Showing papers in "Psychiatric Rehabilitation Journal in 2023"

Who uses recovery colleges? Casemix analysis of sociodemographic and clinical characteristics and representativeness of recovery college students.

Abstract: OBJECTIVE Recovery Colleges support recovery for adults with mental health problems, through coproduction and education principles. This study aimed to determine whether students at three Recovery Colleges in England were representative of mental health service users. METHODS Gender, age, ethnicity, diagnosis, involuntary detention, and inpatient admission were extracted from clinical records. Data for all service user students enrolled, and those who had attended 70% of a Recovery College course were compared to mental health services caseloads, using chi-square goodness-of-fit tests. RESULTS Clinical records were identified for 1,788 students. Significant differences were identified for gender, age, and diagnosis (p < .001). In some Colleges, more students had recent inpatient admissions or involuntary detentions. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Service user students were largely representative of mental health service users, although some groups were underrepresented. Further research is needed to understand why, so that Recovery Colleges can continue to address inequalities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Pilot feasibility trial of a brief mobile-augmented suicide prevention intervention for serious mental illness.

Abstract: OBJECTIVE People with serious mental illnesses (SMIs) are at high risk for suicidal ideation and behavior, and yet few suicide prevention interventions have been customized for this group. We describe the outcomes of a pilot trial of Mobile SafeTy And Recovery Therapy (mSTART), a four-session suicide-focused cognitive behavioral intervention for SMI, designed for the transition from acute to outpatient care and augmented with ecological momentary intervention to reinforce intervention content. METHODS The primary objective of this pilot trial was to evaluate the feasibility, acceptability, and preliminary effectiveness of START. Seventy-eight people with SMI and elevated suicidal ideation were randomized to either: (a) mSTART or (b) START alone (i.e., without mobile augmentation). Participants were evaluated at baseline, 4 weeks (end of in-person sessions), 12 weeks (end of mobile intervention), and 24 weeks. The primary outcome of the study was change in suicidal ideation severity. Secondary outcomes included psychiatric symptoms, coping self-efficacy, and hopelessness. RESULTS A total of 27% of randomized persons were lost to follow-up after baseline, and engagement with mobile augmentation was variable. There was clinically significant improvement (d = 0.86) in suicidal ideation severity scores sustained over 24 weeks, with similar effects seen for secondary outcomes. Preliminary comparison indicated a medium effect size (d = 0.48) advantage at 24 weeks of mobile augmentation in suicidal ideation severity scores. Treatment credibility and satisfaction scores were high. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE START, regardless of mobile augmentation, was associated with sustained improvement in suicidal ideation severity and secondary outcomes in people with SMI at-risk for suicide in this pilot trial. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Evolution of the peer specialist role during COVID-19: Challenges and opportunities for innovation beyond the COVID-19 era.

Abstract: OBJECTIVE To examine peer specialist role-related challenges and opportunities in adapting to a new model of service provision during and beyond the COVID-19 era. METHOD This mixed-methods study analyzes data from a survey (n = 186) as well as in-depth interviews (n = 30) with certified peer specialists in Texas. RESULTS Peers described facing several challenges related to COVID-19 service delivery (e.g., fewer options for providing peer support, issues with access to reliable technology) as well as challenges related to adapting to changes to the peer role (e.g., challenges supporting people in services' community resource needs, challenges building rapport with people in services virtually). However, results also indicate that a new model of service provision during and beyond the COVID-19 pandemic presented peers with new opportunities to provide enhanced peer services, new career development opportunities, and new opportunities related to increased job flexibility. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Results suggest the importance of developing trainings on providing virtual peer support, increasing technological access for peers and individuals in services, and providing peers with flexible job options and resiliency-focused supervision. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Increasing community engagement: Skills used by adults with schizophrenia participating in a psychosocial intervention.

Abstract: OBJECTIVE We present findings from a qualitative study aimed at understanding the experiences of Veterans with schizophrenia and negative symptoms who participated in trial of an intervention to increase social and community participation called Engaging in Community Roles and Experiences (EnCoRE). Our goal was to understand what participants (N = 36) perceived they learned in EnCoRE, how participants used what they learned in their daily lives, and if and how participants built on these experiences in ways that might lead to sustained change. METHOD Our analysis approach was inductive (bottom up), drawing on interpretive phenomenological analysis (IPA; Conroy, 2003), plus some top-down examination of the role of EnCoRE elements in participants' accounts. RESULTS We identified three themes: (a) Learning skills led to increased comfort talking to people and planning activities; (b) Increased comfort led to increased confidence to try new things; and (c) The group atmosphere offered support and accountability that helped participants practice and refine new skills. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The process of learning skills, planning to use them, implementing them, and returning to the group for input helped many surmount feelings of low interest and low motivation. Our findings support having proactive discussions with patients about how building confidence can support improved social and community participation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Racial disparities in the workplace: The impact of isolation on perceived organizational support and job satisfaction.

Abstract: OBJECTIVE Prior research indicates Black employees may be particularly vulnerable to job dissatisfaction and that social support at work is a potential resource that could influence employee outcomes. This study examined racial differences in workplace social networks and support, and how these factors may contribute to perceived organizational support and, ultimately, job satisfaction among mental health workers. METHOD Using data from an all-employee survey in a community mental health center (N = 128), we assessed racial differences in social network supports, hypothesizing that Black employees would report smaller and less supportive social networks, and lower levels of organizational support and job satisfaction compared to White employees. We also hypothesized that workplace network size and support would be positively associated with perceived organizational support and job satisfaction. RESULTS Hypotheses were partially supported. Compared to Whites, Blacks had smaller workplace networks that were less likely to include supervisors, were more likely to report workplace isolation (naming no workplace social ties), and were less likely to seek advice from their social ties at work. Regression analyses showed that Blacks and employees with smaller networks were more likely to perceive lower levels of organizational support, even after controlling for background variables. However, race and network size did not predict overall job satisfaction. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE These findings suggest that Black mental health services staff are less likely to have rich, diverse workplace networks than their White colleagues, which may put them at a disadvantage in terms of accessing support and other resources. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Mental illness identity development and service utilization experiences among Asian Americans with mental illness: A qualitative study.

Abstract: OBJECTIVE Research is significantly lacking on exploring how Asian Americans with mental illness (AAMI) begin to accept their mental illness and identifying factors that might have a significant impact on mental health service utilization. To bridge the gap, this study aimed to explore mental illness identity development and service utilization experiences among AAMI using a qualitative, narration-based research design. METHOD Twenty-one AAMI participated in the semistructured interview. Interview questions were designed to assess the participants' perceived experiences of mental illness identity development, microaggression/discrimination experiences, overall positive and negative experiences when using mental health services, and suggestions to make mental health services accessible to AAMI. Thematic analysis was applied to identify key themes throughout multiple steps of coding. RESULTS Analyses yielded 13 major themes related to the following: (a) contributing factors influencing mental illness identity development, (b) contributing factors utilizing mental health services, and (c) suggestions to make mental health services more available to AAMI. More specifically, it was worth noting that family played a significant role as either a support system or a barrier to adjusting to participants' mental illness and service utilization. Participants also stated that negative attitudes toward mental illness within the Asian community hindered the development of positive self-concept and utilization of mental health services. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Findings from the present study are expected to assist service providers in implementing culturally informed practices when working with AAMI and developing effective strategies to enhance mental health literacy and service utilization. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The utility of community-based participatory research: Increasing research engagement among minoritized ethnoracial groups.

Abstract: OBJECTIVE This article conceptually examined the need for and utility of community-based participatory research (CBPR) approaches for increasing rates of engagement in psychological research among underserved minoritized ethnoracial groups. METHODS This article examined the literature for relevant studies examining rates of research engagement by minoritized ethnoracial groups, significant factors precluding research engagement, and the consequences of this disparity for mental health outcomes. The theoretical literature outlining the development and utility of alternative, community-based participatory research methods was included. Key features of CBPR were examined along with limitations of current approaches. A case study example of CBPR is provided. RESULTS The use of CBPR approaches has been documented to improve health outcomes, reduce stigma toward mental health research and treatment, and build the professional capacity of community partners, particularly among minoritized ethnoracial groups. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE CBPR engagement practices are a means of reducing the mental health research gap for ethnic and racial minoritized groups. The use of such approaches in future research and practice will directly inform how existing psychological treatments may be modified per the needs of the patient, address long standing issues of cultural mistrust toward professional institutions, and reduce mental health stigma in underserved communities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Experiences of adults from a Black ethnic background detained as inpatients under the Mental Health Act (1983).

Abstract: OBJECTIVE People from a Black ethnic (BE) background in England and Wales are disproportionately detained as inpatients under the United Kingdom's Mental Health Act (MHA). Qualitative research into the lived experiences of this group is sparse. This study, therefore, aims to explore the experiences of people from a BE background detained under the MHA. METHOD Semistructured interviews were conducted with 12 self-identified adults from a BE background who were currently detained as inpatients under the MHA. Thematic analysis was used to identify themes across the interviews. RESULTS Four themes emerged from the interviews: "Help is decided by others, not tailored to me"; "I am not a person-I am a Black patient"; "Mistreated or neglected instead of cared for"; and "Sectioning can be a space for sanctuary and support." CONCLUSIONS AND IMPLICATIONS FOR PRACTICE People from a BE background report inpatient detention to be a racist and racialized experience, inseparable from a wider context of systemic racism and inequality. Experiences of detention were also discussed in terms of stigma within BE families and communities, as well as social support that appeared to be lacking outside of the hospital. Systemic racism must be addressed across mental health care, led by the lived experiences of BE people. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Influence of multi-aspect job preference matching on job tenure for people with mental disorders in supported employment programs in Japan.

Abstract: This study examined the association between job tenure and job preference matching for five job preference domains for people with mental disorders enrolled in Individual Placement and Support (IPS) programs in Japan. The domains include occupation type, monthly income, weekly work hours, commute time, and illness disclosure.We conducted secondary analysis of participants who obtained employment in a longitudinal study during the 24-month follow-up period at 16 agencies routinely providing IPS programs. We included 112 participants who expressed job preferences and were employed at least once. A total of 130 employment cases were analyzed. Matches in the five domains were determined using participants' job preferences and employment information. The Match Level (0-5) indicates the number of domains that match the participant's job preferences. Job tenure (weeks worked) was compared between the matched and unmatched groups in each domain and between each match levels using linear regression mixed-effects models.A match for a given domain did not show a significant relationship with job tenure, whereas Match Levels 3 (B = 29.6, 95% CI [10.8, 48.4], p = .003) and 4 (B = 37.0, 95% CI [17.1, 56.9], p < .001) had a significantly longer tenure than those with Match Level 1.A higher match level may be related to a longer job tenure. The results suggest that employment specialists should prioritize clients' preferences in job searches. Further replication studies in other settings and countries should be conducted to verify the findings in this study. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Evaluating the feasibility and potential impacts of a recovery-oriented psychosocial rehabilitation toolkit in a health care setting in Kenya: A mixed-methods study.

Abstract: OBJECTIVES This pilot study evaluated the feasibility and potential impacts of delivering the Psychosocial Rehabilitation (PSR) Toolkit for people with serious mental illness within a health care setting in Kenya. METHOD This study used a convergent mixed-methods design. Participants were people with serious mental illness (n = 23), each with an accompanying family member, who were outpatients of a hospital or satellite clinic in semirural Kenya. The intervention consisted of 14 weekly group sessions of PSR cofacilitated by health care professionals and peers with mental illness. Quantitative data were collected from patients and family members using validated outcome measures before and after the intervention. Qualitative data were collected from focus groups with patients and family members, and individual interviews with facilitators, after the intervention. RESULTS Quantitative findings indicated that patients experienced moderate improvement in illness management and, in contrast to qualitative findings, family members experienced moderate worsening in attitudes toward recovery. Qualitative findings revealed positive outcomes for both patients and family members, as reflected in greater feelings of hope and mobilization to reduce stigma. Factors that facilitated participation included: helpful and accessible learning materials; committed and involved stakeholders; and flexible solutions to promote continued involvement. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE This pilot study found that delivery of the Psychosocial Rehabilitation Toolkit was feasible within a health care setting in Kenya and associated with overall positive outcomes among patients with serious mental illness. Further research on its effectiveness on a larger scale and using culturally validated measures is needed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

"Once a peer always a peer": A qualitative study of peer specialist experiences with employment following state certification.

Abstract: OBJECTIVE Peer specialists are people with lived experience of a mental health or substance use disorder who are certified to deliver peer support services under state training programs. This qualitative study explored recently certified peer specialist (CPS) experiences navigating the job market to find postcertification employment, experiences with employment once in the workforce, and reflections on CPS training. METHOD Qualitative data were collected as part of a multistate, 3-year observational prospective cohort study of CPS graduate employment trajectories. We conducted 25 in-depth, semistructured interviews with a subsample of recent CPS graduates who indicated a range of employment experiences in a survey as part of the parent study. Interviews focused on their current employment and satisfaction with the position and experiences looking for work. Data were analyzed using constant comparative methods informed by grounded theory. RESULTS Participants described factors that supported or undermined securing employment, which included a shortage of CPS positions, their professional networking skills, financial considerations, and a position's alignment with CPS values. Once employed, participants described how relationships with supervisors and coworkers, which ranged from supportive to confused about the value of the peer specialist role, impacted their work. In general, participants held their CPS training and certification in high regard. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Our findings highlight policy, employment, and practice opportunities to strengthen CPS training to improve their work readiness of graduates and expand their role, while preparing organizations and their staff to hire and work inclusively with CPSs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Reading the self-other drama of the clinical encounter: The role of literary reading and writing as a challenge for psychiatrists.

Abstract: OBJECTIVE The purpose of this article is to suggest ways in which literary practices such as reading of fiction and creative writing may be beneficial for psychiatrists in their clinical practice. METHODS Concepts from literary theory, phenomenology, and psychodynamic thinking will be used to move the therapeutic thinking of the medical paradigm beyond the dichotomic body-mind model. The ability to listen and respond to subjective and intersubjective processes, and the understanding of the dynamics and structure of the verbalized qualia will be emphasized. We will draw on our personal experiences from a pilot project applying literary techniques for psychiatrists and psychologists to improve their clinical practice. RESULTS In our analysis, we suggest a framing of the clinical encounter as a hermeneutic situation with a gradually growing scenic and poetic understanding of the texts enunciated in the therapeutic actions and of the texts being produced by the patient's mind. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE This theoretical study suggests two ways in which literary practices and concepts are highly valuable for the clinical practice of psychologists and psychiatrists. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Introduction to the special section on racial disparities in psychiatric rehabilitation services.

Abstract: Although racial disparities in psychiatric rehabilitation services are not new, the urgency of systematic approaches to address them has gained increased attention. In particular, the current social and political climate has spotlighted historically persistent and universally prevalent problems in equitable care. This special section, consisting of six studies and a Letter to the Editor, reveals the operation and impact of structural racism and highlights the need for race-conscious practice and research in psychiatric rehabilitation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

NAVIGATE Program Directors' perspectives on treatment for early psychosis.

Abstract: OBJECTIVE Since the release of the Recovery After Initial Schizophrenia Episode-Early Treatment Program results in 2015, the United States Congress expanded funding for early intervention programs and these programs now exist in every state. The purpose of the present study was to understand the real-world experience of NAVIGATE Program Directors with respect to identifying and recruiting patients with early psychosis and engaging families in treatment. METHOD Utilizing a mixed-methods sequential explanatory design, researchers surveyed 32 program directors in 13 states and engaged in 22 follow-up interviews to explore how NAVIGATE is being translated to serve individuals experiencing early psychosis and their families. RESULTS We found that program directors using the NAVIGATE model encountered difficulty identifying diagnosis at admission and that supporting families of individuals experiencing psychosis was an important aspect of the program with unique complexity. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE These findings have important implications for future mental health research on early intervention programs and may serve to stimulate future research on how early intervention mental health programs can better serve individuals recovering from psychosis and support their families. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Impact of the COVID-19 pandemic on the career development of individuals with psychiatric disabilities.

Abstract: OBJECTIVE The purpose of this preliminary exploratory study was to explore the impact of the COVID-19 pandemic on the career development of diverse individuals with psychiatric disabilities. METHODS Four hundred sixty-nine individuals with psychiatric disabilities and 147 individuals without psychiatric disabilities completed survey questions regarding their employment and educational experiences during the pandemic. We utilized chi-square analyses to explore the differences between those with and without psychiatric disabilities and between racial groups. RESULTS Our results indicated that individuals with psychiatric disabilities, especially Black, Indigenous, and other people of color (BIPOC), experienced greater employment-related uncertainty during the COVID-19 pandemic than the population without psychiatric disabilities. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Individuals with psychiatric disabilities, particularly BIPOC, need access to more stable employment and supports to maintain their employment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Introduction to the special section on community-based participatory research (CBPR) and recovery.

Abstract: Voices of people with lived experience led to a recovery-based revolution in rehabilitation practices and principles. Hence, these same voices must be included as partners in the research enterprise meant to evaluate ongoing developments in this area. Community-based participatory research (CBPR) is the one way to do this. CBPR is not really new to the rehabilitation arena; Rogers and Palmer-Erbs highlighted the paradigm shift in rehabilitation research calling for participatory action research (PAR). PAR is action-oriented and rooted in partnerships between people with lived experience, service providers, and intervention researchers. This special section briefly highlights important topics that highlight the continued need for CBPR in our research enterprise. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Meaning, recovery, and psychotherapy in light of the art of jazz.

Abstract: OBJECTIVE Psychotherapy as a practice in the field of psychiatric rehabilitation is increasingly seen as a means to promote recovery from serious mental illness (SMI). While mostly informed by mental health theory and research, art might offer profound and enduring insights to inform psychotherapy with people with SMI. In this article, we argue that jazz, a form of art which entails both structure and improvising, may enrich and broaden clinicians' abilities to facilitate meaning-making with clients to promote recovery. METHOD Through the literature review and theoretical synthesis, we explore how jazz may be a space where specific processes can be observed and accordingly guide psychotherapy focused on subjective forms of recovery. RESULTS We argue that jazz offers a space to see how timing, risk-taking, the ability to be simultaneously inside and outside an activity, and support for the process of tension and release can inform and inspire the process of improvisation within psychotherapy. CONCLUSION AND IMPLICATIONS FOR PRACTICE Jazz offers a creative framework which can help clinicians observe and facilitate recovery processes in psychotherapy. The perspective of jazz in the therapeutic arena of psychiatric rehabilitation emphasizes the potential of the arts and humanities to continue to enrich our understanding and guide our teaching and training. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The power of community-based participatory research (CBPR).

Abstract: OBJECTIVE Community-based participatory research (CBPR) is based on power as fundamental to doing research. It evolved as a way of "knowing" from the broader idea of natural science. While previously viewed as objective, natural science is now understood as, at least, partially socially constructed. METHOD History of research and epistemology is reviewed in terms of science. More specifically, we delve into science as social construction and how this conceptually opens the door to considering power in its processes. We then unpack CBPR as one way to do mental health research that artfully weaves power into method. RESULTS Natural science has evolved from believing scientism (i.e., the scientific method) is sufficient to describe physical and social phenomena to terms of social constructivism; namely, the social processes that impact investigators are necessary to understand science and its product. This highlights the role of power; namely, investigator choices about hypotheses, methods, analyses, and interpretations influence the products of individual studies. The recovery movement is the embodiment of power that significantly changed research and rehabilitation in mental health. CBPR has emerged to include people with lived experience in the research enterprise. CBPR is partnership among people with lived experience, health scientists, and service providers in all facets of doing research. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Integrating CBPR into rehabilitation science has led to findings and actions that better serve community objectives. Continuing to weave CBPR into research and development will further enhance recovery in practice. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Supporting equitable engagement and retention of women patients in a trauma-informed virtual mental health intervention: Acceptability and needed adaptations.

Abstract: OBJECTIVE This study examines barriers and facilitators to participation in webSTAIR, a telemental health program providing virtual coaching sessions for veterans with posttraumatic stress disorder (PTSD) and depression symptoms, among women veterans from racial and ethnic minority groups. METHOD Using qualitative interviews (n = 26), we compared women veterans from racial and ethnic minority groups who completed (completers; n = 16) and did not complete (noncompleters; n = 11) webSTAIR at rural-serving facilities in the Veterans Health Administration (VA). Interview data were analyzed using rapid qualitative analysis. Chi-square and t tests assessed differences between completers and noncompleters by sociodemographic characteristics and baseline PTSD and depression symptomatology. RESULTS There were no statistically significant sociodemographic differences at baseline between completers and noncompleters; completers reported significantly higher baseline PTSD and depression symptomatology. Noncompleters were more likely to describe feeling angry, depressed, and unable to control their environments during participation in the program as barriers to webSTAIR completion. Completers, despite higher symptomatology, cited internal motivation and support from concurrent mental health services as facilitators. Both groups made recommendations for how VA can better support women veterans from racial and ethnic minority groups, including providing space for peer support and community building, addressing stigma associated with seeking mental health services and fostering mental health provider diversity and retention. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Although previous research has identified racial and ethnic disparities in PTSD treatment retention, mechanisms to improve retention have been unclear. Women veterans from racial and ethnic minority groups should be collaboratively engaged in the design and implementation of telemental health programs for PTSD to improve equitable retention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Social functioning mediates the relationship between psychiatric symptoms and recovery among veteran and community service users with serious mental illness.

Abstract: OBJECTIVE Previous research has established the impact of psychiatric symptoms on social functioning, while there is a paucity of research examining how social functioning relates to personal recovery, an individual's self-assessment of their mental health recovery. This study examined the mediating effect of social engagement, interpersonal communication, and satisfaction with support in the relationship between distinct psychiatric symptom clusters and perceived mental health recovery. METHODS In a cross-sectional study, both patient self-report and provider assessment data were collected for 250 patients with serious mental illness (SMI) across four mental health service sites. Parallel mediation analytic models were used. RESULTS Interpersonal communication partially mediated the relationship between positive and negative symptom clusters and personal recovery. Satisfaction with social supports partially mediated the relationship between excited symptoms and personal recovery. Both interpersonal communication and satisfaction with social supports partially mediated the relationship between general psychological distress and depressive symptoms and personal recovery. Collectively, social functioning mediators explained nearly half of the relationship between general psychological distress and excited symptoms and personal recovery and nearly all of the relationship between positive symptoms and personal recovery. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Clinical providers working with persons with SMI should regularly assess social functioning in addition to assessing psychiatric symptoms and personal recovery factors and should incorporate social skills education into SMI group and individual treatments. Social functioning as a target of treatment may be especially beneficial for patients who are dissatisfied with other interventions or feel they have experienced the maximum benefit from treatment and are seeking additional methods to support personal recovery. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Overpolicing people with serious mental health conditions: Considering racialized trauma for trauma-informed psychiatric rehabilitation services.

Abstract: OBJECTIVE We call for the psychiatric rehabilitation field to assess overpolicing as racialized trauma via a targeted universal trauma screening to provide trauma-informed rehabilitation services. METHODS We examine the overpolicing of low-level, nonviolent activities and offenses through frequent stops, tickets, and arrests of disproportionately those who have mental health conditions and are Black, Indigenous, and people of color. These police interactions can produce traumatic responses and exacerbate symptoms. Assessing and responding to overpolicing is vital for psychiatric rehabilitation to provide trauma-informed services. RESULTS We present preliminary practice data using an expanded trauma exposure form with racialized trauma, such as police harassment and brutality, that is absent from validated screenings. From this expanded screening, the majority of participants reported undisclosed racialized trauma. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE We recommend the field devote practice and research to racialized trauma and policing and the lasting effects to support trauma-informed services. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

When mental health care is stigmatizing: A participative study in schizophrenia.

Abstract: OBJECTIVES Mental health care has been identified as a major source of mental illness stigmatization. Detailed information about these stigmatization experiences is thus needed to reduce stigma in mental health practices. The study aimed to (a) identify the most relevant stigmatizing situations in mental health care encountered by users with schizophrenia and their families; (b) characterize the relative importance of these situations in terms of frequency, experienced stigmatization, and associated suffering; and (c) identify contextual and individual factors associated with these experiences. METHOD An online survey was conducted in France among users and family members to characterize situations of stigmatization in mental health care and identify associated factors. The survey content was first developed from a participative perspective, through a focus group including users. RESULTS A total of 235 participants were included in the survey: 59 participants with schizophrenia diagnosis, 96 with other psychiatric diagnoses, and 80 family members. The results revealed 15 relevant situations with different levels of frequency, stigmatization, and suffering. Participants with a diagnosis of schizophrenia experienced more situations of stigmatization, with a higher frequency. Moreover, contextual factors were strongly associated with experienced stigmatization, including recovery-oriented practices (negatively associated) and measures without consent (positively associated). CONCLUSIONS AND IMPLICATIONS FOR PRACTICE These situations, as well as associated contextual factors, could be targeted to reduce stigmatization and related suffering in mental health practices. Results strongly underscore the potential of recovery-oriented practice as an instrument to fight stigma in mental health care. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Assessment of self-determination in mental health: A new application field of the AUTODDIS scale.

Abstract: OBJECTIVE Self-determination enhances well-being and quality of life. It is also considered a fundamental pillar in improving the efficacy of interventions used to treat people with severe mental disorders (SMD). Yet the assessment of self-determination in relation to mental health requires further research. The aim of this study was to analyze the adequacy and psychometric properties of the AUTODDIS scale in a Spanish population with SMD. METHOD The scale was originally developed and validated to assess self-determination in people with intellectual disability. The scale was administered to a sample of 333 adults with SMD (M = 47.6 years, SD = 11.68), most of whom were receiving treatment in an outpatient setting or at long-stay care facilities in six specialized centers in Spain. RESULTS The quality of the items and the reliability of the scale and its subscales were analyzed. External validity was also explored, and confirmatory factor analysis was used to analyze the fit of the data to different models. The results indicate that the scale demonstrated sufficient evidence of reliability and validity, supporting the adequacy of its use in the field of mental health. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The use of this scale as a tool to assess self-determination and its domains in the mental health field is warranted. The article also discusses the need for more research and assessment tools to facilitate decision making by clinical and organizational stakeholders in promoting self-determination. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Fostering the community participation of individuals with psychiatric disabilities: Effectiveness of a new peer-led photovoice-based intervention.

Abstract: OBJECTIVE Having meaningful social roles and full community participation have been examined as a central tenet of the recovery paradigm. We undertook this study to test a new multimodal, peer-led intervention, which we have developed with the aim of fostering the self-efficacy of individuals with psychiatric disabilities to pursue involvement in community activities of their choice. METHOD We evaluated the effectiveness of the 6-month manualized peer-delivered "Bridging Community Gaps Photovoice (BCGP)" program with a multisite randomized trial (N = 185), with recipients of services at five community mental health programs. Mixed-effects regression models were used to examine the impact of the program on community participation, loneliness, personal stigma, psychosocial functioning, and personal growth and recovery when compared to services as usual. Individuals who were randomized to the BCGP intervention were also invited to participate in exit focus groups, exploring the program's perceived active ingredients of mechanisms of impact. RESULTS Participation in the BCGP program facilitated ongoing involvement in community activities and contributed to a decreased sense of alienation from other members of the community due to internalized stigma of mental illness. In addition, greater attendance of group BCGP sessions had a significant impact on participants' sense of self-efficacy in pursuing desired community activities. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE This study provided initial evidence about the promise of the BCGP program in enhancing community participation. Its implementation in community mental health agencies can further expand the recovery-oriented services provided to people with psychiatric disabilities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Antiracism and mental health recovery: Bridging the gap to improve health disparities among veteran populations.

Abstract: Viewing the Substance Abuse and Mental Health Services Administration's recovery principles through an antiracist lens has guided the authors' vision of recovery-oriented systems for all. In this brief letter, they present some considerations arising from their application of recovery principles to areas affected by racial bias. They are also identifying best practices for incorporating micro and macro antiracism efforts into recovery-oriented health care. These are important steps in promoting recovery-oriented care, but there is much more to do. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Self-stigma among people with serious mental illnesses: The use of focus groups to inform the development of a brief video intervention.

Abstract: OBJECTIVE People with mental illnesses may avoid or delay treatment due to a fear of labeling and discrimination, a phenomenon known as self-stigma. Self-stigma is a major barrier to care and creates obstacles to pursuing employment, independent living, and a fulfilling social life. We aimed to gather input from people with lived experience of mental illness to develop a social-contact-based, brief video-based intervention to reduce self-stigma. METHOD Two (n = 12) focus groups were conducted to inform video content and led to the creation of a script and brief video using a professional actor, who described a story of living with schizophrenia while focusing on symptoms, personal struggles, and recovery. Two (n = 9) additional focus groups were held after video development to gather feedback and suggested edits. Focus group transcripts were analyzed using thematic content analysis. RESULTS Themes emerging in prevideo development included the negative effects of being diagnosed with severe mental illnesses, being stereotyped, the value of relatable recovery stories and seeing the person as a whole, and the utility of focusing on symptoms and experiences rather than diagnosis-specific language. Feedback in the postvideo focus groups was mainly favorable and resulted in edits related to language about "responsibility" and a disclaimer about using a professional actor. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE While participants' experiences of stigma are consistent with extant literature, this is the first study to elicit the perspectives of people living with mental illnesses in developing a video intervention to reduce self-stigma. Studies are needed to examine the efficacy of these videos in reducing self/public stigma. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Explaining job satisfaction among mental health peer support workers.

Abstract: OBJECTIVE Peer support practice has seen exponential growth during the past several decades. While there exists a body of research on job satisfaction among this emerging workforce, many studies had limited sample sizes and demographic diversity and focused on few facets of job satisfaction. The present study examines multiple factors associated with job satisfaction and compensates for limitations of previous smaller studies. METHODS A convenience/snowball sample of 645 peer support staff was recruited via National Association of Peer Supporters and Academy of Peer Services listservs. Eligible participants were at least 18 years of age, currently employed for a minimum of 6 months, and residing in one of the 50 states or one of U.S. territories. Global and multidimensional facets of job satisfaction were measured using the Indiana Job Satisfaction Survey. RESULTS Data from an anonymous online survey were analyzed using hierarchical linear regression. The main hypothesis was supported; coworker support, perceived organizational support, supervisor support, and job empowerment explained 71% of the variance in overall job satisfaction, Adj R² = 0.71, F(9, 271) = 77.77, p < .01, with age and status as a certified peer specialist significant contributors. Perceived organizational support and job empowerment explained most variance in overall job satisfaction. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE As this workforce continues to burgeon, it is crucial to promote peer support values, role clarity, certification, diversity, and optimal organizational and empowerment resources to sustain a satisfied and effective peer support workforce. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Meaningful goal setting: Practitioners' perspectives on goal setting in the illness management and recovery program.

Abstract: OBJECTIVE The aim of our study was to gain insight into how practitioners in mental health care support people with severe psychiatric disabilities in setting and pursuing personal goals that are meaningful to them. METHOD We conducted focus groups with 36 mental health practitioners in Norway and interpreted the data by using reflexive thematic analysis. RESULTS Four themes emerged from the analysis: (a) active collaboration to understand what is meaningful to the individual, (b) being nonjudgmental during the process of goal setting, (c) helping individuals break goals into smaller goals and steps, and (d) allowing time for the process of trying to achieve goals. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Although goal setting is central to the Illness Management and Recovery program, practitioners perceive the work as quite demanding. To succeed, practitioners need to acknowledge goal setting as a long-lasting and shared process, not as a means to an end. As people with severe psychiatric disability often need help in goal setting, practitioners should play an important role in supporting them in setting goals, making plans for achieving them, and taking actual steps in that direction. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Supported education for students with psychiatric disabilities: A systematic review of effectiveness studies from 2009 to 2021.

Abstract: OBJECTIVE For more than a decade, an increase in psychiatric disabilities has been reported worldwide among students in postsecondary education. Supported Education (SEd) interventions support students with psychiatric disabilities to return to or remain in education. As not much is known about the effectiveness of SEd, we conducted a systematic review of the research on the effects of SEd on educational functioning, including study success and student satisfaction. METHOD The EBSCOhost Complete browser (e.g., ERIC, MEDLINE, PsycARTICLES, PsycINFO, SocINDEX) was used to search for peer-reviewed studies representing effectiveness data on SEd published in English or Dutch/Flemish between 2009 and 2021. The quality of the research was assessed for all studies included. RESULTS A total number of seven studies were eligible. The results indicated a positive impact of SEd on the educational functioning (e.g., educational attainment, grade point average, comfort with the student role) of students with psychiatric disabilities. In addition, effects on time spent on educational activities, interpersonal skills, and sustained attention/vigilance were found. The quality of the studies appeared to be moderate. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The limited available evidence suggests the added value of SEd interventions for the educational functioning of students with psychiatric disabilities. Reviewing the effectiveness of SEd was difficult due to differences in the SEd interventions used, the generally small research populations, and differing research designs. To improve the quality of research on this subject, future studies should overcome the identified shortcomings. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Predictors of employment for transition-aged youth with co-occurring substance use disorder and psychiatric disorder in the state vocational rehabilitation service-delivery system.

Abstract: OBJECTIVE To identify state vocational rehabilitation (VR) services that were associated with employment for transition-aged youth with co-occurring disabilities (TAYWCD). METHOD Hierarchical logistic regression analyses were utilized. Participants were 830 youth aged 24 and younger who had a co-occurring substance use disorder and another mental illness. RESULTS After controlling for the effect of demographic covariates, assessment services (OR = .53, 95% CI [.35, .80], p < .01), job placement services (OR = 2.56, 95% CI [1.73, 3.78], p < .001), and supported employment services (OR = 3.7, 95% CI [2.33, 5.89], p < .001) were found to significantly impact employment outcomes. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE State VR services that aligned with the individual placement and support model of supported employment principles were correlated with successful employment outcomes for TAYWCD who received these services. Recommendations include the following: (a) prepare VR counselors to effectively work with individuals with psychiatric disabilities; (b) provide TAYWCD with high-quality assessment and the individual placement and support model of supported employment services; (c) require VR counselors who serve TAYWCD to collaborate with community partner agencies that provide coordinated specialty care model services; (d) require VR counselors to collaborate with community partner agencies that provide recovery-oriented and evidence-based services; (e) encourage clients to formulate a Wellness Recovery Action Plan (WRAP) as a state VR assessment and Individualized Plan for Employment planning service; (f) include the state VR on-the-job training service in the Individualized Plan for Employment; (g) make use of benefits counseling services; and (h) institute in-service learning opportunities in state VR agencies. (PsycInfo Database Record (c) 2023 APA, all rights reserved).