RehabWire - Volume 10, Number 6, July 2008.


Mental Health/Psychiatric Disability

NIDRR research on mental health and psychiatric disability spans several priorities including Employment Outcomes, Health and Function, and Independent Living and Community Participation.

NIDRR Grantees on the Cutting Edge.

Rehabilitation Research and Training Center Promoting Community Integration of Individuals with Psychiatric Disabilities, University of Pennsylvania (H133B031109) led by Mark Salzer, PhD. Bonnie Gracer, Project Officer.
Abstract: The goal of this Center is to insure that people with psychiatric disabilities not only move from institutional care to more integrated settings but also are free to choose to participate in a wide range of roles in their communities. The Center’s five year mission focuses on three core areas: (1) Factors Associated with Community Integration develops a coherent conceptual framework for community integration and identifies key factors, intervention models, and appropriate instrumentation and research methodologies; (2) Policies Associated with Community Integration identifies, develops, and assesses the effectiveness of a range of public policies and system strategies promoting community integration and engage key stakeholders in learning about and utilizing the Center’s findings; and (3) Intervention Supports that Assist Community Integration identifies, develops, and assesses the effectiveness of support service interventions promoting community integration, and provides training, technical assistance, and dissemination based on those initiatives to change behaviors and practices of key stakeholders.
Find out more at: www.upennrrtc.org

Rehabilitation Research and Training Center for Children’s Mental Health, University of South Florida (H133B040024) led by Robert Friedman, PhD. Bonnie Gracer, Project Officer.
Abstract: The Research and Training Center Children’s Mental Health conducts an integrated set of research projects designed, in the short run, to enhance knowledge about effective implementation of systems of care, and, in the long run, to make it possible for children with serious emotional disturbances to live, learn, work, and thrive in their own communities. The Center has developed a theory of factors that contribute to effective implementation; within that theory is a strong emphasis on the importance of understanding from a systemic perspective the interrelationship between the different factors, and their relationship to the community culture and context in which a service delivery system exists. The Center has a set of six interconnected research projects that use both quantitative and qualitative methods, and are holistic in their focus, to further test and develop its theory.
Find out more at: rtckids.fmhi.usf.edu

Rehabilitation Research and Training Center for Community Integration for Individuals with Disabilities, Strengthening Family and Youth Participation in Child and Adolescent Mental Health Services, Portland State University (H133B040038) led by Barbara Friesen, PhD. Bonnie Gracer, Project Officer.
Abstract: This project conducts research, training, and technical assistance activities to study and promote effective, community-based, culturally competent, family-centered, individualized, and strength-based services for children and youth with emotional or behavioral disorders and their families. Projects include: (1) “Community Integration (CI) of Transition-Age Youth”; (2) “Transition to Independence: Outcomes of School-Based Support for Youth with Mental Health and Developmental Disabilities”; (3) “Achieve My Plan (AMP)” develops an intervention to increase youth and family member participation in the individualized service planning process, a conceptual framework for understanding recovery in children’s mental health, and ways to reduce stigma; (4) “Work-Life Integration” addresses CI for adult caregivers of children and youth with emotional disorders, specifically around maintaining employment; (5) “Transforming Transitions to Kindergarten”; and (6) “Practice-Based Evidence: Building Effectiveness from the Ground Up” conducts a case study in partnership with a Native American youth organization and the National Indian Child Welfare Association.
Find out more at: www.rtc.pdx.edu

University of Illinois at Chicago National Research and Training Center on Psychiatric Disability University of Illinois at Chicago (H133B050003) led by Judith A. Cook, PhD. David W. Keer, Project Officer.
Abstract: The University of Illinois at Chicago National Research and Training Center on Psychiatric Disability promotes access to effective consumer-centered and community-based practices for adults with serious mental illness. The Center is conducting five rigorous research projects to enhance the state of evidence-based practice in this field: A randomized controlled trial (RCT) study of Wellness Recovery Action Planning to gather evidence regarding its effectiveness; an RCT to evaluate the effectiveness of BRIDGES, a 10-week peer-led education course designed to provide mental health consumers with basic education about the etiology and treatment of mental illness, self-help skills, and recovery principles; an RCT of peer support services delivered by Georgia’s Certified Peer Specialists at consumer-run Peer Support Centers in order to determine the outcomes of service recipients; a self-directed care program in which adults with serious mental illnesses are given control of financial resources to self-direct their own recovery; and a project using data from 12 clinical trials studies of consumer-operated service programs to create a national data repository to promote research and develop scholarship in this area.
Find out more at: www.psych.uic.edu/uicnrtc

A Mixed Methods Study of Parenting, Children, and Recovery in Mothers with Severe Psychiatric Disabilities led by Joanne Nicholson, PhD (H133F080009). A. Cate Miller, PhD, Project Officer.
Abstract: This project explores the relationship between parenting, children, and recovery for mothers with severe psychiatric disabilities. It explores the person-centered elements of recovery through: (1) the mothers’ parenting experiences; (2) the relationship between children’s well-being, and contribution to family life; and (3) their mothers’ recovery over the 12-month period. The project develops a model of the relationships between parenting, children, and recovery in adults with psychiatric disabilities; and presents the opportunities and targets for interventions and developments in mental health and child welfare policy and practice.

A Survey of Postsecondary Disability Services use by Students with Psychiatric Disability led by Anne P. Sullivan-Soydan, ScD (H133F080030). A. Cate Miller, PhD, Project Officer.
Abstract: This project investigates the services provided by postsecondary campus based offices of disability support services (DSS) across the United States to students with serious psychiatric disabilities. There are three project objectives: (1) document use of services provided by postsecondary campus-based DSS offices to students with serious psychiatric disabilities across the 10 RSA federal regions; (2) explore faculty perspectives on the need and impact of DSS students with serious psychiatric disabilities; and (3) disseminate study findings to the fields of mental health, postsecondary education, and rehabilitation counseling, using print, web-based, and presentation formats.

Pathways in Living: Increasing Mental Health Consumers’ Community Integration Through Peer-Led Education, University of Illinois at Chicago (H133G050217) led by Susan Pickett-Schenk, PhD. David W. Keer, Project Officer.
Abstract: This study examines the effectiveness of the Pathways in Living (PIL) peer-led education course, an eight-week curriculum that uses the Pathways to Recovery self-help workbook in increasing mental health consumers’ ability to identify and pursue the self-determined life goals that enable them to lead full lives within the community. In PIL, trained instructors who are mental health consumers teach other consumers how to identify their strengths, set and achieve goals, and expand their social networks. Preliminary results suggest that greater receipt of PIL is significantly associated with lower self-stigma, and increased ability to identify resources needed to achieve self-determined life goals. Study results provide important information on how peer-led programs increase community integration of mental health consumers.

Instrument to Measure Recovery-Promoting Competence among Providers Serving Spanish Speaking Mental Health Consumers, Boston University (H133G060071) led by E. Sally Rogers, PhD. Leslie J. Caplan, PhD, Project Officer.
Abstract: The purpose of this project is to culturally adapt the Recovery Promoting Relationships Scale (RPRS) for use in four Spanish-speaking cultures. The resulting scale is an intervention blueprint designed to cut across specific disciplines and services, to specify the skills and strategies needed to promote recovery and to improve the expertise of providers serving Spanish-speaking consumers. The goals of this project are: (1) to identify and refine the recovery-oriented competencies required of providers serving mental health consumers of four Spanish speaking cultures; (2) to adapt the RPRS to be culturally relevant to mental health consumers of four Spanish-speaking cultures; (3) to pilot test the psychometric properties of the RPRS; (4) to test the clinical utility of the RPRS; and (5) to systematically develop implications for practice, training of practitioners, and policy, and broadly disseminate the results.

The National Institute of Mental Health offers a middle school curriculum (grades 6-8) on the science of mental illness. By the end of the course "[s]tudents gain insight into the biological basis of mental illnesses and how scientific evidence and research can help us understand its causes and lead to treatments and, ultimately, cures." This and other curriculum supplements are availabe at science-education.nih.gov

Promoting Health, Empowerment, and Community Integration Among People with HIV/AIDS: The Medication Adherence Program Study-II (MAPS-2), University of Illinois at Chicago (H133G060224) led by Lisa A. Razzano, PhD. David W. Keer, Project Officer.
Abstract: The Center on Mental Health Services Research and Policy at the University of Illinois at Chicago (UIC) is collaborating with the Chicago Department of Public Health (CDPH) to assist people with HIV/AIDS live healthier, more productive lives. Clients at CDPH clinics are offered the opportunity to participate in an innovative program designed to improve adherence to medication and treatment regimens, promote physical health and wellness, cultivate consumer empowerment, and foster community integration. This program examines the effects of peer-delivered medication support services compared to services delivered by traditional medication specialists among people living with HIV/AIDS. The addition of the peer component builds upon the success of the UIC Medication Adherence Program Study-I (MAPS-1), a three-year, NIDRR-funded investigation of the impact of specialized medication adherence services provided to people living with HIV/AIDS.
Find out more at: www.psych.uic.edu/mhsrp

Effectiveness of a Teleconference Fatigue Management Program for People with Multiple Sclerosis, University of Illinois at Chicago (H133G070006) led by Marcia Finlayson, PhD. David W. Keer, Project Officer.
Abstract: This project tests the effectiveness and efficacy of a teleconference energy conservation education program for people with multiple sclerosis (MS). The project is guided by self-efficacy theory and builds on existing pilot work. The program is delivered by teleconference by a licensed occupational therapist. Participants are provided with a telephone and headset, and a program manual. On the designated days, participants call a toll-free phone number and participate in an educational group session facilitated by the therapist. Measures of the primary and secondary outcomes are administered over the telephone by a research assistant before and after the program, at three months, and at six months. By collecting data at these points and having a wait-list control group, the project is able to test whether: (1) individuals in the immediate intervention group achieve better outcomes than individuals in the wait-list control group; (2) the program leads to significant reductions in fatigue impact and fatigue severity, and improved quality of life; and (3) improvements in the outcomes can be maintained over six months. Analyses involve t-tests and mixed effects regression models.

Please note: These abstracts have been modified. Full, unedited abstracts, as well as any available REHABDATA citations, are available at naric.com.

The RRTC for Children’s Mental Health publishes two Data Trends products: Summaries, which detail recent publications on systems of care for children with emotional and behavioral disabilities; and News Briefs, highlighting related items in the field. Both are free electronic subscriptions with archives available at datatrends.fmhi.usf.edu/

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Current Literature: Selections from REHABDATA

Walker, J., Gowen, L. (2008) Focal point: Workforce, 22(1) NARIC Accession Number: O17145. Project Number: H133B040038.
Abstract: Articles in this issue focus on job and roles that have evolved to fit within a transforming children’s mental healthcare system. Topics include: staffing the transformation of children’s mental healthcare systems, direct support services and how they work, changes in the clinician’s role in an evidence-based practice, an evaluation perspective on an evidence-based practice, family partners in systems of care and wraparound, promoting family voice in residential treatment programs, early childhood mental health consultation, multisystemic therapy from multiple perspectives, and outcomes in home-based treatment.
Download O17145.

Baron, R. (2008) Mainstream career training: Accessing community resources for people with serious psychiatric disabilities. NARIC Accession Number: O17188. Project Number: H133F060044.
Abstract: Study examined the extent to which people with serious mental illness have access to mainstream career training resources offered by community colleges, technical schools, and specialized nonprofit agencies. Qualitative interviews were conducted with mental health, vocational rehabilitation (VR), workforce development system administrators; mental health services providers and consumers; and mainstream career training program personnel. Analysis of the data collected focused on 4 core issues: (1) current patterns of referrals; (2) potential patterns of referrals; (3) barriers to the utilization of mainstream career training resources; and (4) recommended practices, programs, and policies to improve access to and success in mainstream job programs for people with psychiatric disabilities. Respondents were nearly unanimous in observing that mental health, VR, and workforce development personnel rarely refer people with serious mental illness to mainstream career training resources in their communities. Reasons for the predominance of referrals to specialized mental health providers and the failure to use mainstream resources included: weak consumer motivation, educational levels that disqualify consumers for career training, a history of failure in past initiatives, unresponsive treatment in mainstream programs, and the lack of funding to provides the supports consumers need to succeed in mainstream programs.

Walker, J., Gowen, L.(2008) Focal point: Caregiver-child: Mutual influences on mental health, 22(2). NARIC Accession Number: O17218. Project Number: H133B040038.
Abstract: Articles in this issue examine the mutual impact of caregiver and child mental health through consideration of personal, lived experiences as well as practice and research. This issue also highlights practical strategies to promote positive outcomes for children and caregivers who experience mental health difficulties.
Download O17218

Jivanjee, P., Koroloff, N (2008) Starting points for communities developing new transition programs for young people with mental health difficulties. NARIC Accession Number: O17233. Project Number: H133B040038.
Astract: Document presents practical advice for communities interested in developing transition programs for youth with mental health disorders. The information provided is based on a review of the literature, research conducted with young people 16 to 24 years old and their families, and evaluations completed with several transition service providers.
Download O17233

logo for the Cochrane Collaboration

The Cochrane Collaboration has three review groups with a mental health focus: Schizophrenia; Depression, Anxiety, and Neuroses; and Developmental, Psychological, and Learning Problems. Visit www.thecochranelibrary.org and click By Review Group to browse by topic.

Swarbrick, M. (2007) Consumer-operated self-help centers. Psychiatric Rehabilitation Journal, 31(1), 76-79. NARIC Accession Number: J52955. Project Number: H133P050006.
Abstract: Article provides an overview of a consumer-operated self-help center model that has evolved in New Jersey and illustrates how it has become a viable component of the mental health system. The centers are a consumer-operated service that is proving to be a positive resource for mental health consumers living in the community and supports the idea of recovery and wellness. The goal is to inspire psychiatric rehabilitation practitioners to create their own consumer-operated self-help alternatives.

Jivanjee, P., Kruzich, J. (2007) Community integration of transition-age individuals: Views of young with mental health disorders. Journal of Behavioral Health Services & Research. NARIC Accession Number: J54232. Project Number: H133B040038.
Abstract: This study examined perceptions of community integration in young adults with mental health disorders transitioning to adulthood. Focus groups were conducted with 59 young men and women to better understand what community integration means to them. Discussion explored barriers and supports for community integration, as well as the participants’ goals for the future and their advice to others facing similar challenges. Primary themes that emerged from the data provide descriptions of the participants experiences and perspectives related to forming connections with others; deciding whether or not to tell others about their mental health; their need for practical, accessible supports and services; challenges and successes in the educational system; finding meaningful adult roles; searching for a place to call home; and finding personal fulfillment.

Newman, C., Liberton, C. (2007) 19th annual research conference proceedings: A system of care for children’s mental health: Expanding the research base, February 22-24, 2006, Tampa, Florida. NARIC Accession Number: O17121. Project Number: H133B040024.
Abstract: Book presents the proceedings of an annual conference on children’s mental health service delivery system. It provides an overview of the conference presentations ands addresses many aspects of current design, implementation, and evaluation of systems of care for children and their families. Chapters are organized around central topics featured during the conference: (1) implementing systems of care, (2) implementing and evaluating evidence-based practices, (3) strengths and family-driven services, (4) system navigation and clinical outcomes in a system of care, (5) interventions in early childhood, (6) school-based mental health services, (7) youth voice and transition services, (8) collaboration and services within the juvenile justice population, (9) wraparound implementation, (10) issues in understanding and treating trauma victims, (11)strategies for continuous quality improvement and financing, and (12) instrumentation and methodology.
Download O17121

Walker, J., Powers, L. (2007) Introduction to the youth self-efficacy scale/mental health and the youth participation in planning scale. NARIC Accession Number: O17127. Project Number: H133B040038.
Abstract: Report provides information about 2 new measures that are highly relevant to research and evaluation in children’s mental health. The first measure, the Youth Self-Efficacy Scale/Mental Health (YSES/MH), was designed to assess youth perceptions of self-efficacy with respect to managing their own mental health conditions, managing their own services and supports, and using their experience and knowledge to help peers and improve service systems. The second measure, the Youth Participation in Planning (YPP) scale, assesses youth perceptions of whether interdisciplinary teams that create service, care, or treatment plan support meaningful youth participation in the planning process. Preview versions of the YSES/MH and the YPP are included.
Download O17127

Where Can I Find More? A quick keyword search is all you need to connect to a wealth of disability and rehabilitation research. NARIC’s databases hold more than 75,000 resources. Visit www.naric.com/research to search for literature, current and past research projects, and organizations and agencies in the US and abroad.