Ongoing Mental Illness Research Articles

Blonde (2022)

Blonde (2022)

Refugee mental health research: challenges and policy implications.

Mental illness is common among forced migrant populations, and ongoing mental illness can hinder refugees' ability to negotiate the asylum process. This editorial rehearses the challenges of undertaking research among forced migrant populations, exploring how they could be addressed in future research, and outlines differences between forced migrant groups. It points to the growing body of evidence that can be called on in advocating for systemic change in government policy and mental health services, with significant support for a sensitive and objective inquisitorial approach to gathering evidence in support of asylum claims.

Behavioral Health Organizations Struggle Financially During Pandemic

Back to table of contents Previous article Next article ProfessionalFull AccessBehavioral Health Organizations Struggle Financially During PandemicKatie O'ConnorKatie O'ConnorSearch for more papers by this authorPublished Online:11 May 2020https://doi.org/10.1176/appi.pn.2020.5b21AbstractMany behavioral health organizations reported in a survey that they may be able to keep their doors open only a few months longer due to the financial impact of the COVID-19 pandemic.Almost two-thirds of community behavioral health organizations (CBHOs) believe they can survive financially only for three months or less under the economic conditions resulting from the COVID-19 pandemic, according to an online survey.The survey was conducted April 6 to 12 by the National Council for Behavioral Health and ndp | analytics, an economic and communications research firm. It included responses from 880 CBHOs located all over the United States and revealed that organizations have had to turn patients away, close programs, and generally reduce their operations as the economic realities of the current pandemic climate have set in.Over 60% of CBHOs across the country have closed at least one program due to COVID-19, according to the survey, while 31% of organizations have canceled or rescheduled appointments or turned away patients. The impacts have been more severe for smaller organizations that serve 2,000 patients or fewer annually.Nineteen percent of CBHOs believe they could survive only one month or less under the current COVID-19 conditions, the survey found. Only 9.4% of organizations believe they could survive a year or more.Throughout the COVID-19 pandemic, APA has urged Congress to provide funding to behavioral health organizations.“The COVID-19 pandemic could cause mental health care capacity to diminish across the country, just when communities need care the most,” said APA CEO and Medical Director Saul Levin, M.D., M.P.A. “If behavioral health organizations are forced to close, tens of thousands of patients will find themselves without necessary and life-saving mental health and addiction treatment.”“People have ongoing mental illness needs,” says Joe Parks, M.D. “Pandemics and economic crises don’t mean people with schizophrenia or bipolar disorder get better. They still need follow-up visits and refills, psychosocial support, and help to maintain their housing.”Losing access to care at CBHOs could force patients to turn to emergency departments (EDs) because they have nowhere else to go, which is not ideal in the era of COVID-19, pointed out Joe Parks, M.D., medical director of the National Council for Behavioral Health. People with mental illness have two to three times the rate of medical illness compared with the rest of the population, he said, as well as other risk factors that make them especially vulnerable to COVID-19.CBHOs often serve as the vital link between patients with mental illness and primary care so they can get treatment for both their physical and mental illnesses. In addition to physical and mental health services, CBHOs also provide patients with community supports, from job training to housing services and food assistance.CBHOs don’t just have an impact on patients, they also provide employment opportunities for providers and many other support staff in the community. In terms of the impact on employees, 46.7% of all CBHOs have had to, or plan to, lay off or furlough employees, according to the survey results. More furloughs and layoffs have taken place, or are planned, at organizations serving 8,000 patients or more.CBHOs do not have regular or widespread use of personal protective equipment (PPE) normally, so most centers had limited PPE stock to begin with. But now, these CBHOs have also been dealing with a significant lack of PPE, with 82.9% reporting that they don’t have enough PPE for two months of operations.“Behavioral health organizations need equal priority with the rest of health care,” Parks said. Just like other health facilities, CBHOs need access to PPE and testing capabilities so they can provide in-person care when necessary, and they need to be reimbursed for telemedicine services when in-person care is not an option, or is easier and clinically appropriate. “If we want our EDs to function well, we need our behavioral workforce to be strong throughout this pandemic,” he said.Parks said there will likely be a surge of need for mental health services soon, as the country reels from the economic and social impacts of the pandemic. “We should anticipate the next surge and ensure we have the mental health capacity and workforce to meet the need.“We need to get our priorities straight,” he added. ■“COVID-19 Economic Impact on Behavioral Health Organizations” is posted here. ISSUES NewArchived

How the media cover mental illnesses: a review

PurposeMental illness has become an important public health issue in society, and media are the most common sources of information about mental illnesses. Thus, it is important to review research on mental illnesses and media. The purpose of this paper is to provide a narrative review of studies on mental illnesses in the media and identifies important research gaps.Design/methodology/approachA combination of searching key databases and examining reference lists of selected articles was used to identify relevant articles. In total, 41 empirical studies published in the last 12 years were reviewed.FindingsThe review found that substantial research had been done to investigate media portrayals of mental illnesses and the effects of such portrayals might have on the public. Media still portray mental illnesses negatively in general, which contributes to the ongoing mental illness stigmatization. Nonetheless, discussions of mental illnesses in direct-to-consumer advertisements and social media tend to be more objective and informative. These objective portrayals could help improve mental health literacy and reduce stigma. More importantly, media can also reduce the stigma if used strategically. Research has found that entertainment-education programs and web-based media have strong potential in reducing mental illness stigma. Recommendations for future research are also discussed.Practical implicationsFindings can guide future efforts to use media to educate the public about mental illnesses and reduce mental illness stigma.Originality/valueThis study reviews the most recent research on mental illnesses in the media and provides important references on the media representation of mental illnesses, media effects of such representation, and using media to reduce stigma.

Conceptualising wellbeing for young people living with mental illness

Background/Aims: Assisting clients to achieve wellbeing, even in the presence of ongoing mental illness, should be a primary goal of mental health services. However, little is known about what wellbeing means for young people living with mental illness. The aim of this study is to explore the ways in which young Australians living with mental illness conceptualise their wellbeing. Methods: Five focus groups were conducted with young people (n=20; age range: 16–25 years) living with mental illness. Results were analysed qualitatively using constant comparative analysis. Results: Analysis of the data indicated that participants were describing two different but complementary types of concepts. We conceptualised these two types of concepts as ‘building blocks’ and ‘foundations’ of wellbeing, respectively. Five building blocks were identified, which together constituted wellbeing for participants: i) sense of self; ii) relationships; iii) sense of the future; iv) feelings and experiences; v) agency. These building blocks were supported or undermined by seven foundations: i) activities; ii) having things; iii) mental illness; iv) the past; v) coping strategies; vi) environmental supports and barriers; vii) personal characteristics. Conclusions: The findings support the use of a recovery paradigm for young people with mental illness. The framework presented can be used to assist young people to consider different aspects that make up their wellbeing and plan ways to address these by attending to multiple foundational factors.

Art Making as a Mental Health Recovery Tool for Change and Coping

The intrinsic benefits of art making may be implicated in how and why people with mental illness turn to art therapy to aid their recovery. In this longitudinal multiple case study adult participants (N = 12) with severe and ongoing mental illness were recruited through their involvement in diverse community mental health art therapy programs. An interpretive phenomenological data analysis revealed that participants utilized art making as a change mechanism and coping tool that encouraged development of flexible and adaptable approaches toward overcoming barriers in their recovery process.

Family carers: lived experience of caring for relatives with an SMI

This study explored family carers’ lived experience of caring for a relative with an ongoing mental illness. An interpretative phenomenological approach was adopted. Participants (n = 8) were self-selecting and members of SHINE, an Irish voluntary organisation supporting people with mental illness and their families. Three super-ordinate themes were interpreted from the interview data. The first theme, ‘nobody told me this was the way it is’ represents participants’ experiences of not understanding what was happening to their relative and what they should do when their relative was first diagnosed. The second theme, ‘feeling excluded’, represents the participants’ sense of exclusion. For some, the reason for this exclusion was because of the confidentiality embedded in the Mental Health Act. The final theme, ‘you don't feel judged’ represents the importance of the support group to participants, especially at the beginning when their relative was first diagnosed. The study findings illustrate the importance of education for relatives, and the role support groups play in support and education.

What happens to depressed adolescents? A follow-up study into early adulthood

BackgroundThis study describes the mental illness and psychosocial outcomes of adolescents who experienced a depressive disorder and identifies predictors of full remission and recurrence. Methods140 adolescents with major depressive disorder, dysthymic disorder, or depressive disorder NOS were offered psychosocial and/or antidepressant treatment across two clinical trials. Three to nine years later (mean 5.7 years), 111 adolescents and young adults completed self-, parent- and clinician-reported measures of psychopathology and psychosocial functioning in a naturalistic follow-up study. The Structured Clinical Interview for DSM-IV Axis 1 Disorders was used to determine the presence or absence of depressive disorder as well as other Axis 1 Disorders. ResultsBy the follow-up assessment, most adolescents made a full remission from their index depressive disorder (92.6%). Recurrence of depressive disorder (52.4%) during the follow-up period was common, as was the experience of other disorders including anxiety, substance abuse and eating disorders. Time to full remission and recurrence did not vary between baseline types of depressive disorder. Self-reported depressive symptoms and anxiety disorder were associated with failure to achieve full remission while socio-economic status, self-reported self-efficacy and depressive symptoms were associated with recurrence of depressive disorder. LimitationsDue to different treatment starting times, the length of the follow up period varied by up to 5.2 years. ConclusionsAdolescents who experience depressive disorder are at high risk of ongoing mental illness and psychosocial impairment. Predictors of the course of depressive disorder may be of use in determining which adolescents may require more intensive intervention.

Cardiovascular fitness in early adulthood and future suicidal behaviour in men followed for up to 42 years

Cardiovascular fitness influences many aspects of brain function. However, the relationship between cardiovascular fitness and suicidal behaviour is unknown. Therefore, we aimed to determine whether cardiovascular fitness at age 18 years is associated with future risk of suicide attempt/death. We performed a population-based Swedish longitudinal cohort study of male conscripts with no previous or ongoing mental illness (n = 1,136,527). The conscription examination, which took place during 1968-2005, included the cycle ergonometric test and tests of cognitive performance. Future risk of suicide attempt/death over a 5- to 42-year follow-up period was calculated with Cox proportional hazards models controlling for several confounders including familial factors. At least one suicide attempt was recorded for 12,563 men. Death by suicide without a prior attempt was recorded in 4814 additional individuals. In fully adjusted models low cardiovascular fitness was associated with increased risk for future attempt/death by suicide [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.64-1.94]. The HR changed only marginally after exclusion of persons who received in-patient care for depression (HR 1.76, 95% CI 1.61-1.94). Poor performance on both the cardiovascular fitness and cognitive tests was associated with a fivefold increased risk of suicide attempt or suicide death (HR 5.46, 95% CI 4.78-6.24). Lower cardiovascular fitness at age 18 years was, after adjustment for a number of potential confounders, associated with an increased risk of attempt/death by suicide in adulthood. It remains to be clarified whether interventions designed to improve fitness in teens can influence the risk of suicidal behaviour later in life.

Examining Relationships Between Receiving Mental Health Services in the Pennsylvania Prison System and Time Served

This study examined a cohort of 7,046 men who were released from the Pennsylvania State prison system between 1999 and 2002 to Philadelphia County to assess the relationships between receipt of mental health services in prison and prison exit. Administrative data on prison stays for 7,046 men released from Pennsylvania prisons to Philadelphia locations were analyzed. Of the 7,046 men, 8.7% received ongoing or intensive mental health services and 25.9% received mental health services while incarcerated. Multivariate analyses indicate that use of mental health services was positively associated with increased odds of serving the full prison sentence (as opposed to receiving parole), although the relationship between mental health services received and length of prison episode was inconclusive. Dynamics related to prison release warrant further attention in efforts to reduce the prevalence of mental illness in prisons and to facilitate community reentry for persons so diagnosed.

Highlights of the 1998 Institute on Psychiatric Services. Issues in public-sector managed care.

Highlights of the 1998 Institute on Psychiatric Services. Issues in public-sector managed care.

The deserving and the undeserving: Selectivity and progress in a community care service

Despite increasing evidence of the potential efficacy of community services for people with serious and ongoing mental illness, the popular media and professional literature reflect mounting concern regarding those people who do not receive the care they need. For community care services to become more accessible, acceptable and appropriate to the needs of all those people who are disabled by serious mental illness, more information is needed about the people they currently fail to serve. This study addresses this issue by examining the progress, characteristics and views of one hundred consecutive referrals to an exemplary community care service. In particular, those who were accepted for care (60%) are compared with those who themselves refused care (27%), and those who were rejected by the service (9%). The results replicate those of other studies of community care: people accepted for care showed greater improvement in many areas than those who did not get into the service. However, those people rejec...