https://onlinelibrary.wiley.com/doi/pdf/10.1016/j.wpsyc.2012.05.009

Peer support among persons with severe mental illnesses: A review of evidence and experience

Background: There is an increasing global commitment to recovery as the expectation for people with mental illness. There remains, however, little consensus on what recovery means in relation to me...

Recovery from versus recovery in serious mental illness: One strategy for lessening confusion plaguing recovery

The notion of recovery has become a dominant force in mental health policy, evident in reports of the Surgeon General and President's New Freedom Commission. In both reports, recovery is stipulated as the overarching goalof care and foundation for reforms at state and local levels. Little consensus exists regarding the nature of recovery in mental illness, however, or about the most effective ways to promote it. The authors offer a conceptual framework for distinguishing between various uses of the term, provide a definition of recovery in mental health. and conclude with a discussion of the implications of this concept for meaningful reform.

Recovery in Serious Mental Illness: A New Wine or Just a New Bottle?

The notion of "recovery" has recently taken center stage in guiding mental health policy and practice. However, it is not yet clear what the term means and what is to be entailed in transforming the nation's mental health system to promote it. The authors discuss the various meanings of recovery as applied to mental illness and list the top ten concerns encountered in efforts to articulate and implement recovery-oriented care. These concerns include the following: recovery is old news, recovery-oriented care adds to the burden of already stretched providers, recovery involves cure, recovery happens to very few people, recovery represents an irresponsible fad, recovery happens only after and as a result of active treatment, recovery-oriented care is implemented only through the addition of new resources, recovery-oriented care is neither reimbursable nor evidence based, recovery-oriented care devalues the role of professional intervention, and recovery-oriented care increases providers' exposure to risk and liability. These concerns are addressed through discussion of the two over-arching challenges that they pose, namely the issues of resources and risk.

The top ten concerns about recovery encountered in mental health system transformation.

Background There is evidence that the process of transition from paediatric (child) to adult health services is often associated with deterioration in the health of adolescents with chronic conditions.Transitional care is the term used to describe services that seek to bridge this care gap. It has been defined as ‘the purposeful, planned movement of adolescents and young adults with chronic physical and medical conditions from child-centred to adult-oriented health care systems’. In order to develop appropriate services for adolescents, evidence of what works and what factors act as barriers and facilitators of effective interventions is needed. Objectives To evaluate the effectiveness of interventions designed to improve the transition of care for adolescents from paediatric to adult health services. Search methods We searched The Cochrane Central Register of Controlled Trials 2015, Issue 1, (including the Cochrane Effective Practice and Organisation of Care Group Specialised Register), MEDLINE, EMBASE, PsycINFO, and Web of Knowledge to 19 June 2015. We also searched reference lists of included studies and relevant reviews, and contacted experts and study authors for additional studies. Selection criteria We considered randomised controlled trials (RCTs), controlled before- and after-studies (CBAs), and interrupted time-series studies (ITSs) that evaluated the effectiveness of any intervention (care model or clinical pathway), that aimed to improve the transition of care for adolescents from paediatric to adult health services. We considered adolescents with any chronic condition that required ongoing clinical care, who were leaving paediatric services and going on to receive services in adult healthcare units, and their families. Participating providers included all health professionals responsible for the care of young people.

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Transition of care for adolescents from paediatric services to adult health services

This article takes its inspiration from a poem by Borges, in which the author makes a plea to simply be "let in" without being wondered at or required to succeed. Based on the view that these issues have applied historically to people with mental illnesses--first during the period of the asylum, and now more recently as a result of deinstitutionalization--this article argues for the adoption of a broad conceptual framework of inclusion that, based on a disability paradigm, neither alienates or requires people to succeed. First, the ways in which such a framework augments existing approaches to treatment, rehabilitation, and recovery are outlined. Next, the authors describe the three elements of friendship, reciprocity, and hopefulness as aspects of inclusion that may provide a foundation for efforts toward recovery, and illustrate each of these elements through the stories of participants in a supported socialization program. Implications for future research and policy are suggested based on these data.

"Simply to be let in": inclusion as a basis for recovery.

Women with serious mental illness often parent without adequate support from psychiatric and behavioral health providers. The lack of such services is significant, given that women with SMI have children at the same or higher rates as women without psychiatric disabilities. In this call to action, we argue that the need to develop supported parenting initiatives for women with SMI is necessary and long overdue. First, we describe numerous social and systemic barriers in the U.S. that have hindered the development of parenting supports for women with SMI over the last century. We next describe recent qualitative and quantitative findings regarding the parenting needs and strengths of these mothers. Finally, we conclude with suggestions for future research, program development, and systems-level policy changes to support mothers with SMI in parenting most effectively.

Supported Parenting to Meet the Needs and Concerns of Mothers with Severe Mental Illness

An increasing number of studies in recent years have examined the issue of family homelessness. The majority of this research has taken a quantitative approach, focusing primarily upon the demographics and characteristics of homeless mothers and children and the conditions of shelter facilities. The goal of this study was to examine the experience of family homelessness from an alternative perspective through interviews with formerly homeless mothers about their lives before and after leaving the shelter system. In-depth interviews with 24 formerly homeless single mothers in New York City were conducted and subsequently analyzed employing a qualitative-narrative approach. Major themes that emerged from the women's life stories are elucidated: poverty, neglect, abuse, troubled interpersonal relationships, and mental health concerns. Surprisingly, a majority of women spoke of their experience in the shelter system in positive terms. This and other findings are discussed in the context of the women's life experiences and support services provided by the New York City shelter system. Social policy issues and recommendations for future research and program development are presented.

“Please Ask Me How I Am”: Experiences of Family Homelessness in the Context of Single Mothers’ Lives

To help inform the design of a self-management intervention for improving the physical health of adults with serious mental illnesses, we conducted focus groups about their perceived medical care and physical health needs. Adults with serious mental illnesses participated in four semi-structured focus groups conducted at a transitional living facility, a social club, and a Hispanic outpatient mental health clinic. Questions included their recent experiences of seeking medical care, the effect of having a mental illnesses diagnosis, strategies for active self-care, and perceived barriers to better physical health. In addition to various systemic barriers to better medical care, participants articulated limited knowledge and self-efficacy regarding active self-management of their physical health. Despite their interest in learning more about health promotion, most participants expressed a sense of personal futility and powerlessness in improving their health. These data suggest that any effort to improve the wellbeing of these adults will need to address self-efficacy in the hope of improving self-care for their physical health needs.

Thomas Styron

Papers

The top ten concerns about recovery encountered in mental health system transformation.

"Simply to be let in": inclusion as a basis for recovery.

Supported Parenting to Meet the Needs and Concerns of Mothers with Severe Mental Illness

“Please Ask Me How I Am”: Experiences of Family Homelessness in the Context of Single Mothers’ Lives

Self-efficacy and self-care: missing ingredients in health and healthcare among adults with serious mental illnesses.