Community Mental Health Journal最新文献

Personal recovery is increasingly important in service delivery. While personal recovery has been examined in relation to several mental health issues, it has yet to be reviewed in recovery from substance use disorders. This review of qualitative studies, which followed PRISMA guidelines, used a 'Best Fit' framework synthesis. To organise studies, the a-priori, transdiagnostic CHIME framework was employed. 2885 papers were initially identified, with 3 added in updated searches; 13 papers were included for analysis. Findings show that CHIME captures many elements related to recovery from substance use. However, the original framework does not consider challenges associated with trauma, loss, and stigmatisation. Including a 'Difficulties' domain supports the use of the CHIME-D framework. Personal recovery from substance use is a complex and individual process. The CHIME-D framework emphasises the importance of professionals adopting a balanced approach to recovery, recognising both benefits and challenges.

Recently psychiatrically hospitalized Veterans are at elevated risk for suicide soon after discharge. Social connectedness is a robust protective factor against suicide; however, many Veterans have limited sources of social support and well-being. Promoting engagement in community activities may help increase social connectedness, but there is limited research on the barriers and facilitators experienced by mental health providers, community organizations, and Veterans' loved ones to support such efforts. The current study collected qualitative data via interviews with 29 participants from these three groups in different regions of the United States. Interviews focused on participants' experiences with organizational- and systems-level factors impacting current implementation of strategies for supporting Veteran engagement in community activities. Data were analyzed using templated summarization and matrix analysis. Participants generally valued community engagement for this high-risk population and identified barriers related to mental health challenges and lack of central coordination of activities. Mental health administrators and policy makers invested in increasing social connectedness among high-risk Veteran groups should consider leveraging existing community networks to address identified barriers to community engagement.

There is today a broad consensus about the conceptualisation of recovery in adults facing mental health challenges: a personal journey grounded in societal connectedness, hope, constructing a life with meaning and purpose, empowerment, and autonomous management of symptoms based on their acceptance. However, recent findings show that this conception cannot be automatically transposed to adolescents. Based on a scoping review methodology, this paper examines the application of the recovery model to adolescents mental health through the identification of strengths, weaknesses and knowledge gaps. Studies that investigated the adaptation of the recovery model to adolescents (age-range: 12-18) were selected and mapped, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A deductive thematic analysis was conducted to see which components apply to adolescents (strengths) and which do not or hardly apply (weaknesses). An inductive thematic analysis was conducted to identify knowledge gaps. 13 studies identified as relevant were mapped and analysed. Main strengths identified were importance given to connections, to hope and to empowerment. Main weaknesses were the idea of a personal journey, importance given to autonomous management of symptoms, to identity and to building a life project with meaning and purpose. Knowledge gaps were how to adapt to developmental challenges, how to integrate multiple actors in the decision-making process, how to increase adolescents' participation and how to foster resilience. When applying the recovery model to adolescents, it is essential to account for their specific needs. Recovery should be re-conceptualized rather than grounded in adult-centric theoretical frameworks. Integrating resilience as a core component can further support adolescents in the process of recovery from mental illness, while navigating through developmental challenges.

People experiencing mental illness smoke tobacco at disproportionately higher rates than the general population. Staff at mental health services are well placed to assist clients with smoking cessation, yet such support is often limited by time or knowledge constraints. Guided by the COM-B model, this study explored barriers and facilitators of smoking cessation among people receiving treatment for mental health disorders as perceived by staff members of community mental health services in Brisbane, Australia. Three focus groups were conducted in August-October 2021 with 29 healthcare professionals and peer support workers employed at three community mental health services. Data were analysed qualitatively using a combined deductive and inductive approach to identify themes grouped by the COM-B domains of capability, opportunity, and motivation. Capability barriers included clients' reliance on smoking to manage anxiety or other mental illness symptoms and difficulties engaging with cessation support, while staff knowledge was a facilitator. Opportunity barriers included smoking being perceived as social currency and clients' limited support networks, whereas facilitators included cessation assistance from peer workers and smokefree environments. Motivation barriers were entrenched behaviours and using smoking as a coping mechanism, with facilitators including staff prioritising cessation and peer-led programs. These findings highlight the need for staff training to address misperceptions about smoking, improve confidence in offering cessation support, and foster trust with clients. Expanding the range of available smoking cessation support options, including peer support programs, and creating supportive service environments may enhance smoking cessation success for individuals experiencing mental illness.

Outreach to individuals experiencing unsheltered homelessness is often conducted by specialists lacking mental health training despite the high prevalence of severe mental illness among individuals experiencing homelessness. We developed a novel screener, the Homeless Outreach Behavioral Screen (HOBS), a 4-item scale for use by outreach specialists to identify unsheltered persons who may benefit from referral to specialized mental health services. We describe the participatory development of the HOBS and report on preliminary data from a sample of unsheltered individuals in Los Angeles (n = 649). HOBS items show good internal consistency and reliability (alpha = 0.80). Each additional domain of difficulty scored as present is associated with an 8.7 fold (95% CI: 6.1-13.0) increased odds the individual is appropriate for specialty mental health services. Though further validations studies are needed, the HOBS shows potential to reduce barriers to accessing services for vulnerable individuals.

There is limited research on the impact of art forms, including opera, on audience and cast engagement in understanding mental health needs and support for Veterans at risk for post-traumatic stress disorder (PTSD) and homelessness. This qualitative study explores post-performance discussions from audience and cast members after live performances of an opera about Vietnam Veterans and family members, and their experiences of war-time trauma, housing instability, and receiving services to promote recovery and resilience. Audio-recorded and transcribed comments by Veterans (n=8), family members (n=9), providers (n=5) and cast (n=9) were analyzed using thematic analysis for key themes, with examples of quotes. Main themes included: 1) Struggling Post-military Service, including feeling misunderstood and self-isolation; 2) Finding Hope, through commitment and community; and 3) Healing through the Opera by sharing difficult societal issues, promoting empathy, and sharing resources, with lived experiences shared across themes by Veterans, family members, providers and cast/production team with a peer facilitator. The reflections they shared about their journey from trauma and homelessness through implementing strategies to obtain needed services, were fostered through live opera performances and peer-facilitated, post-discussions.

Recovery Colleges (RCs) are increasingly implemented worldwide, with a fidelity measure recently developed in the United Kingdom (UK). However, RCs may vary based on their operating contexts. In the Netherlands, a key deviation is that RCs are often peer-run rather than co-produced with mental healthcare providers, as outlined in the fidelity measure. This study assessed the measure's suitability in the Dutch context, leading to the development of a reflection tool (Phase 1) which was subsequently evaluated (Phase 2). The development phase involved focus groups with peer facilitators and coordinators from 16 RCs (N = 29) to capture critical elements of Dutch RCs. The tool was piloted (N = 5) and evaluated more broadly (N = 24). The tool provided valuable insights, highlighting shared values among RCs internationally and conceptual differences between Dutch and UK models. The findings raised questions about the boundaries of fidelity in co-created contexts such as RCs.

Art provides a space for expression and personal growth, promoting well-being and reducing stigma, particularly for individuals with mental illness. Museums have shifted to create inclusive experiences for marginalized groups. This study aimed to explore the experiences of people with mental illness who participated in an Art and Museum Intervention program, examining the meanings they attributed to social participation and meaningful occupations through art. A qualitative descriptive study was conducted with 18 participants from a Psychosocial and Occupational Rehabilitation Center in A Coruña, Spain, using purposeful sampling. Data were gathered through focus groups, in-depth interviews, and participant observation, followed by thematic analysis. Participants actively engaged in the study, sharing their experiences of art as a means of social integration. The collaboration between the museum and the rehabilitation center ensured a community-based approach. Two main themes emerged: (1) Art as an agent of socialization, including teamwork, building support networks, community integration, and overcoming stigma; and (2) Well-being and empowerment through meaningful occupation, with subthemes of positive emotions, empowerment, and art as a meaningful activity. The study highlights how museum-led art interventions enhance well-being and social participation, positioning art as a valuable tool in mental health recovery and community inclusion.

This study was conducted as a randomized controlled experimental trial with the aim of determining the effect of MBSR program on the mental health and care burden in family caregivers of individuals with psychosis. This study was designed prospective, two-armed (1:1), randomized clinical trial with assessments on primary and secondary outcomes at baseline, post-intervention, at the 1-month follow-up, and 3-month follow-up. The primary outcome of the study was the change in care burden. Secondary outcomes included changes in anxiety, hopelessness, and self-compassion levels. The study sample consisted of 50 family caregivers (intervention group = 25, control group = 25). In the intervention group, there was a statistically significantly decrease in state anxiety, trait anxiety, hopelessness and caregiver burden, as well as a significant increase in self-compassion compared to the control group at post-intervention, at the 1-month follow-up and 3-month follow-up. These results show promise that MBSR may be an effective intervention for family caregivers of individuals with psychosis. CLINICAL TRIAL REGISTRY: This study was registered in the Clinical Trials under the code NCT05245305 (2022-02-17).