Social Value of Supported Employment for Psychosocial Program Participants

Members of a psychiatric psychosocial program designed to provide both supported employment and peer support were surveyed about their current social activities, sources of social support, and social life improvement since joining the program. Survey respondents who worked a mainstream job (n = 17) reported greater peer contact in community locations, and correspondingly greater social life improvement, than those who remained unemployed or worked volunteer jobs (n = 45). Results of a hierarchical regression analysis (N = 62) that explored this positive correlation between mainstream work, community-based peer contact, and social life satisfaction suggest that working a job in an integrated setting that paid at least minimum wage encouraged program participants to meet and interact in community locations, thereby strengthening peer mutual support while furthering social integration. This unique pattern of findings requires replication, and we recommend that other psychosocial programs conduct similar quality improvement studies to provide further insights into the relationship between peer support and community integration.     

Special Education Versus Inclusive Education: The Role of the TEACCH Program

Our study aimed at comparing, over a period of 3 years, the effectiveness of three different educational approaches addressed to children with autism and severe mental retardation. The first one was a treatment and education of autistic and related communication handicapped children (TEACCH) program implemented in a residential center; the second was a TEACCH program implemented at home and at mainstream schools, after a specific parent psychoeducational training; the third approach referred to inclusive education in mainstream schools, in which a nonspecific approach was implemented. Each subject was assessed twice, using the Psycho-Educational Profile-Revised (PEP-R) and Vineland Adaptive Behavior Scale (VABS)-survey form. Effectiveness of TEACCH appeared to be confirmed, showing positive outcomes in the natural setting, and revealing its inclusive value.     

Incarceration Histories of Homeless Veterans and Progression Through a National Supported Housing Program

There is increasing concern that adults with a past history of incarceration are at particular disadvantage in exiting homelessness. Supported housing with case management has emerged as the leading service model for assisting homeless adults; however there has been limited examination of the success of adults with past history of incarceration in obtaining housing within this paradigm. Data were examined on 14,557 veterans who entered a national supported housing program for homeless veterans, the Housing and Urban Development-Veterans Affairs Supportive Housing program (HUD-VASH) during 2008 and 2009, to identify characteristics associated with a history of incarceration and to evaluate whether those with a history of incarceration are less likely to obtain housing and/or more likely to experience delays in the housing attainment process. Veterans who reported no past incarceration were compared with veterans with short incarceration histories (≤1 year) and those with long incarceration histories (>1 year). A majority of participants reported history of incarceration; 43 % reported short incarceration histories and 22 % reported long incarceration histories. After adjusting for baseline characteristics and site, history of incarceration did not appear to impede therapeutic alliance, progression through the housing process or obtaining housing. Within a national supported housing program, veterans with a history of incarceration were just as successful at obtaining housing in similar time frames when compared to veterans without any past incarceration. Supported housing programs, like HUD-VASH, appear to be able to overcome impediments faced by formerly incarcerated homeless veterans and therefore should be considered a a good model for housing assistance programs.     

Viability of Using Employment Rates from Randomized Trials as Benchmarks for Supported Employment Program Performance

Cumulative employment rates published by randomized trials are based on each enrollee’s pre-planned 18–24-months of study participation. By contrast, community programs typically report employment rates for clients active in services during a calendar quarter. Using data from three supported employment programs in randomized trials, we show that trial cumulative employment rates are about twice as large as quarterly employment rates for the same program. Therefore, we recommend that administrators, service networks, and mental health authorities begin to publish quarterly employment rates, and quarterly median earnings, to allow policymakers to set realistic performance expectations for supported employment programs.     

The Michigan gender identity test (MIGIT)

This paper provides in detail the rationale, administration procedure, coding, and scoring of the Michigan Gender Identity Test (MIGIT). Included are instructions and scoring sheets to be used in administering the test. It is believed the MIGIT fills the need for an age-appropriate test for the assessment of gender identity in children over 18 months of age. The experimental use of the MIGIT is encouraged, with the view of further refining it and enhancing its potential as a research and clinical instrument.     

The Texas Medication Algorithm Project Patient and Family Education Program: a consumer-guided initiative

Educating patients with mental illness and their families about the illness and its treatment is essential to successful medication (disease) management. Specifically, education provides patients and families with the background they need to participate in treatment planning and implementation as full "partners" with clinicians. Thus, education increases the probability that appropriate and accurate treatment decisions will be made and that a treatment regimen will be followed. The Texas Medication Algorithm Project (TMAP) has incorporated these concepts into its philosophy of care and accordingly created a Patient and Family Education Program (PFEP) to complement the utilization of medication algorithms for the treatment of schizophrenic, bipolar, and major depressive disorders. This article describes how a team of mental health consumers, advocates, and professionals developed and implemented the PFEP. In keeping with the TMAP philosophy of care, consumers were true partners in the program's development and implementation. They not only created several components of the program and incorporated the consumer perspective, but they also served as program trainers and advocates. Initially, PFEP provides basic and subsequently more in-depth information about the illness and its treatment, including such topics as symptom monitoring and management and self-advocacy with one's treatment team. It includes written, pictorial, videotaped, and other media used in a phased manner by clinicians and consumer educators, in either individual or group formats.     

The MacArthur Foundation Depression Education Program for Primary Care Physicians: background and rationale

In order to improve the assessment and management of depression in general medical care, the John D. and Catherine T. MacArthur Foundation supported the development, evaluation, and dissemination of an eight-hour depression education program (DEP) for primary care physicians. This publication includes a paper describing the background and educational rationale for the program structure, the complete participant's workbook, and a facilitator's guide for teaching the program. Given in two separate four-hour workshops by a psychiatrist and a primary care physician, DEP is delivered to small groups of learners (about 12) using an interactive adult learning model and multiple teaching techniques including targeted yet flexible objectives, two lectures, videotape demonstration and discussion, role-play exercises, a focused monograph on depression, an interview checklist, structured assessment and outcomes tools, clinical case studies, and audiotape review of actual patient interviews. DEP has been shown in a prospective randomized trial to improve physicians' interview-ing skills as well as simulated-patient satisfaction scores. Over 150 PCPs in four states have taken DEP in more than 30 separate programs given by 24 trained facilitators. Participants, despite a wide diversity of background knowledge and skills, have uniformly reported remarkably positive learner satisfaction with all dimensions of the Program.     

The Economics of Integrated Depression Care: The University of Michigan Study

A goal of the Robert Wood Johnson Depression and Primary Care Initiative at the University of Michigan is to create and implement the clinical care and financial systems necessary to enable links between primary care and mental health specialty depression care. This paper describes the economic issues related to resources required, the mechanisms to distribute those resources, and the support that must be garnered from stakeholders. By systematic measurement and application, we assess the cost, price and selected consequences of these efforts. The study illustrates the need for both centralized and distributed capacity and support for innovative models of care.     

日本卒中学会继续医学教育项目回顾

目的 介绍日本卒中学会,转变卒中学会并非单一学科的继续医学教育的观念。 方法 举例分析2014年、2015年、2016年日本卒中学会主题、内容和形式。 结果 每届日本卒中学会主题彰显学科时代特点、内容丰富、举办形式多样,演讲者多达20多个专业 的医务人员。日本卒中学会是多学科联合举办的继续医学教育项目。 结论 日本卒中学会为今后我国卒中会议的多学科联合举办提供了可借鉴的参考依据。     

Evaluation of the CHOICES Program of Peer-to-Peer Tobacco Education and Advocacy

CHOICES is a consumer driven program for addressing tobacco in people with mental illness that employs mental health peer counselors. Since 2005, CHOICES has conducted over 298 community visits reaching more than 10,000 smokers with mental illness (about 2500/year). A telephone based outcome study was conducted in 102 outpatient smokers who received a CHOICES peer-to-peer session. At 1-month follow up participants (N = 86; 84%) reported smoking an average of 13 cigarettes per day which was significantly reduced from a baseline of 19 (P < 0.001). Twenty-five individuals (29%) tried to quit smoking in the month after the peer session and another 47 (55%) reduced their smoking. Feedback from smokers about the program was positive. Most (N = 59, 71%) said it was a lot easier to talk with a consumer about smoking compared to their psychiatrist or staff. Peer-to-peer communication about tobacco use can be effective to increase awareness and change smoking behaviors.     

The Efficacy and Impact of a Special Education Legislative Advocacy Program Among Parents of Children with Disabilities

Journal of Autism and Developmental Disorders - With the looming reauthorization of the Individuals with Disabilities Education Act (IDEA), it is important for parent input to inform legislative...     

Impacting Entry into Evidence-Based Supported Employment: A Population-Based Empirical Analysis of a Statewide Public Mental Health Program in Maryland

We use discrete-time survival regression to study two empirical issues relating to take-up of individual placement and support (IPS) supported employment (SE) services for persons with serious mental illness: (1) the influence of client characteristics on take-up probability, and (2) the possible impacts of a major recent initiative in one state (Maryland) to overcome barriers to IPS-SE expansion. Our longitudinal analysis of population-based Medicaid cohorts, during 2002–2010, provides tentative evidence of positive state initiative impacts on SE take-up rates, and evidence of effects on take-up for clients’ diagnoses, prior work-history, health and demographic characteristics, and geographic accessibility to SE providers.     

Difficulties Experienced by University Students with Severe Mental Illness Who Participate in Supported Education Programs

Knowledge about the difficulties students with severe mental illness (SMI) encounter is essential to helping them meet the challenges of studying in universities. Therefore, a study was conducted in Israel with 80 university students with SMI to ascertain their difficulties and the relationship between these difficulties and their level of recovery. The two subscales of an instrument measuring students’ difficulties that were ranked the highest were “Learning Skills and Management of Academic Tasks” and “Social Inclusion Difficulties.” Inverse relationships were found between the students’ difficulties and their perceived level of recovery. The findings illuminate that one of the major challenges that students with SMI experience is to meet academic requirements while coping with mental illness. They also indicate that students’ difficulties may not be limited to academic functioning. Therefore, there is a need to broaden the view of students’ difficulties to include social and contextual factors in the university environment.     

Effectiveness of Supported Education for Individuals with Psychiatric Disabilities: Results from an Experimental Study

In recent years post-secondary education hasbeen recognized as a viable option in the psychosocialrehabilitation of individuals with mental illness. Thisstudy reports the first evidence of effectiveness of a supported education demonstration projectwhich used an experimental design to compare the effectsof different model types. A total of 397 participantswere assigned to one of three conditions: group, classroom, and individual (control). Atgraduation from the program significant differences inprogram participation rates were found; group membersparticipated most, followed by classroom participants, then those assigned to the individualcondition. Also, immediate, intermediate, and long termoutcomes were examined. On four immediate outcomes(motivation, satisfaction, enjoyment, and learning)significant participation effects were found (highparticipants scoring highest, followed by moderateparticipants, and then non-participants). On twointermediate outcome (empowerment and school efficacy)condition differences were found (classroom scoringhighest followed by group, then individual). Although nocondition differences were found on behavioral outcomes,the percentage of individuals enrolled in school or vocational education was more than twicethat reported at baseline. Overall, the resultsdemonstrated success in engaging participants, affectingself-perceptions, and increasing enrollment inpost-secondary education.     

The Assaultive Staff Action Program (ASAP): 25 Year Program Analysis

The Assaulted Staff Action Program (ASAP) is a voluntary, system-wide, peer-help, crisis intervention program to address the psychological sequelae in staff victims of patient assaults. It has been associated with cost-effective, quality support services to staff victims of patient assaults and declines in assaults facility-wide in several facilities, after an ASAP was fielded. ASAP’s functions and service provisions have been reported in previous 5-year intervals. The present paper reports on its most recent 5-year interval as ASAP complete its 25th year of service. The 5-year summary and the basic strengths and limitations of the program over this 25 year period are examined.