“More to life than mental health”: Investigating the Roles of Community Mental Health Case Managers in Promoting Community Integration for Adults with Psychiatric Disabilities

The recovery movement in the field of community mental health has brought attention to more holistic outcomes of services for adults with psychiatric disabilities, including community integration. However, there is a lack of empirical investigations of the roles that service providers, and case managers (CMs) in particular, can play in promoting such outcomes for their clients. The present study took an exploratory, hypothesis-building approach to describing the ways in which CMs supported the community integration of their clients with serious mental illness. A cross-sectional design was used with qualitative and quantitative data collected from 6 CMs and a sampling of 20 clients. Findings documented that clients’ community issues were often viewed as relevant to CM services, though to varying degrees. CMs were primarily described as promoting community integration by connecting clients to resources, providing encouragement, and serving other supportive functions (e.g., goal planning, accountability, regular check-ins). CM practices varied in the extent to which they aligned with recovery principles, including CM’s primary goals in case management, CMs viewing themselves as central vs. supplemental to clients’ community lives, how they related to clients (parental vs. coach roles) , and methods they used to connect clients to community resources. Mixed method analyses revealed that CMs whose practices aligned more closely with the principles of recovery and client-centered care (e.g., holistic, collaborative approaches) tended to have clients with higher community integration scores. Higher functioning clients generally reported more peripheral, supplemental support from CMs whereas lower functioning clients described support from their CMs as involving stronger guidance and direction. The present study was intended to be exploratory and hypothesis-building; as such, limitations included having a small sample size and a cross-sectional design. Nevertheless, a key benefit of this study was its ability to identify recommendations for future research and considerations for practice which are more likely to be implementable in real-world settings. One key recommendation generated from this study to be tested in future research is that bolstering CMs’ use of client-centered approaches to case management (holistic perspective, collaborative approach) might allow them to more effectively promote clients’ community integration

Strategies to Influence a Quality and Compliance Culture

Sales of defective or substandard products carry a potential risk of unintended effects on the consumer. The purpose of this single-case study was to explore the strategies to influence a culture of quality and compliance. Findings identified the value of weaving quality and compliance into a unified matrix to establish a holistic approach to endowing the organizational culture with the behaviors and habits that drive quality and compliance across business unit boundaries. To treat any aspect of quality and compliance as a separate element of the culture may undermine the overall effectiveness of quality and compliance programs, leaving room for employees to doubt the value top leadership places on these requirements

Validation of the Patient Perception of Migraine Questionnaire

Objective: The purpose of this study was to assess the psychometric properties of the Patient Perception of Migraine Questionnaire (PPMQ), which measures patient satisfaction with migraine therapy. Methods and Data: The PPMQ was administered to 940 patients as part of a 3-month, multinational, open-label, clinical trial comparing the effects of oral naratriptan 2.5 mg with the patient's customary therapy for the treatment of migraine. Psychometric properties of the PPMQ were evaluated in terms of its latent factor structure, validity, reliability, sensitivity, and development of a scoring method. Classical Test theory and Item Response theory (IRT) modeling were both used to measure reliability. Results: The PPMQ was able to detect treatment differences (P > .001), and all items significantly correlated with diary ratings of headache pain (r = .18−.51, p > .0001) and the Medical Outcomes Short Form-36 pain scale (r = .27, p > .0001). A principal components factor analysis revealed that the items on the PPMQ were psychometrically distinct and unidimensional (loadings, 0.74–0.91), with the exclusion of two items. The reliability (i.e., internal item consistency) of the PPMQ post-trial was high in both treatment groups (Cronbach's α = 0.96). An IRT analysis also ensured the formation of homogenous items, which were stable on repeat administration. Items did not require weighting and can be simply summed to yield a total score. Conclusion: Based on the data from this one clinical trial, the 15-item PPMQ was shown to be a valid and reliable instrument that seems to efficiently and comprehensively measure patient perception of drug attributes in relation to the treatment of symptoms associated with migraine headaches

The Role of Recovery in Attenuating the Negative Effects of Perceived Stigmatizing Attitudes for Persons with Psychiatric Disabilities

For many people who experience psychiatric disabilities (PD), community experiences are largely characterized by stigmatizing interactions, discrimination, and losses of opportunities for employment, housing, or relationships. Social withdrawal and loss of self-esteem can be secondary consequences of such negative experiences. However, research has also explored various mechanisms through which people in historically stigmatized social groups can minimize some of the negative effects of stigma. Many of these strategies are theorized to be similar to a mental health recovery orientation which emphasizes the empowerment, capabilities, and strengths of mental health consumers. The present investigation explores the possibility of recovery attenuating some of the negative consequences of perceived stigma for individuals diagnosed with PD. Specifically, the study hypothesizes that the relationship between perceived stigma and social functioning indicators (i.e., vocational engagement, social network size and contact, community integration) will be stronger in those with a lower sense of recovery than those in a high recovery group. A series of logistic and linear regressions testing perceived stigma as a predictor of the three outcomes were compared for participants with recovery scores in the highest and lowest thirds of the sample. Results partially supported hypotheses for social networks and community integration: those with a higher sense of recovery experienced a weaker relationship between stigma and these negative outcomes than their lower-recovery peers. This finding supports the theory that one\u27s sense of recovery has potential to attenuate some of the negative outcomes associated with stigmatizing attitudes. Contrary to hypotheses, however, results of analyses on vocational engagement indicated a positive relationship between stigma and vocational engagement, suggesting that those with more vocational experiences are more aware of stigmatizing attitudes. Altogether, these findings provide a basis for further theory-building and research on the relationship between recovery, stigmatizing attitudes, and community experiences

Proposals to Amend the Senate Cloture Rule

Paragraph 2 of Senate Rule XXII, also known as the “cloture rule,” was adopted in 1917. It established a procedure, amended several times over the intervening years, by which the Senate may limit debate and act on a pending measure or matter. Aside from unanimous consent agreements, cloture is the only way the Senate can limit debate

Library collection deterioration: a study at the University of Illinois at Urbana-Champaign

A survey of bound items in the bookstacks of the University of Illinois library at Urbana-Champaign was conducted following the methodology used in the 1979 survey of the Green Library stacks at Stanford University. A reliable random sampling technique was used. The survey found that 37.0% of the items at Illinois are seriously deteriorated (paper is embrittled), 33.6% are moderately deteriorated (paper is becoming brittle), and 29.4% are in good condition (paper shows no signs of deterioration). The total cost of the survey was $1,845.45 (excluding permanent staff salaries). The methodology can be adapted by other libraries for collection condition surveys

Who Participates in an Internet-Based Research Program for Mothers of Infants? A Secondary Prevention Research Study Among Low-Income Families

Objective: The objective of this study was to evaluate the participation rates and factors associated with nonparticipation among mothers living in low-income households who were invited to join a parent-education and -support research program delivered via the Internet with professional support. Methods: Four hundred and seventy-seven mothers of infants were contacted via a variety of recruitment methods, including presentations at clinics/classes, direct mailings, print advertisement, and Internet posts. Research staff attempted to contact these mothers by phone, to assess their eligibility, and interest in participation. For those who were eligible but declined participation, we assessed reasons for declining and collected demographic information. Results: Seventy-four percent of those eligible agreed to participate in the program. Statistical tests comparing participants and decliners on demographic variables found no significant differences on mother’s age and marital status. There was a significant difference on baby’s age due to many decliners in the prenatal period. Mothers were an average age of 28 years and most were married (65.6%). Our sample of low-income participants was diverse with a large number of Latina mothers. Approximately half had a high-school diploma or less but 84% reported being moderately or very comfortable using a computer and half had a computer at home

Affective Images of Climate Change

Climate change is not only a scientific phenomenon, but also a cultural one. Individuals’ opinions on climate change are often based on emotion rather than on scientific evidence. Therefore, research into the emotional characteristics of the imagery that the non-expert public find relevant to climate change is important in order to build a database of effective climate change imagery, which can then be used by scientists, policymakers, and practitioners in mobilizing climate adaptation and resilience efforts. To this end, we collected ratings of relevance to climate change as well as emotional arousal and valence on 320 images to assess the relationship between relevance to climate change and the emotional qualities of the image. In addition, participants’ environmental beliefs were measured, to investigate the relationship between beliefs and image ratings. The results suggest that images rated highly relevant to climate change are higher in negative emotional valence and emotional arousal. Overall, images were rated as being more relevant to climate change by participants with higher pro-environmental disposition. Critically, we have compiled the mean relevance, valence, and arousal ratings of each of these 320 images into a database that is posted online and freely available (https://affectiveclimateimages.weebly.com; https://www.nmu.edu/affectiveclimateimages) for use in future research on climate change visuals