Community Mental Health Journal最新文献

{"title":"The Future of Psychosocial Supports in Australia- Are the Recommendations from the National Disability Insurance Scheme Review the Answer?","authors":"Tania Shelby-James, Megan Rattray","doi":"10.1007/s10597-025-01467-8","DOIUrl":"https://doi.org/10.1007/s10597-025-01467-8","url":null,"abstract":"<p><p>The introduction of the National Disability Insurance Scheme (NDIS) in 2013 and the resulting changes in mainstream funding for psychosocial supports have led to disparities in funding between the two existing systems. Currently, people supported under the NDIS receive significantly more funding compared to those supported through federal and state programs. The NDIS review has highlighted this inequity, prompting a commitment to increase state and federal funding for foundational psychosocial supports. However, the specifics of this funding remain unclear. This article synthesises and critically evaluates the recent NDIS review recommendations relating to psychosocial disability and makes recommendations on how both systems could be enhanced to ensure equitable and accessible psychosocial support provision in Australia.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Service Engagement and Disengagement in Community-Based Coordinated Specialty Care for Early Psychosis in Texas.","authors":"Molly A Lopez, Samantha J Reznik, Calliope Custer, Paul J Rathouz","doi":"10.1007/s10597-025-01468-7","DOIUrl":"https://doi.org/10.1007/s10597-025-01468-7","url":null,"abstract":"<p><p>Coordinated specialty care (CSC) is an evidence-based, early intervention approach for individuals with a recent onset of psychosis. This study identifies program and individual characteristics that predict (1) initial engagement in care; (2) the use of peer and family partner services; and (3) time to disengagement. Administrative data representing CSC encounters at 22 community mental health programs were analyzed. Logistic regressions were used to model initial CSC engagement, as well as the use of peer or family partner services, given initial engagement. Cox proportional hazards regression was used to quantify program disengagement, with possible time-varying effects of peer service use. Identified predictors of initial engagement included: race/ethnicity, age, diagnosis, program urbanicity, and program maturity. Identified predictors of disengagement in the first year included: diagnosis, program urbanicity, and program maturity. Peer and family partner services did not significantly predict disengagement. These results suggest equity issues for some individuals, while also highlighting the importance of program characteristics on pathways to care. Future research should include program factors as key predictors for engagement, explore both person-centered and program-centered strategies to maximize engagement, and optimize and examine the role of individual and family peer services in engagement. Such a shift would align with the call to understand pathways to care from a community-level rather than individual lens.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational Therapy Interventions and Outcomes in United States' Early Intervention in Psychosis Programs: A Mixed Methods Survey Study.","authors":"Halley Read, Keely A McCormick","doi":"10.1007/s10597-025-01471-y","DOIUrl":"https://doi.org/10.1007/s10597-025-01471-y","url":null,"abstract":"<p><p>Young adults experiencing psychosis are at high risk for disengagement from their daily lives. Occupational therapy (OT) services play an important role in fostering participation, yet their intervention efficacy in Early Intervention in Psychosis (EIP) remains poorly understood. To determine the commonly utilized OT interventions and measurement tools that require further research to determine their efficacy and effectiveness. Cross-sectional, mixed-methods survey study. Quantitative descriptive statistics were completed on Microsoft Excel and qualitative thematic analysis was completed by two researchers using Dedoose. Online survey. Occupational therapy practitioners (OTPs) working on EIP programs in the United States were recruited through purposive and snowball sampling. The survey consisted of 24 closed and open-ended questions assessing use of interventions, outcomes tracked, and measurement tools. Study had 21 respondents. The most frequent interventions were self-regulation and activities of daily living (ADL). Self-regulation interventions were overwhelmingly sensory-based. Most commonly reported outcome measure was observation of participation in occupations. This study confirms the use of sensory and ADL-based interventions by OTPs in EIP programs. Findings suggest a strong sense of the role of OT within EIP as intervention use is relatively consistent across programs and focuses on client-centered, occupation-based interventions. Outcome tracking and quality improvement were gaps as most OTPs are not using standardized methods or not performing this. Additional study is required to determine the efficacy of commonly used interventions and to improve outcome measurement methods in EIP programs. Occupational therapy is an undervalued profession on teams that provide services to young adults dealing with the onset of a psychotic illness. This study is the first of many needed to demonstrate the impact OT services can have on the outcomes of the young adults who receive care for their psychotic illness. This study identifies what OT interventions are common, and what outcomes OT professionals track to determine their services' impact on these mental health care teams. These results will help to build the needed research on how helpful these common interventions are for young adults facing psychotic illnesses.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and Supports for Families of Youth with Behavioral Health Needs.","authors":"Danielle M Romain Dagenhardt, Melinda Kavanaugh, Tina Freiburger","doi":"10.1007/s10597-024-01386-0","DOIUrl":"10.1007/s10597-024-01386-0","url":null,"abstract":"<p><p>As mental health needs increase for youth across the United States, little is known about how these youth engage with emergency psychiatric services (EPS) and how accessing of these services is experienced by the family caregivers. This study utilized interviews with 19 youth and their adult caregivers, detailing their experiences with EPS and community needs. Interviews were conducted in-person and over the phone, lasting approximately 45 min. Qualitative data were analyzed following grounded theory to elicit a potential new theoretical view of youth and family experiences and needs associated with EPS. Themes elicited included: (1) family and school challenges, (2) challenges for caregivers, (3) structural and system challenges exacerbate issues, (4) family and friend supports, (5) community supports. Families in this study struggled with numerous family, school, and community barriers, indicating a need for targeted supports that address the family and community systems.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"682-692"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Programmatic and Organizational Barriers and Facilitators to Addressing High-Risk Issues in Supportive Housing and Housing First Programs.","authors":"Nick Kerman, Timothy de Pass, Sean A Kidd, Christina Mutschler, Abe Oudshoorn, John Sylvestre, Tim Aubry, Benjamin F Henwood, Frank Sirotich, Vicky Stergiopoulos","doi":"10.1007/s10597-024-01373-5","DOIUrl":"10.1007/s10597-024-01373-5","url":null,"abstract":"<p><p>Risk management is an important component of service delivery in supportive housing and Housing First programs. However, there is no evidence on the implementation of risk management approaches in these settings. This qualitative study examined what service providers working in supportive housing and Housing First programs in Canada identify as the programmatic and organizational factors that affect the prevention and management of high-risk behaviours and challenges (e.g., overdose, suicide attempts, non-suicidal self-injury, falls and fall-related injuries, fire-setting, hoarding, apartment takeovers, violence, property damage, drug selling) in their programs. In-depth interviews were completed with a purposive sample of 32 service providers. Data were analyzed using an integrative approach that incorporated techniques from qualitative description and thematic analysis. Four thematic factors, which were comprised of various barriers and facilitators, that affected management of high-risk issues in supportive housing and Housing First programs were identified: [1] flexibility in addressing risk issues; [2] early identification of risk issues; [3] built environment and housing location; and [4] resource availability. Overall, the findings underscore how service providers aim to identify high-risk issues promptly, beginning as early as referral, and that their capacity to effectively do this and intervene accordingly is dynamically shaped by various aspects of the program model, environment, and availability of internal and external resources. Yet, the findings also highlight how risk management approaches may conflict with other programmatic goals and values, and the importance of considering these collectively. Systems-level changes to strengthen programs' capacity to prevent risk and implications for future research are discussed.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"661-673"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceiving Ethical Discomfort Triggered by Situations that Resist Meaning in Community Mental Health Settings: A Grounded Theory.","authors":"Marie-Claude Jacques, Jacques Quintin, Nadine Larivière, Claude Charpentier","doi":"10.1007/s10597-024-01415-y","DOIUrl":"10.1007/s10597-024-01415-y","url":null,"abstract":"<p><p>Community mental health care is a practice setting conducive to the emergence of special situations since the intervention takes place in the client's living environment, a context fraught with multiple and often unpredictable events and triggers. In addition, the healthcare workers are often alone in making decisions. This can lead to a persistent feeling of discomfort when the situation can be seen from several different angles and the healthcare workers find it difficult to make the right decision or are uncomfortable with the consequences of a decision they must make. This is the phenomenon of ethical discomfort. The aim of this study was to develop a grounded theory to better understand the relationships between ethical discomfort situations, their impact on lived experience by healthcare workers, and the mental processes and strategies employed by community mental health workers. We used a constructivist grounded theory methodology and conducted focus group interviews with five rural and urban community mental health teams. Our findings describe the context and process surrounding the identification of ethical discomfort by community mental health workers. Strategies such as dialogue with oneself, colleagues, or clients were helpful in deepening ethical reflection and alleviating ethical discomfort. Future research on ethical issues in community mental health care could help to develop ethical support interventions adapted to this mental health care context.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"783-796"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Analysis of Trialogues Between People with Lived Experience, Their Relatives, and Mental Health Professionals.","authors":"Francisco José Eiroa-Orosa, María Incera-Rosas","doi":"10.1007/s10597-024-01402-3","DOIUrl":"10.1007/s10597-024-01402-3","url":null,"abstract":"<p><p>Trialogue meetings, aligned with the Recovery model in mental healthcare, foster the development of a shared language and mutual understanding among persons with lived experience, their relatives, and professionals. This study analysed the first mental health trialogue experience in Barcelona, involving six meetings with thirteen voluntary participants over three months. Using qualitative methods for data collection and reflexive thematic analysis, three main themes emerged: Recovery process, Interaction with mental health services, and Trialogue dynamics. Benefits included open dialogues in a safe space, learning from diverse perspectives, and sharing expertise. The meetings created an environment of empathy and respect while promoting open communication. This approach holds substantial potential for transforming mental healthcare systems, suggesting trialogues can be an effective tool for enhancing communication within community-based mental health initiatives. The findings provide a comprehensive picture of the trialogue process, highlighting its potential to foster mutual understanding among participants.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"764-774"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards a Better Use of Safety Planning in Emergency Departments: An Exploratory Study of Patients and Clinicians' Perspectives.","authors":"Camille Brousseau-Paradis, Christine Genest, Nathalie Maltais, Monique Séguin, Jessica Rassy","doi":"10.1007/s10597-024-01394-0","DOIUrl":"10.1007/s10597-024-01394-0","url":null,"abstract":"<p><p>Suicidality frequently leads to emergency department (ED) visits, yet few interventions are offered in EDs to mitigate suicide risk. This study uses a descriptive interpretative design to evaluate the key components for a successful use of such an intervention, the Stanley-Brown safety plan, in EDs. Semi-structured interviews were conducted with patients and ED clinicians and were analyzed using a thematic analysis approach. Participants' perspectives revealed 6 key recommendations for a successful use of the safety plan in EDs: (1) personalize the content of the safety plan, (2) offer a variety of formats, (3) avoid periods of high emotional intensity, (4) engage a broad range of professionals in safety planning, (5) use limited time to make meaningful interventions, (6) propose alternative interventions. A change in the ED culture is needed to ensure that the management of suicidal patients in EDs includes brief therapeutic interventions like safety planning, to mitigate suicide risk.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"724-733"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Formative Evaluation of Post-Opera Live Discussion of the Center Cannot Hold Part 2 and Resilience Workshop.","authors":"Kenneth Wells, Juanita Booker-Vaughns, Tiffany Dzou, Elyn R Saks","doi":"10.1007/s10597-024-01407-y","DOIUrl":"10.1007/s10597-024-01407-y","url":null,"abstract":"<p><p>There are few studies of impacts of arts on recovery in schizophrenia, on audience and cast responses. We developed a formative qualitative evaluation of audience and cast discussions after viewing live performances in a university setting of an opera based on Elyn Saks' journey from psychosis, teaching law and falling in love, coupled with pre-opera workshop on community approaches to resilience. Live discussions were conducted with audience, cast members, and workshop presenters after performance of the opera, with recording and transcription, and reflexive thematic qualitative analysis sequentially conducted by 3 investigators/2 event leaders). Across 3 events, there were 81 comments (65'10\" total time) from facilitator, audience members, cast and creators. Key themes across participant groups were: (1) Connecting with the story; (2) Identifying \"normal\" lifestyles with mental illness; (3) Refocusing goals of care for providers; (4) Increasing awareness around mental health; with an overarching theme the value of art on mental health to highlight awareness of these issues. Live art events (opera with pre-workshop) on mental health with author with lived experience present, were noted by audience and cast as enhancing connection, enhancing understanding of mental illness and clarifying goals for care, through the shared experience of art. This may inform future research and art events on mental health.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"776-782"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peer Support Workers in Mental Health Services: A Qualitative Exploration of Emotional Burden, Moral Distress and Strategies to Reduce the Risk of Mental Health Crisis.","authors":"Justyna Klingemann, Halina Sienkiewicz-Jarosz, Bartłomiej Molenda, Piotr Świtaj","doi":"10.1007/s10597-024-01370-8","DOIUrl":"10.1007/s10597-024-01370-8","url":null,"abstract":"<p><p>This research aimed to explore the experience of emotional burden among peer support workers (PSWs) in mental health care in Poland. It also examined the issue of moral distress in relation to this professional group and identified institutional sources of support for the well-being of PSWs in the workplace. The data presented in the article are derived from fourteen qualitative in-depth individual interviews with PSWs employed in four mental health centres with different organisational structures. The narratives of PSWs revealed several experiences that could be considered to be moral distress. The inability to assist patients was found to be associated with both individual and institutional barriers. Furthermore, our findings suggest that organisations can implement a number of specific practices to ensure the wellbeing of PSWs, which dissemination would be beneficial to teams employing PSWs.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"629-638"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}