Community Mental Health Journal最新文献

Asian Americans (AA) have experienced increased rates of serious mental illness over the past decade. Past research has identified perceived and personal mental illness stigma as significant barriers to seeking treatment for mental health concerns, particularly in the Asian American community. One way to address stigma has been through narratives told from the perspective of community members of a stigmatized identity. Therefore, this study examines the impact of This Is My Brave: Stories from the Asian, Pacific Islander, and Desi American Community (TIMB: SAC; a narrative-based stigma reduction intervention) on audience members. Participants (N = 89; mean age = 27.62[SD = 9.82]) had a significant increase in intentions to seek care and a significant decrease in personal mental illness stigma, perceived mental illness stigma, and anti-Asian American stereotypes from pre-intervention to post-intervention. We did not find any significant differences between AA and non-AA individuals on any of the dependent measures (personal stigma, perceived stigma, anti-racism, anti-Asian attitudes, and intentions to seek care). This study has implications for TIMB: SAC as a stigma reduction intervention.

Individual Placement and Support (IPS) is a well-established evidence-based model of supported employment (Drake & Bond, 2023). This study aimed to examine program engagement and employment outcomes achieved in an IPS program based in an Australian community mental health service and identify differential employment patterns and opportunities for service development. IPS programs were in place at 9 community mental health service locations (4 rural/5 urban), with a governance model supporting program actualisation and monitoring. A multi-component evaluation comprising service-level data included: (i) routine monitoring of client-level characteristics, referral processes, caseload, and employment outcomes; (ii) quarterly reporting of referral patterns and targets. There were 1167 referrals during the 10-year evaluation period; the majority, 58% were male, the mean age was 33.9 years, and psychotic disorders were frequently reported (45.7%). Program engagement was substantial (mean = 1.5 years). Over a third, 36.3% obtained employment; retained for lengthy periods (mean = 45.5 weeks), 70.4% for 13 weeks or more (31.4% exiting as independent workers). Similar outcomes were attained regardless of age, gender, or diagnosis. Logistic regression analyses revealed the strongest predictor of employment (AOR = 3.20; p < 0.001) or vocational outcome (AOR = 2.20; p < 0.001) was associated with rural MHS-locations with fewer (1-3) employment consultants. Positive employment outcomes were demonstrated irrespective of diagnosis. Longitudinal outcomes suggest an increased likelihood of obtaining employment in rural locations and in programs with fewer employment consultants, providing insight into factors that may support IPS implementation in real-world settings.

This engagement award project evaluated the preliminary effectiveness of a culturally tailored psychoeducation session aimed at reducing mental health stigma among African American women and their social support networks. Participants included 25 community members, including African American women of reproductive age and members of their social support networks, engaged in a two-hour psychoeducation group session. This session addressed perinatal mood disorders, cultural and historical factors contributing to mental health stigma, impacts of untreated conditions, and culturally appropriate resources. Participants completed the Stigmatized Attitudes Toward Mental Illness Scale (SATMIS) before and after the psychoeducation session, along with a satisfaction questionnaire. Analysis revealed a large (Cohen's d = 0.98), significant reduction in stigmatized attitudes toward mental illness from pre-session (M = 62.4, SD = 10.2) to post-session (M = 48.9, SD = 9.7; p < .001). Most (92%) participants reported high satisfaction with the psychoeducation session. This engagement project provides preliminary evidence that a brief, culturally tailored psychoeducation group session can effectively reduce mental health stigma among African American women and their support networks. Given the disproportionate burden of perinatal mood and anxiety disorder (PMADs) and maternal mortality among African American women, this approach shows potential for addressing a significant barrier to mental health care utilization in this population.

To explore service user experiences and perspectives of social prescribing for mental health and to develop theoretically informed strategies to optimise their experience. This qualitative study utilises semi-structured interviews with participants recruited via gatekeepers across social prescribing services in England and Wales. A topic guide, informed by the Theoretical Domains Framework (TDF) and the COM-B model of behaviour change, was used to structure interviews. Data were analysed using Thematic Framework Analysis guided by the TDF. A total of eighteen service users participated in this research. Ten were aware of social prescribing and could provide an accurate explanation of what it is; three recognised the term but could not explain the concept; and five had no prior knowledge, despite accessing social prescribing services. Overall, awareness of social prescribing, its benefits for mental health, and service accessibility were limited and identified as key areas for improvement. Eleven theoretical domains identified related to engagement with social prescribing services for mental health. Twenty-one analytical themes were generated across the eleven domains. Of these themes, seven suggested changes to the current provision, with the remaining fourteen providing recommendations for future services. Findings advance the field of social prescribing for mental health by providing insight into the experiences and perceptions of service users, underpinned by a robust behavioural framework analysis to identify behavioural determinants.

Day centres provide low-threshold support for people with severe and prolonged mental illness. However, their effectiveness has not yet been empirically evaluated. This study examines whether regular attendance at day centres improves mental health outcomes. Two surveys were conducted: a cross-sectional survey of 87 service users and a longitudinal study of 16 new admissions (assessments at baseline, one month, and three months after admission). Psychosocial participation limitations (IMET), quality of life (MANSA), symptom severity (SCL-K-9, PHQ-9), self-esteem (G-SISE) and self-efficacy (ASKU) were measured. Descriptive statistics and the Wilcoxon-signed-rank test were used for analysis. Three primary goals for attending a day centre were most important: daily routines, social contacts, and meaningful activities. Significant improvements (p < 0.05) were observed in all outcomes, with large effect sizes (r = > 0.5). This study provides initial evidence that the use of day centres supports recovery from mental illness by restoring key psychosocial functions.

Treatment completion in interventions within correctional settings is challenging both generally and for people with mental illness (MI). Few studies have explored treatment completion alongside feedback from this population. We examined the rates of treatment completion alongside participant feedback to explore how participant feedback can improve treatment completion. Mixed-methods were used to examine treatment completion rates and clinical characteristics of participants (n = 24), and to explore participant feedback. We used thematic, qualitative analysis of participant feedback (n = 17) obtained from interviews, alongside univariate statistics to describe the sample of treatment completers and non-completers. Three-quarters of participants completed the treatment. Non-completers had a higher proportion of one or more infractions than completers. Four themes from participant feedback emerged in the qualitative analysis: Practice, Applicable Takeaways, Intervention Pace, and Group Dynamics. Participants' feedback highlights important considerations for responsive practices to improve treatment completion among incarcerated men with MI.

Measurement-based care (MBC) is an evidence-based practice that can improve the identification of co-occurring mental health conditions and substance use disorders, as well as population differences in care in lower resource settings, through ongoing monitoring of patient-reported symptoms. The current study examined, as reported by different stakeholders prior to implementation, barriers and facilitators of implementing screening tools to monitor mental health and substance use symptoms in the outpatient behavioral health setting at a safety-net hospital. A purposeful sampling approach was used to recruit stakeholders from two outpatient clinics (child, adult) to participate in individual interviews (clinic leadership) and stakeholder-specific focus groups (clinicians and administrative staff). De-identified transcripts were coded using a directed content analytic approach guided by constructs from the Consolidated Framework for Implementation Research (CFIR). A total of 14 clinicians, 6 clinic leaders, and 4 administrative staff participated in interviews and focus groups. Results indicate stakeholder agreement on specific implementation constructs (e.g., patient needs, networks and communication) and unique perspectives influenced by the stakeholders' day-to-day responsibilities. However, there were inconsistent responses regarding networks and communication across stakeholder groups. Clinicians only identified barriers, clinic leadership only identified facilitators, and administrative staff did not identify communication as a barrier or facilitator. Thus, when implementing MBC within a safety-net behavioral health clinic setting, cohesive communication may be perceived differently by clinicians, clinic leadership, and administrative staff and should be validated across staff roles.