Mental Health Rehabilitation Research Articles

Cost-effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-COVID-19 condition after hospitalisation for COVID-19: the REGAIN RCT

BackgroundFollowing the COVID-19 pandemic, millions of people continue to experience ongoing physical and mental health sequelae after recovery from acute infection. There is currently no specific treatment for the diverse symptoms associated with post-COVID-19 condition. Physical and mental health rehabilitation may help improve quality of life in such patients. This study reports the cost-effectiveness of a programme of physical and mental health rehabilitation compared to best practice usual care in people with post-COVID-19 condition who were previously hospitalised.MethodsWe conducted an economic evaluation within a randomised controlled trial from the perspective of the UK national health service (NHS) and personnel social services perspective (PSS). Resource used and health-related quality of life were collected using bespoke questionnaire and the EQ-5D-5 L questionnaire at three, six, and 12 months. Incremental costs and quality adjusted life years accrued over the follow-up period were estimated and reported as the incremental cost-effectiveness ratio. Estimate uncertainty was managed by multiple imputation and bootstrapping cost-effectiveness estimates; and displayed graphically on the cost-effectiveness plane.ResultsOver a 12-month time horizon, incremental costs and QALYs were £305 (95% CI: -123 to 732) and 0.026 (95% CI: -0.005 to 0.052) respectively. The ICER was £11,941 per QALY indicating cost-effective care. Sensitivity analyses supported the base case findings. The probability of the intervention being cost-effective at a £30,000 per QALY willingness-to-pay threshold was 84%.ConclusionThe within-trial economic evaluation suggested that people with post-COVID-19 condition after hospitalisation should be offered a programme of physical and mental health rehabilitation as it likely reflects a cost-effective use of NHS resources. Hospitalisation for COVID-19 has become less commonplace: further evaluation in non-hospitalised patients may be worthwhile.Trial registrationISRCTN registry ISRCTN11466448 23rd November 2020.

Empowering health: exploring the vital role of facilitator organisations in supporting chronic disease patients in Assam, India

BackgroundThe research centers on an underrated type of mediator organization namely facilitator organizations (FO) that work in the health care setting. These organizations are mediators that bridge the gap between patients (healthcare customers) and medical services. The facilitator organizations considered for the study are non-governmental organizations situated in Assam that works in align to chronic diseases, particularly cancer.MethodsThe data collection was done through organizational referrals for the study making it a snowball sampling, progressively incorporating additional contemporary entities. The study's respondents were facilitator organizations (i.e.Non-Government Organizations) actively involved in addressing chronic disease. Data were gathered from these facilitator organizations situated in Assam, India, supporting healthcare customers specifically those with cancer. Key informant interviews and semi-structured questionnaires were used for data collection, the responses were documented using a field diary and the Lovelock service model was used as a reference for the construction of the questionnaire and developing the research framework.ResultsThe analysis of data shows that facilitator organisations maintain continuity in relationships, which enhances health management and outcomes for customers. The shift in cancer care towards a patient-centred approach and the crucial role of FOs in providing comprehensive and individualized care, addressing diverse patient needs thereby addressing the holistic development of the health care customer is vital. In addition, effective patient-centred communication, incorporating trust, compassion, respect and comprehensive support including mental health therapy, occupational therapy, and rehabilitation plays a crucial role in leading a normal life. `ConclusionThe facilitator organizations dealing with Cancer have to meet a broad range of services outside the core medical service providers for their healthcare customers. These efforts contribute to the overall recovery of both the healthcare customer with cancer and their family.

Role of Art Therapy in Mental Health Rehabilitation: Evidence from Clinical Interventions.

Role of Art Therapy in Mental Health Rehabilitation: Evidence from Clinical Interventions.

THE SILENT STRUGGLE: DEPRESSION AND ITS DETERMINANTS AMONG ADULTS IN THE WAKE OF THE COVID-19 PANDEMIC IN DELHI

Introduction: The beginning of 2020 flooded with news of coronavirus disease 2019 (COVID-19) throughout the world.Many countries have shown higher ratesof depression, anxiety, hazardous and harmful alcohol use, and lower mental well-being than usual ratio. Hence, this study was planned to assess the prevalence of depression and its determinants among adults living in Delhi during the COVID-19 pandemic.Methods:A cross-sectional study was conducted during May and June 2020 on adults more than 18 years of age living in Delhi. A total of 267 respondent’s data were collected and analyzed. Data werecollected using a pre-tested, semi-structured questionnaire,and the Patient Health Questionnaire-9 (PHQ) scale was used to assess depression.Mann Whitney and Kruskal Wallis testswere used to check the association of depression with socio-demographic, behavioral,and COVID-19-related factors. Results:Out of 267 subjects around 61% were males, 61.8% were above 30 years of age and around 88% were living in urban areas. The prevalence of depression among the general population was found to be significantly high at 79.8%. Depression score was significantly higher among females (p=0.024), in the younger age (<30 years) (p <0.001), in the unmarried group (p<0.001), and among non-smokers (p=0.006). Respondents who had undergone COVID-19 testing (p =0.018),been quarantined (p =0.009), come into contact with COVID-19-positive patients (p =0.030) and who were scared of working during the pandemic (p<0.001) reported highlevels of depression.Conclusion:The study showed high depression among the adult population during the COVID-19 pandemic. Improving mental health screening, counsellingsessions, and rehabilitation could be pivotal in addressing this challenging period

Exploring healthcare professional’s engagements and experiences towards people who use new psychoactive substances in different addiction and mental healthcare services

PurposeNew psychoactive substance (NPS) use in mental health and addiction health-care services is a common co-morbidity. This paper aims to explore the survey responses with health-care professional’s (HCPs) engagements and experiences towards people who use NPS in five health-care services.Design/methodology/approachA theoretically adapted online survey design explored the engagements and experiences of participants towards people who use NPS across (n = 3) community and (n = 2) rehabilitation mental health and addiction health-care services consisting of (n = 1,027) service users.FindingsA total of 92 participants (of 120 participants) completed the survey and 28 did not. Most (56.33%) reported neutral to poor experiences and engagements and a lack of NPS-related policies, procedures and educational training. Participants (99%) recognised the harmful effects of NPSs and (87%) requested clinical assessment procedures. The participants are unable to identify and manage acute intoxication by NPS, lack knowledge of NPS adverse effects and requested NPS-specific training on drug legislation.Research limitations/implicationsThe sample may not be representative with the broader UK population. The study’s methods are comparable to similar research surrounding NPS in health-care services. Similar studies may advance the findings.Practical implicationsThe implications for practice include NPS awareness trainings, educational updates through seminars and conferences. Participants requested clearer NPS assessment, referral and management processes. Several policy-making and procedural opportunities exist to ensure a better health outcome for people who use NPS.Originality/valueTo the best of the authors’ knowledge, this is the first theoretically adapted survey to explore participant’s engagements and experiences with people who use NPS in addiction and mental health settings.

Development of Mental Health and Social Rehabilitation Service Models for Psychosocial Disabilities

This study aims to determine the extent to which policies related to persons with disabilities and mental health can accommodate the rights of people with psychosocial disabilities, then the extent to which the model of mental health services and social rehabilitation for psychosocial disabilities contributes to mental health treatment in DIY. YAKKUM Rehabilitation Center through capital development of mental health services and post-recovery social rehabilitation that is accessible and community-resourced. This model is oriented towards improving the quality of life of people with psychosocial disabilities and the existence of communities that contribute proactively to community-based mental health efforts in DIY. The data mining method in this study uses a mixed method, namely discriptive studies, descriptive qualitative, participant as observer and participant non observer. Subjects in this study included people with psychosocial disabilities, caregivers, mental health cadres, village governments, puskesmas and related local organizations. The results of this study show that the service model developed by the YAKKUM rehabilitation center is able to encourage social recovery in people with psychosocial disabilities, strengthen their role in the community in community-based mental health, local mental health policies that accommodate the rights of people with psychosocial disabilities, the existence of a mental health service system that focuses on fulfilling the rights of psychosocial disabilities and social rehabilitation.

Utilising co-design to develop a lived experience informed personal safety tool within a mental health community rehabilitation setting.

Mental health personal safety tools aim to promote a recovery focus and empower an individualised approach to consumer care. These clinical tools are predominantly utilised in acute mental health settings with a person during or straight after a crisis. There is currently a gap in the literature regarding the preparation of personal safety tools in non-acute mental health settings. This descriptive article discusses the learnings and outcomes from a co-designed project that aimed to develop a personal safety tool suitable for a community mental health rehabilitation setting. Seven people with lived experience engaging within a mental health community-based rehabilitation service were recruited through convenience sampling to participate in the co-design project. A focus group approach was utilised during four group meetings to develop a personal safety tool template. Experiences and ideas about safety planning were transcribed during meetings and thematic analysis extracted key themes. Five steps underpinned the co-design process that included identifying the need, establishing the co-design group, planning, design and development, and review and closure. Consumer involvement commenced at step two of the co-design process. The completed personal safety tool was designed with consumer input and review. The personal safety tool consisted of nine intervention components. Four key themes emerged from focus group meetings that informed the content of the tool: (i) ensuring the personal safety tool is individualised and meaningful, (ii) promoting exploration of personal strengths and interests, (iii) enabling opportunities to learn self-management skills, and (iv) treating the personal safety tool as a dynamic and adaptable tool. Findings suggest that a personal safety tool targeted to a mental health community-based rehabilitation setting should have an individualised and preventative focus to mental health care. Embedding co-design principles can support opportunities for meaningful consumer engagement and establishing consumer and clinician partnerships.

Exploring the Quality-of-Care Dynamics of Inpatient Psychosocial Rehabilitation in Community-Based Mental Health Services: A Comprehensive Analysis.

This study aims to investigate the intricacies of inpatient psychosocial rehabilitation by examining a community-based mental health inpatient rehabilitation service in Nova Scotia, Canada. It provides a comparative analysis with national standards using the Quality Indicator for Rehabilitative Care (QuIRC) and offers recommendations for improvement. The study will link findings to research on enhancing specific domains, focusing on strategies to address identified challenges and leverage opportunities to meet or exceed national benchmarks in promoting recovery and social inclusion. This study utilizes the QuIRC as a primary assessment tool to evaluate the quality of care in psychiatric and psychosocial rehabilitation care unit. The QuIRC assessment findings reveal crucial insights across several domains, including the living and therapeutic environment, treatments and interventions, self-management and autonomy, social interface, human rights, and recovery-based practices. The study identifies strengths and areas for improvement by comparing unit scores with national averages in Canada, offering a detailed examination of the quality of care provided in a community-based psychosocial rehabilitation service. Using the QuIRC identifies strengths and areas for improvement of current care provided, opening opportunities for positive change and improved quality of care. By highlighting the critical indicators of the quality of care and best practices derived from the QuIRC assessment, this study provides practical insights that can be directly applied by practitioners, policymakers, and stakeholders, fostering an understanding of essential elements that support effective mental health rehabilitation within community settings.

Life is better but not without challenges: experiences following discharge from community-based residential mental health rehabilitation-a qualitative content analysis.

Community-based residential mental health rehabilitation units for people experiencing severe and persistent mental illness are increasingly available in Australia. Research completed 20 years ago suggested that people leaving these services often experienced impoverished social lives and other challenges in the community. It is unclear whether contemporary consumers experience similar difficulties. This qualitative study explored contemporary consumers' experiences after leaving community-based residential services. An inductive qualitative content analysis of individual interviews was completed with consumers 12-18 months following discharge from three community care units (CCUs) in Queensland, Australia. The interview schedule explored three questions: (1) What does life look like after leaving the CCU, (2) Has the CCU impacted their life, and (3) How could the CCU experience be improved? A convenience sample was used, with sampling continuing until thematic saturation was achieved. A member of the research team who had relevant lived experience actively supported the analysis and interpretation. Seventeen interviews were completed. Three themes were identified: 'life is better but not without challenges', 'the CCU helps you get ready to go out into the world', and 'strict rules are important but rigid expectations can be hard; things could be better'. Consumers reflected positively on their lives post-discharge from a community-based residential rehabilitation unit and viewed the service as having supported improvements in their lives. The findings suggest the appropriateness of optimism about the possibility of sustained improvements in quality of life after leaving community-based transitional residential rehabilitation support.

Learning Underlies Change: The National School of Rehabilitation, Integration, and Recovery in Mental Health

Learning Underlies Change: The National School of Rehabilitation, Integration, and Recovery in Mental Health

An Audit to Assess Nicotine Management on a Mental Health Rehabilitation Unit in Mersey Care NHS Foundation Trust

An Audit to Assess Nicotine Management on a Mental Health Rehabilitation Unit in Mersey Care NHS Foundation Trust

An Audit to Assess Compliance With DVLA Guidelines on a Mental Health Rehabilitation Unit

An Audit to Assess Compliance With DVLA Guidelines on a Mental Health Rehabilitation Unit

International Experience of Implementing Cognitive Remediation for People With Psychotic Disorders.

Cognitive remediation (CR) is an effective therapy for the cognitive impact of mental illness, especially schizophrenia. Global efforts are being made to implement CR into routine mental health services with the aim of improving functional outcomes for the population of people recovering from mental illness. Implementation and dissemination of CR in heterogeneous settings require knowledge gleaned from formal implementation research and pragmatic experiential learning. This article describes cross-cultural approaches to CR implementation, focusing on initiatives in France, the United States, Australia, and Japan. Key leaders in the implementation of CR in France, the United States, Australia, and Japan were asked to describe the implementation and dissemination process in their settings with respect to the categories of context, implementation, outcomes, facilitators, and barriers. All 4 sites noted the role of collaboration to leverage the implementation of CR into mental health rehabilitation services. In France, high-level, government organizational backing enhanced the dissemination of CR. Academic and clinical service partnerships in the United States facilitated the dissemination of programs. The advocacy from service users, families, and carers can aid implementation. The support from international experts in the field can assist in initiating programs but maintenance and dissemination require ongoing training and supervision of staff. CR is an effective intervention for the cognitive impact of schizophrenia. Programs can be implemented in diverse settings globally. Adaptations of CR centering upon the core components of effective CR therapy enhance outcomes and enable programs to integrate into diverse settings.

Connections between specific mental health diagnoses of schizophrenia, bipolar disorder and schizoaffective disorder and primary substance use

PurposeThis study aims to use the database of consumers referred to the dual diagnosis shared care service to examine those connections. The Eastern Dual Diagnosis Service, based in Melbourne, Australia, has established a database of consumers with co-occurring mental health disorders and problematic substance use. An examination of mental health and substance-use information obtained over a two-year period in the delivery of dual diagnosis shared care to consumers of mental health services is supporting an improved understanding of substance use and the connections to specific mental health diagnoses of schizophrenia, bipolar disorder and schizoaffective disorder.Design/methodology/approachThis research uses a quantitative approach to review the prevalence of primary substance use and mental health diagnoses for consumers referred to as dual diagnosis shared care. Reviewed are referrals from adult mental health community and rehabilitation teams operating within a mental health and well-being program between January 2019 and December 2020 inclusive.FindingsOf the 387 clients referred to the specialist dual diagnosis shared care, methamphetamine, alcohol and cannabis are associated with 89.4% of the primary mental health diagnosis (PMHD). The most common PMHDs are schizophrenia, schizoaffective disorder and bipolar disorder. The most common PMHD and substance-use connection was schizophrenia and methamphetamine. Nicotine was reported to be used by 84% of consumers and often occurred in addition to another problematic primary substance.Originality/valueImproved dual diagnosis data collection from a community-based clinical mental health service is increasing understanding of the mental health and substance-use relationship. This is now providing clarity on routes of investigation into co-occurring mental health and problematic substance-use trends and guiding improved integrated treatments within a contemporary mental health setting.

Exploring women’s experiences of an inpatient mental health rehabilitation service

Exploring women’s experiences of an inpatient mental health rehabilitation service

Identification of factors associated with hospitalization in an outpatient population with mental health conditions: a case-control study.

Addressing relevant determinants for preserved person-centered rehabilitation in mental health is still a major challenge. Little research focuses on factors associated with psychiatric hospitalization in exclusive outpatient settings. Some variables have been identified, but evidence across studies is inconsistent. This study aimed to identify and confirm factors associated with hospitalization in a specific outpatient population. A retrospective monocentric case-control study with 617 adult outpatients (216 cases and 401 controls) from a French community-based care facility was conducted. Participants had an index outpatient consultation between June 2021 and February 2023. All cases, who were patients with a psychiatric hospitalization from the day after the index outpatient consultation and up to 1 year later, have been included. Controls have been randomly selected from the same facility and did not experience a psychiatric hospitalization in the 12 months following the index outpatient consultation. Data collection was performed from electronic medical records. Sociodemographic, psychiatric diagnosis, historical issues, lifestyle, and follow-up-related variables were collected retrospectively. Uni- and bivariate analyses were performed, followed by a multivariable logistic regression. Visit to a psychiatric emergency within a year (adjusted odds ratio (aOR): 13.02, 95% confidence interval (CI): 7.32-23.97), drug treatment discontinuation within a year (aOR: 6.43, 95% CI: 3.52-12.03), history of mental healthcare without consent (aOR: 5.48, 95% CI: 3.10-10.06), medical follow-up discontinuation within a year (aOR: 3.17, 95% CI: 1.70-5.95), history of attempted suicide (aOR: 2.50, 95% CI: 1.48-4.30) and unskilled job (aOR: 0.26, 95% CI: 0.10-0.65) are the independent variables found associated with hospitalization for followed up outpatients. Public health policies and tools at the local and national levels should be adapted to target the identified individual determinants in order to prevent outpatients from being hospitalized.

Paving the way for COVID survivors' psychosocial rehabilitation: Mining topics, sentiments, and their trajectories over time from Reddit.

Objective: This study examined major themes and sentiments and their trajectories and interactions over time using subcategories of Reddit data. The aim was to facilitate decision-making for psychosocial rehabilitation. Materials and Methods: We utilized natural language processing techniques, including topic modeling and sentiment analysis, on a dataset consisting of more than 38,000 topics, comments, and posts collected from a subreddit dedicated to the experiences of people who tested positive for COVID-19. In this longitudinal exploratory analysis, we studied the dynamics between the most dominant topics and subjects' emotional states over an 18-month period. Results: Our findings highlight the evolution of the textual and sentimental status of major topics discussed by COVID survivors over an extended period of time during the pandemic. We particularly studied pre- and post-vaccination eras as a turning point in the timeline of the pandemic. The results show that not only does the relevance of topics change over time, but the emotions attached to them also vary. Major social events, such as the administration of vaccines or enforcement of nationwide policies, are also reflected through the discussions and inquiries of social media users. In particular, the emotional state (i.e., sentiments and polarity of their feelings) of those who have experienced COVID personally. Discussion: Cumulative societal knowledge regarding the COVID-19 pandemic impacts the patterns with which people discuss their experiences, concerns, and opinions. The subjects' emotional state with respect to different topics was also impacted by extraneous factors and events, such as vaccination. Conclusion: By mining major topics, sentiments, and trajectories demonstrated in COVID-19 survivors' interactions on Reddit, this study contributes to the emerging body of scholarship on COVID-19 survivors' mental health outcomes, providing insights into the design of mental health support and rehabilitation services for COVID-19 survivors.

Cross-sectoral collaborations between nonprofit organizations and businesses: implications for organizations providing mental health rehabilitation services

ABSTRACT This article presents a case study of a community garden in Israel, the product of a collaboration between a Social Service Nonprofit Organization (SSNO) providing mental health rehabilitation services and a real-estate business firm. The study examines the inter-organizational dynamics of this collaboration, as well as its benefits and challenges for the SSNO and its service users, based on interviews with key figures, onsite observations, and document analysis. The results indicate that collaboration with business can offer SSNOs benefits in terms of financial resources and volunteers, but at the same time involves difficulties, which are intensified in the context of mental health SSNOs.

Clinical effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-covid-19 condition (REGAIN study): multicentre randomised controlled trial

ObjectiveTo evaluate whether a structured online supervised group physical and mental health rehabilitation programme can improve health related quality of life compared with usual care in adults with post-covid-19 condition...

Assessing the clinical and cost-effectiveness of inpatient mental health rehabilitation services provided by the NHS and independent sector (ACER): protocol

BackgroundMental health rehabilitation services provide specialist treatment to people with particularly severe and complex problems. In 2018, the Care Quality Commission reported that over half the 4,400 mental health inpatient rehabilitation beds in England were provided by the independent sector. They raised concerns that the length of stay and cost of independent sector care was double that of the NHS and that their services tended to be provided much further from people’s homes. However, there has been no research comparing the two sectors and we therefore do not know if these concerns are justified. The ACER Study (Assessing the Clinical and cost-Effectiveness of inpatient mental health Rehabilitation services provided by the NHS and independent sector) is a national programme of research in England, funded from 2021 to 2026, that aims to investigate differences in inpatient mental health rehabilitation provided by the NHS and independent sector in terms of: patient characteristics; service quality; patient, carer and staff experiences; clinical and cost effectiveness.MethodsACER comprises a:1) detailed survey of NHS and independent sector inpatient mental health rehabilitation services across England; 2) qualitative investigation of patient, family, staff and commissioners’ experiences of the two sectors; 3) cohort study comparing clinical outcomes in the two sectors over 18 months; 4) comprehensive national comparison of inpatient service use in the two sectors, using instrumental variable analysis of routinely collected healthcare data over 18 months; 5) health economic evaluation of the relative cost-effectiveness of the two sectors. In Components 3 and 4, our primary outcome is ‘successful rehabilitation’ defined as a) being discharged from the inpatient rehabilitation unit without readmission and b) inpatient service use over the 18 months.DiscussionThe ACER study will deliver the first empirical comparison of the clinical and cost-effectiveness of NHS and independent sector inpatient mental health rehabilitation services.Trial registrationISRCTN17381762 retrospectively registered.