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Essential New Roles for Peers and Service Recipients in the Whole-Health Era This blog post written by Dr. Ron Manderscheid describes how he envisions new and expanded roles for peer providers based on philosophical shifts in healthcare system approaches as mandated by the Affordable Care Act (ACA). The ACA emphasizes the importance of person-centered, integrated healthcare systems, and this presents a unique opportunity for peers to help redefine and shape these changes in care systems as they evolve to integrate behavioral and physical health care and meet the needs of people who may not have previously sought care. Peer providers will likely play a key role in helping to fill in gaps in staffing, as they would be ideal candidates to help others navigate their health services and be able to provide both emotional and practical support. Dr. Manderscheid suggests new roles may also be incorporated for these peers as they interact with individuals who may have come seeking only physical health care. Not only can they serve as ambassadors for recovery, but they may go beyond their traditionally defined roles and be able to support whole-health services.
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.
Will the Affordable Care Act Move Patient-Centeredness to Center Stage? In 2001, the Institute of Medicine designated patient-centeredness as a top priority for healthcare systems, defining it as "care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions." The path toward implementing patient-centered care had started several decades earlier, as steps were being taken to ensure that patients played a central role in addressing the ethical, economic, and clinical considerations of their care. This article discusses the history of these trends and the infrastructure development required, as well as the new policies of the Patient Protection and Affordable Care Act, which mandate reporting measures to ensure patient satisfaction in quality of care and other performance areas. The Consumer Assessment of Health Plans Study will play a major role in this reporting, working with a consortium of both public and private healthcare organizations. The implications of this and how it will cause our healthcare system to evolve are discussed.
Mental Health Court Helps Save a Troubled Talent from the Street Published in October 2013, this article shares an inspiring success story of San Francisco's Behavioral Health Court, which allowed a young woman to get treatment rather than putting her in jail and in the process helped her to bring music back into her life. Her success story highlights the value of programs such as these, which help to rehabilitate individuals who have run-ins with the law that are associated with symptoms of their mental health problems. These programs often are able to help people get back onto their feet and remain out of the criminal justice system while adhering to individual treatment plans and reclaiming their lives.
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.
How Mindfulness Can Help Your Creativity This article introduces mindfulness and meditation, as well as recent research that shows the positive effect of these practices in increasing creative problem solving and adaptability. The author discusses implications of this effect for recovery from mental health problems, specifically in relation to suicide prevention. He notes that people contemplating suicide may be thinking in habitual and even rigid ways, and that mindfulness and meditation may help them move out of these ways of thinking and come up with alternative ways to address issues they are facing, which in turn may bring them relief.
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.
How Your Mental Health May Be Impacting Your Career This article discusses political and social factors that affect the employment potential and poverty risks for people with mental health problems. Barriers within both employment and health systems that do not properly accommodate or address mental health issues are examined, and potential solutions are introduced.
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.
Living WRAP 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.
WHO Comprehensive Mental Health Action Plan Adopted by World Health Assembly This article discusses the World Health Organization's adoption of the draft Comprehensive Mental Health Action Plan 2013-2020. This plan provides guidelines for entities including national governments, agencies that support economic and governmental development around the world, mental health organizations, colleges and universities, research institutions, and society as a whole. The article identifies four key objectives of the plan: - "Strengthen effective leadership and governance for mental health, - Provide comprehensive, integrated and responsive mental health and social care services in community-based settings, - Implement strategies for promotion and prevention in mental health and - Strengthen information systems, evidence and research for mental health." The plan is available for download at the following link: http://apps.who.int/gb/ebwha/pdf_files/WHA66/A66_10Rev1-en.pdf.
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.
Grounded in Faith: Resources on Mental Health and Gun Violence This report serves as a tool to help ensure that the current debate on gun control does not perpetuate stereotypes and harmful beliefs regarding individuals with mental health issues. It includes a section with statistics on mental health and gun violence and specific faith-based resources for members of the Interfaith Disability Advocacy Coalition (IDAC) and others.
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.
Low Quality Job As Bad For Health As No Job Although studies have shown that one's mental health has a tendency to improve once employed, the research described in this article suggests that one's mental health can be impacted negatively if the job obtained is of low psychosocial quality. Unfavorable psychosocial work conditions referred to in the study include high demands, low control, low job esteem, and insecurity. Researchers' results showed that unemployed people and individuals with poor-quality jobs had a heightened chance of developing common mental disorders.
Pathways to Recovery (PTR): Impact of Peer-Led Group Participation on Mental Health Recovery Outcomes In this study, researchers used peer-led groups to explore positive effects on recovery outcomes for individuals with mental health issues. Based on Pathways to Recovery: A Strengths Recovery Self-Help Workbook, the strengths-based model used helped participants feel better about themselves and their lives by supporting them in developing and working toward goals based on their personal and environmental strengths. This research highlights the importance of using peer-led groups to help with the recovery process.
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.
Youth WRAP 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.
Building Safer Communities: Improving Police Response to Persons with Mental Illness This document provides recommendations from the International Association of Chiefs of Police (IACP) on how police officers can best help in a situation where an individual with a mental health issue is in need of crisis intervention. It is the hope of the IACP that these recommendations will reduce the chance of any injury or trauma during a mental health-related police response and will increase understanding and collaboration among law enforcement, community members, and people with lived experience.
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.
What is needed to deliver collaborative care to address comorbidity more effectively for adults with a severe mental illness? This paper examines collaborative care services for people with severe mental disorders that have worked to address comorbidity and the relationship of mental disorders to homelessness, substance use disorders, unemployment, and other health issues in Australia. Researchers identified many key program components that help make integration of care most effective: shared treatment plans and client records, promotion of a "housing first approach," education for staff about comorbidity, and cross-sector collaboration among agencies when serving shared clients. Cross-sector collaboration is described as a real benefit for consumers and staff and as an effective strategy to move Australia toward having more holistic, socially inclusive mental health care.
Peer-delivered services included at statewide provider conference-finally The 2013 Coordinated Care Organization Oregon conference included a panel discussing peer-delivered wellness services this year. In this article, the author describes the progress that this shows in how peer-delivered services are viewed, also highlighting that this is the first time a consumer panel has been at a statewide provider conference in Oregon.
Press releases: President Obama calls for Mental Health First Aid in gun control proposal Linda Rosenberg, President and CEO of the National Council for Behavioral Health, begins this January 2013 statement as follows: "As part of his recommendations to protect our communities from gun violence, President Obama today rightly called for Mental Health First Aid training to help teachers and staff recognize the signs of mental health disorders in young people and find them appropriate care." The statement defines Mental Health First Aid as an evidence-based training program that helps people identify mental health problems in youth and connect them with support as needed, and that also teaches individuals how to respond in a crisis situation. This approach to addressing mental disorders in youth provides an opportunity for the community to discuss mental health while also engaging young adults and their families.
Your language matters when writing about mental illness In this article, the Mental Health Association of Portland describes the impact of language when writing about mental disorders. A bad choice of language to describe a particular mental health problem or individual has the potential to demean, hurt, and perpetuate stereotypes. This article provides guidelines for journalists from disability rights' literature and from individuals with mental disorders on respectful language that helps embrace diversity and dignity.
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.
Mental illness & violence: We need to step up In this blog post, the author discusses violence in the United States, failures within the country's mental health system, and common stereotypes related to individuals with mental disorders and how these misconceptions feed negative and harmful beliefs about people with mental disorders. These negative and harmful beliefs cause fewer people to seek treatment and even reduce the likelihood of self-disclosure by individuals who have had success in their recovery journeys. The author suggests that self-disclosure from individuals in recovery from mental health issues who are living healthy lives could help with people's exposure to mental health consumers, providing a balance to the violent portrayals of individuals with mental disorders too often presented by the media. He also suggests that self-disclosure could help society, especially individuals in need of treatment, understand that recovery is possible.
Developing the philosophy of recovery in South African mental health services The growth in power and importance of the recovery movement around the world has had an increasing effect on how mental health care is viewed and implemented. This article explores positive outcomes associated with new understandings of recovery and the recovery movement and ways in which a recovery framework can be incorporated into mental health services in South Africa.
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.
Sustainable development helps us to flourish This article examines the connection between sustainable environmental practices and positive mental health, suggesting that efforts to improve conditions for our planet have the potential to also improve mental health throughout society. The author explores ways the natural environment is connected to psychological wellness, emphasizing ways it serves one's needs, not only for food and water, but also for one's spiritual and emotional wellness. In the Mental Health Foundation of New Zealand's recognition of these described connections, some common goals for their work with organizations are listed: integrating social, cultural, economic, and environmental goals; regenerating natural and social capital; affirming the value of local communities; valuing nature intrinsically; and promoting non-material sources of happiness.
Neighbourliness: Local connections and mental wellbeing This Mental Health Foundation of New Zealand article explores social capital and its potential to support growing communities and enhance mental health. The author discusses social capital as it is defined by Robert Putnam, "the collective value of all 'social networks' and the inclinations that arise from these networks to do things for each other." The article highlights the impact of local community projects and campaigns on increasing trust between community members and social connectedness. It also covers the current status of social connectedness in New Zealand, recommendations for building local connections and opportunities at the local level, and encouraging quality relationships among neighbors and community members.
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.
Words can wound: How the media describe the mentally ill and disabled In this Kaiser Health News article, authors discuss the offensive language that a National Public Radio correspondent used during a recent interview. This incident not only highlighted the insensitivity that still exists in people's references to individuals with mental disorders, but it also shed light on how negative portrayals in the media can play a role in perpetuating the negative and harmful attitudes and beliefs associated with mental disorders.
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.
Victorious Black Women brings hope, provides hope to women of color This Peers Envisioning and Engaging in Recovery Services (P.E.E.R.S.) article describes the efforts of an Oakland, CA-based organization: Victorious Black Women. Victorious Black Women operates on the premise that the road to healing for black women is linked to the sharing of stories with one another. This article discusses Victorious Black Women's overall approach to healing and recovery for women of color and the personal experiences of their Co-Founder, Renee Harris, who describes how someone reaching out to her meant a huge step in her own recovery journey. In recognizing the influence of culture on self-expression and ways of coping with stress, this organization also works to educate the community about culturally competent mental health services to help women of color.
Native American tribal communities provide hope for overcoming historical trauma This Peers Envisioning and Engaging in Recovery Services (P.E.E.R.S.) article discusses the historical trauma experienced by many Native American tribal communities and the hope for overcoming it. Suicide, infant mortality, and unemployment rates of Native American tribal communities are among the highest in the country. The historical trauma intervention model described in this article takes an approach to healing that includes four main components: confronting the trauma, understanding the trauma, releasing the pain, and transcending the trauma.
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.
First in a series of three policy briefs on peer supports in mental health delivery systems. Policy issue #1: Organizational models for peer support This issue brief, the first in a series of three issue briefs on peer support from Independent Living Research Utilization in collaboration with the Human Services Research Institute, provides information on two key peer support models: consumer-operated service programs (COSPs) and peer providers. This series of issue briefs has as its goal encouraging conversations about peer services among state policymakers. It discusses practices for each of these models, ways policymakers can choose the right approach for their communities, and questions for policymakers looking to develop and/or support these models.
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.
WHO European review of social determinants of health and the health divide This article discusses the disparities in health that still exist between and within countries in the European region. Specifically, the article examines a review of inequities in health between and within countries across the WHO European region. The authors explore ongoing research that has contributed to an understanding of social causes of these inequities, and they go on to describe policies that will help in reducing the current health divide.
Final report of the World Conference on Social Determinants of Health The World Conference on Social Determinants of Health, brought together in 2011 in Brazil by the World Health Organization (WHO), was a global conference that sought to encourage action on the social determinants of health. This event provided an opportunity for stakeholders to share their experiences with strategies for reducing health inequities and to discuss potential next steps of the WHO Commission on Social Determinants of Health. This final report, available for download, provides a full summary of this important conference.
Peers and peer-led interventions for people with schizophrenia The authors of this article discuss key principles and types of peer-led interventions and their success in nurturing recovery for individuals with schizophrenia and other mental disorders. The three types of interventions explored include self-help, consumer-operated services, and peer support services.
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.
Mental-health advocate is also a symbol of recovery Newly elected Board President of the National Alliance on Mental Illness, Keris Myrick, shares her story of recovery and continued efforts to educate others on recovery and discrimination issues as they relate to mental disorders. In this article she describes a negative experience of being locked in an emergency room psychiatric area while awaiting services, how many individuals of color receive mental health services that oftentimes involve a police car and handcuffs, and ways she has learned to cope with her symptoms while also striving to make a difference for others.
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.
Supporting workers with mental health problems to retain employment: Users' experiences of a UK job retention project Researchers set out to gain a deeper understanding of the connections between challenges experienced in the workplace by people with mental disorders, support received during employment, and job retention. This study showed that feelings of guilt and self-blame among consumers are barriers to job retention but that, with support, individuals are able to improve communication with their employer including communication to seek accommodations, and experience increased confidence in their self-advocacy abilities. Individual interviews were used to collect data that revealed that peer support groups were a useful intervention that helped individuals with mental disorders retain employment. Researchers concluded that interventions that focus on the employee, his or her work, and the workplace offer more hope than those that focus solely on the individual for improving employment among individuals with mental 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.
United Nations convention on the rights of persons with disabilities: A roadmap for change This study examines the United Nations Convention on the Rights of Persons with Disabilities as a means of advancing the social inclusion of individuals with mental disorders or intellectual disabilities. This convention focused on many social barriers that impact the full social participation of people with disabilities while also providing guidance on ways of incorporating disability policy in different countries. The researcher of this study goes on to discuss ways the mental health community will need to work on moving toward creating a new disability discussion that looks at services and supports needed to help people with mental disorders gain complete access to society.
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.
Initial outcomes of a mental illness self-management program based on Wellness Recovery Action Planning In this study, researchers set out to examine psychosocial outcomes in individuals participating in Wellness Recovery Action Planning (WRAP), a peer-led, self-management intervention for mental disorders that focuses on holistic health, strengths, and social support. The 80 individuals who completed surveys before and after WRAP participation showed significant improvement in symptoms, recovery, feelings of hopefulness, self-advocacy, and physical health. Researchers go on to highlight the effectiveness of the WRAP model and its potential to increase self-management and lead to recovery for individuals with mental disorders.
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.
Effects of a peer-run course on recovery from serious mental illness: A randomized controlled trial This study examined how peer-run services impact the recovery of individuals with mental disorders. At the end of a 12-week course, Recovery Is Up to You, researchers found that the course had improved participants' hopefulness, senses of personal effectiveness, and empowerment, even 3 months after the course had been completed. Researchers' findings show that the role of peer-run services in recovery is a positive one with the potential to improve the recovery journey significantly.
A randomized controlled trial of effects of wellness recovery action planning on depression, anxiety, and recovery This study examined how effective Wellness Recovery Action Planning (WRAP) sessions were in reducing anxiety and depression and increasing self-perceived recovery among participants with a serious mental health problem. The study included 519 people who took part either in eight WRAP sessions given by certified WRAP educators in recovery or in usual treatment. Researchers found that training in WRAP diminished depression and anxiety and boosted participants' perceived recovery over time. Results suggested that WRAP is an important evidence-based and recovery-focused intervention.
A study of the impact of social support development on job acquisition and retention among people with psychiatric disabilities In this study, researchers explored the connection between methods for developing social support and employment-related outcomes among people with mental health problems receiving Supported Employment services. Researchers found that individuals with higher numbers of unpaid supporters were more likely to be employed for longer periods of time. Person-Centered Planning was noted as an effective technique in building support; it is a way of building natural, unpaid social supports to promote continued employment.
Adaptation guidelines for serving Latino children and families affected by trauma The adaptation guidelines discussed in this publication highlight key factors that should be addressed when adapting mental health practices to be used in working with Latino/Hispanic individuals impacted by trauma. Focus groups composed of experts in various fields including child trauma research, clinical practice, and cultural diversity discussed a number of important areas to consider while supporting Latino/Hispanic children and families. Some of the key areas identified are cultural values, immigration, child welfare, communication and linguistic competence, and diversity among Latinos.
Pathways to integrated health care: Strategies for African American communities and organizations; Consensus statements and recommendations In a roundtable discussion hosted by the U.S. Department of Health and Human Services Office of Minority Health, dozens of health professionals including psychologists, counselors, primary care doctors, and individuals from advocacy organizations discussed efforts to address health disparities that impact African Americans. These professionals explored the history of these health inequalities, some successful integrated care models, and recommendations for countering these disparities. This report summarizes the group's findings and goes on to emphasize the need for culturally designed prevention methods to holistically address the wellness and mental health of African Americans.
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.
Dealing with postrace letdown This article explores postrace letdown (PRLD), a term used to describe the common physical and/or mental feelings that many athletes feel after the climax of months of hard work and training. Dr. Doug Jowdy, a licensed psychologist and former sports psychologist, discusses how PRLD is not uncommon for elite athletes, who often are overtrained with little rest, recovery, or regeneration. He suggests a training program that incorporates rest, a celebration of achievement, allotted time for the body to regenerate, quality nutrition that encourages recovery, and reflection.
Lindsey Wright shares message of hope In this article, Lindsey Wright shares how she dealt with depression and managing her career as a professional golfer. She describes how her symptoms built up gradually, leading to insomnia, anxiety, and eventually the realization that she needed help. After taking some time off from golf to focus on her mental health she was able to return to professional golf and get back to a place in her life where she felt happy again.
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.
Darryl Strawberry opens up: Baseball legend discusses overcoming depression In this article Darryl Strawberry shares some of his life experiences as a professional baseball player, what it was like growing up in a home with an abusive father, and how he dealt with his depression and substance use as an African-American man. Strawberry discusses the common misconceptions regarding mental and substance use disorders in the African-American community and makes the point that depression does not discriminate. Through his memoir Straw: Finding My Way, he hopes to inspire all people experiencing mental health challenges to get help.
Study shows physical and mental health benefits of sports participation in adolescents This article describes the results of a study on the benefits that sports can have for adolescents. Research shows that 12- to 14-year-olds who play team sports and are physically active feel healthier and are happier with their lives. The study concludes that participation in youth sports not only has the potential to increase satisfaction with life at a key time in development but also to improve school connectedness, social support, and bonding with peers.
Mental Health Month spotlight: Zack Greinke This PsychCentral Mental Health Month spotlight article highlights Zack Greinke, an MLB pitcher. Greinke is not only known for his 60 mile per hour curveball, but also for deciding to take time off from baseball to dedicate himself to recovery from depression and social anxiety disorder. Through medication and counseling support, Greinke was able to return to the sport and show how possible it is for people struggling with mental disorders to overcome and manage their lives.
Former Celtics player discusses his struggle with addiction in new book Chris Herren, a former National Basketball Association (NBA) player, began his recovery journey to address a substance use disorder years ago. In his book, Basketball Junkie: A Memoir, he tells how he came close to losing everything, including his loved ones, and how he has regained control of his life.
Holdsclaw recounts fight with depression The lived experience of Women's National Basketball Association (WNBA) player Chamique Holdsclaw is described in this article. In 2006, she wrote an autobiography in which she shares details of her depression and a suicide attempt that changed her life. Through her autobiography she works to demystify mental disorders and show that anyone can have one. In 2010, she joined a panel on emotional and physical well-being sponsored by the NFL and the Morehouse School of Medicine that addressed various issues like dementia, depression, substance use disorders, and financial stress. Also, Holdsclaw is a spokesperson for Active Minds, an organization that works with students to change views of mental disorders on college campuses. She has found a way to educate others about mental health, continue to make the most of her athletic talent, and fight her depression by staying active, being open with the people around her, and working through her feelings.
Dolphins' WR Brandon Marshall talks mental health This article describes Brandon Marshall's 2011 visit to Harvard University to speak with students about mental health. He is an NFL player who has struggled with borderline personality disorder (BPD) and has learned how to manage his mental disorders effectively. In the introduction to his presentation to Harvard students, it was noted that a study had recently found that 44 percent of Harvard students do not seek counseling support when they feel they need it because they do not believe it works. Marshall encouraged students to take the good from his lived experience with BPD and success in therapy and to seek help, explaining that he could relate to the pressure that undergraduates feel. It is Marshall's hope to continue to work toward countering any misconceptions people have about mental disorders and treatment and to use his celebrity to become the face of mental health and raise awareness.
Clara Hughes conquers the dark weight of depression In this article, six-time Olympic medal winner Clara Hughes describes her experience with depression in the hope that sharing her story will help decrease the negative and harmful attitudes and beliefs associated with depression. She talks about her symptoms, which included overtraining that led to an injury, weight gain, and excessive sleep, and how it was a national team doctor who made the connection between these behaviors and depression. Since Hughes has addressed her mental health challenges, she has become the national spokesperson for Let's Talk, a Canadian campaign that supports mental health services and has continued to work toward increasing awareness through billboard and television messaging.
Putting the pieces back together This article describes the recovery journey of Major League Baseball (MLB) pitcher Justin Duchscherer. The author recounts the emotional buildup of isolation and despair that Duchscherer experienced leading to his decision to put his professional baseball career on hold to seek mental health support for clinical depression. As happens for many professional athletes, the money, fame, and high-stress, high-demand environment Duchscherer was in took a toll on his mental health. Once he began seeking treatment for his depression and educating himself on mental disorders, self-acceptance set in. Also, the author notes that, for Duchscherer, the support of his team and agent was key to his recovery journey.
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.
Behind the wins and losses: Changing the way mental health is viewed in sports This April 2011 blog post discusses the prevalence of mental disorders among professional athletes. It notes that the 2011 suicide of Dave Duerson, former NFL player, and 2009 suicide of professional soccer player Robert Enke, highlighted the severity of this issue and need for support and changes in the way mental health is viewed and addressed in the sports world and society as a whole. Chronic traumatic encephalopathy (CTE), a degenerative disease caused by multiple concussions and head injuries, is described as a common condition among many athletes with symptoms that include depression, memory loss, aggression, dementia, and confusion. The author goes on to emphasize the need for an increase in public understanding of mental disorders, their impact on athletes, and the roles that they play in the lives of so many others.
Promotion of mental health through coaching competitive sports Competing in sports has the potential to impact athletes' mental health greatly. The coach's overall approach to coaching, and the relationship the coach has with athletes, are also key factors in an athlete's mental health and overall development of human potential. This article highlights approaches to coaching that are healthy, emphasizing an instructor-mentor approach where coaches use sports as a vehicle to tutor and provide guidance for other life skills. This article also highlights various lessons to be taught and learned from healthy coaching relationships, including leadership skills and problem solving.
Early guidance, preventive therapy urged for young athletes This article discusses the 2012 suicide of former National Football League (NFL) player Junior Seau while also exploring professional athletes' vulnerability to development of mental disorders like depression. It describes sports-related psychological therapy in high school as a means of preventing later mental health problems and also of helping young athletes prepare for the professional realm. The article notes that, if visits with a psychiatrist were a mandatory part of a professional athlete's job, these visits could serve as a method of ongoing support and could also help normalize mental health care.
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.
Social firms: A means for building employment skills and community integration In Europe, social firms are commercial businesses that create opportunities for work and social integration for people with challenges to employment. This article describes a case study in which a Norwegian social firm worked to provide employment for workers with mental and substance use disorders. The article also discusses the value of this approach as a training option, as a means of supporting social integration, and as a method of countering negative and harmful attitudes and beliefs about people with mental health problems.
Empowerment in supported employment research and practice: Is it relevant? Researchers in this study explored the connection between empowerment and quality of life of individuals with mental disorders entering supported employment. This study also examined empowerment's relationship to engagement in community life and individuals' experience with negative attitudes and beliefs. Results reaffirmed the value of empowerment in the supported employment setting and the importance in considering social and community integration benefits of having a job.
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.
Consumer empowerment and self-advocacy outcomes in a randomized study of peer-led education In this study, researchers worked with over 400 participants to evaluate the effectiveness of Building Recovery of Individual Dreams and Goals (BRIDGES), a peer-led education intervention program. This program works to empower individuals with mental disorders by teaching skills and providing information and support needed to become more involved in the decisionmaking process during treatment. Results yielded significant results with participants showing an increase in self-esteem, self-advocacy, and their ability to maintain these improvements over time.
The road from addiction recovery to productivity: Ending discrimination against people with alcohol and drug problems This article explores the discrimination commonly experienced by individuals with substance use disorders, including discrimination in policies that limit employment and health care. Researchers discuss the role of these discriminatory actions on one's recovery and a project, Join Together, that works to address discrimination.
A questionnaire survey on attitudes and understanding towards mental disorders This study sought to gather information about attitudes and general understanding of mental disorders among people in Hong Kong, China. Questionnaires were used to collect data from over 1,000 participants who represented different age groups and socioeconomic statuses. Survey data showed increased knowledge and acceptance among survey participants who had regular contact with people with mental health conditions. The study concluded that people developing and implementing mental health awareness programs should incorporate strategies to increase social contact between individuals with mental disorders and those without these disorders in the general public.
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.
Promoting self-determination and financial security through innovative asset building approaches This research article explores the benefits of Individual Development Account (IDA) programs and how they help in the recovery journey and build confidence among individuals with mental disorders. Some challenges associated with IDAs and the future direction of this program are also discussed.
Building a cross disability peer employment support model: Report to the New York State Medicaid infrastructure grant This report examines the prevalence of unemployment and underemployment among individuals with disabilities. Its findings identify peer support as a way of improving social capital, one's relationships and connections outside the mental health and addictions systems, and social networks for this group. This increase in social interactions was found to increase individuals' employment connections and opportunities. Researchers offer recommendations to help in developing peer employment support models to help individuals with disabilities secure employment.
Medication Optimization 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.
Health care and public service use and costs before and after provision of housing for chronically homeless persons with severe alcohol problems This study examined whether housing individuals experiencing both chronic homelessness and alcoholism using a Housing First approach would result in a reduction in the use and costs of health care. The Housing First model separates housing from clinical issues by addressing homelessness first, providing individuals with permanent housing without prerequisites for treatment and sobriety, and then supporting them in addressing clinical or other issues. Researchers found that the Housing First intervention not only resulted in significant cost savings per person each month but also helped people remain in housing longer and helped them reduce their alcohol consumption.
Project-based Housing First for chronically homeless individuals with alcohol problems: Within-subjects analyses of 2-year alcohol trajectories This study examined a Housing First nonabstinence-based program for chronically homeless individuals and its impact on residents' alcohol use. Researchers found a significant decrease in alcohol use and alcohol-related problems over the course of their 2-year study. They attributed this decrease not only to less difficult rules for residents to follow but also to support and encouragement shared between and among program residents.
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.
America's plague of incarceration: A plague of prisons; the epidemiology of mass incarceration in America This review of Ernest Drucker's book A Plague of Prisons: The Epidemiology of Mass Incarceration in America discusses the theme of Drucker's book, which is the significant individual and societal damage that has resulted from treating drug use as a criminal problem rather than as a public health crisis. The review also covers Drucker's recommendations for remedying this situation. Drucker discusses the need for prevention strategies including drug treatment, education, and job training; and concrete community supports to allow for reintegration upon release from prison. He also notes the need for drug law reforms and addressing of targeting of minorities and impoverished communities by law enforcement.
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.
Asset development for people with psychiatric disabilities: The essential roles of financial security in recovery The University of Illinois at Chicago's National Research and Training Center on Psychiatric Disability conducted the study described in this report. The study examined how effectively asset development programs called individual development accounts (IDAs) in combination with other support programs helped individuals with severe mental disorders to recover. Researchers conducted a literature review and provided findings from an IDA program providing general financial education to individuals with mental disorders. After highlighting the success of IDA programs for people with mental disorders and the need for increased access to such programs, researchers share recommendations for program development and future research.
Let's get real: Real Skills for people working in mental health and addiction Let's get real: Real Skills for people working in mental health and addiction is an implementation plan that works to ensure that mental health and addiction services are based on essential knowledge, skills, and attitudes that support recovery, are person-centered, and are culturally competent. Visitors to the Ministry of Health of New Zealand's Web site can download at no cost the full Let's get real implementation plan, which discusses the Let's get real framework, planned steps, and the roles of providers and organizations.
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.
Wellness and recovery through asset building services This article discusses the impact of poverty on individuals with mental disorders and the importance of financial asset building in recovery. The article discusses the wellness model, a strengths-based appoach that stresses the importance of helping individuals with mental disorders shift their own self images to that of strong, independent persons with rights. The article also describes the financial services model including ways capacity building and support help people with mental disorders to achieve financial security and independence, important aspects of their recovery journey.
Housing for people with mental illness: Update of a report to the President's New Freedom Commission This article summarizes many of the issues associated with the high rates of homelessness for individuals with mental disorders, all of which were reviewed by the Subcommittee on Housing and Homelessness of the President's New Freedom Commission. The article examines key subcommittee recommendations, as well as other topics related to preventing and responding to the issue of homelessness among people with mental disorders.
Executive Summary: Mental Health America Attitudinal Survey: Understanding of and Attitudes Towards Mental Illness This Mental Health America study examined Americans' attitudes towards mental health and substance use disorders over a 10-year span. There were a number of aspects covered in this survey such as Americans' understanding of mental disorders compared to other health conditions and participants' comfort level with interacting with someone receiving treatment for a mental or substance use disorder. Survey results from this study showed an 89 percent improvement in the way Americans view depression.
Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. This article examines research evidence that shows lesbians, gay men, and bisexuals (LGB) having higher rates of mental disorders than heterosexuals. In seeking to understand this disparity, the author has developed and presents a framework to examine the factors contributing to this increased prevalence. He suggests that minority stress, which includes prejudice and discrimination experienced or anticipated by LGBs as well as a number of other factors, makes for a hostile and stressful environment that leads to the development of mental disorders.
Gender differences in mental health In an effort to identify effective approaches to treating and preventing mental disorders, this paper examines gender differences in various mental disorders including eating disorders, schizophrenia, and depression.
Dismantling the poverty trap: Disability policy for the twenty-first century This article explores the high rate of poverty and unemployment that many individuals with disabilities experience and the role that economic reforms can play in addressing these issues. Researchers share recommendations for guiding such reforms.
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.
Substance abuse prevention dollars and cents: A cost-benefit analysis This report explores the importance of supporting substance abuse prevention programs. It analyzes substance use, including that of youth, costs of substance abuse to the country, and some potential cost savings of successful prevention programs and policies.
Poverty, social inequality and mental health In this article, researchers note the role that poverty plays in suffering and inequality around the world and explore the direct and indirect impacts of poverty. They also examine the development of emotional, behavioral, and psychiatric problems in the context of the growing disparities between rich and poor, with special emphasis on the problems experienced by children.
"Mental health is everybody's business": Roles for an intersectoral approach in South Africa This study, which involved surveys, structured interviews, and focus groups, evaluates South Africa's progress in engaging multiple sectors of society in addressing the social determinants of mental health. This study also provides recommendations for this type of collaboration to help guide other countries in these types of efforts. Study findings included the need to develop programs and make legislative changes, the importance of raising awareness in various sectors to build engagement across these sectors, and the need for an overall structured approach to action to promote and support mental health.
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 in faith communites: A training curriculum for faith leaders supporting trauma This training guide is a resource for faith leaders assisting trauma survivors who are members of their congregations. The guide discusses the nature of psychological trauma and how it impacts individuals, including the impact of trauma on one's spirituality. The guide enhances faith leaders' understanding and skills and provides information they can use to help survivors.
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.
Improving the physical health of people with serious mental illness: A systematic review of lifestyle interventions This literature review explores the quality of research in the U.S. on the topic of unmet health needs of people with mental disorders and lifestyle interventions that could improve overall health and reduce premature morbidity. Through the review, researchers were also able to summarize intervention strategies, explore various health outcomes, and assess the role that race, ethnicity, and culture played in these interventions.
Homelessness, poverty and social exclusion in the United States and Europe This paper examines high rates of homelessness across different nations in the context of various forms of social exclusion: income, wealth, housing, and incarceration. The author goes on to explain the impact that discrimination and societal choices have on homelessness across societies and identifies racial minorities and individuals with mental disorders as having the highest rates of homelessness everywhere.
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.
Social inclusion and mental health This article describes recent approaches to enhancing social inclusion for individuals with mental disorders. Specific limitations and benefits of these methods are discussed. The four approaches discussed include legislation, community-based supports/services, antidiscrimination initiatives, and system monitoring and evaluation.
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.
Recovery model: A Christian appraisal This article examines recovery from the perspective of a Christian worldview, in the context of Christian theology and psychology. The author discusses how others' negative attitudes and harmful beliefs regarding people with mental disorders can be a barrier to recovery, the concept of empowerment as being fundamental to Christian theology, and the role that key Christian concepts such as sin, grace, and redemption play in recovery from a Christian perspective. The article examines this issue including implications for individuals, communities, and providers.
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.
Social Inclusion This article discusses how public perspectives regarding individuals with mental disorders have changed since the 1960s. It describes social inclusion as a moral imperative and encourages individuals to find ways to promote and support full inclusion of people with mental disorders into their communities.
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.
Research and Practice Brief 2: Self-Determination, Beneficence, Choice, and Adherence This brief highlights the new direction of the mental and substance use disorder treatment field which is moving toward the incorporation of self-determination and increased consumer/survivor choice throughout treatment. It gives a functional definition of self-determination and explores related topics such as autonomy and rational decision-making processes. In an effort to provide direction to providers in this field, this brief offers a conceptual foundation for this transformation in services and describes the efforts of the Center on Adherence and Self-Determination (CASD) to provide guidance.
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..
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.
Mental health and inequity: A human rights approach to inequality, discrimination, and mental disability This article discusses the value in taking a human rights approach to the inequality experienced by individuals with behavioral health problems. A rights-based approach emphasizes the respect of individuals' dignity, independence, and freedom to make choices. In this article, the author explores issues of terminology, advocacy movements, and the implications of international treaties for responses to discrimination and disparities within and outside the healthcare system.
Mental health services in faith communities: The role of clergy in black churches This article discusses ways in which behavioral health needs are addressed within faith communities. Researchers discuss a number of specific factors including the role of faith leaders in behavioral health services delivery, the development of church-based programs, and models that link churches and service agencies. Barriers to effective church and agency partnerships are also discussed.
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.
Issues of access to and inclusion in behavioral health services for lesbian, gay, bisexual, transgender, questioning and intersex consumers In recognition of behavioral health disparities experienced by lesbian, gay, bisexual, transgender, questioning, and intersex (LGBTQI) individuals, this article discusses key goals of an LGBTQI initiative to reduce inequalities in behavioral health outcomes. These goals focus on prevention of mistreatment, culturally affirmative environments of care, and clinically competent behavioral health care for LGBTQI consumers. Recommendations for data collection and trainings are made and a vision is outlined for inclusion that is responsive to the needs of LGBTQI individuals.
Evidence-based practices and multicultural mental health Current trends in the behavioral health field show a significant increase in the promotion of evidence-based practices (EBPs) and requirement that they be incorporated into health and behavioral health care services. This emphasis reflects efforts to increase quality and accountability in services provided. This article not only addresses the use of EBPs and what it means for health and behavioral health services but also how they relate to better care for multicultural populations. Some key factors discussed include the history of EBPs, cultural competence and adaptations of EBPs, and recommendations for policy.
Racial Disparity in Mental Health Services: Why Race Still Matters This book explores ways in which various factors such as racial identity, substance abuse, and socioeconomic conditions relate to differences in health and behavioral health services provided to different racial groups. Throughout this book, a number of experts from different disciplines discuss how various populations, including adolescents, the elderly, and minorities in general, experience inequality in today's system. Some specific topics discussed include, culture and race in provider-client relationships, cultural competence and improving mental health in African American women, and race/ethnicity and adolescent substance abuse.
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.
Child wellness and social inclusion: Values for action This article discusses various approaches to promoting inclusion of youth through Participatory Action Research (PAR). Recognizing the immense contributions that inclusion has on wellness, researchers address specific values of social inclusion on child wellness and the action needed to implement these values.
Inclusion of people with mental health disabilities into the workplace: Accommodation as a social process This literature review discusses issues related to successful integration of people with mental health challenges into the workplace, especially the role that managers, supervisors and coworkers play in this process.
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.
Beyond the storms: Reflections on personal recovery in Devon This book is a collection of personal stories of recovery shared by individuals who have experienced behavioral health problems and emotional distress. As individuals share their journeys through recovery they describe the despair and difficulty they were confronted with, as well as the hope, endurance, triumph, and determination associated with the recovery process. This book also describes techniques and makes suggestions that readers can use to manage their own recovery such as, developing a WRAP plan, acknowledging small achievements, and taking personal responsibility.
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.
Social connectedness and health: A literature review This literature review focuses on the link between social isolation and well-being in the elderly, youth, individuals with disabilities, and the severely ill. It also provides an overview of strength-based community development strategies and the community development projects that have used these strategies.
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.
Journal of Primary Prevention "SPECIAL ISSUE: Homelessness & Mental Illness" This journal issue includes 16 articles that focus on the issues of homelessness and behavioral health problems. Articles included in this issue focus on a variety of related topics including homelessness prevention, Critical Time Intervention, homelessness among veterans, reemployment, and the role of family contact and housing stability.
Recovery and homelessness services: New directions for the field This article examines recovery and recovery-oriented care. The authors suggest recommendations for integrating recovery-oriented care into the homeless assistance network while considering how widespread certain behavioral health problems---including substance abuse, mental health problems, and traumatic disorders---are among chronically homeless individuals.
Social Inclusion for the United States This paper describes ways the concept of social inclusion is used throughout the United Kingdom and how it could be used within the United States. The paper highlights ways in which social inclusion has become a framework for addressing many social policy issues within the UK and the many dimensions of social inclusion including health, education, housing, skills, advancement, and opportunity.
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.
Recognizing work as a priority in preventing or ending homelessness This report highlights the role of employment in the lives of homeless individuals. It asserts that, in addition to traditional approaches to assisting homeless clients with resources such as affordable housing and other supportive services, employment should also be a primary focus. Researchers suggest that programs that make work a priority have the potential to help instill higher levels of motivation and hope in homeless individuals who are striving to better their lives and that these programs offer an important tool in preventing and ending homelessness. The paper describes principles, practices, and strategies to use to make employment more central to programs for homeless people.
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, social exclusion and social inclusion This article outlines a social systems approach to understanding social exclusion of people with behavioral health problems. The author notes that social exclusion and inclusion are not opposites and offers an alternative way of thinking about them both. She asserts that society needs policy initiatives to eliminate structural barriers that lead to social exclusion and to challenge negative ideas and misconceptions about people with behavioral health problems.
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 services to people who are homeless with co-occurring and mental illness and substance abuse This article details a study in which researchers contrasted outcomes for two groups of adults with co-occuring mental and substance use disorders who had been homeless. One group was in a Housing First program, the other in standard care. Housing First provides consumers with permanent, independent housing without requiring them beforehand to attain sobriety and enter treatment. Standard care requires participants to enter treatment before being placed in housing. After 48 months, researchers found no statistically significant differences in alcohol and drug use between the groups.
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.
Relationship between attitudes toward mental illness and provision of pharmacy services The goal of this research study was to compare pharmacists perceptions of people with depression with views of people with schizophrenia. Researchers also wanted to examine whether pharmacists' attitudes influenced willingness to provided services to patients with behavioral health problems. Results suggest that pharmacists' surveyed held more positive attitutes toward individuals with depression versus those with schizophrenia. Pharmacists' survey responses also suggest that they are more willing to provide services to individuals with behavioral health problems if their responses reflect that they have less negative attitudes. Minority pharmacists were more willing to provide services to patients with behavioral health problems.
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.
WHO report on mental health and development: Targeting people with mental health conditions as a vulnerable group This report from the World Health Organization asserts that people with behavioral health problems are often unfairly marginalized during development efforts around the world. To address this issue, the report emphasizes the need to consider people with behavioral health problems when planning a development agenda. Some of the recommendations include mainstreaming behavioral health services within the general health system, rebuilding behavioral health services during and after emergencies, and including people with behavioral health problems in the development process.
Towards an agenda for disability research in Europe: Learning from disabled people's organizations This policy statement from the European Research Agendas for Disability Equality (EuRADE) project makes the case for including people with disabilities at every stage of social policy research, from the planning stages to completion. The authors assert that disability must be mainstreamed in research and disability-related research must be grounded in the social model of disability. The statement notes the challenges and opportunities for integrating people with disabilities into European research and outlines ways to promote acceptance and disability equality in research.
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.
Average earnings significantly affected by serious mental illness MedWire News reports on findings of a new study showing that people with mental health problems earn significantly lower wages. The study, published in the British Journal of Psychiatry, uses survey data collected by the World Health Organization.
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.
The spirituality of imperfection This book asks readers to understand their imperfections and find positive meaning in suffering and failure. Through several stories, the book explores the idea that no one is perfect and that humans need to understand their limitations as part of life.
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.
An update on affirmative businesses or social firms for people with mental illness Affirmative businesses employ people with mental health problems at fair-market wages to provide needed services and products. The model emerged in Italy in the 1970s, subsequently spreading throughout Europe and independently appearing in North America and Asia. This article provides an overview of the affirmative business model, its development and diffusion, and its current state.
Supported employment: Randomised controlled trial This study in the United Kingdom examined the individualized placement and support (IPS) approach that has shown some success in promoting the employment of people with mental health problems in the United States. Participants from South London were randomly placed in the IPS group or the traditional vocational services group. The IPS did not outperform traditional services in this study. However, the investigators note that this may indicate that IPS was not effectively implemented in South London, not that IPS will not work in the UK.
Recovering from Illness or Recovering your Life? Implications of Clinical Versus Social Models of Recovery from Mental Health Problems for Employment Support Services This article includes seven case studies, which the authors analyze to identify the strengths and weaknesses of two mental health recovery models for employment support services (clinical and social). Based on data, the authors conclude that the social recovery model shows more promise than the clinical model. However, they note that such an approach should include consultation with mental health professionals.
Poverty, social stress & mental health This article explores the relationship between mental health problems and poverty. Specifically, the authors discuss the prevalence of mental health problems and poverty, the effect of mental health on socioeconomic status and vice versa, issues specific to women and children, and the complexities of measuring mental health and socioeconomic status.
Mental health reform in the Russian Federation: An integrated approach to achieve social inclusion and recovery This article describes a multifaceted, comprehensive approach to mental health interventions and policy reform, which included training, policy discussion, multidisciplinary collaboration, and support for nongovernmental organizations. Through a 3-year action-research project, the approach was piloted at three sites in a Russian region. Investigators found promising results, as hospital admissions decreased at two sites and the rate of readmission decreased at all sites.
Development of mental health first aid guidelines on how a member of the public can support a person affected by a traumatic event: a Delphi study This article provides guidelines for assisting a child or adult who has experienced a traumatic event in hopes of preventing potential mental health problems. The authors describe the process they used to identify these guidelines, which included conducting a literature search, developing a questionnaire, and recruiting experts to vet potential guidelines. While the resulting list would benefit from an evaluation of effectiveness, it is useful to those developing a first aid or trauma intervention curriculum and to individuals assisting survivors of trauma.
Community integration of persons with psychiatric disabilities in supportive independent housing: A conceptual model and methodological considerations This paper outlines factors that affect community integration of people with psychiatric disabilities who are living in supportive independent housing. These factors form the authors' proposed conceptual model. Grounded in this model, the authors also recommend methodology for future research in this area.
Attitudes that determine willingness to seek psychiatric help for depression: a representative population survey applying the Theory of Planned Behaviour This article explores attitudes that affect help-seeking behavior. Researchers used a telephone interview (grounded by the Theory of Planned Behavior model) with a population sample in Germany to determine attitudes that encourage help-seeking behavior and those that hinder it. They found that attitudes and beliefs affected respondents' willingness to seek help for symptoms of depression, and they suggest that as public perceptions of depression change, help-seeking behavior will also change.
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.
Public beliefs about and attitudes towards people with mental illness: a review of population studies This article reports on a review of 62 studies conducted between 1990 and 2004 that examined attitudes concerning people with mental health problems. Many of the studies were conducted in Europe. The review concluded that significant progress has been made in attitude research in psychiatry during this time period. However, much work remains to provide a sound research base for developing evidence-based interventions aimed at reducing negative perceptions and improving attitudes towards people with mental health problems.
"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.
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.
Q&A: First lady Rosalynn Carter on America's mental health crisis TIME interviewed Former First Lady Rosalynn Carter, advocate for improving the mental health system and ending the negative perceptions that keep many people from getting proper care. In the interview, Mrs. Carter comments on topics including psychiatric drugs for children and the needs of returning service members.
Within our reach: Ending the mental health crisis This book, written by former first lady Rosalynn Carter with Susan Golant and Kathryn Cade, offers an assessment of the current state of mental health. The book focuses on both the progress Mrs. Carter has seen during her 35 years of advocacy and the serious issues that must still be addressed before the mental health system can adequately meet the needs of people with mental health problems.
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 recovery: What helps and what hinders? This report covers research findings about the factors that can help consumers recover, as well as the factors that can negatively influence consumers and ultimately hinder their recovery. The researchers' long-term goal is to develop a core set of systems-level indicators to measure critical elements and processes of mental health service environments that facilitate recovery.
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.
Attitudes of mental health professionals about mental illness: A review of the recent literature Investigators identified and reviewed empirical studies of the attitudes of mental health professionals published since 2004. Most of these studies revealed overall positive attitudes among mental health professionals. However, investigators also found evidence of negative attitudes and expectations, particularly with respect to social acceptance of people with mental health problems. Results indicate a need for greater research attention to mental health professionals' views and for improved attitudes among caregivers.
Recovery in our words: A book of possibilities and hope Townsend and Griffin offer consumers a planned approach to taking control of mental health problems and interactions with treatment professionals.
Shunned: Discrimination against people with mental illness Thornicroft's book explores how negative perceptions affect the lives of people with mental health problems.
Six out of ten of Britons 'find it difficult to cope mentally' A recent survey commissioned by Together, a British mental health charity, found that 62% of British respondents report having had difficulty coping mentally at least once in their lives.
More us than them: positive depictions of mental illness on Australian television news This 2007 study reviewed television news coverage of mental health issues, including self-depictions from people with mental health problems and views expressed by mental health experts and politicians. Investigators conducted a broad-ranging content and frame analysis of mental health problems as depicted in the Australian television news media. The study supports the importance of involving people with histories of mental health problems in news coverage.
Determinants of minority mental health and wellness This compilation of articles examines social, cultural, and economic factors that impact the mental wellness of people of color in America.
The Importance of Community Development For Health and Well-Being This report examines the key role that environmental and community forces play in promoting health and preventing disease. In addition, the authors assert that social and public works programs will be more successful if people living in impacted neighborhoods are afforded the opportunity to participate in the creation and management of the initiatives that affect them.
Evaluation of a middle school mental health education program: Executive summary Wahl details his findings that the "Breaking the Silence" curriculum may help prevent the formation of negative attitudes and foster more accurate understanding and acceptance of people with psychiatric disorders among middle school aged children.
Action towards healthy living-for all This journal article suggests that remedial measures are necessary to ensure that public policies become more closely aligned with the findings of biomedical and social research regarding the key essentials of health and well-being.
Fair society, healthy lives: Strategic review of health inequalities in England post 2010 This paper describes British issues in health equity, social determinants of health, and UK-style societal interventions in both mental health and overall health with mental health playing a critical role.
EMCI think tank: Mental healthcare media blueprint This document details the recommendations from a 2008 roundtable discussion brought together leaders from entertainment, media, and mental health to discuss potential strategies to change the national dialogue regarding mental health problems.
Mental health, resilience and inequalities This report explores the evidence that mental health influences a very wide range of outcomes for individuals and communities. These include healthier lifestyles, better physical health, improved recovery from illness, fewer limitations in daily living, and other factors.
Media, Mental Health and Discrimination: A Frame of Reference for Understanding Reporting Trends This paper describes a theoretical tool to help identify negative stereotypes and inaccurate portrayals of mental health problems in media reports. The author contends that existing content analysis methodologies often miss depictions of mental health problems based on stereotypes or erroneous ideas about people with these problems.
Pathways to recovery: A strengths recovery self-help workbook This resource provides a guide to help consumers and consumer facilitators implement a mental health recovery-based approach to the management of mental health problems.
Work transitions for peer support providers in traditional mental health programs: unique challenges and opportunities. Peer support is gaining recognition as a valuable component of mental health service delivery and as a meaningful employment opportunity for mental health consumers. Despite the potential benefits of peer support, there continue to be many barriers to the development and funding of peer positions. This article reports on the results of a multisite project whose goal was to build capacity for employment of trained peer providers in local, community-based mental health programs.
Implementation of mental health parity: lessons from California. This article reports the experiences of health plans, providers, and consumers with California's mental health parity law and discusses implications for implementation of the 2008 Federal parity law.
Integrating Wellness, Recovery, and Self-management for Mental Health Consumers. Three distinct, yet interrelated, terms—wellness, recovery, and self-management—have received increasing attention in the research, consumer, and provider communities. This article traces the origins of these terms, seeking to understand how they apply, individually and in conjunction with one another to mental health consumers. They share a common perspective that is health centered rather than disease centered and that emphasizes the role of consumers, as opposed to professional providers, as the central determinants of health and well-being.
Using Situation Testing to Document Employment Discrimination Against Persons with Psychiatric Disabilities The authors of this article note that research has suggested that discrimination toward, and inaccurate perceptions of, people with mental health problems may cause people with these problems to be unemployed or underemployed. However, when this article was published, research had not yet looked closely at exclusionary and discriminatory employer behavior. In this article, the authors examine employment among people with mental health problems; review ways to determine how discrimination affects people with mental health problems on the job; and propose a new methodology, situation testing, which they write allows for a better understanding of workplace discrimination toward people with mental health challenges.
Recovering Consumers and a Broken Mental Health System in the United States: Ongoing Challenges for Consumers/ Survivors and the New Freedom Commission on Mental Health. Part I: Legitimization of the Consumer Movement and Obstacles to It. This article is the first of a two-article series that examines how multiple counteracting forces have situated the psychiatric consumer movement today, either propelling it or trying to reverse its achievements in shaping the production of mental health services. This part of the series describes how professionals came to embrace consumer/survivor perspectives, as well as attempts of oppositional forces to de-legitimize the movement's gains early in federally funded initiatives of consumer-run demonstration projects.
On our own: patient-controlled alternatives to the mental health system This seminal work written in 1978 helped inspire the mental health self-help advocacy movement. The author used her negative experiences in public and private psychiatric hospitals to imagine a system that is consumer driven and directed.
Firewalkers: Madness, Beauty & Mystery VOCAL Virginia used grant funding from SAMHSA's Campaign for Mental Health Recovery to produce a living anthology of stories of people who have experienced the turbulence of a mental health crisis. A guide to radically rethinking mental health, Firewalkers redefines mental illness as "a journey of emotional turbulence, crazy blessings, ecstatic visions, and mad gifts."
Social Inclusion as a determinant of mental health and wellbeing This Research Summary was developed as part of the VicHealth Mental Health Promotion Plan in 2005 to provide an overview of the impact of social inclusion on mental health.
Vision and Progress: Social Inclusion and Mental Health This report examines the progress of the National Social Inclusion Programme as it works to implement the activities outlined by the 2004 Mental Health and Social Exclusion Report. Details are given on the progress made so far and on the work still to be done.
Mental Health and Social Exclusion: Social Exclusion Unit Report This report examines the impact mental health problems have on increasing social exclusion. The report also developed a 27-point action plan to address this problem.
Closing the gap in a generation: Health equity through action on the social determinants of health This report examines the final findings from the World Health Organization's Commission on Social Determinants of Health.
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.
Coping With Thoughts of Suicide: Techniques Used by Consumers of Mental Health Services Suicide is a devastating public health problem, and research indicates that people with prior attempts are at the greatest risk of completing suicide, followed by persons with depression and other major mental and substance use conditions. Because there has been little direct input from individuals with serious mental illness and a history of suicidal behavior concerning suicide prevention efforts, this study examined how this population copes with suicidal thoughts.
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.
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.
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.
Social exclusion in clients with comorbid mental health and substance misuse problems A case-control study to examine aspects of social exclusion between service users who have comorbid diagnoses and those with a single diagnosis. Samples were drawn from the service users of a mental health Trust in the South-East of England, from both Adult Mental Health (n = 400) and Drug and Alcohol services (n = 190). Data were collected from Care Programme Approach assessment forms and medical records.
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.
What to do when you think an employee may need mental health help This fact sheet list the steps you should take when you think an employee may need mental health help. Steps on education, language and encouraging dialogue are dicussed.
Employment equity and mental disability Recent research on the civil rights issue of employment equity for people with psychiatric disabilities is reviewed.
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].
Genetic attribution for schizophrenia, depression, and skin cancer: Impact on social distance In this study it was predicted that both genetic attribution for illness and type of illness would be related to a desire for social distance. There was a significant interaction between illness type and genetic attribution for illness, with an increase in willingness to interact when schizophrenia was described as genetically caused and a decrease in willingness to interact when major depression was described as genetically caused.
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.
Insight and psychosis: Comparing the perspectives of patient, entourage and clinician In this study, the authors hypothesized that socio-cultural factors influence insight in patients with schizophrenia. The authors tested this hypothesis through comparison of insight in 18 triads, each composed of a patient, a family member and a clinician. The sample consisted of patients who were first diagnosed with psychosis in the last two years, and who were either immigrants from Africa or the Caribbean Islands, or Canadian born. Insight was assessed by analysis of narratives collected from patients, family members and clinicians for a research project on the negotiation of treatment.
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.
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.
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.
What's in a Name? Terms preferred by service recipients A large multi-site study examining effectiveness of consumer operated service programs as an adjunct to traditional mental health services. Researchers examined individuals' preferred term describing their status as service recipients.
Empowerment of women and mental health promotion: A qualitative study in rural Maharashtra, India The global burden of mental illness is high and opportunities for promoting mental health are neglected in most parts of the world. Many people affected by mental illness live in developing countries, where treatment and care options are limited. In this context, primary health care (PHC) programs can indirectly promote mental health by addressing its determinants i.e. by enhancing social unity, minimizing discrimination and generating income opportunities.
"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.
Association between community and client characteristics and subjective measures of the quality of housing The objective of this study was to examine the relationship between subjective perceptions of the quality of housing among mental health consumers and both client characteristics and objective measures of the client's neighborhood.
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.
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.
New York City Voices New York City Voices includes articles on many mental health topics, such as recovery from mental health and substance use challenges, support resources, wellness practices, and public policy. Authors include mental health consumers, ex-patients /survivors, family members, and mental health and substance use treatment providers. Currently in blog format, the publication was previously at a different Web site; archived issues are now available at this Web site: http://willslist.org/newyorkcityvoices_archive.
Empowerment and serious mental illness: Treatment partnerships and community opportunities Two targets of empowerment are discussed in this paper: treatment partnerships and community opportunities. Strategies that enhance treatment partnerships include provider endorsement of recovery rather than promoting an approach that suggests poor prognoses, treatment plans that are collaborative rather than unilateral decision making that is perceived as coercive, and treatment services provided in the person's community rather than geographically or psychological distant institutions.
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