What are important ingredients of Intensive Home Support for people with severe mental illness according to experts?:A concept mapping approach

Background Deinstitutionalization in mental health care has been an ongoing process for decades. More and more people with severe mental illness (SMI), who previously lived in residential supported housing settings and were formerly homeless, are now living independently in the community but need intensive support to enable independent living. The support provided by regular outpatient teams is inadequate for this target group. This study explored the ingredients for an alternative form of outpatient support: intensive home support (IHS).Methods Concept mapping was used, following five steps: (1) brainstorming, (2) sorting, (3) rating, (4) statistical analysis &amp; visual representation, and (5) interpretation. Purposive sampling was used to represent several perspectives, including researchers, professionals, peer workers, and policy makers.Results Experts (n=17) participated in the brainstorming step and the sorting and rating steps (n=14). The 84 generated statements were grouped into 10 clusters:. (1) housing rights; (2) informal collaboration; (3) reciprocity in the community; (4) normalization and citizenship; (5) recovery; (6) sustainable funding; (7) equivalence; (8) flexible, proactive 24/7 support; (9) public health and positive health; and (10) integrated cooperation in support at home.Conclusions Given the diversity of the ingredients contained in the clusters, it seems that IHS should be designed according to a holistic approach in collaboration with several sectors. Additionally, IHS is not only the responsibility of care organizations but also the responsibility of national and local governments. Further research about collaboration and integrated care is needed to determine how to implement all of the ingredients in practice.<br/

Current insights of community mental healthcare for people with severe mental illness:A scoping review

Background: For the last four decades, there has been a shift in mental healthcare toward more rehabilitation and following a more humanistic and comprehensive vision on recovery for persons with severe mental illness (SMI). Consequently, many community-based mental healthcare programs and services have been developed internationally. Currently, community mental healthcare is still under development, with a focus on further inclusion of persons with enduring mental health problems. In this review, we aim to provide a comprehensive overview of existing and upcoming community mental healthcare approaches to discover the current vision on the ingredients of community mental healthcare.Methods: We conducted a scoping review by systematically searching four databases, supplemented with the results of Research Rabbit, a hand-search in reference lists and 10 volumes of two leading journals. We included studies on adults with SMI focusing on stimulating independent living, integrated care, recovery, and social inclusion published in English between January 2011 and December 2022 in peer-reviewed journals.Results: The search resulted in 56 papers that met the inclusion criteria. Thematic analysis revealed ingredients in 12 areas: multidisciplinary teams; collaboration within and outside the organization; attention to several aspects of health; supporting full citizenship; attention to the recovery of daily life; collaboration with the social network; tailored support; well-trained staff; using digital technologies; housing and living environment; sustainable policies and funding; and reciprocity in relationships.Conclusion: We found 12 areas of ingredients, including some innovative topics about reciprocity and sustainable policies and funding. There is much attention to individual ingredients for good community-based mental healthcare, but very little is known about their integration and implementation in contemporary, fragmented mental healthcare services. For future studies, we recommend more empirical research on community mental healthcare, as well as further investigation(s) from the social service perspective, and solid research on general terminology about SMI and outpatient support

The relations between executive functions and occupational functioning in individuals with bipolar disorder:A scoping review

BACKGROUND: Patients with bipolar disorder experience impairments in their occupational functioning, despite remission of symptoms. Previous research has shown that neurocognitive deficits, especially deficits in executive functions, may persist during euthymia and are associated with diminished occupational functioning. OBJECTIVES: The aim of this scoping review was to identify published studies that report on the relationships between executive functions and occupational functioning in BD to review current knowledge and identify knowledge gaps. In addition to traditional neuropsychological approaches, we aimed to describe executive functioning from a self-regulation perspective, including emotion regulation. METHODS: We applied the methodological framework as described by Arksey and O’Malley (Int J Soc Res Methodol Theory Pract 8:19–32, 2005) and Levac et al. (Implement Sci 5:1–9, 2010). We searched PubMed and psycINFO for literature up to November 2021, after which we screened papers based on inclusion criteria. Two reviewers independently performed the screening process, data charting process, and synthesis of results. RESULTS: The search yielded 1202 references after deduplication, of which 222 remained after initial screening. The screening and inclusion process yielded 82 eligible papers in which relationships between executive functions and occupational functioning are examined. CONCLUSION: Neurocognitive deficits, including in executive functions and self-regulation, are associated with and predictive of diminished occupational functioning. Definitions and measurements for neurocognitive functions and occupational functioning differ greatly between studies, which complicates comparisons. Studies on functional remediation show promising results for improving occupational functioning in patients with BD. In research and clinical practice more attention is needed towards the quality of work functioning and the various contexts in which patients with BD experience deficits. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40345-022-00255-7

Experiences, needs and expectations of welfare benefits recipients regarding the welfare to work services and their caseworker:Preliminary results from a mixed methods study.

Introduction: This study explored experiences, needs and expectations of welfare benefits recipients from a large municipality in the Netherlands, regarding their caseworker and the welfare to work (WTW) services. Preliminary results are presented, final and more extensive results will be published in a peer reviewed journal. Material and Methods: We used quantitative data from a client satisfaction survey that was held between July and December 2019 and filled in by 213 people who had received WTW services (response rate 15,6%). General satisfaction rate and agreement with 31 statements were assessed. Four group interviews with a total of 15 people receiving WTW services were conducted using a semi-structured interview guide. Verbatim transcripts were analysed using the principles of thematic analysis. Results: The survey showed that the majority of clients is reasonably satisfied with the WTW services. The qualitative data showed positive and negative experiences of clients. Most clients described the relationship with their caseworker as hierarchic and expressed the need for a collaborative and trusting relationship. Clients want to work together with their caseworker and do not want to be pushed or forced to accept any job. Conclusions: Our findings illustrate there is room for improvement in the WTW services. It is likely that WTW services that match the needs and expectations of welfare benefits recipients are more effective in terms of clients finding and keeping a job and thus no longer being dependent on welfare benefits

What is the meaning of paid employment for well-being?:A focus group study on differences and similarities between autistic adults with and without employment

PurposeThe aim of the present study was to explore the meaning of work for the subjective well-being of autistic adults with and without paid (competitive) employment and to evaluate the differences and similarities between these groups.MethodsEight focus groups were conducted, including a total of 64 autistic adults. Four groups entailed participants with current paid employment (including part-time) and four groups entailed participants without paid employment. All discussions were audiotaped and transcribed verbatim to enable inductive thematic content analysis. Data were analyzed using ATLAS.ti 9.ResultsGenerally, both groups viewed paid employment as very important for well-being, albeit for different reasons. Three themes were found: (1) Not having paid employment was associated with lacking societal recognition, and subsequent low self-esteem, which was a dominant theme in those without work; (2) Work can seriously damage (mental) health and well-being, found in both groups; and (3) Paid employment provides many benefits for well-being, with subthemes: 'purpose,' 'social contacts,' 'growth and use of talents,' 'structure and calmness,' and 'income and freedom', which was a dominant theme in those with paid employment.ConclusionsBoth groups found paid employment highly important for their well-being, albeit for different reasons. However, both also agreed that paid employment can be very harmful to (mental) health and well-being. Suitable, well-supported jobs are important for well-being, may help to buffer stress in other life areas, and may even prevent autistic burnout. More studies are needed on how healthy jobs can be created where autistic individuals get positive energy and experience high well-being. This will also help to reduce socio-economic inequality.</p

Illness Management & Recovery (IMR) in the Netherlands; a naturalistic pilot study to explore the feasibility of a randomized controlled trial

Multivariate analysis of psychological dat

Who benefits from individual placement and support?:A meta-analysis

Aims Individual placement and support (IPS) is an evidence-based service model to support people with mental disorders in obtaining and sustaining competitive employment. IPS is increasingly offered to a broad variety of service users. In this meta-analysis we analysed the relative effectiveness of IPS for different subgroups of service users both based on the diagnosis and defined by a range of clinical, functional and personal characteristics. Methods We included randomised controlled trials that evaluated IPS for service users diagnosed with any mental disorder. We examined effect sizes for the between-group differences at follow-up for three outcome measures (employment rate, job duration and wages), controlling for methodological confounders (type of control group, follow-up duration and geographic region). Using sensitivity analyses of subgroup differences, we analysed moderating effects of the following diagnostic, clinical, functional and personal characteristics: severe mental illness (SMI), common mental disorders (CMD), schizophrenia spectrum disorders, mood disorders, duration of illness, the severity of symptoms, level of functioning, age, comorbid alcohol and substance use, education level and employment history. Results IPS is effective in improving employment outcomes compared to the control group in all subgroups, regardless of any methodological confounder. However, IPS was relatively more effective for service users with SMIs, schizophrenia spectrum disorders and a low symptom severity. Although IPS was still effective for people with CMD and with major depressive disorder, it was relatively less effective for these subgroups. IPS was equally effective after both a short and a long follow-up period. However, we found small, but clinically not meaningful, differences in effectiveness of IPS between active and passive control groups. Finally, IPS was relatively less effective in European studies compared to non-European studies, which could be explained by a potential benefits trap in high welfare countries. Conclusions IPS is effective for all different subgroups, regardless of diagnostic, clinical, functional and personal characteristics. However, there might be a risk of false-positive subgroup outcomes and results should be handled with caution. Future research should focus on whether, and if so, how the IPS model should be adapted to better meet the vocational needs of people with CMD and higher symptom severity

The effects of a stigma awareness intervention on finding and retaining paid employment a cluster randomized controlled trial among unemployed people with mental illness

Introduction: Stigma is one of the barriers to paid employment for people with mental illness. Deliberate (non-)disclosure decisions may prevent this, but the effects of stigma awareness interventions are mostly unknown. This study aims to examine the effectiveness of a stigma awareness intervention for employment specialists and a decision aid and two infographics about disclosure of mental illness on finding and retaining employment for unemployed people with mental illness, compared to usual guidance. Material and methods: A clustered RCT was conducted. Participants were unemployed people with mental illness who receive social benefits (N=153) and were recruited at eight locations. The control group received guidance as usual and the experimental group received guidance as usual combined with the stigma awareness intervention. Health, wellbeing, job seeking activities and disclosure were measured at baseline and 3, 6 and 12 months. Multilevel analyses were conducted to analyze the effects of the intervention on finding and retaining employment, controlled for other factors. Results: In the experimental group, after six (T2) and twelve months (T3) almost twice as many participants had found paid employment (T2: CG=26.1% vs EG=50.7%, p=0.003; T3: CG=34.4% vs EG=53.8%, p=0.026), and retained paid employment after twelve months (CG=23.4% vs EG=49.2%, p=0.002), compared to the control group. Conclusions: A stigma awareness intervention contributes to more often finding and retaining paid employment for people with mental illness

Effectiveness of an intervention for managing victimization risks related to societal participation for persons with severe mental illness: A cluster RCT study protocol

Background: People with severe mental illness (SMI) are more likely to experience criminal victimization than other community members. In addition, (self-) stigma and perceived discrimination are highly prevalent in this group. These adversities in the social context often have major adverse effects on the rehabilitation and recovery of these persons. Current practice, however, lacks instruments to address these issues. As a reaction, the Victoria intervention was developed and pilot-tested with client representatives, professionals, trainers and researchers. The Victoria intervention is a method for community mental health care workers to expand their awareness of this topic and support them in assessing victimization and incorporate appropriate services, including trauma screening and rehabilitation services, in their health care planning. For clients, the Victoria intervention aims to increase their awareness, active management of possible victimization risks and promote safe social participation. As a new intervention, little is known about its use in real practice and its effects on client outcomes. Methods/design: To determine the feasibility and effectiveness of this intervention, a process evaluation and a first cluster randomized controlled trial (RCT) will be carried out. Outpatients from eight Flexible Assertive Community Treatment (F-ACT) teams from two mental health care (MHC) organizations in the Netherlands are included in the study. Teams in the intervention group will receive three half-day training sessions, and bi-monthly supervision meetings for 18months. Teams in the control group provide care as usual. For the process evaluation, a multi-method design is used. To assess effects on client outcomes, clients will be interviewed about their experiences on victimization and societal participation using validated questionnaires at baseline, and after 9 and 18months. Discussion: This study is the first to evaluate an intervention aiming at recognition of victimization, (self-) stigma and perceived discrimination, and targeting outpatients' insights into possible risks and coping skills to tackle these risks to enhance safe societal participation. Results of this study may validate the Victoria intervention as a practice to better manage risk for adversities related to societal participation