeutic decisions. Findings showed low levels of consumer involvement among psychiatrists. The researchers encourage psychiatrists to develop involvement skills and highlight the role that consumer participation in treatment decisions can have on recovery.
Accommodating Veteran Employees with Mental Health Issues: Addressing Post Traumatic Stress Disorder and Traumatic Brain Injury
This report provides resources and ideas on workplace accommodations for returning veteran employees with behavioral health problems. It is geared towards employers, employee assistance professionals, and others who support veteran employees. The report highlights key indicators that an employee may need support, provides statistics on Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI), and guidance on how to develop appropriate workplace accommodations.
Housing First: The Pathways Model to End Homelessness for People with Mental Illness and Addiction
This manual provides a strong basis for introducing the evidence-based Housing First approach in addressing homelessness. It includes guidance in developing policies and programs. The DVD offered with this manual demonstrates the concepts shared, also including success stories of clients, model teams in action, and useful tips.
Engagement and Self-Determination: A Manifesto
In this Center on Adherence and Self Determination (CASD) Research and Practice brief, the CASD describes why they focus on adherence and self-determination, highlighting the importance of individuals choosing their own interventions. This brief also discusses the influence of care seeking and service participation on individuals' goals and ways in which recovery has influenced people's understanding of behavioral health problems and the role of self-determination in service systems.
Report from Barcelona: Fostering social inclusion to end homelessness
This article discusses ways in which Barcelona, Spain has responded to the millions of people in the city who have been strongly impacted by the global economic recession. It describes the increased staffing of homeless assistance programs in Barcelona since the recession and the increase in the availability of emergency housing in the city. This article also describes how the city government, charities, and non-governmental organizations have banded together to launch a social inclusion initiative to address the needs of citizens.
Recovery: A Philosophy of Hope and Resilience
This newsletter emphasizes programs that support recovery from substance abuse and addiction, research on recovery, and National Alcohol and Drug Addiction Recovery Month.
The Role of Social Capital in Building Healthy Communities
This report focuses on the role that community-based institutions play in developing healthy communities and encouraging social capital. Information from case studies done in four U.S. cities are used to address the different views of social capital, local social service delivery systems, and influence of faith communities in providing support to families and communities.
Shared decision-making preferences of people with severe mental illness
In this pilot study, researchers examined consumers' preferences regarding shared decision making. Shared decision making empowers consumers, providing them with information and choices to help them make informed decisions and actively participate in their treatment. Researchers concluded that most consumers prefer greater participation in mental health treatment decisions including decisions regarding medication options than they are afforded.
Shelter from the storm: Trauma-informed care in homelessness services settings
As the field of homeless services has advanced, providers have increasingly realized the importance of addressing long-term healing for people who have experienced homelessness, many of whom are trauma survivors. Trauma-Informed Care (TIC) provides a framework that can be used to support trauma survivors in homeless service settings and represents a promising area for increasingly effective and sensitive service approaches for highly vulnerable people. This paper explores the evidence for TIC within homelessness service settings and examines implications for providers, programming, policy, and research.
Homeless services in the U.S.: Looking back, looking forward: An open letter to policymakers, advocates, and providers
In this editorial, the author suggests strategies for developing inclusive, comprehensive approaches to ending homelessness. She emphasizes the importance of incorporating new research findings and program models as well as linking multiple systems of care to effectively meet the needs of individuals who have experienced homelessness.
Preventing homelessness: A consumer perspective
This article written by a consumer who was homeless and who is now the executive director of a supportive housing program describes the isolation, feelings of hopelessness, lack of mental health support, and violence that many homeless individuals face. The author emphasizes that the goal of all homelessness prevention efforts should be safe, stable, affordable housing in mainstream settings with high-quality services. He discusses various homelessness prevention resources and approaches and highlights the importance of involving consumers who have experienced being homeless in homelessness prevention planning and program development. He encourages consumers to work with programs to help develop a relevant foundation where consumers' autonomy is promoted and where people are challenged to reach their potential.
Effect of mental health care and shared decision making on patient satisfaction in a community sample of patients with depression
This study examined the effect that shared decision making and receipt of mental health care had on the satisfaction levels of consumers with depression. It also sought to determine whether gender affected this relationship. Researchers conclude that shared decision making and receipt of mental health care are both positively connected to consumers' satisfaction. Implications for physician education are also discussed.
Transforming the nation's health: Next steps in mental health promotion
In this commentary, A. Kathryn Power, Director of the SAMHSA Center for Substance Abuse Prevention, advocates for a public health approach to behavioral health promotion and behavioral disorder prevention. She discusses the relationship of behavioral health to overall health and presents a strategy to build resilience at the individual, family, and community levels. She also describes SAMHSA's work to attain the goals within the strategy.
Change in level of positive mental health as a predictor of future risk of mental illness
In the study described in this article, investigators found that both behavioral health promotion and protection are essential to maintaining positive behavioral health and preventing behavioral health disorders.
Mental health promotion in a reformed health care system
This article discusses the opportunity that the 2010 health care reform law provides for public health, health promotion, and disease prevention to become more central to U.S. health care. Because a cornerstone of public health is behavioral health promotion, the authors consider how this important element could fit into a reformed health care system.
Mental health promotion as a new goal in public mental health care: A randomized controlled trial of an intervention enhancing psychological flexibility
"This article reports on a study of a new treatment approach that promotes positive mental health by stressing mindfulness, acceptance, and decision-making based on one's values. The authors conclude that this treatment approach improves positive mental health by helping consumers to develop psychological flexibility and skills of acceptance and value-based action."
Community integration of adults with psychiatric disabilities and histories of homelessness
"This article describes a study in which researchers evaluated components of community integration among adults with behavioral health problems. Half of the adults in the study were assigned to independent apartments in a Housing First approach, and half to a control group. The researchers found that providing consumers with housing choice positively impacted their psychological well-being and that providing them with independent scatter-site housing had a positive impact on their social integration. They recommended additional research to explore community integration from the perspective of consumers themselves."
Housing First for long-term shelter dwellers with psychiatric disabilities in a suburban county: A four-year study of housing access and retention
This article describes a study in which behavioral health consumers with long histories of shelter use were assigned to a Housing First program or a control group. Housing First provides consumers with permanent, independent housing without being required beforehand to attain sobriety and enter into treatment. In the study, outcomes over four years were better for the group in the Housing First program.
Peer support/peer provided services underlying processes, benefits, and critical ingredients
This article defines peer-provided services and explores research on the effectiveness of such services. The author also discusses the elements of an effective peer support system and the qualities that peer providers should possess.
Empowerment and peer support: Structure and process of self-help in a consumer-run center for individuals with mental illness
This study found that having social supports and developing a sense of self-esteem were factors that motivated people with behavioral health problems to continue to attend a self-help drop-in center. Findings from the study also suggest that people with behavioral health problems benefit from helping their peers.
Certified Peer Specialist Roles and Activities: Results From a National Survey
The authors of this study surveyed 291 certified peer specialists (CPSs) from 28 States. The study found that the CPSs worked most often within their agencies, not in the community, and did most of their work with individuals, not groups. The CPSs most frequently provided support on self-determination, health and wellness, hope, communication with providers, illness management, and negative and harmful perceptions associated with mental health problems.
Consumer-delivered services as a best practice in mental health care delivery and the development of practice guidelines
This article examines evidence related to using consumer-delivered services in behavioral health care. Based on a review of available literature, the author recommends ways to implement this type of service and discusses how the evidence and these recommendations may affect policymakers and providers.
Effects of participation in consumer-operated service programs on both personal and organizationally mediated empowerment: Results of multisite study
This study explores the effectiveness of consumer-operated service programs (COSPs). The authors explain that more evidence is needed to determine whether COSPs are effective and how they can be improved. However, they found some evidence to suggest that these programs empower consumers, and they explain that consumers who attend more often show more improvement. The authors also explain that studies of COSPs are complicated by the different types of COSPs available and by differing definitions of "empowerment." They conclude that researchers should continue to study COSPs but should more specifically study components of COSPs rather than whole programs.
Mental health self-help: Consumer and family initiatives
This book includes an overview of the mental health self-help movement, which is a movement for behavioral health consumers and advocates to provide or improve treatment for people experiencing behavioral health problems. The authors provide a history of the movement, consider issues in training and funding for treatment, and suggest future directions for the movement. This book will be useful for community, clinical psychology, and public health researchers, as well as clinicians, counselors, social workers, case managers, and policymakers.
The role of peer support services in the creation of recovery-oriented mental health systems
Research shows that peer-provided services encourage a recovery-oriented mindset that empowers mental health consumers. This position statement from Mental Health America (MHA) promotes the use of peer-provided services and calls on behavioral health professionals to incorporate peer support in community-based services.
Key ingredients of peer programs identified
This briefing paper provides research-based recommendations for those building peer-support programs or managing community systems of care. It identifies program practices that promote mental health, empower consumers, and instill hope of recovery and suggests integrating peer-support into community systems of care.
Infants of depressed mothers living in poverty: Opportunities to identify and serve
Depression can affect parenting and thus the health, safety, and development of an infant under the care of a parent experiencing depression. This paper discusses ways that existing service programs for mothers living in poverty can be used to identify and provide appropriate mental health services to mothers who are depressed and caring for infants.
Social capital and psychiatry: Review of the literature.
This article explores social capital as it relates to mental health. The writers provide a history and several definitions for social capital, discuss the available literature on social capital's relationship with mental health, and conclude with recommendations for further exploring this relationship. The writers also discuss how clinicians and mental health systems may benefit from an increased understanding of social capital.
Recovery as a journey of the heart
Sharing her own story of recovery from schizophrenia, and the stories of other consumers/survivors, Dr. Patricia Deegan emphasizes the importance of hope in the recovery process. She discusses the need for mental health professionals to see consumers/survivors as human beings who need supportive relationships, an expectation of recovery, and opportunities to grow and succeed.
Debt and mental health: The role of psychiatrists
This article explores the relationship between mental health problems and problem debt, as well as the role mental health professionals should play in responding to patient debt. The writers explain that in Britain the number of people who report debt is much higher among those with mental health problems. The article includes an explanation of debt and problem debt, the factors that contribute to debt, and recommendations for how mental health professionals can help patients who are in debt.
Contextual errors and failures in individualizing patient care: A multicenter study
The U.S. Department of Veterans Affairs funded this study to explore how often physicians ask patients probing questions to better understand biomedical and contextual factors that may complicate patients' medical problems. Asking about these factors ensures that physicians make informed diagnoses and recommend appropriate care; however, investigators found that the physicians studied were more likely to provide appropriate care for medical conditions without complicating factors than for those with complicating factors, and they were less likely to ask about complicating contextual factors than about complicating biomedical factors.
Warrior resilience training in Operation Iraqi Freedom: Combining rational emotive behavior therapy, resiliency, and positive psychology
The article's author describes his experience teaching Warrior Resilience Training (WRT) to service members deployed to Operation Iraqi Freedom. This training is offered in the combat zone to increase the resilience of combat personnel, and the author provides feedback related to WRT, as well as suggestions for better integrating and marketing behavioral health services through leaders on the front line.
Psychological resilience and postdeployment social support protect against traumatic stress and depressive symptoms in soldiers returning from Operations Enduring Freedom and Iraqi Freedom.
This article outlines the methods, results, and conclusions of a study showing that interventions to increase psychological resilience and social support may protect against mental health problems among service members returning from Operations Enduring Freedom and Iraqi Freedom.
The impact of Consumer-Operated Services on Empowerment and Recovery of People With Psychiatric Disabilities
This study investigates the correlation between the amount of recovery services offered and the degree of recovery attained. A total of 1,824 people with psychiatric disabilities were studied, some of whom had received peer support services in the last four months. Although peer support showed a significant correlation to recovery, there was not a strong enough association to suggest causation.
Adaptability and resiliency of Military families during reunification: Initial steps of a longitudinal study
"This study attempts to identify factors that increase or decrease the risk of family problems following the initial ""honeymoon"" period that occurs upon a service member's return.
Integrating peer-provided services: a quasi-experimental study of recovery orientation, confidence, and empowerment
This study compared the effectiveness of the Vet-to-Vet program, a peer education and support program, and standard care without peer support on measures of recovery orientation, confidence, and empowerment. Study results suggest that participation in peer support may enhance personal well-being, as measured by both recovery-oriented and more traditional clinical measures.
Recovering in mental illness broadening our understanding of wellness
This book, aimed at mental health clinicians and advocates, examines what recovery means from a variety of perspectives including qualitative studies that include mental health consumers' subjective experiences. Its goal is to inform the work of professionals interested in developing a better understanding of recovery and learning how they can work with consumers to support them in their recovery.
"Finding and keeping work: specifying the issues, activities, roles and supports needed for those with
This paper is written for those trying to create programs for people with mental health problems who are looking for employment or seeking support to retain employment. The paper suggests that a holistic approach is preferred and offers individualized or customized strategies for supporting consumers in this situation.
Social inclusion and recovery: A model for mental health practice
This book, written by two mental health professionals who are also mental health consumers, focuses on how important it is for mental health professionals to work with consumers/survivors in a way that helps consumers/survivors live as fully participating members of the community. The book includes personal stories and explores the important supportive and facilitative roles that mental health professionals play as allies in the recovery process.
The Department of Defense Plan to Achieve the Vision of the DoD Task Force on Mental Health: Report to Congress
Presented to Congress in September 2007, this document describes the U.S. Department of Defense's (DoD's) plan to address the categories of recommendations in the DoD Task Force on Mental Health's vision of change through a focus on six key areas: (1) leadership, culture, and advocacy; (2) access to care; (3) quality of care; (4) building of resilience and inclusion of people with mental health problems; (5) surveillance, research, and evaluation; and (6) care transition and coordination.
An achievable vision: Report of the Department of Defense task force on mental health
This 2007 report of the Department of Defense Task Force on Mental Health identifies four interconnected goals that the task force deemed essential to maintaining the psychological health, enhancing the resilience, and ensuring the recovery of service members and their families, all of which are essential to maintaining a ready and fully capable military force. The report provided detailed recommendations for necessary steps to achieve these goals.
Mental health and social inclusion journal
This journal focuses on promoting social inclusion for people who have mental health problems and includes ways people can enjoy fuller lives in their local communities. Journal articles explore housing, finance, spirituality, cultural diversity, friendships, and relationships and enable readers to stay up to date on innovative approaches, best practices, difficulties, dilemmas, and possible solutions.
Family network support and mental health recovery
This study sought to determine which aspects of the family support network are perceived by mental health consumers/survivors as most important to their recovery process. Study findings revealed that support and reciprocity among family members are important dimensions of a personal support network that aids in the recovery process.
IAVA and Ad Council launch historic campaign
This press release announces the launch of a historic public service announcement (PSA) campaign. Through a partnership of IAVA and the Ad Council, this groundbreaking, multiyear effort seeks to ease the readjustment for service members returning home from Iraq and Afghanistan. The PSAs direct viewers to the first and only online community exclusive to Iraq and Afghanistan veterans, www.CommunityofVeterans.org. The social networking site offers a unique platform for veterans to connect with one another confidentially and serves as a portal for comprehensive mental health resources.
Pillars of peer support: Transforming mental health systems of care through peer support services
This report summarizes the results and findings of the Pillars of Peer Support Services Summit, held at The Carter Center in November 2009. The Summit brought together representatives from States that currently provide formal training and certification for peer providers working in mental health systems. The purpose was to examine the multiple levels of support States need to provide in order to create a strong and vital peer workforce that is able to engage in mental health systems transformation.
Evolving definitions of mental illness and wellness
This article stresses the importance of adopting a more integrated view of mental and physical wellness and translating this view into concrete changes to our country's overall care delivery model. The article discusses the positive benefits that can be achieved through implementing linked approaches.
Mental health issues and the media: An introduction for health professionals
Morris provides students and professionals in nursing and allied professions, psychiatry, psychology, and related disciplines with an introduction to the ways in which the media shapes our attitudes about mental health issues. Covering the press, literature, film, television, and Internet, this comprehensive text includes practical advice and recommendations on how to combat negative images for service users, healthcare workers, and media personnel.
The Social Determinants of Health: How Can a Radical Agenda Be Mainstreamed?
This article is a commentary on the World Health Organization's Report on the Social Determinants of Health (SDOH).
Crisis Residential Facilities Healthier Than Psychiatric Hosptitals? - Study Finds More Mental Health Improvements At Consumer-Managed Program
This article discusses a study that examined the effectiveness of a consumer-managed facility. The consumer-managed facility showed better outcomes for participants and better cost efficiency than a larger, county-run facility.
A randomized trial of a mental health consumer-managed alternative to civil commitement for acute psychiatric crisis
This experiment compared the effectiveness of an unlocked, mental health, consumer-managed, crisis residential program (CRP) with the effectiveness of a locked, inpatient psychiatric facility (LIPF) for adults civilly committed for severe psychiatric problems. Following screening and informed consent, participants (n = 393) were randomized to the CRP or the LIPF and interviewed at baseline and at 30-day, 6-month, and 1-year post admission. Outcomes were costs, level of functioning, psychiatric symptoms, self-esteem, enrichment, and service satisfaction. Treatment outcomes were compared using hierarchical linear models. Participants in the CRP experienced significantly greater improvement on interviewer-rated and self-reported psychopathology than did participants in the LIPF condition; service satisfaction was dramatically higher in the CRP condition. CRP-style facilities are a viable alternative to psychiatric hospitalization for many individuals facing civil commitment.
History of Childhood Maltreatment Linked to Higher Rates of Unemployment, Poverty: Outcomes of Aubuse and Neglect Impost Significant Cost to Individual and Society
This article discusses the results of a study that examined the long-term impacts of childhood maltreatment, both for the individual and for society.
The Role of Social Network and Support in Mental Health Service Use: Findings From the Baltimore ECA Study
A significant number of people with mental illness do not use mental health services to receive treatment for their symptoms. This study examined the hypothesis that social network and social support affect mental health service use. Increased contact with the social network and higher levels of social support were associated with greater use of general medical services. However, more social support was associated with use of fewer services within the specialty psychiatric sector.
Compeer friends: A qualitative study of a volunteer friendship programme for people with serious mental illness
This study explored the benefits and drawbacks of an intentional friendship programme (Compeer, Inc), which develops new social relationships for people with serious mental illness by matching them in one-to-one relationships with community volunteers for weekly social activities.
Social support, activities, and recovery from serious mental illness: STARS study findings
Research on the role of social support in recovery from severe mental illness is limited and even more limited is research on the potential effects of participating in various activities. This study explores these relationships by analyzing baseline data from a 153-participant subsample in the Study of Transitions and Recovery Strategies.
The meaning and importance of employment to people in recovery from serious mental illness: Results of a qualitative study
Given the high rates of unemployment and underemployment among individuals with psychiatric disabilities, only a small number of studies have investigated the role work has in the lives of people who have been successful vocationally during their recovery from serious mental illness. This study sought to add to existing literature by determining how individuals perceive work and its effect on their recovery.
Social relationships as a decisive factor in recovering from severe mental illness
Recovery research often describes recovery from mental illness as a complex individual process. In this article a social perspective on recovery is developed. Researchers aim to ascertain which factors people regard as decisive to their own recovery and what makes them beneficial.
Passing for "normal": Features that affect the community inclusion of people with mental illness
The purpose of this study was to investigate specific features that indicate to community members that a person has a mental illness and the emotional reactions elicited by these features, in hopes of understanding barriers to the community integration of people living with mental illnesses.
Attitudes toward mental health services: age-group differences in Korean American adults
The present study examined the attitudes toward mental health services held by younger and older groups of Korean Americans. The findings provide important implications for interventions targeted to improve access to mental health care among minority populations. Based on the similarities and differences found between young and old, both general and age-specific strategies need to be developed in order to increase effectiveness of these programs.
Addressing Recovery from Severe Mental Illness in Clinical Supervision of Advanced Students
This article begins a dialogue about the need to incorporate emerging knowledge about recovery as an attainable outcome for individuals with mental illness in academic curricula. The author proposes that clinical supervision from a recovery model is faced with at least four semi-distinct challenges: the discovery and avoidance of negative misconceptions, the setting of consensually valid and personally relevant goals, the development of a therapeutic relationship, and the assessment of barriers to recovery and outcomes.
So I wouldn't feel like I was excluded: The learning experience in computer education for persons with psychiatric disabilities.
This paper describes an exploratory, qualitative examination of factors that aid in the acquisition of computer skills by 12 adults across 2 settings: a structured, professionally-taught program and a less structured peer-taught setting. These pilot findings highlighted the importance to teaching effectiveness of striking a balance between flexibility and structure, with computer knowledge having broader implications for social inclusion.
Perceived helpfulness of websites for mental health information : A national survey of young Australians
Despite the high risk of developing a mental disorder during adolescence, many young people fail to receive appropriate treatment from mental health professionals. Recent studies have found certain mental health information websites have improved mental health literacy and reduced symptoms of depression. However, studies exploring young people's perceptions of such resources still remain scarce. The current paper compared young people's preference for a website with self-help books and two face-to-face services-counselling and mental health services.
To seek advice or not to seek advice about the problem: The help-seeking dilemma for obsessive-compulsive disorder
The present study aimed to explore some variables hypothetically involved in the help-seeking process among patients with obsessive-compulsive disorder.
Behavioral health needs and problem recognition by older adults receiving home-based aging services
The aims of this study were to examine behavioral health problems in a sample of older adults receiving home-based aging services, their recognition of behavioral health problems, and covariates of problem recognition.
Touch in mental health nursing: An exploratory study of nurses' views and perceptions
The aim of this study was to explore psychiatric nurses' perceptions of physical touch with people who experience mental health problems. A descriptive exploratory qualitative research design was used. Semi-structured interviews were carried out with 10 registered psychiatric nurses who met the inclusion criteria and were randomly selected to participate in the study.
Desire for social distance from people with mental disorders.
The review examines measurement of social distance; characteristics of people who desire greater social distance; experiences that affect social distance; characteristics of people that elicit social distance; the effects of psychiatric labelling; the effects of causal explanations for mental disorders; and interventions to reduce social distance.
An emotive subject: Insights from social, voluntary and healthcare professionals into the feelings of family carers for people with mental health problems.
This paper explores the emotions of family carers from the perspectives of social, voluntary and healthcare professionals. Sixty-five participants were interviewed, the sample included directors, managers and senior staff from social, voluntary and healthcare organisations.
SESAMI study of employment support for people with severe mental health problems: 12-month outcomes
In the context of UK policy to promote employment for people with disability as a means to greater social inclusion, this study investigated how people with severe mental health problems fare in existing supported employment agencies. The aim of the study was to identify factors associated with successful placement in work and to test the impact of working on psychological well-being in this group.
Impact of a mental health teaching programme on adolescents
This study examines the positive impact of a six lesson study course on mental health issues given to a class of 14 and 15 year olds versus a control class who did not receive the lessons. Researchers found the lessons were successfully able to increase understanding and acceptance of mental health issues in peers while promoting disclosure among these adolescents along with prosocial behaviors. Participating pupils had positive reactions to the lessons and recognized the importance of learning about mental health.
The specter of shame in substance misuse
This article provides an introduction to the concept of shame as it relates to substance misuse. Empirical research on shame and addiction and the theoretical and operational definitions that underpin them are discussed.
Implicit prejudice toward injecting drug users predicts intentions to change jobs among drug and alcohol nurses
In the current research, drug and alcohol nurses reported their level of stress working with people who inject drugs , their job satisfaction, their explicit prejudice toward people who inject drugs , and their intentions to leave drug and alcohol nursing.
Discrimination, historical loss and enculturation: Culturally specific risk and resiliency factors for alcohol abuse among American Indians
This report investigates the effects of discrimination, historical loss and enculturation on meeting diagnostic criteria for 12-month alcohol abuse among American Indians who share a common culture in the upper Midwest.
Language and the recovery advocate: Why we worry about words
In this article the author addresses the need for a "recovery-oriented vocabulary" in order to support recovery efforts and reduce the discriminatory policies that exist in communities.
Shame, not guilt, related to substance-abuse problems; Reducing feelings of shame may be key to more effective treatment
This study included three groups of participants with different levels of alcohol and drug problems. Two groups were primarily female college students about 20 years of age. The third group was comprised of predominantly male inmates from a metropolitan area jail who were, on average, 31 years of age.It appears that individuals who are prone to shame when dealing with a variety of life problems may also have a tendency to turn toward alcohol and other drugs to cope with this feeling.
Self-labeling and its effects among adolescents diagnosed with mental disorders
This study uses mixed-method interviews with 54 US adolescents receiving integrated mental health services in a mid-sized mid-Western city to examine: (1) the extent to which they use psychiatric terms to refer to their problems ("self-label"), and (2) the relationships between adolescents' self-labeling and indicators of psychological well-being. Researchers found that adolescents who self-labelled had more negative attitudes towards themselves and were more likely to suffer from depression. Additionally, correlations were found between the likelihood to self-label with higher perceived negative public attitudes, younger age of diagnosis, and higher socio-economic status.
Social exclusion and mental health: Conceptual and methodological review
The aim of this study was to conduct a conceptual and methodological review of social exclusion, focusing initially on the origins and definitions of the concept and then on approaches to its measurement, both in general and in relation to mental health.
Mental health training for law enforcement professionals
The purpose of this pilot study was to determine topics of interest and preferred modalities of training for police officers in their work with persons with mental illness. Police officers across Massachusetts attending in-service mental health training were asked to rate the importance of potential mental health topics and the effectiveness of potential training modalities on a Likert-type scale.
Increasing social support for individuals with serious mental illness: evaluating the compeer model of intentional friendship
In this study, the authors conducted a quasi-experimental study of Compeer, which matches community volunteers and people with SMI to increase social support.
Soldier attitudes toward mental health screening and seeking care upon return from combat
This study examined soldier attitudes about postdeployment mental health screening, treatment, barriers to care, strategies for overcoming barriers, and settings, personnel and timing for conducting postdeployment mental health screening.
Correlates of mental health service use among lesbian, gay, and bisexual mothers and prospective mothers
This cross-sectional study aimed to describe the mental health services used by women in the perinatal period and to identify potential correlates of mental health service use. Providers may benefit from additional knowledge about the LBG social context that is relevant to perinatal health, and from identifying a strong referral network of skilled and affordable counsellors.
Beliefs about depression and depression treatment among depressed veterans
In this article the authors states that they studied beliefs about depression and depression treatment among patients in a randomized trial of a chronic care intervention to improve depression treatment in the Veterans Administration healthcare system (n = 395).
Community integration of transition-age individuals: views of young with mental health disorders
This qualitative study examines the perceptions of young adults with mental health disorders of community integration.Implications of the study discuss roles for behavioral health services in encouraging empowerment, choices, and connections so that young people with mental health disorders may achieve their preferred levels of community integration.
Exploring the role and perspectives of mental health nurse practitioners following psychosocial interventions training.
The authors reports the findings of a study on the roles and perspectives of mental health nurse practitioners towards clients with enduring mental illness and their carers following completion of Psychosocial interventions (PSI) training.
Perceived dangerousness of children with mental health problems and support for coerced treatment
This study examined the public's beliefs regarding the potential for harm to self and others and the public's willingness to invoke coercive or legal means to ensure treatment of children.
Striving to help college students with mental health issues
In this article, the author suggests that the mental health problems in the college population appear to be increasing in number and severity. In addition, it is believed that many students do not actually seek much-needed counseling services due to lack of knowledge about mental health problems or services, fear of prejudice, or denial of the severity of the problem.
Transformation of children's mental health services: The role of school mental health
This article examines the intersection of school mental health programs and the New Freedom Commission's recommendations in order to highlight the role of school mental health in the transformation of the child and adolescent mental health system.
School mental health promotion: MindMatters as an example of mental health reform
In this article, a historical review of the development and implementation of MindMatters is used to exemplify the changes and outcomes of shifting policy and practice in school mental health promotion. Achievements include a conceptualization of mental health as a positive concept, addressing prejudice and discrimination, building capacity in the education sector and developing evaluation strategies to address complex, whole-school change.
Current Issues in undergraduate psychiatry education: The findings of a qualitative study
The purpose of this article is to identify the current issues in undergraduate psychiatric education in the United Kingdom for lead teachers at United Kingdom medical schools.
Mental illness careers in an era of change
In this article, the authors use data from 238 persons treated in Vermont State Hospital during the 1950s to evaluate several fundamental career assumptions and to illustrate how different predictors are contextualized by the career.
Getting Beyond "Don't Ask; Don't Tell": An Evaluation of US Veterans Administration Post deployment Mental Health Screening of Veterans Returning From Iraq and Afghanistan
In this study the authors sought to evaluate outcomes of the Veterans Administration (VA) Afghan and Iraq Post-Deployment Screen for mental health symptoms. Among 750 Iraq and Afghanistan veterans who were referred to a VA medical center and 5 associated community clinics, 338 underwent post deployment screening; 233 (69%) screened positive for mental health problems.
Psychosis and the experience of employment
This study explored the experiences of people diagnosed with schizophrenia or schizoaffective disorder in relation to paid employment. Eight participants with experience of paid employment were interviewed. The data were analyzed using Interpretative Phenomenological Analysis (IPA) [Smith et al. (In: Murray, Chamberlain, editors) Qualitative health psychology, 1999].
Campus mental health: Know your rights
Campus Mental Health: Know Your Rights is a guide for college and university students to the legal rights one has when seeking mental health
services. It also explains what can be expected in interactions with mental health service providers and what obligations one might have.
Unmet needs and treatment seeking in high users of mental health services: Role of illness perceptions
The aim of the present study was to investigate how illness perceptions in high users of mental health services were related to unmet needs and treatment-seeking behaviours.
Mental health problems in rural contexts: A broader perspective
The objectives of this article are to expand and comment upon a recent review in Australian Psychologist of the literature in relation to mental health problems in rural contexts by Jackson et al. (2007). In this article the authors reviews recently published qualitative research on the help-seeking attitudes and experiences of rural Australian adolescents.
The influence of culture on immigrant women's mental health care experiences from the perspectives of health care providers
In this article, the authors suggest that although cultural knowledge and practices influence immigrant women's coping choices and strategies, awareness of social and economic differences among diverse groups of immigrant women is necessary to improve the accessibility of mental health care for immigrant women.
Use of health care services for psychological distress by immigrants in an urban multicultural milieu
This article finds that research in the United States tends to attribute low rates of use of mental health services by immigrants to economic barriers. The author's purpose of the study was to examine this issue in the context of Canada's universal health care system.
The effect of healing gardens and art therapy on older adults with mild to moderate depression.
This study evaluated the effect of garden walks alone, garden walks with guided imagery, and art therapy on mild to moderate depression in older adults. Focus group interviews at the end of the 6-week intervention suggest that all 3 interventions were helpful to participants with mild to moderate depression.
Community integration for older adults with mental illnesses: Overcoming barriers and seizing opportunities
This report is the third in a series of reports prepared by the National and Statewide Coalitions to Promote Community-Based Care under Olmstead project. It is designed to help State and local Olmstead coalitions understand the barriers that older adults face and learn about the innovative solutions being adopted and adapted across the country.
Chapter 5 of "Mental health: A report of the Surgeon General": Older adults and mental health
This chapter of the Surgeon General's report on mental health addresses various areas of interest for the older adult population, specifically considering mental disorders in older people - their diagnosis and treatment, and the various risk factors that may complicate the course or outcome of treatment.
Rural and frontier mental and behavioral health care: Barriers, effective policy strategies, best practices
This report focuses on the following areas: barriers to mental and behavioral health service delivery in rural America, model programs and effective activities for rural America, model policy strategies for rural mental and behavioral health care delivery, the role telehealth should play in service delivery to rural America, and the role that State Offices of Rural Health and other State and local organizations should play in service delivery to rural America.
A survey of preferred terms for users of mental health services.
This survey was conducted to determine how users of mental health services would like to be addressed by professionals. Three hundred two persons participating in a variety of inpatient and outpatient psychiatric programs were surveyed.
Evaluating the effectiveness of a consumer-provided mental health recovery education presentation
The current study investigated the effectiveness of the In Our Own Voice (IOOV) mental health education program in improving knowledge and attitudes about mental illnesses.
Solutions to discrimination in work and housing identified by people with mental illness
This study examines perceived solutions to discrimination in housing and employment situations.
Mental Illness and Employment Discrimination
This article presents a review of recent research that seeks to determine employment-related barriers experienced by people with mental health problems. In this study, the researcher takes a broad view of the discrimination process to include cognitive, attitudinal, behavioral, and structural disadvantages. Based on her review, she concludes that people with mental health problems continue to face many barriers in attitudes and social and economic structures that keep them from active participation in the workforce. This highlights the need for modern mental health rehabilitation models and legislative philosophies which focus on citizenship rights and full social participation.
"It's important to be proud of the place you live in": Housing problems and preferences of psychiatric survivors.
This paper reports findings from a series of focus group meetings held with survivors of mental illness to address issues concerning housing preferences and housing needs.
Social network's healing power is borne out in poorer nations
This article describes the findings of a 3-decade-long study by the World Health Organization (WHO) which found that mental health consumers in poorer countries have higher rates of recovering from schizophrenia. Key findings described explore the role that family support, culture, and other social networks have on individuals with schizophrenia. This article discusses the differences in the roles of doctors, the invaluable role of families, and the importance of integrating social and cultural supports with medicine to achieve more positive outcomes.
A family's painful journey
This article discusses the issues faced in Maryland in seeking assistance for children with severe mental illness. It focuses on State budget cuts for wraparound mental health coverage.
American with Disabilities Act of 1990
The current text of the Americans with Disabilities Act of 1990 ["ADA"], as amended.
Mental health in the workplace: An issue for one in five employees
This report was developed by a committee of engaged citizens in Minnesota who were asked to examine how the mental health issues
of employees impact the workplace and to identify successful strategies or models for addressing the mental health challenges of those working and for accommodating
those with serious mental health problems who
want to work.
President's New Freedom Commission on Mental Health
The Commission's mission was to study the United States mental health service delivery system, including both private and public sector providers. The Commission advised the President on methods to improve the system. The Commission's goal was to recommend improvements that will enable adults with a serious mental illness and children with a serious emotional disturbance to live, work, learn, and participate fully in their communities.
An attribution model of public discrimination towards persons with mental illness
In this study, researchers build on previous work by developing and estimating a model of the relationships between causal attributions (e.g., controllability, responsibility), familiarity with mental illness, dangerousness, emotional responses (e.g., pity, anger, fear), and helping and rejecting responses. The results from this study also suggest that familiarity with mental illness reduces discriminatory responses.