Community Mental Health Journal最新文献

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).

These evaluation studies explored the impact of the 'Recovery Together' program on participants' mental health and alcohol and other drug recovery and experiences with related services. They also aimed to inform the development of a Recovery College in the Northern Territory (NT). These studies used participatory action research and qualitative methods. Ethics approvals were obtained. Eighteen participants participated in semi-structured interviews across Darwin, Alice Springs and Katherine. Data were analysed using inductive and deductive approaches. Many participants expressed dissatisfaction with these local services, referring to inadequate support, disempowering approaches, and complicated referral pathways. However, they valued the 'Recovery Together' program for building foundational recovery skills - stress, illness and relapse management, coping strategies, communication and advocacy. Participants also reported increased empowerment, hope, and peer connection. These findings underpin the need in the NT for a Recovery College that builds on peer education and recovery-oriented approaches to improve recovery outcomes.

Peer Recovery Support Specialists (PRSS) play a crucial role in the behavioral health (BH) workforce, assisting individuals in their recovery from substance use and mental health challenges. Despite their essential contributions to the BH field, research on resilience among peers remains limited. To address the literature gap, this study examined how PRSS' personal resilience and workplace satisfaction with supervisor and organizational support mediate the relationship between burnout and job satisfaction. Secondary analysis was conducted using cross-sectional survey data of U.S.-based PRSS (N = 454). Validated measures of burnout, personal resilience, job satisfaction, and workplace support were utilized. Path analysis was used to test the hypothesized mediating roles of personal resilience and satisfaction with supervisor and organizational support. The hypothesized model accounted for 42% of the variance in job satisfaction and yielded excellent model fit: χ² (14) = 14.52, p = .41, RMSEA = 0.01 (90% CI = 0.00-0.05), CFI = 1.00, and TLI = 1.00. All three variables were statistically significant mediators. Burnout was directly and negatively associated with job satisfaction. Personal resilience and satisfaction with supervisor and organizational support were positively associated with job satisfaction and negatively with burnout. This study identified key mediating pathways through which burnout impacts job satisfaction among PRSS, underscoring the dual importance of personal resilience and workplace supports and demonstrating the multilevel conditions that can shape PRSS' professional well-being. Results highlighted the need for organizations, policymakers, and researchers to collaboratively develop and assess PRSS-centric interventions that foster supportive and well-resourced work environments.

Interorganizational collaboration (i.e., organizations working together towards one goal) is one approach that can be used by community-based organizations to ensure marginalized individuals receive needed care. Though there has been some research on the mechanisms of collaboration from the perspective of leadership, less literature has focused on the perspective of staff working in community-based settings. The study aimed to explore staff perceptions of interorganizational collaboration within a North Carolina county and to gather their recommendations for strengthening such collaboration. Semi-structured interviews were conducted with twenty community-based staff that worked with behavioral health clients, were employed in varying roles and occupied different levels of the organization. Employing a generic qualitative methodology, data were analyzed using an inductive coding approach with the help of a research assistant. Thematic analysis was used across codes to generate seven themes. Community-based staff viewed collaboration as primarily driven by historic relationships and being facilitated by the possession of similar technological infrastructure. Staff reflected on the disconnect between interpersonal relationships and organizational relationships when it came to prioritizing client care. Solutions to improving collaboration as a way of strengthening a client's access to care included organizations providing time and space to network, building out technological infrastructure for more organizations, and emphasizing the ability to provide holistic care through collaboration. Using staff-driven solutions to improving collaboration can encourage buy-in and can build sustainable relationships.

The collaborative care model (CoCM) is an evidence-based model shown to improve treatment of depression and anxiety in the primary care setting. However, there is limited research on CoCM outcomes in underserved populations and which factors impact outcomes. We performed a retrospective chart review to examine GAD-7 scores for patients (N = 1,034) seen in primary care clinics within an urban, safety-net hospital system. The Wilcoxon signed-rank test and linear mixed models were used. Our population was 81% female and 89% self-identified Black or African American. There were significant reductions on GAD-7 scores from baseline to 3-, 6-, 9-, and 12-months follow-up (p < .001). The analysis suggested gender, patient age, clinic setting, and number of visits were significant. The effect sizes for these covariates were 0.94, 3.77, 1.98, and 0.74, respectively. Further research including patients' social determinants of health and comorbidities may help refine CoCM and optimize its effectiveness.

Research suggests shame plays a mediatory role in the relationship between trauma and psychosis, however, there is limited information on how this may occur. This qualitative study explored how experiences of shame in people living with psychosis is linked to past trauma. Fourteen adults completed semi-structured interviews. Reflexive thematic analysis was used to develop four themes: (1) shame maintains trauma; (2) trauma-related shame drives disconnection from the self; (3) avoiding shame from trauma leads to disconnection from aliveness; and (4) pervasive shame from trauma leads to isolation. The findings suggest that shame may play a key role in maintaining the influence of trauma on sense of self and on the way people engage with the world, including in the context of psychosis. Future research could explore whether addressing shame through intervention has any impact on the influence trauma has on people experiencing psychosis.

The health effects of social conditions such as income, education, and employment have been demonstrated to be persistent and wide-reaching. In this study, we examine the effect of social determinants of health, those conditions in which people live, among individuals with serious mental illnesses (SMI) who are actively engaged with mental health services. Using a sample of 203 clients at a community mental health clinic, this study (1) explores the prevalence of three social determinants of health: food insecurity, homelessness, and neighborhood disorder, and (2) assesses their associations with five outcomes of health, including mental health (overall mental health and life satisfaction) and physical health (overall physical health, number of chronic health conditions, and perceived daily limits). Our findings demonstrated that food insecurity and neighborhood disorder were prevalent within our sample of people with SMI (64% and 93% respectively), while homelessness was not (7%). Furthermore, a series of OLS regressions showed food insecurity and neighborhood disorder to be associated with poor mental and physical health, while homelessness was not significantly associated with any outcomes. These findings suggest that individuals with SMI who are actively engaged in treatment have increased risk of food insecurity and poor neighborhood conditions, which in turn may negatively impact their overall health. We suggest that mental health service providers be aware of the influence of social conditions on their patients and that clinics may be uniquely positioned to identify and intervene for individuals at risk of experiences that may be detrimental to their recovery.

Research indicates high prevalence rates of adverse experiences in people experiencing first-episode psychosis. Despite recommendations that mental health staff should routinely ask about adverse experiences, documentation indicates these are not being recorded in service-users' clinical records across different mental health settings. This study audited 48 service-user records in a UK early intervention in psychosis (EIP) community mental health service to examine how often, where, and by whom adverse experiences were recorded. Searching for 22 adverse experience terms, 64.6% of clinical records documented at least one adverse experience, with 80.6% reporting more than one. The profession that most often recorded adverse experiences in service-users' clinical records was psychiatrists. While EIP services may document adverse experiences more frequently than other community mental health settings, recorded rates remain lower than expected based on previous research prevalence rates. Further studies should consider adverse experiences recording across UK EIP services to ensure service-users with adverse experiences receive appropriate support.