Abstract
BackgroundPeople with psychotic illness suffer from reduced quality of life and often from an insufficient level of social inclusion. These variables are associated with several negative outcomes, such as higher neuro-cognitive deficits, negative symptoms, internalised stigma, increased cardiovascular risk and, most importantly, excess mortality. To date, only a minority of social interventions in psychosis have been investigated. Since 2011, the Department of Mental Health and Substance Abuse in Modena introduced the “Social Point” program, which provides social inclusion interventions to promote active social participation for patients suffering from severe mental illness.The aim of this study was to assess whether a social inclusion intervention is associated with better outcomes in terms of personal and social recovery, with particular reference to the areas of social functioning and activity, and subjective dimensions such as self-esteem, self-stigma and perceived quality of life.MethodsA cross-sectional design was adopted to compare 30 subjects, selected at the completion of “Social Point” program, with a group of subjects, matched for socio-demographic and clinical features, selected from a wait list for “Social Point”. All subjects were evaluated by means of instruments assessing: level of disability, level of functioning, severity of psychopathology, self-esteem, internalised stigma and quality of life.ResultsOverall, the results of the study suggest that social inclusion interventions may be effective in people suffering from non-affective psychosis. A dose-effect relationship was also found between higher number of activities per patient and better outcomes within both social and psychopathological domains. However, due to the cross-sectional design of the study no definitive causality can be inferred.ConclusionPsychosocial interventions promoting social inclusion are likely to represent an effective approach to improve personal and social recovery.
Highlights
People with psychotic illness suffer from reduced quality of life and often from an insufficient level of social inclusion
The aim of this study was to assess, in a comparative cross-sectional design, whether the social interventions provided by “Social Point” associate with better outcomes in the areas of personal and social recovery, with particular focus placed on social functioning and level of activity, and subjective measures in the areas of self-esteem, self-stigma and perceived quality of life of subjects under the care of the mental health services in Modena
The analysis of Global Assessment of Functioning (GAF) total score showed a higher level of functioning in those subjects who had completed Social Point” program (SP) program [SP mean = 67.4 (SD = 13.4) vs wait list (WL) mean = 52.0 (SD = 17.5), p = 0.0006]; the SP group mean score fell within the “mild impairment” (70–61) range, whereas subjects in the WL group presented a “moderate impairment” (60–51)
Summary
People with psychotic illness suffer from reduced quality of life and often from an insufficient level of social inclusion. These variables are associated with several negative outcomes, such as higher neuro-cognitive deficits, negative symptoms, internalised stigma, increased cardiovascular risk and, most importantly, excess mortality. People suffering from psychosis experience lower quality of life and reduced social inclusion [2, 3]. They are more likely to live alone [4], be unemployed [5], have fewer significant relationships [6] and are at high risk of. Improving social outcomes in psychosis represents a paramount objective for mental health services in terms of economic sustainability and ethical implications [20]
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