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A systematic review of shared decision-making interventions for service users with serious mental illnesses: state of the science and future directions
- Authors:
- THOMAS Elizabeth C, et al
- Journal article citation:
- Psychiatric Services, early cite 9 August 2021,
- Publisher:
- American Psychiatric Association
Objective: Shared decision making (SDM) is a health communication model that may be particularly appealing to service users with serious mental illnesses, who often want to be involved in making decisions about their mental health care. The purpose of this systematic review was to describe and evaluate participant, intervention, methodological, and outcome characteristics of SDM intervention studies conducted within this population. Methods: Systematic searches of the literature through April 2020 were conducted and supplemented by hand searching of reference lists of identified studies. A total of 53 independent studies of SDM interventions that were conducted with service users with serious mental illnesses and that included a quantitative or qualitative measure of the intervention were included in the review. Data were independently extracted by at least two authors. Results: Most studies were conducted with middle-age, male, White individuals from Western countries. Interventions fell into the following categories: decision support tools only, multicomponent interventions involving decision support tools, multicomponent interventions not involving decision support tools, and shared care planning and preference elicitation interventions. Most studies were randomized controlled trials with sufficient sample sizes. Outcomes assessed were diverse, spanning decision-making constructs, clinical and functional, treatment engagement or adherence, and other constructs. Conclusions: Findings suggest important future directions for research, including the need to evaluate the impact of SDM in special populations (e.g., young adults and racial-ethnic minority groups); to expand interventions to a broader array of decisions, users, and contexts; and to establish consensus measures to assess intervention effectiveness. (Edited publisher abstract)
Interventions to increase retention in mental health services: a systematic review
- Authors:
- GREEN Jennifer A., BINA Rena, GUM Amber M.
- Journal article citation:
- Psychiatric Services, 67(5), 2016, pp.485-495.
- Publisher:
- American Psychiatric Association
Objective: Several systematic reviews have evaluated interventions that aim to increase mental health service initiation and engagement as well as adherence to pharmacological treatment. No reviews have focused on evaluating these interventions’ effects on retention in mental health services, however, which was the goal of this systematic review. Methods: PubMed, PsycINFO, and Social Services Abstracts were searched for studies that met the inclusion criteria. All studies published prior to March 29, 2015, that compared two or more groups on any measure of retention in mental health services were included. Methodological quality was assessed for each included study. An effect size was calculated for each outcome, although a meta-analysis was not conducted because of heterogeneity across interventions. To facilitate narrative analysis, interventions were categorized by targets - the types of predictors of or barriers to mental health service use that the intervention aimed to address. Results: Eleven studies met inclusion criteria. The interventions produced medium to large effects on retention outcomes. Many interventions addressed more than one target. Interventions that targeted mental health knowledge, mental health attitudes, and barriers to treatment all enhanced retention in mental health services compared with control groups. Most interventions with those targets had a large effect on retention and relatively good methodological ratings. Conclusions: The most effective retention interventions were comprehensive, addressing mental health knowledge, mental health attitudes, and barriers to treatment. The authors recommend that researchers apply relevant theories to refine these interventions and evaluate the interventions by using rigorous methodology and a range of retention outcomes, mediators, and moderators. (Publisher abstract)
Supported employment: assessing the evidence
- Authors:
- MARSHALL Tina, et al
- Journal article citation:
- Psychiatric Services, 65(1), 2014, pp.16-23.
- Publisher:
- American Psychiatric Association
Objective: Supported employment is a direct service with multiple components designed to help adults with mental disorders or co-occurring mental and substance use disorders choose, acquire, and maintain competitive employment. This article describes supported employment and assesses the evidence base for this service. Methods: Authors reviewed meta-analyses, research reviews, and individual studies from 1995 through 2012. Databases surveyed were PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, Published International Literature on Traumatic Stress, the Educational Resources Information Center, and the Cumulative Index to Nursing and Allied Health Literature. Authors chose from three levels of evidence (high, moderate, and low) based on benchmarks for the number of studies and quality of their methodology. They also described the evidence for service effectiveness. Results: The level of research evidence for supported employment was graded as high, based on 12 systematic reviews and 17 randomized controlled trials of the individual placement and support model. Supported employment consistently demonstrated positive outcomes for individuals with mental disorders, including higher rates of competitive employment, fewer days to the first competitive job, more hours and weeks worked, and higher wages. There was also strong evidence supporting the effectiveness of individual elements of the model. Conclusions: Substantial evidence demonstrates the effectiveness of supported employment. Policy makers should consider including it as a covered service. Future research is needed for subgroups such as young adults, older adults, people with primary substance use disorders, and those from various cultural, racial, and ethnic backgrounds. (Publisher abstract)
Permanent supportive housing: assessing the evidence
- Authors:
- ROG Debra J., et al
- Journal article citation:
- Psychiatric Services, 65(3), 2014, pp.287-294.
- Publisher:
- American Psychiatric Association
Objectives: Permanent supportive housing provides safe, stable housing for people with mental and substance use disorders who are homeless or disabled. This article describes permanent supportive housing and reviews research. Methods: Authors reviewed individual studies and literature reviews from 1995 through 2012. Databases surveyed were PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, Published International Literature on Traumatic Stress, the Educational Resources Information Center, and the Cumulative Index to Nursing and Allied Health Literature. The authors chose from three levels of evidence (high, moderate, and low) on the basis of benchmarks for the number of studies and quality of their methodology. They also described the evidence of service effectiveness. Results: The level of evidence for permanent supportive housing was graded as moderate. Substantial literature, including seven randomized controlled trials, demonstrated that components of the model reduced homelessness, increased housing tenure, and decreased emergency room visits and hospitalization. Consumers consistently rated this model more positively than other housing models. Methodological flaws limited the ability to draw firm conclusions. Results were stronger for studies that compared permanent supportive housing with treatment as usual or no housing rather than with other models. Conclusions: The moderate level of evidence indicates that permanent supportive housing is promising, but research is needed to clarify the model and determine the most effective elements for various subpopulations. Policy makers should consider including permanent supportive housing as a covered service for individuals with mental and substance use disorders. An evaluation component is needed to continue building its evidence base. (Publisher abstract)
Diagnostic issues in dementia: advancing the research agenda for DSM-V
- Editors:
- SUNDERLAND Trey, et al, (eds.)
- Publisher:
- American Psychiatric Association
- Publication year:
- 2007
- Pagination:
- 145p.
- Place of publication:
- Arlington, VA
This book comprises of nine chapters with research suggestions for consideration for the upcoming Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V) process, reflecting the effort toward a new diagnostic nomenclature in the evolving field of dementia. Contents include: Alzheimer's disease and the aging brain; Dementia: epidemiological considerations, nomenclature, and a tacit consensus definition; Diagnostic criteria in dementia; Mild cognitive impairment should be considered for DSM-V; Neuropsychological testing in the diagnosis of dementia; Diagnostic categories and criteria for neuropsychiatric syndromes in dementia; Biomarkers in the diagnosis of Alzheimer's disease; Neuroimaging as a surrogate marker of disease. Genetics and dementia nosology.
Understanding and treating borderline personality disorder: a guide for professionals and families
- Editors:
- GUNDERSON John G., HOFFMAN Perry D., (eds)
- Publisher:
- American Psychiatric Association
- Publication year:
- 2005
- Pagination:
- 171p.
- Place of publication:
- Arlington, VA
The intended audiences for this book are the families and therapists of those who suffer from borderline personality disorder (BPD). The relationship between a person with BPD and other family members is often very difficult, with a great deal of disappointment, blame, guilt, and resentment on all sides. It is common for therapists to assume that BPD is simply the result of bad parenting, which can lead to therapy that does more harm than good. While many individuals with BPD have abusive backgrounds, many do not; and most people who suffer abuse do not develop BPD. The authors stress the importance of validating the feelings of clients and loved ones while avoiding patterns of blame and guilt, and give concrete advice on how to achieve this difficult balance. The authors give detailed descriptions of all the major therapies and treatment programs used with BPD, and discuss the evidence for the effectiveness of each type. The reader may be discouraged to learn that the outcome of therapy and medication is very unpredictable. Certain types of therapies, like Dialectical Behavioural Therapy, have been shown to be helpful in the short term, but the long-term benefits are less certain. Medications can relieve symptoms but rarely cause dramatic improvement. This book also includes four personal accounts of BPD: two by persons suffering from the disorder and two by family members.
Psychiatric Services
- Publisher:
- American Psychiatric Association
Psychiatric Services, established in 1950, is published monthly by the American Psychiatric Association for mental health professionals and others concerned with treatment and services for persons with mental health problems. It aims to improve care and treatment, to promote research and professional education in psychiatric and related fields, and to advance the standards of all psychiatric (Edited publisher abstract)
A systematic review of the effectiveness of community-based mental health outreach services for older adults
- Authors:
- VAN CITTERS Aricca D., BARTELS Stephen J.
- Journal article citation:
- Psychiatric Services, 55(11), November 2004, pp.1237-1249.
- Publisher:
- American Psychiatric Association
Psychiatric outreach services providing mental health assessment and treatment for older people are widely promoted, but there has been little evaluation of their effectiveness. This review of mainly North American studies is confined to 14 quantitative studies identified from a much larger body of qualitative evidence. It provides limited evidence in support of the effectiveness of outreach services in identifying isolated older people with mental health problems, and more substantial evidence to suggest that such services are effective in improving psychiatric symptoms. The reviewers conclude that more rigorous studies are needed.
Evidence-based practices in mental health care
- Editors:
- DRAKE Robert, GOLDMAN Howard
- Publisher:
- American Psychiatric Association
- Publication year:
- 2003
- Pagination:
- 115p.,bibliogs.
- Place of publication:
- Arlington, VA
Reprinted articles from the American Psychiatric Association: implementing evidence-based practices (EBP) in routine mental health service settings; EBP for persons with severe mental illnesses; strategies for disseminating EBP to staff who treat people with serious mental illness; integrating EBP and the recovery model; supported employment as an EBP; dual diagnosis services for clients
The homeless mentally ill: a task force report of the American Psychiatric Association
- Editor:
- LAMB H. Richard
- Publisher:
- American Psychiatric Association
- Publication year:
- 1984
- Pagination:
- 339p.,bibliog.
- Place of publication:
- Washington, DC