Search results for ‘Subject term:"mental health problems"’ Sort:
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Patient-rated mental health needs and quality of life improvement
- Authors:
- SLADE Mike, et al
- Journal article citation:
- British Journal of Psychiatry, 187(3), September 2005, pp.256-261.
- Publisher:
- Cambridge University Press
Patient-rated unmet need is cross-sectionally associated with quality of life. This study aims to test the hypotheses that: (a) higher patient-rated unmet need is associated with lower individual quality of life assessments by a patient over time; and (b) reduction in patient-rated unmet need precedes improvement in quality of life. One hundred and one individuals using adult mental health services in Croydon, London were asked to complete 6-monthly questionnaires, comprising quality of life (Manchester Short Assessment of Quality of Life, MANSA) and unmet need (Camberwell Assessment of Need Short Appraisal Schedule, CANSAS) assessments. Seventy-three participants provided 240 separate pairs of consecutive assessments. Random effects regression models indicated an impact on current quality of life for both average level of unmet need and change in unmet need over the past month. The authors conclude that changes in patient-rated unmet needs may cause changes in quality of life.
Development of the REFOCUS intervention to increase mental health team support for personal recovery
- Authors:
- SLADE Mike, et al
- Journal article citation:
- British Journal of Psychiatry, 207(6), 2015, pp.544-550.
- Publisher:
- Cambridge University Press
Background: There is an emerging evidence base about best practice in supporting recovery. This is usually framed in relation to general principles, and specific pro-recovery interventions are lacking. Aims: To develop a theoretically based and empirically defensible new pro-recovery manualised intervention, called the REFOCUS intervention. Method: Seven systematic and two narrative reviews were undertaken. Identified evidence gaps were addressed in three qualitative studies. The findings were synthesised to produce the REFOCUS intervention, manual and model. Results: The REFOCUS intervention comprises two components: recovery-promoting relationships and working practices. Approaches to supporting relationships comprise coaching skills training for staff, developing a shared team understanding of recovery, exploring staff values, a Partnership Project with people who use the service and raising patient expectations. Working practices comprise the following: understanding values and treatment preferences; assessing strengths; and supporting goal-striving. The REFOCUS model describes the causal pathway from the REFOCUS intervention to improved recovery. Conclusions: The REFOCUS intervention is an empirically supported pro-recovery intervention for use in mental health services. It will be evaluated in a multisite cluster randomised controlled trial (Publisher abstract)
Use of standardised outcome measures in adult mental health services: randomised controlled trial
- Authors:
- SLADE Mike, et al
- Journal article citation:
- British Journal of Psychiatry, 189(4), October 2006, pp.330-336.
- Publisher:
- Cambridge University Press
A randomised controlled trial, involving 160 representative adult mental health patients and paired staff (ISRCTN16971059). The intervention group (n=101) (a) completed monthly postal questionnaires assessing needs, quality of life, mental health problem severity and therapeutic alliance, and (b) received 3-monthly feedback. The control group (n=59) received treatment as usual. The intervention did not improve primary outcomes of patient-rated unmet need and of quality of life. Other subjective secondary outcome measures were also not improved. The intervention reduced psychiatric inpatient days (3.5 v.16.4 mean days, bootstrapped 95% CI1.6–25.7), and hence service use costs were £2586 (95% CI 102–5391) less for intervention-group patients. Net benefit analysis indicated that the intervention was cost-effective. Routine use of outcome measures as implemented in this study did not improve subjective outcomes, but was associated with reduced psychiatric inpatient admissions.