Experience Of Mental Illness Research Articles

Honest, Open, Proud (HOP) for people with mental illness in Hong Kong: a randomized controlled trial.

Self-stigma among people with mental illness is negatively associated with personal and clinical recovery. Due to the concealable nature of mental illness, people with mental illness experience constant struggles between concealment and disclosure. Disclosure of mental health challenges can potentially minimize negative impacts of self-stigma and enhance self-esteem and sense of empowerment. Honest, Open, Proud (HOP) is a peer-led intervention that promotes autonomous and dignified decisions about disclosure. This study examined the effectiveness of HOP on concealment motivation, empowerment, self-stigma, stigma stress, and recovery among people with lived experience of mental illness in Hong Kong. A total of 162 participants with a mean age of 45.38 were recruited and randomized into intervention group and waitlist control group. Participants in the intervention group were invited to attend a 6-session HOP group intervention. Significant improvement in optimism score from the empowerment scale was found in the intervention group compared to the waitlist control group and the effect was sustained at 1-month follow-up. However, significant changes were not found in other outcome variables. Only improvement in optimism was observed in the current study. Future study needs to examine the effects of HOP with further modification to maximize the benefit for people with lived experience of mental illness in the local context.

Exploratory study of an ally training program for mental health support

PurposeThe purpose of this study was to evaluate the effects of an online mental health ally program on several measurements of readiness to help and stigma reduction. Allyship is one way to support people with mental health challenges beyond traditional care services.Design/methodology/approachThe efficacy of the program was evaluated in pre and postintervention surveys (n = 26) including measures of self-care, help-seeking intentions, peer-support self-efficacy, advocacy, knowledge of resources and stigma. A within-subject, repeated measures design was conducted analyzing changes at completion. Twenty-six participants who completed the program (either with or without lived experience of mental illness) were included in the study. A subgroup of participants (n = 11) who reported lived experiences of mental illness were assigned additional measures of internalized stigma, stigma stress, stigma resistance and self-esteem.FindingsAnalysis of mean differences indicated a statistically significant change in scores pre and postcompletion. The program increased peer-support, help-seeking intentions and self-esteem, while reducing internalized stigma and stigma stress. Findings provide preliminary support for program effectiveness in training individuals to support others and themselves through mental health challenges.Research limitations/implicationsTrained allies might improve the lives of individuals with mental health challenges by reducing discrimination and improving social support. We discuss the implication of allies to complement the mental health system.Originality/valueTo the best of the authors’ knowledge, this is the first exploratory study on the efficacy of an online ally training program for individuals with mental illness. The NoStigmas Ally Program is a novel and original development in ally training.

People with mental illness stigmatize mental illness less: A comparison study between a hospital-based sample of people with mental illness and a non-clinical general population sample in urban India.

Evidence shows that stigma negatively influences the quality of life of persons with severe mental illness. Nonetheless, stigma towards mental illness is lower among persons with a lived experience of mental illness compared to the rest of the population. Understanding the association between stigma of mental illness and the mental status of individuals living in urban India and whether this association is moderated by demographic factors opens a new avenue for prevention of social exclusion. Persons diagnosed with schizophrenia, bipolar disorder, or severe unipolar depression (cases, n = 647) were recruited from among hospital patients in New Delhi between November 2011 and June 2012 and matched with non-psychiatric urban dwellers by age, sex, and location of residence (controls, n = 649). Propensity score matching with multivariable linear regression was used to test whether stigma towards mental illness, measured by a 13-item Stigma Questionnaire, differed between cases and controls. Cases reported significantly lower stigma scores than controls (b = -0.50, p < 0.0001). The strength of the association between mental illness and stigma was not affected after controlling for age, caste, sex, education, and employment status, while wealth marginally reduced the strength of the association. These findings suggest individuals with a lived experience of mental illness, in New Delhi, India, may be more tolerant towards mental illness and support the need to involve persons with lived experience in the development and implementation of health promotional campaigns and programs aimed at reducing stigma towards mental illness.

Intellectualizing My Anorexia: My (Literal and Literary) Encounters With Madness

I was fourteen the first time I was hospitalized for my mental illness. I would be hospitalized several more times in the following two years, in programs ranging from pediatric psych wards to residential treatment facilities, and even one stay in the ICU following a suicide attempt. Ten years later, my academic career is built on my research around how to create more authentic and ethical representations of mental illness, using my own experience as the case study around which I build my methodology. In essence, I have made my trauma the subject of my academic studies, and yet—as my therapist often says—I cannot see how it could have been any other way. Mentally ill memoirists and essayists possess unique authorial insight into their experiences but are often viewed as unreliable narrators due to the very conditions on which that experience is predicated. Therefore a creative work integrating lived experience of mental illness and critical knowledge of research in medical humanities and literary theory offers a unique perspective in that the author holds a dual position of authority over the reader while also garnering suspicion from them. In this hybrid creative nonfiction piece, I reflexively examine this unique position as I inhabit the dual roles of both patient and expert.

A Market of Lived Experience-User Involvement and the Commodification of Personal Experiences of Mental Illness.

Working actively to engage service users in participatory practices is both a policy expectation and a moral imperative for mental health social workers in contemporary Western mental health care. Recent research suggests that such practices of service user involvement are becoming increasingly individualised and driven by market logic. Based on an ethnographic study within a Swedish public psychiatric organisation, this article applies the concept of commodification to examine this trend. By showing how the practice of user involvement takes the form of a market where personal narratives and experiences of mental health problems are bought and sold as commodities, the analysis illuminates how market logic permeates the everyday practice of user involvement. One consequence of this commodification is that user organisations, as well as individual service users, are restricted in their role as independent actors pursuing their own agenda, and instead increasingly act on behalf of the public and as providers of personal experiences. While it is vital that service user perspectives are heard and recognised within mental health services, mental health social workers need to be aware of the risks of commodifying lived experience. When attention is directed to individual experiences and narratives, there is a risk that opportunities to advocate on behalf of the user collective as a whole and speak from a more principled and socio-political standpoint are lost. In addition, the commodification of personal experience tends to rationalise and privilege user narratives that conform to the dominant institutional logic of the mental health organisation, while excluding more uncomfortable and challenging voices, thereby undermining the ability of service users to raise critical issues that do not align with the interests of the mental health organisation.

Pathways to care among patients with mental illness at two psychiatric facilities in Johannesburg, South Africa.

A patient's pathway to care is often characterized by a sequence of actions taken to remedy ill-health. Research exploring the help-seeking behavior of individuals with mental health problems in sub-Saharan Africa is relatively limited. This study assessed the perceptions and experiences of mental illness and treatment among patients with mental illness at two psychiatric facilities in Johannesburg, South Africa. 309 interviewer administered surveys were conducted between January and July 2022. We used a logistic regression model to examine factors associated with receiving treatment for mental illnesses from traditional healers. Semi-structured interviews were conducted with 18 participants during the same period. Interviews were transcribed and translated into English. Data were managed using NVivo 11 software and thematically analyzed. Results showed that 144 (47%) patients sought mental health care from traditional healers. Higher anxiety symptoms, number of people in the household, believing that traditional medicine can cure mental illnesses, and township living were associated with seeking mental healthcare from traditional healers. Qualitative analysis indicated that participants often believed that mental illness was due to bewitchment and consulted with multiple traditional healers, thus spending large amounts of money for treatment and ultimately delaying access to biomedical care. Collaborative approaches between traditional healers and biomedical professionals show promise in terms of allowing for improved identification and treatment of individuals with mental disorders.

A scoping review of studies examining mental health literacy among Arabs worldwide.

There is growing interest in Mental health literacy (MHL) worldwide, given its important role in overcoming barriers to service use and reducing mental health disparities. However, little is known about MHL among Arabs. We conducted a scoping review to examine MHL levels and correlates among Arabs in both Arab and non-Arab countries, based on Jorm's MHL framework. We conducted a scoping review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using six electronic databases: PubMed, PsycINFO, CINAHL, Soc Index, Web of Science, and Scopus. Data were summarized and synthesized. Nine studies examining MHL among Arabs met our inclusion criteria. Seven of them used a quantitative cross-sectional design. Four studies were conducted in Arab, and five were in non-Arab countries. Five studies were conducted among university students. The studies included indicate moderate to high levels of MHL. Higher MHL was associated with female gender, personal experience of mental health illness, and with help-seeking behaviours. Our review shows a significant lack of empirical studies on Arabs' MHL. These findings should be considered as a call for action for public health researchers, mental health workers, and policymakers to prioritize research in this field.

Experiences of goal planning in Australian community pharmacy settings for people experiencing mental illness: A qualitative study.

Person-centred goal planning is increasingly being incorporated into healthcare interventions. People experiencing severe and persistent mental illnesses (SPMIs) have high levels of co-occurring health conditions, reducing their life expectancy when compared with the general population. As medications are commonly used in the treatment of SPMIs, community pharmacists are well-placed to support the health and wellbeing of this population. To examine pharmacists' and service users' experiences of goal planning as a component of a community pharmacy-based health intervention for people experiencing SPMIs (PharMIbridge intervention). This study utilised a qualitative exploratory approach with an interpretive description method. Semistructured interviews were undertaken with community pharmacists (n = 16) and service user participants (n = 26) who had participated in pharmacist support services for people experiencing SPMIs (PharMIbridge intervention). Four themes relating to goal planning were identified. First, goal planning provided purpose and motivation for participation in the intervention. Planning realistic goals was important but often challenging. Both pharmacists and service users highlighted the relational aspects of goal planning and how strong relationships supported positive behaviour change and outcomes. Finally, individualised and flexible approaches were important aspects of the intervention, ensuring goals were meaningful to service users. The findings from this study identified positive outcomes from the inclusion of goal-planning processes in a community pharmacy-based health intervention. Further research regarding tools, strategies or training that could support future goal-planning interventions in primary healthcare is needed. The PharMIbridge randomised controlled trial research team included lived experience members and was overseen by an expert panel that included members with a lived experience of mental illness and representatives from key organisations. The training provided to pharmacists was co-designed and co-delivered by the researchers and lived experience representatives, and pharmacists were supported by lived experience mentors. Service user participants were invited to participate in the interviews through a number of pathways (e.g., at the completion of the intervention, flyers). Those interested were provided with the full study participant information and provided with a $30 gift voucher at the conclusion of the interview.

A framework for precision “dosing” of mental healthcare services: algorithm development and clinical pilot

BackgroundOne in five adults in the US experience mental illness and over half of these adults do not receive treatment. In addition to the access gap, few innovations have been reported for ensuring the right level of mental healthcare service is available at the right time for individual patients.MethodsHistorical observational clinical data was leveraged from a virtual healthcare system. We conceptualize mental healthcare services themselves as therapeutic interventions and develop a prototype computational framework to estimate their potential longitudinal impacts on depressive symptom severity, which is then used to assess new treatment schedules and delivered to clinicians via a dashboard. We operationally define this process as “session dosing”: 497 patients who started treatment with severe symptoms of depression between November 2020 and October 2021 were used for modeling. Subsequently, 22 mental health providers participated in a 5-week clinical quality improvement (QI) pilot, where they utilized the prototype dashboard in treatment planning with 126 patients.ResultsThe developed framework was able to resolve patient symptom fluctuations from their treatment schedules: 77% of the modeling dataset fit criteria for using the individual fits for subsequent clinical planning where five anecdotal profile types were identified that presented different clinical opportunities. Based on initial quality thresholds for model fits, 88% of those individuals were identified as adequate for session optimization planning using the developed dashboard, while 12% supported more thorough treatment planning (e.g. different treatment modalities). In the clinical pilot, 90% of clinicians reported using the dashboard a few times or more per member. Although most clinicians (67.5%) either rarely or never used the dashboard to change session types, numerous other discussions were enabled, and opportunities for automating session recommendations were identified.ConclusionsIt is possible to model and identify the extent to which mental healthcare services can resolve depressive symptom severity fluctuations. Implementation of one such prototype framework in a real-world clinic represents an advancement in mental healthcare treatment planning; however, investigations to assess which clinical endpoints are impacted by this technology, and the best way to incorporate such frameworks into clinical workflows, are needed and are actively being pursued.

Patient identity narratives through the cultural formulation interview in a New York City outpatient clinic.

Anthropologists have critiqued cultural competence programs in medical settings while introducing mental health clinicians to social theories on culture for practice. We explore how patients articulated narratives about themselves and how clinicians responded to such narratives through an intervention known as the Cultural Formulation Interview that anthropologists have helped develop. We conducted over 500 hours of fieldwork from 2014 to 2019 at an outpatient clinic in New York, analyzing multiple data (participant observation, medical records, patient-clinician sessions, and individual debriefing interviews) in a trial joining clinical and ethnographic methods. Our study enrolled 45 patients and six clinicians, yielding 117 patient-clinician appointments and 98 debriefing interviews. Most patients differed in how they presented their identities through demographic forms and discussed them in sessions with their clinicians. Two-thirds of the patients drew connections between their personal identities and experiences of mental illness. These results reveal why cultural identities should not be taken for granted in clinical settings.

Investigating SANE’s programs around stigma in the media: exploring media engagement experiences of advocates with lived experience of complex mental illness

ABSTRACT Objective SANE facilitates and supports media engagements with their Peer Ambassadors to help elevate the perspectives and lived experiences of people with complex mental illness. This study aimed to explore Peer Ambassadors’ media engagement experiences to better understand their support needs and facilitate improved preparation for their future media engagements. Methods Peer Ambassadors (n = 10) participated in interviews about their media engagement experiences. Participant responses were inductively coded and analysed thematically. Results Three main themes were identified. These related to factors that motivate and influence media engagement experiences, and lived experience advocates’ support and training needs. These were: Empowerment as motivation to share lived experiences with the media; Openness, flexibility and transparency is needed from journalists to positively influence media engagement experiences; Preparation and support for Peer Ambassadors surrounding media engagements is essential. Discussion Media engagements provide a valued opportunity for Peer Ambassadors to share their experiences with large audiences and generate widespread impact on awareness and public stigma. Recommended practices should focus on providing support and training to lived experience advocates to best equip them for undertaking media engagements. Proactively creating additional media opportunities could be expected to increase the reach and impact, as well as the diversity, of the lived experience stories being shared.

Experiences with physical activity, health and well-being among young adults with serious mental illness

ABSTRACT Purpose To explore how young adults with serious mental illness (SMI) experience physical activity and how these experiences influence their perceived health and well-being. Methods Nine young adults with SMI who had participated in an aerobic high-intensity interval training program were interviewed in depth. The interviews were transcribed and subjected to reflexive thematic analysis. Results The results indicated that people with SMI mainly experience physical activity as a meaningful activity that contributes to an increased sense of well-being and better health. However, to overcome various barriers, it is crucial to experience social support and encouragement. The following three main themes were identified through reflexive thematic analysis: (1) positive changes in focus and an increase in well-being occur through physical activity; (2) increased mental strength results from physical activity; and (3) a lack of support and feelings of safety prevent physical activity. Conclusions This study shows that adapted physical activity is an important resistance resource that can promote stronger self-identity, increased mental well-being and social engagement and thus contribute to an improved ability to manage stressors. Furthermore, the findings reveal that to engage in physical activity and promote sustainable life changes, it is important for individuals to choose a physical activity based on personal interest and meaning.

A Focus Group Study of the Views of Persons with a History of Psychiatric Illness about Psychiatric Medical Aid in Dying

Background Medical aid in dying (MAID) is legal in a number of countries, including some states in the U.S. While MAID is only permitted for terminal illnesses in the U.S., some other countries allow it for persons with psychiatric illness. Psychiatric MAID, however, raises unique ethical concerns, especially related to its effects on mental illness stigma and on how persons with psychiatric illnesses would come to feel about treatment and suicide. To explore those concerns, we conducted several focus groups with persons with lived experience of mental illness. Methods We conducted three video-conference-based focus groups involving adults residing in the U.S. who reported a prior diagnosis of any psychiatric illness. Only participants who reported thinking that MAID for terminal illness was morally acceptable were included. Focus group participants were asked to respond to a series of four questions. Groups were facilitated by a coordinator who was independent of the research team. Results A total of 22 persons participated in the focus groups. The majority of participants had depression and anxiety disorders; no participants had psychotic disorders such as schizophrenia. Many participants strongly favored permitting psychiatric MAID, generally on the basis of respect for autonomy, its effects on stigma, and the severe suffering caused by mental illness. Others expressed concerns, typically related to difficulties in ensuring decision-making capacity and to the risk that MAID would be used in lieu of suicide. Conclusions Persons with a history of psychiatric illness, as a group, have a diverse array of views about the permissibility of psychiatric MAID, reflecting nuanced consideration of how it relates to the public perception of mental illness, stigma, autonomy, and suicide risk.

“I literally had no support”: barriers and facilitators to supporting the psychosocial wellbeing of young people with mental illness in Tasmania, Australia

BackgroundThere has been limited focus on understanding the barriers and facilitators to meeting the broader psychosocial needs of young people with mental illness from the perspectives of young people. This is required to advance the local evidence base and inform service design and development. The aim of this qualitative study was to explore young people’s (10–25 years) and carers’ experiences of mental health services, focusing on barriers and facilitators to services supporting young people’s psychosocial functioning.MethodsThis study was conducted throughout 2022 in Tasmania, Australia. Young people with lived experience of mental illness were involved in all stages of this research. Semi-structured interviews were conducted with 32 young people aged 10–25 years with experience of mental illness, and 29 carers (n = 12 parent–child dyads). Qualitative analysis was guided by the Social-Ecological Framework to identify barriers and facilitators at the individual (young person/carer level), interpersonal, and service/systemic level.ResultsYoung people and carers identified eight barriers and six facilitators across the various levels of the Social-Ecological Framework. Barriers included, at the individual level: (1) the complexity of young people’s psychosocial needs and (2) lack of awareness/knowledge of services available; at the interpersonal level: (3) negative experiences with adults and (4) fragmented communication between services and family; and at the systemic level: (5) lack of services; (6) long waiting periods; (7) limited service accessibility; and (8) the missing middle. Facilitators included, at the individual level: (1) education for carers; at the interpersonal level: (2) positive therapeutic relationships and (3) carer advocacy/support; and at the systemic level: (4) flexible or responsive services, (5) services that address the psychosocial factors; and (6) safe service environments.ConclusionsThis study identified key barriers and facilitators to accessing and utilising mental health services that may inform service design, development, policy and practice. To enhance their psychosocial functioning, young people and carers want lived-experience workers to provide practical wrap-around support, and mental health services that integrate health and social care, and are flexible, responsive and safe. These findings will inform the co-design of a community-based psychosocial service to support young people experiencing severe mental illness.

Personal experience of mental illness and stigma

Personal experience of mental illness and stigma

COVID-19 mortality among veterans with serious mental illness in the veterans health administration

ObjectivePersons with serious mental illness (SMI: schizophrenia-spectrum disorders, bipolar disorder) experience increased risk of mortality after contracting COVID-19 based on the results of several international evaluations. However, information about COVID-19 mortality risk among patients with SMI in the Veterans Health Administration (VHA) has been limited, precluding identification of protective factors. The current evaluation was conducted to assess COVID-19 mortality risk among VHA patients with SMI and to evaluate potential protective factors in mitigating mortality risk following a positive COVID-19 diagnosis. MethodsNational VHA administrative data was used to identify all patients (N = 52,916) who received a positive COVID-19 test result between March 1, 2020, and September 30, 2020. Mortality risk was assessed by SMI status via bivariate comparisons and multivariate regression analyses. ResultsIn unadjusted analyses, VHA patients with SMI overall and patients with bipolar disorder in particular did not experience increased mortality risk in the 30 days following a positive COVID test, although patients with schizophrenia had increased risk. Within adjusted analyses, patients with schizophrenia remained at increased mortality risk (OR = 1.38), but at reduced levels relative to previous evaluations in other healthcare settings. ConclusionsWithin VHA, patients with schizophrenia, but not those with bipolar disorder, experience increased mortality risk in the 30 days following a positive COVID-19 test. Large integrated healthcare settings such as VHA may offer services which may protect against COVID-19 mortality for vulnerable groups such as persons with SMI. Additional work is needed to identify practices which may reduce the risk of COVID-19 mortality among persons with SMI.

Does the peer-led Honest, Open, Proud program reduce stigma's impact for everyone? An individual participant data meta-regression analysis.

Many people with mental illness experience self-stigma and stigma-related stress and struggle with decisions whether to disclose their condition to others. The peer-led Honest, Open, Proud (HOP) group program supports them in their disclosure decisions. In randomized controlled trials, HOP has shown positive effects on self-stigma and stigma stress on average. This study examined individual predictors of HOP outcomes and tested the hypothesis that stigma stress reduction at the end of HOP mediates positive HOP effects at follow-up. Six RCTs were included with data at baseline, post (after the HOP program) and at 3- or 4-week follow-up. Baseline variables were entered in meta-regression models to predict change in self-stigma, stigma stress, depressive symptoms and quality of life among HOP participants. Mediation models examined change in stigma stress (post) as a mediator of HOP effects on self-stigma, depressive symptoms, and quality of life at follow-up. More shame at baseline, and for some outcomes reduced empowerment, predicted reduced HOP effects on stigma stress, self-stigma, depressive symptoms, and quality of life. Younger age was related to greater improvements in stigma stress after the HOP program. Stigma stress reductions at the end of HOP mediated positive effects on self-stigma, depressive symptoms and quality of life at follow-up. Participants who are initially less burdened by shame may benefit more from HOP. Stigma stress reduction could be a key mechanism of change that mediates effects on more distal outcomes. Implications for the further development of HOP are discussed.

Collaborating with Traditional and Faith Healers in Mental Health: A Public Health Approach

There is an increasing interest in collaboration between biomedical services and traditional and faith healers for mental health care. In this article, we briefly outline recent research in this area and discuss some of the challenges to collaboration, particularly in relation to the care of people living with serious mental illness (SMI). Several approaches to collaborative mental health care have been attempted primarily in Africa, but also in Asia. Challenges to these collaborations include mutual distrust, power differentials, conceptual and methodological problems, and a lack of organizational support and resources. Importantly, the perspectives of people with lived experiences of mental illness are seldom considered. Research suggests that “bottom-up” approaches using community engagement, dialogue, and mutual learning may enable more effective and sustainable collaboration. We identify a need for greater involvement of people with lived experience of mental illness and their families and consider the potential of a public mental health approach in which collaborations are embedded within communities and existing support structures and accompanied by policies and interventions to address social as well as spiritual and medical needs.

How patients with severe mental illness experience care provided by psychiatric mental health nurse practitioners.

Previous studies in somatic health care revealed that patients find nurse practitioners reliable, helpful, and empathic and feel empowered, at peace, and in control when cared for by nurse practitioners (NPs). Only one study so far considered what value people with severe mental illness (SMI) attached to treatment by a psychiatric mental health nurse practitioner (PMHNP). To explore what meaning people with SMI associate with the care provided by a PMHNP. A qualitative study from a phenomenological perspective was conducted, in which 32 people with SMI were interviewed. Data were analyzed using Colaizzi's seven-step method and the metaphor identification procedure (MIP). Eight fundamental themes emerged: (1) impact of the PMHNP on well-being, (2) feeling connected with, and (3) acknowledged by the PMHNP; (4) the PMHNP's care (not) needed; (5) perception of the PMHNP as a person; (6) shared decision-making; (7) PMHNP's expertise; and (8) flexibility of contact with the PMHNP. MIP analysis revealed six metaphors: PMHNP is a travel aid, means trust, is a combat unit, means hope, is an exhaust valve, and a helpdesk/encyclopedia. The interviewees highly appreciated the treatment and support by the PMHNP for the impact on their well-being. Thanks to the connection with and recognition by the PMHNP, they felt empowered, human, and understood. Challenged by the PMHNP, they focused on possibilities to strengthen self-confidence and self-acceptance. For further positioning of and education for PMHNPs, it is recommended to consider the meaning people with SMI associate with treatment and support by a PMHNP.

Examining Place-Based Neighborhood Factors in a Multisite Peer-Led Healthy Lifestyle Effectiveness Trial for People with Serious Mental Illness.

People with severe mental illness (SMI) experience significantly higher obesity-related comorbidities and premature mortality rates than healthy populations. The physical and social characteristics of neighborhoods where people with SMI reside can play an important role in promoting or hindering healthy eating and physical activity. However, this is seldom considered when designing and testing health behavior interventions for these populations. This study used baseline data from an obesity control trial for low-income, minority people with SMI to demonstrate the utility of assessing neighborhood- and city-level place-based factors within the context of lifestyle interventions. GIS was used to create a zip-code-level social and built environment geodatabase in New York City and Philadelphia, where the trial occurred. Chi-square and t-tests were used to assess differences in the spatial distribution of health-related built and social environment characteristics between and within cities and diet and physical activity outcomes. All types of neighborhood characteristics showed significant environmental differences between and within cities. Several neighborhood characteristics were associated with participants' baseline healthy eating and physical activity behaviors, emphasizing that place-based factors may moderate lifestyle interventions for SMI patients. Future behavioral interventions targeting place-dependent behaviors should be powered and designed to assess potential moderation by place-based factors.