Psychiatric rehabilitation

About: Psychiatric rehabilitation is a research topic. Over the lifetime, 1775 publications have been published within this topic receiving 35961 citations. The topic is also known as: psychosocial rehabilitation.

Recovery from mental illness: The guiding vision of the mental health service system in the 1990s.

Abstract: he implementation of deinstitutionalization in the 1960s and 1970s, and the increasing ascendance of the community support system concept and the practice of psychiatric rehabilitation in the 1980s, have laid the foundation for a new 1990s vision of service delivery for people who have mental illness. Recovery from mental illness is the vision that will guide the mental health system in this decade. This article outlines the fundamental services and assumptions of a recovery-oriented mental health system. As the recovery concept becomes better understood, it could have major implications for how future mental health systems are designed. The seeds of the recovery vision were sown in the aftermath of the era of deinstitutionalization. The failures in the implementation of the policy of deinstitutionalization confronted us with the fact that a person with severe mental illness wants and needs more than just symptom relief. People with severe T CHANGING TOWARD THE FUTURE

A meta-analysis of cognitive remediation in schizophrenia

Abstract: Objective: This study evaluated the effects of cognitive remediation for improving cognitive performance, symptoms, and psychosocial functioning in schizophrenia. Method: A meta-analysis was conducted of 26 randomized, controlled trials of cognitive remediation in schizophrenia including 1,151 patients. Results: Cognitive remediation was associated with significant improvements across all three outcomes, with a medium effect size for cognitive performance (0.41), a slightly lower effect size for psychosocial functioning (0.36), and a small effect size for symptoms (0.28). The effects of cognitive remediation on psychosocial functioning were significantly stronger in studies that provided adjunctive psychiatric rehabilitation than in those that provided cognitive remediation alone. Conclusions: Cognitive remediation produces moderate improvements in cognitive performance and, when combined with psychiatric rehabilitation, also improves functional outcomes.

Supported employment: evidence for an evidence-based practice

Abstract: Supported employment for people with severe mental illnesses is an evidence-based practice, based on converging findings from 4 studies of the conversion of day treatment to supported employment and 9 randomized controlled trials comparing supported employment to a variety of alternative approaches. These two lines of research suggest that between 40% and 60% of consumers enrolled in supported employment obtain competitive employment while less than 20% of similar consumers do so when not enrolled in supported employment. Consumers who hold competitive jobs for a sustained period of time show benefits such as improved self-esteem and better symptom control, although by itself, enrollment in supported employment has no systematic impact on nonvocational outcomes, either on undesirable outcomes, such as rehospitalization, or on valued outcomes, such as improved quality of life. The psychiatric rehabilitation field has achieved consensus on a core set of principles of supported employment, although efforts continue to develop enhancements. A review of the evidence suggests strong support for 4 of 7 principles of supported employment, while the evidence for the remaining 3 is relatively weak. Continued innovation and research on principles is recommended.

A Behavioral Weight-Loss Intervention in Persons with Serious Mental Illness

Abstract: Background Overweight and obesity are epidemic among persons with serious mental illness, yet weight-loss trials systematically exclude this vulnerable population. Lifestyle interventions require adaptation in this group because psychiatric symptoms and cognitive impairment are highly prevalent. Our objective was to determine the effectiveness of an 18-month tailored behavioral weight-loss intervention in adults with serious mental illness. Methods We recruited overweight or obese adults from 10 community psychiatric rehabilitation outpatient programs and randomly assigned them to an intervention or a control group. Participants in the intervention group received tailored group and individual weight-management sessions and group exercise sessions. Weight change was assessed at 6, 12, and 18 months. Results Of 291 participants who underwent randomization, 58.1% had schizophrenia or a schizoaffective disorder, 22.0% had bipolar disorder, and 12.0% had major depression. At baseline, the mean body-mass index ...

Housing First Services for People Who Are Homeless With Co-Occurring Serious Mental Illness and Substance Abuse:

Abstract: The literature on homeless adults with severe mental illness is generally silent on a critical issue surrounding service delivery—the contrast between housing first and treatment first program philosophies. This study draws on data from a longitudinal experiment contrasting a housing first program (which offers immediate permanent housing without requiring treatment compliance or abstinence) and treatment first (standard care) programs for 225 adults who were homeless with mental illness in New York City. After 48 months, results showed no significant group differences in alcohol and drug use. Treatment first participants were significantly more likely to use treatment services. These findings, in combination with previous reports of much higher rates of housing stability in the housing first group, show that “dual diagnosed” adults can remain stably housed without increasing their substance use. Thus, housing first programs favoring immediate housing and consumer choice deserve consideration as a viable ...