Current and Preferred Housing of Psychiatric Consumers/Survivors

As part of a participatory action research project, we surveyed 300 psychiatric consumers/survivors from southwestern Ontario regarding their housing preferences and housing satisfaction. We found that, while 79% of the sample preferred independent living, 76% were living in some other type of setting (e.g., temporary shelter, supportive housing, sheltered care). Those living in temporary shelters reported the lowest levels of housing satisfaction, and those who were living in the type of housing that they preferred had the highest levels of housing satisfaction. This information is being used by stakeholder groups involved in the project to help build the capacity of the community to provide the types of housing that are preferred by consumers/survivors

The Article Idea Chart: A participatory action research tool to aid involvement in dissemination

Participatory-action research encourages the involvement of all key stakeholders in the research process and is especially well suited to mental health research. Previous literature outlines the importance of engaging stakeholders in the development of research questions and methodologies, but little has been written about ensuring the involvement of all stakeholders (especially non-academic members) in dissemination opportunities such as publication development. The Article Idea Chart was developed as a specific methodology for engaging all stakeholders in data analysis and publication development. It has been successfully utilised in a number of studies and is an effective tool for ensuring the dissemination process of participatory-action research results is both inclusive and transparent to all team members, regardless of stakeholder group.Keywords: participatory-action research, mental health, dissemination, community capacity building, publications, authorshi

The orientation phase of the nurse-client relationship: Testing Peplau\u27s theory

This investigation used a prospective design to examine the orientation phase of the nurse-client relationship. One hundred and twenty-four newly formed nurse-client dyads constituted the sample; Client subjects were individuals with a chronic mental illness. The following variables predicted by Peplau\u27s theory to be related to development of the therapeutic nurse-client relationship were examined: nurses\u27 preconceptions of their clients, clients\u27 preconceptions of their nurses, other interpersonal relationships of clients and nurses, and anxiety of clients and nurses. Variables were measured for both nurses and clients at 0, 3 and 6 months into their relationship. Preconceptions of both clients and nurses were related to the duration of the orientation phase and development of the therapeutic alliance. There was support for the importance of other interpersonal relationships with clients but not nurses. Anxiety was not found to be significantly related to the development of the therapeutic relationship. Findings therefore support some tenets of Peplau\u27s theory, but not others. This gives direction for future research and theory refinement

Perceptions of stigma among people with lived experience of methamphetamine use within the hospital setting: qualitative point-in-time interviews and thematic analyses of experiences

ObjectivesAs part of a larger mixed-methods study into harm reduction in the hospital setting and people with lived experience of methamphetamine use, stigma was found to be a prominent issue. The aim of this secondary analysis was to investigate the issue of stigma.DesignParticipants completed a one-time qualitative interview component to assess their experiences in the hospital setting.SettingThe study setting included secondary and tertiary care in Southwestern Ontario, Canada. Participants who had received care from these settings were also recruited from an overdose prevention site, a primary healthcare center, a national mental health organization, an affordable housing agency, and six homeless-serving agencies between October 2020 and April 2021.ParticipantsA total of 104 individuals completed the qualitative component of a mixed-methods interview. Sixty-seven participants identified as male, thirty-six identified as female, and one identified as non-binary. Inclusion criteria included past or current use of methamphetamine, having received services from a hospital, and being able to communicate in English.MethodsOpen-ended questions regarding experiences in the hospital setting were asked in relation to the lived experience of methamphetamine. A secondary analysis was conducted post-hoc using a thematic ethnographic approach due to prominent perceptions of stigma.ResultsThree themes were identified. The first theme identified that substance use was perceived as a moral and personal choice; the second theme pertained to social stigmas such as income, housing and substance use, and consequences such as being shunned or feeling less worthy than the general patient population; and the third theme highlighted health consequences such as inadequate treatment or pain management.ConclusionThis study revealed that stigma can have consequences that extend beyond the therapeutic relationship and into the healthcare of the individual. Additional training and education for healthcare providers represents a key intervention to ensure care is non-stigmatizing and patient-centered, as well as changing hospital culture

Extrinsic Factors Influencing the Person’s Motivation for Engagement and Retention in the Addiction Recovery Process. A Systematic Literature Review

Background Globally, up to 80% of patients enrolled for addiction care are lost to follow-up within the first three months of treatment. This review synthesizes evidence on extrinsic factors that influence motivation for engaging in addiction recovery and corresponding empirical definitions. Methods A systematic search for peer-reviewed articles was conducted through electronic databases, including Ovid MEDLINE, PsychINFO, CINHAL, and scanning references. The included articles were published in English or French between 1946 and 2018. Results The identified sixteen articles indicated that extrinsic factors for the person’s engagement and retention in the addiction recovery process included: motivation-enhancing healthcare structures, therapeutic relationships, and supportive social networks. Results also indicated that empirical definitions of motivation for engagement and retention in the addiction recovery process varied across studies. Conclusion Extrinsic factors can influence the person’s motivation for engagement and retention in the addiction recovery. Research with full operational definitions of motivation for engagement and retention in the addiction recovery is needed. Keywords: Addiction recovery; engagement; extrinsic factors; motivation; retentio

Developing an innovative health data management system for individuals with mental illness

The creation of a system for smart technology that not only links multiple devices but funnels and integrates data into one database is highly innovative. This system will seek to incorporate real-time integration of data in order to provide Health Care Professionals with notifications and enhanced monitoring capabilities

Mothers with Serious Mental Illness: Their Experience of “Hitting Bottom”

This study sought to understand the experience of “hitting bottom” from the perspective of 32 mothers with serious mental illness. Secondary narrative analysis of 173 stories about experiences related to hitting bottom were identified. Enactment of their perceived mothering roles and responsibilities was compromised when confronted by the worst of illness. Subsequent to women's descent to bottom was their need for a timely and safe exit from bottom. An intense experience in bottom further jeopardized their parenting and treatment self-determination and, for some, their potential for survival. The results suggest that prevention of bottom is feasible with early assessment of the diverse issues contributing to mothers' vulnerabilities. Interventions to lessen their pain may circumvent bottom experiences. Healing necessitates purposeful approaches to minimize the private and public trauma of bottom experiences, nurture growth towards a future, and establish resources to actualize such a life

Case 6 : No Fixed Address: A Cost-Effectiveness Analysis of a Program to Prevent Psychiatric Discharge to Homelessness

Najwa D\u27Souza, the CEO of Hampden Health Care, is looking for an intervention that will reduce the rate of discharge to homelessness from the psychiatric units at her hospitals. She is presented with the No Fixed Address (NFA) program as a possible solution. This intervention is a multipronged, hospital-based intervention that provides support to psychiatric clients who are either experiencing homelessness or are at risk of homelessness. To implement the program at Hampden Health Care, hospital staff would refer clients they suspect are at risk of being discharged to homelessness to the NFA program. From there, clients would have the option of receiving streamlined Ontario Works support or seeing a housing advocate who is employed by the local shelter system, Hampden Community House. Excited about the possibilities this intervention holds, Najwa must conduct an economic evaluation to assess the NFA program’s value for money, and support decision making for Hampden Health Care and other relevant stakeholders. Students take the perspective of someone on Najwa’s health economics team. They are given a list of parameters including the types, quantities, and costs per unit of the resources needed for the two interventions being compared (usual care versus NFA program). Students must incorporate the parameters into a model-based economic evaluation comparing the costs and consequences of the alternative interventions. Students are then tasked with working through the rest of the steps to complete a cost-effectiveness analysis