RESUMEN
As rates of substance use and mental disorders continue to rise, individuals with mental health and substance use challenges and their supporters could benefit from practical, accessible, cost-effective, wellness-focused tools outlining simple daily strategies to promote long-term recovery. The current article describes such a tool, the Journey to Wellness Guide, based on the Wellness Model, and developed through a co-production process. Co-production refers to a process of research, service design, and educational materials development where people with lived experience of mental health and/or substance use challenges share decision-making power throughout all stages of production, including the sharing of results. The co-production process resulted in a well-received wellness tool and tip guides for personal use, supporting others, and use in a group context. The value of this tool for psychosocial nursing and behavioral health care worker self-care and practice is outlined. [Journal of Psychosocial Nursing and Mental Health Services, 61(9), 24-30.].
Asunto(s)
Trastornos Mentales , Servicios de Salud Mental , Enfermería Psiquiátrica , Humanos , Trastornos Mentales/terapia , Trastornos Mentales/psicología , Salud Mental , AutocuidadoRESUMEN
The need for behavioral health care prevention, treatment, and recovery supports, including crisis alternatives, has grown and is now receiving federal support through enhanced funding. When a person experiences severe emotional distress, crisis alternatives are a viable option instead of inpatient hospitalization to address the distress and restore balance. Peer respite programs are voluntary, short-term, crisis alternatives for people experiencing mental distress. Models have evolved in response to funding and regulatory requirements, yet research is limited. The current article describes a unique peer-led program, Wellness Respite, in operation for 7 years, including data from recent satisfaction surveys and the role of nurses in the program. Implications of a home-like, short-term crisis alternative and the role of the nurse are emphasized. [Journal of Psychosocial Nursing and Mental Health Services, 60(11), 26-32.].
Asunto(s)
Trastornos Mentales , Servicios de Salud Mental , Enfermería Psiquiátrica , Humanos , Cuidados Intermitentes , Trastornos Mentales/psicología , Promoción de la SaludRESUMEN
OBJECTIVE: Little is known about the employment experiences of people with preexisting behavioral health conditions during the coronavirus disease of 2019 (COVID-19) pandemic, despite the recognized importance of work for this group. METHOD: Two hundred and seventy two adults with behavioral health conditions, recruited through statewide mental health networks in NJ and NY, completed an online survey in April-May 2020. Multivariable analysis examined the effects of sleep and dietary changes, COVID-19 exposure, anxiety (Generalized Anxiety Disorder-2), and depressive symptoms (Patient Health Questionnaire-2) on employment status and job changes. Respondents' open-ended descriptions of pandemic-related changes in employment were analyzed using the constant comparative method. RESULTS: Two-thirds (65%) were employed, only 4% became unemployed, and 29% reported changes in their jobs as a result of the pandemic. In logistic regression analysis controlling for age, race, education and gender, workers were more likely than nonworkers to report altered eating and sleeping habits, but not greater anxiety or depression. However, those whose jobs changed were more likely to report COVID-19 exposure, altered sleep patterns, clinically significant anxiety symptoms, and both anxiety and depressive symptoms compared to those whose jobs had not changed. Qualitative analysis revealed work's positive impact (pride in job performance, using new skills, feeling safer working from home) and its negative effects (lifestyle disruption, worry about job security, isolation from coworkers). CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: This is the first study to suggest the important role that work played for people with preexisting behavioral health disorders during the pandemic, with both positive and negative influences, and important implications for services and supports. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Asunto(s)
Trastornos de Ansiedad , COVID-19 , Depresión , Empleo , Pandemias , Adulto , Trastornos de Ansiedad/epidemiología , COVID-19/psicología , Depresión/epidemiología , HumanosRESUMEN
People with behavioral health disorders may be particularly vulnerable to the impact of the COVID-19 pandemic, yet little is known about how they are faring. A mixed-methods, anonymous needs assessment was conducted to understand changes in the lives of adults with mental health and substance use disorders since the pandemic onset. A cross-sectional, online survey was completed by 272 adults in April and May 2020, recruited from statewide networks of community programs in New Jersey and New York. Measures included the Patient Health Questionnaire-2 and the Generalized Anxiety Disorder-2 to screen for depressive and anxiety disorders. Also assessed was the pandemic's impact on sleep and dietary patterns, exposure to COVID-19 infection, and access to health care and medications. Finally, respondents were asked to describe in their own words any changes in their lives since the pandemic began. Over one-third (35.1%) screened positive for generalized anxiety disorder and over one-quarter (29.6%) screened positive for major depressive disorder. The majority reported pandemic-related changes in eating and sleeping patterns and exposure to COVID-19 infection. Multivariable logistic regression analysis found that many changes attributed to the pandemic were positively and significantly associated with screening positive for anxiety and depressive disorders. Qualitative analysis confirmed these findings and identified participants' resilience stemming from social support, emotion management, and self-care. These results can inform the design of services that assist this population to bolster self-management skills and reestablish daily habits to improve their lives during and following the pandemic.
Asunto(s)
Trastornos de Ansiedad/psicología , COVID-19/psicología , Trastorno Depresivo Mayor/psicología , Salud Mental , Adulto , Estudios Transversales , Conducta Alimentaria , Humanos , New Jersey/epidemiología , New York/epidemiología , Pandemias , SueñoRESUMEN
Caregivers are a source of support for family members with disabilities. However, caregivers are at risk for caregiver burden, which can erode self-care skills and lead to poor physical and mental health outcomes. Caregiver Wellness Self-Care, developed to address that risk, is a 5-week group program in which participants learn about strategies that cultivate their inner resources, while connecting with others for support. Wellness, self-care, mindfulness, and yoga-based information and practices are taught in the sessions and included in participant handouts. Self-reflection and planning activities with facilitated discussions further support awareness and personal transformation. Designed by and for people providing care to an adult family member with a mental health disorder and a developmental/intellectual disability, the program was piloted three times. The current article describes the development of the program through caregiver involvement, participant and facilitator feedback, and implications for future efforts to build caregiver wellness self-care skills. Implications for nurses are highlighted. [Journal of Psychosocial Nursing and Mental Health Services, 59(5), 25-32.].
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Personas con Discapacidad , Atención Plena , Adulto , Cuidadores , Familia , Humanos , AutocuidadoRESUMEN
Individuals served by behavioral health programs experience risk factors that threaten health and longevity. Health behavior changes may be supported through environmental modifications known as nudges. The current review (a) examines the potential value of nudges for helping individuals receiving services from behavioral health programs, and (b) offers physical and social environment strategies to support positive health behaviors. The authors discuss literature related to nudges and environmental influences on health behaviors. The research related to nudges supports the potential value of this framework for nurses in behavioral health settings, who are in a strong position to help address health and wellness concerns disproportionately experienced by individuals in behavioral health programs. [Journal of Psychosocial Nursing and Mental Health Services, 59(1), 21-28.].
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Conductas Relacionadas con la Salud , Psiquiatría , HumanosRESUMEN
Many people with serious mental illnesses live in poverty, which can worsen mental and overall health. The authors suggest strategies to improve health outcomes through behavioral health services and supports that directly target financial wellness while reducing dependence on public benefits. Although some services focus on financial education, this effort is likely insufficient for addressing poverty and its accompanying financial hopelessness. A social-ecological approach with the core goal of financial wellness may improve outcomes. Financial wellness is a social justice issue that must be elevated to a high-priority area of intervention in behavioral health services.
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Servicios Comunitarios de Salud Mental/provisión & distribución , Trastornos Mentales/economía , Trastornos Mentales/terapia , Pobreza/psicología , Humanos , Justicia Social , Apoyo SocialRESUMEN
Developed in collaboration with WHO Department of Mental Health and Substance Abuse, this study (conducted in India, the UK, and the USA) integrated feedback from mental health service users into the development of the chapter on mental, behavioural, and neurodevelopmental disorders for ICD-11. The ICD-11 will be used for health reporting from January, 2022. As a reporting standard and diagnostic classification system, ICD-11 will be highly influential by informing policy, clinical practice, and research that affect mental health service users. We report here the first study to systematically seek and collate service user perspectives on a major classification and diagnostic guideline. Focus groups were used to collect feedback on five diagnoses: depressive episode, generalised anxiety disorder, schizophrenia, bipolar type 1 disorder, and personality disorder. Participants were given the official draft diagnostic guidelines and a parallel lay translation. Data were then thematically analysed, forming the basis of co-produced recommendations for WHO, which included features that could be added or revised to better reflect lived experience and changes to language that was confusing or objectionable to service users. The findings indicated that an accessible lay language version of the ICD-11 could be beneficial for service users and their supporters.
Asunto(s)
Grupos Focales/métodos , Clasificación Internacional de Enfermedades/normas , Trastornos Mentales/diagnóstico , Servicios de Salud Mental/organización & administración , Organización Mundial de la Salud/organización & administración , Trastornos de Ansiedad/clasificación , Trastornos de Ansiedad/diagnóstico , Trastorno Bipolar/clasificación , Trastorno Bipolar/diagnóstico , Trastorno Depresivo/clasificación , Trastorno Depresivo/diagnóstico , Estudios de Evaluación como Asunto , Femenino , Guías como Asunto , Humanos , India/epidemiología , Masculino , Trastornos Mentales/clasificación , Trastornos Mentales/psicología , Servicios de Salud Mental/normas , Trastornos de la Personalidad/clasificación , Trastornos de la Personalidad/diagnóstico , Esquizofrenia/clasificación , Esquizofrenia/diagnóstico , Reino Unido/epidemiología , Estados Unidos/epidemiologíaRESUMEN
Self-employment is an alternative to wage employment and an opportunity to increase labor force participation by people with psychiatric disabilities. Self-employment refers to individuals who work for themselves, either as an unincorporated sole proprietor or through ownership of a business. Advantages of self-employment for people with psychiatric disabilities, who may have disrupted educational and employment histories, include opportunities for self-care, additional earning, and career choice. Self-employment fits within a recovery paradigm because of the value placed on individual preferences, and the role of resilience and perseverance in business ownership. Self-employment creates many new US jobs, but remains only a small percentage of employment closures for people with psychiatric disabilities, despite vocational rehabilitation and Social Security disability policies that encourage it. This commentary elucidates the positive aspects of self-employment in the context of employment challenges experienced by individuals with psychiatric disabilities and provides recommendations based on larger trends in entrepreneurship.
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Personas con Discapacidad/psicología , Empleo/métodos , Empleo/psicología , Trastornos Mentales/psicología , Emprendimiento , Humanos , Autoeficacia , Seguridad Social , Estados Unidos , Trabajo/psicologíaRESUMEN
TOPIC: Funding for behavioral health service provider agencies is always limited, making it difficult to decide how and when to spend scarce resources on staff training. If evidence existed for a clear return on investment for certain training topics or techniques, agency administrators may find it easier to make the decisions about how much and what type of training to provide to staff. PURPOSE: In spite of expert opinion and some evidence that the most common training approaches are ineffective, yielding no return on investment, or a negative return (money wasted), agencies continue to provide primarily single-session lecture-based training-either face-to-face or via a tedious and uninspiring online format. If this article, along with previous education and training columns, were to convince administrators to use their limited training dollars more wisely, the result is likely to be improved staff competencies and better service outcomes. SOURCES USED: Sources include the personal experience of the author and the available literature on training effectiveness and return on investment for training initiatives. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Administrators need to make informed choices about using best practices for staff development. While the well-designed studies that would clearly document return on investment for training in behavioral health services may not be possible or affordable, dialogue and consensus are needed on what measures might indicate effective training outcomes. (PsycINFO Database Record
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Análisis Costo-Beneficio , Personal de Salud/educación , Servicios de Salud Mental/normas , Desarrollo de Personal/normas , Adulto , HumanosRESUMEN
TOPIC: Training evaluations may encompass different dimensions, from engagement of learners to the achievement of specific and meaningful learning objectives to the ultimate goal of changing what the learners do after completing the training. Yet, most behavioral health agencies fail to evaluate training at all, or limit their evaluations to simple satisfaction measures. PURPOSE: Well-designed evaluations can inform decisions on how to use an agency's limited training budget or whether to renew a contract for an external trainer. These decisions, and related training investment choices, are not trivial, as service delivery resources are limited and the costs of education and training can be substantial. SOURCES USED: Sources include the personal experience of the author and the available literature on training effectiveness and evaluation. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Evaluation of education and training programs should go beyond simple satisfaction ratings. A multilevel training evaluation strategy will yield rich information that can be used to refine content, improve instruction, ensure greater relevance to learners' work roles, and lead to improvements in day-to-day practice. (PsycINFO Database Record
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Personal de Salud/normas , Servicios de Salud Mental/normas , Evaluación de Programas y Proyectos de Salud/normas , Enseñanza/normas , Humanos , Evaluación de Programas y Proyectos de Salud/métodosRESUMEN
Individuals with major mental disorders could benefit from low cost, functional ways to support healthy lifestyles. Walking is a popular, preferred, accessible, and safe physical activity for many people. Walking is free, requiring no specialized equipment or membership fee, and is important to support engagement in other daily living activities. The current study explores the benefits of walking and strategies for promoting walking among community-dwelling individuals with major mental disorders. Key issues include strengthening engagement, tracking progress, and sustaining participation to achieve goals related to walking. The authors propose ways that nurses can support increased walking behavior for improved health and well-being in this population. [Journal of Psychosocial Nursing and Mental Health Services, 56(3), 25-32.].
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Vida Independiente/psicología , Trastornos Mentales/terapia , Caminata/fisiología , Humanos , Trastornos Mentales/psicología , Enfermería PsiquiátricaRESUMEN
TOPIC: This column provides an overview of methods for training to improve service provider active listening and reflective responding skills. PURPOSE: Basic skills in active listening and reflective responding allow service providers to gather information about and explore the needs, desires, concerns, and preference of people using their services-activities that are of critical importance if services are to be truly person-centered and person-driven. SOURCES USED: Sources include the personal experience of the authors as well as published literature on the value of basic counseling skills and best practices in training on listening and other related soft skills. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Training in listening is often needed but rarely sought by behavioral health service providers. Effective curricula exist, providing content and practice opportunities that can be incorporated into training, supervision, and team meetings. When providers do not listen well to the people who use their services, the entire premise of recovery-oriented person-driven services is undermined. (PsycINFO Database Record
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Recolección de Datos/métodos , Entrevista Psicológica , Anamnesis/métodos , Trastornos Mentales , Servicios de Salud Mental/normas , Psiquiatría , Enseñanza/psicología , Competencia Clínica , Consejo/métodos , Consejo/normas , Humanos , Entrevista Psicológica/métodos , Entrevista Psicológica/normas , Trastornos Mentales/diagnóstico , Trastornos Mentales/psicología , Relaciones Profesional-Paciente , Psiquiatría/educación , Psiquiatría/normasRESUMEN
TOPIC: This column describes challenges for hiring, training, and supervising psychiatric rehabilitation service providers for positions that involve the use of digital health technology. PURPOSE: Adoption and implementation of any new technology or technique requires workforce development. This article outlines considerations for policymakers, funders, and service agency administrators as digital health technologies become more widespread. SOURCES USED: The article discusses issues based on professional experience of the authors and available literature. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The literature on adoption of innovations in general, and the adoption of psychiatric evidence-based practices in particular, indicates that funding and adoption of new techniques and technologies are not adequate to ensure full and sustained implementation. The use of any new treatment or technology requires training and other supports to ensure that users have the competencies needed to make it work and that the workplace supports its use. As new digital health technologies become available, considerations of their cost and effectiveness need to include an examination of the required competencies of the service providers who will use them and the added cost of developing, enhancing, and maintaining those competencies. Specific attitudes, knowledge, and skills will be relevant to hiring decisions. Relevant preservice and on-the-job training opportunities, technical assistance, and supervision will be needed. Implementation needs to be monitored, not assumed, and the rights of the people who use technology-supported services must be fully protected. (PsycINFO Database Record
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Tecnología Biomédica , Capacitación en Servicio , Servicios de Salud Mental , Rehabilitación Psiquiátrica , Desarrollo de Personal , Humanos , Capacitación en Servicio/normas , Servicios de Salud Mental/normas , Rehabilitación Psiquiátrica/educación , Rehabilitación Psiquiátrica/normas , Desarrollo de Personal/normas , Recursos HumanosRESUMEN
TOPIC: As behavioral health care policies evolve, based on shifting paradigms and a developing base of evidence, day-to-day practices at the direct service level must change. Workforce development initiatives are a critical component to effect such change yet may be overlooked, underfunded, or implemented in ways that are ineffective. PURPOSE: This article highlights considerations for training focused on policy, for training issues relevant across recent policy initiatives, and components of effective workforce development initiatives. SOURCES USED: Sources include the personal experience of the authors and the available literature on education, training, and workforce development, as well as select references related to policy initiatives in psychiatric rehabilitation and behavioral health care. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Until policy initiatives include the necessary funding for and guidance on evidence-based workforce development, they are unlikely to achieve their full promise. (PsycINFO Database Record
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Política de Salud , Rehabilitación Psiquiátrica , Desarrollo de Personal , Humanos , Rehabilitación Psiquiátrica/educaciónRESUMEN
TOPIC: This column describes strategies for helping educators and trainers address common problems with executive functioning and memory for their audiences, to better facilitate learning. PURPOSE: The purpose of the article is to suggest strategies for maximizing learning and goal achievement for students in academic settings, as well as for building employee knowledge and skills in the psychiatric rehabilitation workforce through worksite-based training. SOURCES USED: The content in this column is drawn from the professional experience of the authors as well as available literature. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Educators and trainers encounter many challenges when assisting people to achieve desired learning objectives. Attending to the cognitive needs of all learners, by supporting their planning, attention, memory, and reasoning skills, can minimize some of these challenges. Educators and trainers may implement the strategies described to better engage with their audiences, whether in an academic or clinical practice environment. Implementation of specific strategies to offset limitations will positively affect all learners, who benefit both from maximized knowledge and skill acquisition as well as improved job performance. Improved learning will likely translate to better practitioner skill over time, which should lead to improved outcomes for service users in the field of psychiatric rehabilitation. (PsycINFO Database Record
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Rendimiento Académico , Disfunción Cognitiva/rehabilitación , Remediación Cognitiva/normas , Empleo , Función Ejecutiva/fisiología , Aprendizaje/fisiología , Remediación Cognitiva/métodos , HumanosRESUMEN
Replies to comments by Muralidharan et al (see record 2017-13255-009) on the original article by Silver and Nemec (see record 2016-43088-001). The original authors thank the commentators for raising additional questions regarding "peerness." They were honored that their paper prompted this thought and effort to submit comments. (PsycINFO Database Record
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Trastornos Mentales , Grupo Paritario , Promoción de la Salud , Humanos , Trastornos Mentales/terapiaRESUMEN
TOPIC: This article raises questions regarding defining the role of peer specialists and related employment practices. PURPOSE: The questions raised may be used to guide future research. SOURCES USED: Areas needing further investigation were identified through personal and professional experience, discussions with colleagues, and a review of published literature on peer workers. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Questions are raised regarding the definition of "peerness"; the variety and contradictions in definitions of the role of the peer specialist; existing and potential avenues for career advancement; credentialing standards; the design, implementation, and evaluation of existing and effective peer support service models, including integration of peer workers in other service models; and best practices for supporting the well-being of peer workers and their nonpeer colleagues. More and higher quality research data are needed in order to inform and contribute to the use and support of peer specialists in promoting positive system transformation. (PsycINFO Database Record
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Trastornos Mentales/rehabilitación , Grupo Paritario , Especialización , HumanosRESUMEN
Regardless of an individual's mental health status, habits are difficult to establish and/or eliminate. Given the importance of good habits to overall health and wellness, nurses and other mental health service providers need to understand the force of habits (positive and negative), factors that make habit change difficult, and approaches that are likely to facilitate building and maintaining good habits. The current article provides a cursory overview of several factors (i.e., motivation, will-power, and rewards) that impact habit formation. Relevant theories and research are presented. Habit formation can be fostered through a careful analysis of current behaviors, specific and measurable short-term goals or objectives, and a detailed action plan.
Asunto(s)
Terapia Conductista/métodos , Hábitos , Promoción de la Salud/métodos , Estilo de Vida , Trastornos Mentales/enfermería , Trastornos Mentales/prevención & control , Motivación , Educación Continua en Enfermería , Humanos , Rol de la EnfermeraRESUMEN
TOPIC: This column describes the experience of prejudice and discrimination that some mental health service users encounter in their interactions with service providers and organizations. PURPOSE: The intent of this column is to highlight potential action steps to address the negative beliefs and attitudes of service providers that contribute to prejudice and discrimination. SOURCES USED: This description draws from published material and the authors' experience. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: If the most effective approaches to reduce public prejudice and discrimination toward people diagnosed with a mental illness are education and contact, then those methods may be useful methods to help mental health service providers view and engage persons served from a strengths-based recovery and wellness orientation.