Factors influencing placement recommendations for hospitalized individuals with chronic mental illness

This study was undertaken to identify factors that may preclude a patient's discharge from a community mental health center and result in the patient being labeled "unplaceable." Placement recommendations differed between the state hospital staff and a mental health professional employed by the center to evaluate 28 patients. A measure designed to assist in the assessment of patients' competencies suggested the professionals' recommendations were more related to patients' skills in areas associated with community living than were those of the state hospital staff. Follow-up indicated that 15 patients discharged according to the professionals' recommendations maintained community tenure. Use of a more psychometrically sound and comprehensive assessment concerning discharge and placement may improve likelihood of success.     

Understanding successful community living by individuals with serious and persistent mental illness.

34 volunteers diagnosed as chronically mentally ill were administered a questionnaire to evaluate what factors were important in preventing rehospitalization. The volunteers were divided into two groups based on their relapse history. Analysis showed the nonrelapse group were more likely to attribute factors such as in-home therapy, taking medication, and having fun with friends than did the group who had experienced at least one relapse in the past 24 months.     

Microaggressions: The experience of individuals with mental illness

The main objective of the study was to investigate the types of microaggressions experienced by individuals with mental illness (MI) based on this marginalized group status. This study included 4 focus groups, comprised of 18 individuals diagnosed with MI(es). The researchers qualitatively identified four themes (a) conveying stereotypes against individuals with MI (i.e. assumptions of inferiority, seeking attention or being dramatic, assumptions of coldness, bringing MI upon themselves, and using MI as an excuse), (b) invalidating the experience of having a MI (i.e. doubting existence, doubting severity, and avoiding acknowledgment of the MI), (c) defining a person by their disorder, and (d) misuse of terminology. Participants revealed the main perpetrators (i.e. family, friends, and professionals) of the microaggressions. The researchers discuss: how the identified themes compare to the three categories of microaggressions (i.e. microinsults, microinvalidations, and microassaults); similarities and differences between the current results and previously identified racial, gender, and sexual orientation microaggressions perpetrated in daily interactions and in therapeutic settings; and the perpetrators of microaggressions as they relate to prejudicial attitudes and social distance. Finally, the authors make recommendations for practitioners and researchers.     

Introducing the living with illness group: A specialized treatment for patients with chronic schizophrenic conditions

This paper introduces a specialized psychotherapy/psychoeducational group treatment for patients with chronic psychotic symptoms who receive only partial benefit from psychotropic medications, psychotherapy, and milieu/activities therapy. The goal of the group is to assist patients to accurately identify the feelings, thoughts, and behaviors that are dysfunctional symptoms of their disability and then use the functional aspects of their brain as well as learned coping strategies to compensate for their disability. The group format, philosophy, procedures, and typical topics of discussion are detailed.The authors would like to thank Bruce Levine, Ph.D., and Terry Fujeoko, Ph.D., for their assistance with the initial formation of the group. Mr. Howe and Dr. Fujeoko originated the Living with Illness group and began the first group in 1985 at Waterbury Hospital Health Center, Waterbury, CT.     

Sexual coercion among women living with a severe and persistent mental illness: Review of the literature and recommendations for mental health providers

Women with severe and persistent mental illness (e.g., schizophrenia, bipolar disorder) are at enhanced risk for sexual coercion and several resulting sexual health complications. We examine the prevalence and types of sexual coercion encountered by women with severe and persistent mental illness and provide recommendations for interventions to reduce the prevalence of sexual coercion. Mental health professionals working with this population need to provide increased attention to the problem of sexual coercion and can take measures to intervene safely and effectively.     

Day-to-day living with severe chronic obstructive pulmonary disease: Towards a family-based approach to the illness impacts

Objective: This study explores the perspectives of both patients and family members regarding the impact of chronic obstructive pulmonary disease (COPD) in their family life.

Design: An exploratory qualitative study was conducted with patients and their family members in the chronic phase of COPD. Individual interviews were performed to explore participants’ perspectives and submitted to thematic analysis.

Results: Six major themes emerged from patients’ perspective: (1) impact of COPD symptoms on personal and family daily life; (2) (over)protective family support; (3) difficulties in couple communication; (4) sense of identity loss; (5) fear of COPD progression; and (6) coping resources. Five main themes emerged from the family members’ perspective: (1) restrictions in family’s social life; (2) emotional distress related to COPD exacerbations; (3) tension in couple relationship; (4) financial strain of COPD; and (5) coping resources.

Conclusions: The overall findings illustrate the complex interaction between the experience of living with COPD and communication patterns, emotional states, social support and social roles within the family. The results highlight the need to develop family-based interventions to facilitate a functional adjustment to COPD. However, these interventions in COPD remain undeveloped and empirical evidence is needed.     

Word-attack skills in individuals with mental retardation

This article assesses the state of the literature on word-attack skills and phonological awareness (PA) in individuals with mental retardation, in light of progress towards the development of effective teaching procedures. The literature contains promising findings. Studies have shown PA to be correlated with word-attack skills in individuals with mental retardation, as has been shown conclusively in typically developing children. This suggests that instruction in PA would facilitate the acquisition of word-attack skills in individuals with mental retardation, as it does with typically developing children. As of yet, however, very few experimental studies designed to demonstrate effective teaching procedures for PA and word-attack skills have been published. This research field might evolve most effectively and efficiently by following a two-step research program. First, test new teaching procedures in a series of small-N studies, each study incorporating modifications of teaching procedures based on the results of the previous study. Once procedures prove effective at this level, the resources necessary to pursue large-scale studies can be used to their best advantage.