scholarly journals Glucose Control and Medication Adherence Among Veterans With Diabetes and Serious Mental Illness: Does Collocation of Primary Care and Mental Health Care Matter?

Diabetes Care ◽  
2014 ◽  
Vol 37 (8) ◽  
pp. 2261-2267 ◽  
Author(s):  
Judith A. Long ◽  
Andrew Wang ◽  
Elina L. Medvedeva ◽  
Susan V. Eisen ◽  
Adam J. Gordon ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Illness ◽  
Medication Adherence ◽  
Mental Health Care ◽  
Serious Mental Illness ◽  
Glucose Control

scholarly journals Evaluating agency-led adaptions to an evidence-based lifestyle intervention for adults with serious mental illness

2020 ◽  
Vol 1 ◽  
pp. 263348952094320
Author(s):  
Kelly A Aschbrenner ◽  
Gary R Bond ◽  
Sarah I Pratt ◽  
Kenneth Jue ◽  
Gail Williams ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Serious Mental Illness ◽  
Real World ◽  
Evidence Based ◽  
Cardiovascular Risk Reduction ◽  
Evidence Based Practices ◽  
Practical Advantage

Background: Limited empirical evidence exists on the impact of adaptations that occur in implementing evidence-based practices (EBPs) in real-world practice settings. The purpose of this study was to measure and evaluate adaptations to an EBP (InSHAPE) for obesity in persons with serious mental illness in a national implementation in mental health care settings. Methods: We conducted telephone interviews with InSHAPE provider teams at 37 (95%) of 39 study sites during 24-month follow-up of a cluster randomized trial of implementation strategies for InSHAPE at behavioral health organizations. Our team rated adaptations as fidelity-consistent or fidelity-inconsistent. Multilevel regression models were used to estimate the relationship between adaptations and implementation and participant outcomes. Results: Of 37 sites interviewed, 28 sites (76%) made adaptations to InSHAPE ( M = 2.1, SD = 1.3). Sixteen sites (43%) made fidelity-consistent adaptations, while 22 (60%) made fidelity-inconsistent adaptations. The number of fidelity-inconsistent adaptations was negatively associated with InSHAPE fidelity scores (β = −4.29; p < .05). A greater number of adaptations were associated with significantly higher odds of participant-level cardiovascular risk reduction (odds ratio [ OR] = 1.40; confidence interval [CI] = [1.08, 1.80]; p < .05). With respect to the type of adaptation, we found a significant positive association between the number of fidelity-inconsistent adaptations and cardiovascular risk reduction ( OR = 1.59; CI = [1.01, 2.51]; p < .05). This was largely explained by the fidelity-inconsistent adaptation of holding exercise sessions at the mental health agency versus a fitness facility in the community (a core form of InSHAPE) ( OR = 2.52; 95% CI = [1.11, 5.70]; p < .05). Conclusions: This research suggests that adaptations to an evidence-based lifestyle program were common during implementation in real-world mental health practice settings even when fidelity was monitored and reinforced through implementation interventions. Results suggest that adaptations, including those that are fidelity-inconsistent, can be positively associated with improved participant outcomes when they provide a potential practical advantage while maintaining the core function of the intervention. Plain language abstract: Treatments that have been proven to work in research studies are not always one-size-fits-all. In real-world clinical settings where people receive mental health care, sometimes there are good reasons to change certain things about a treatment. For example, a particular treatment might not fit well in a specific clinic or cultural context, or it might not meet the needs of specific patient groups. We studied adaptations to an evidence-based practice (InSHAPE) targeting obesity in persons with serious mental illness made by teams implementing the program in routine mental health care settings. We learned that adaptations to InSHAPE were common, and that an adaptation that model experts initially viewed as inconsistent with fidelity to the model turned out to have a positive impact on participant health outcomes. The results of this study may encourage researchers and model experts to work collaboratively with mental health agencies and clinicians implementing evidence-based practices to consider allowing for and guiding adaptations that provide a potential practical advantage while maintaining the core purpose of the intervention.

Perceived Barriers to Medical Care and Mental Health Care Among Veterans With Serious Mental Illness

2008 ◽  
Vol 59 (8) ◽  
pp. 921-924 ◽  
Author(s):  
Amy L. Drapalski ◽  
Jaime Milford ◽  
Richard W. Goldberg ◽  
Clayton H. Brown ◽  
Lisa B. Dixon
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Medical Care ◽  
Serious Mental Illness ◽  
Perceived Barriers

scholarly journals Creating Primary Care Access for Mental Health Care Clients in A Community Mental Health Setting

2008 ◽  
Vol 27 (2) ◽  
pp. 129-138 ◽  
Author(s):  
Tamison Doey ◽  
Pamela Hines ◽  
Bonnie Myslik ◽  
JoAnn Elizabeth Leavey ◽  
Jamie A. Seabrook
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Health Care Services ◽  
Primary Care Clinic ◽  
Health Clinic ◽  
Care Clinic ◽  
Mental Health Association

Successful support of persons living with a mental illness in the community is challenged by the lack of primary care accessible to this population. The Canadian Mental Health Association–Windsor Essex County Branch explored options to provide mental and physical health care, initially creating an integrated primary care clinic and later a larger community health clinic co-located with its mental health care services and staffed by a multidisciplinary team. A retrospective review of 805 charts and a client satisfaction survey were conducted in 2001 to evaluate this service. Findings indicate that access to primary care and mental health care co-located at a community-based clinic has reduced the number of emergency room visits and admissions, and length of stay in hospital, for individuals with moderate to serious mental illness. A client survey in January 2008 supports these preliminary findings.

Acceptance and the Recovery Paradigm in Mental Health Care

2016 ◽  
pp. 17-36
Author(s):  
Lauren Mizock ◽  
Zlatka Russinova
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Serious Mental Illness ◽  
Well Being ◽  
Personal Recovery ◽  
Recovery Processes ◽  
Recovery Movement ◽  
Mental Illness Treatment

Chapter 2 offers an overview of the recovery movement in the provision of mental health care for serious mental illness. Within the recovery movement in mental illness treatment, recovery is understood as a process of living a satisfying life of well-being and autonomy, as opposed to mere symptom elimination. Early theory of the recovery paradigm is outlined, highlighting the process of acceptance of serious mental illness within this model. Applications of the recovery paradigm to mental health care are discussed, as well as the various types of recovery from a serious mental illness. Acceptance is examined as the neglected paradox of recovery. Other parts of the chapter include discussion questions, activities, the “Personal Recovery Processes Worksheet,” and diagrams.

Mental illness management in corrections

2015 ◽  
Author(s):  
Charles L. Scott ◽  
Brian Falls
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Community Mental Health ◽  
Mental Health Care ◽  
Serious Mental Illness ◽  
The United States ◽  
Revolving Door ◽  
Community Settings ◽  
Correctional Systems

An increasing number of individuals with mental illness are now treated in correctional environments instead of community settings. In the incarcerated population, prevalence estimates of serious mental illness (SMI) range from 9 to 20% compared to 6% in the community. More astonishingly, over three times more persons with serious mental illness in the United States are located in jails and prisons than in hospitals. It was not always like this. How did U.S. correctional systems become de facto mental health institutions for so many? Scholars point to a number of reasons for the increasing prevalence of mental illness among incarcerated individuals, including deinstitutionalization and limited community resources, prominent court decisions and legislative rulings, and the ‘revolving door’ phenomenon. There are many similarities between correctional and community mental health care services. Both systems typically provide appropriate medications, emergency care, hospitalization, medication management, and follow-up care. However, key differences often exist in correctional systems, including restricted formularies due to concerns of medication abuse or cost, alternative involuntary medication procedures, restricted access by visitors, and the inability of mental health providers to control the treatment environment. This chapter summarizes the historical context of correctional versus community mental health; factors resulting in the increasing management of people with mental illness in correctional settings; and similarities and differences between the provision of mental health care in correctional versus community settings.

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