Families Living with Severe Mental Illness: A Literature Review

Schizophrenia is a severe mental illness, which is stressful not only for patients, but also for family members. Numerous studies have demonstrated that family caregivers of persons with a severe mental illness suffer from significant stresses, experience moderately high levels of burden, and often receive inadequate assistance from mental health professionals. Effective family functioning in families with schizophrenia may be influenced by a variety of psychosocial factors. The purpose of this article was to present a review of the social science literature related to families living with schizophrenia that has been published during the last three decades. There is general agreement in the literature that a multitude of variables affect families with a severe mental illness, such as schizophrenia. Therefore, this literature review examined the most frequently investigated variables (coping, psychological distress and caregiver burden, social support, caregiver resiliency and depression, and client behavioral problems) as they are related to families and schizophrenia.     

Parental Uncertainty and Posttraumatic Stress in Serious Childhood Illness

Purpose: To explicate the link between parental uncertainty and posttraumatic stress as a way to stimulate advancement in the design and evaluation of nursing interventions for parents of children with serious illness.
Methods: The literature on Mishel's uncertainty in illness theory and its reconceptualization-parental uncertainty in serious childhood illness-and posttraumatic stress are reviewed and synthesized. Pertinent methodological and sociocultural issues are discussed.
Conclusions: The literature indicates support for the theoretical link between parental uncertainty and posttraumatic stress. This linkage provides direction for the design and evaluation of nursing interventions to support parents of children with serious childhood illness.     

Goal Setting Among People Living with Mental Illness: A Qualitative Analysis of Recovery Camp

People living with mental illness (consumers) often experience difficulty in achieving life goals, particularly those important for their recovery. An innovative approach to address consumers' goals for recovery can be found in the form of therapeutic recreation (TR) initiatives. Recovery Camp is a five-day TR program, bringing together people with a serious mental illness, undergraduate health students, and staff members. This article aims to examine the types of goals set by consumers in the context of Recovery Camp, and to what extent the self-identified goals were attained. The consumers (n = 27) were invited to set goals that they wished to achieve during the week. On the final day of Recovery Camp, each participant rated the degree to which they felt that each of their goals was achieved or not. The goals were themed using content analysis, revealing four key themes: connectedness, developing healthy habits, challenging oneself, and recovery. All goals were, to some extent, attained. The results suggest people with a mental illness are able to both set and evaluate the self-identified goals in the context of a TR initiative. A collaborative recovery approach indicates that goal planning should be undertaken in direct consultation with the consumer.     

Educating for Wellness: A Wellness Education Group Intervention for Adults with Chronic Severe Mental Illness Living in the Community

Chronic severe mental illness (CSMI) is a common disorder in the United States associated with numerous adverse health effects. Health promotion educational interventions can be beneficial. The purpose of this project was to implement and evaluate a community-based educational program for adults with CSMI. Analyses of quantitative and qualitative data showed overall satisfaction with the program and achievement of some specific consumer health modifications. Three primary areas of interest and benefit included socialization and support, education and information, and motivation to change. The Wellness Education Group Intervention (WEGI) can serve as a model for wellness education with adults in similar communities.     

Managing Weight in Persons Living with Severe Mental Illness in Community Settings: A Review of Strategies Used in Community Interventions

Although several published reviews have summarized the results of behavioral weight management interventions for persons with severe mental illness, little attention has been paid to the interventions themselves, despite the breadth of intervention strategies that have been examined in published trials. This study identified and systematically described 16 behavioral weight management interventions for community-dwelling persons with severe mental illness. Intervention content and delivery features that were considered included (a) approach to weight management; (b) theoretical constructs targeted to achieve behavior change; (c) diet, exercise, and/or self-regulation skills; (d) instructional strategies; and (e) intervention format including duration, intensity, and setting. Findings revealed modest, but sustained, weight loss. Individual and societal resources to address obesity among persons living with severe mental illness are limited. Further research is needed to identify the most effective and the most parsimonious interventions.     

Obesity and Mental Illness: Implications for Cognitive Functioning

A priority research and clinical agenda is to identify determinants of cognitive impairment in individuals with neuropsychiatric disorders (NPD). The bidirectional association between NPD and cognitive performance has been reported to be mediated and/or moderated by obesity in a subset of individuals. Obesity can be conceptualized as a neurotoxic phenotype among individuals with NPD as evidenced by alterations in the structure and function of neural circuits and disseminated networks, diminished cognitive performance, and adverse effects on illness trajectory. The neurotoxic effect of obesity provides a rationale for screening, treating, and preventing obesity in neuropsychiatric populations. Research endeavors that aim to refine mediators and moderators of this association as well as novel strategies to reverse the injurious process of obesity on cognition are warranted.