The following interview is part of a “future of mental health” interview series that will be running for 100+ days. This series presents different points of view about what helps a person in distress. I’ve aimed to be ecumenical and included many points of view different from my own. I hope you enjoy it. As with every service and resource in the mental health field, please do your due diligence. If you’d like to learn more about these philosophies, services, and organizations mentioned, follow the links provided.
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Confronting ableism requires confronting capitalism, which values people only for the efficiency of their output within mechanized schedules.
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The book presents an overview of current challenges in the healthcare system and the potential impact of system engineering. It describes an integrated framework for the delivery system and the tools and methodologies used for performance assessment and process improvement with examples of lean concept, evidence-based practice and risk assessment. The book then reviews system engineering methodologies and technologies and their applications in healthcare. Moving on to coverage of the design, planning, control and management of healthcare systems, the book contains chapters on 12 services sectors: preventive care, telemedicine, transplant, pharmacy, ED/ICU, OR, decontamination, laboratory, emergency response, mental health, food and supplies, and information technology. It presents the state-of-the-art operations and examines the challenges in each service unit.
Read MoreThis chapter provides an overview of what can be done in the future to address the prevention and control of mental and behavioral disorders. It begins with a description of what has come before, examining progress and pitfalls. This is followed by a discussion of the evolution needed to bring about Winslow's vision of mental health care as an integral part of the public health. It examines the growing role of such factors as the social determinants of health; attention to the full spectrum of mental health and illness from prevention through recovery across the life span; the importance of resilience in preventing behavioral problems; the still evolving key role of consumers in treatment and recovery; and the policy changes needed to embrace mental health as an intrinsic part of the public health.
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Social work research must more consistently link case and cause, iteratively developing processes for bringing micro-, mezzo-, and macrostreams of information together. We further argue that meaningful engagement with the initiative requires social work scholars and practitioners to actively scale up practice and research inquiry. We detail two key strategies for employing a scaled-up social work practice and research ethos: (a) employing a critical economic lens and (b) engaging with diverse publics.
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This pre-post study examined mental health service utilization and cost before and after participating in self-direction. Findings from this modest pre-post examination of self-direction suggest that mental health self-direction can result in more person-driven, individualized services without increasing costs.
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This Open Forum describes the National Survey of Peer-Run Organizations, which was conducted in 2012 to gather information about peer-run organizations and programs, organizational operations, policy perspectives, and service systems. A total of 895 entities were identified and contacted as potential peer-run organizations. Information was obtained for 715 (80%) entities, and 380 of the 715 responding entities met the criteria for a peer-run organization.
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The paper describes how peer interviewers were recruited, hired, trained, and supervised. The authors discuss some benefits and challenges associated with the approach. Peer interviewer benefits and challenges: the shared lived experience between the peer interviewers and study participants contributed to increased comfort and a high response rate overall. The study opened up professional opportunities for peers, but inconsistent work hours were a challenge and resulted in turnover and difficulty filling vacant positions. The lead evaluator and supervisors worked closely with peer interviewers to ensure conflict of interest was mitigated to reduce bias.
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This paper describes data collection methods and demonstrates how participatory strategies to involve people with psychiatric histories intersected with Internet research to achieve study aims. People with psychiatric histories were involved in designing and implementing a web-based survey to collect data on peer-run organizations' operations and views on national policy. Participatory approaches were used throughout design, data collection analysis, and dissemination. The extensive involvement of people with psychiatric histories in project design and implementation were important strategies that contributed to this study's success.
Read MoreThis study sought to identify risk factors for child protective services (CPS) involvement among parents with serious mental illnesses. Compared with parents without CPS contact, parents with a CPS contact were more likely to be nonwhite and to be less educated. They were also more likely to have less attachment-related social support, more parenting-related needs in numerous areas, and more substance use–related issues and to have experienced adverse childhood and traumatic events. One-quarter of the parents with CPS contact reported not having a mental disorder diagnosis at the time of the first contact, and those in the CPS group were less likely to have taken medications at the time of the first contact than were parents who did not have a CPS contact.
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The recovery movement has evolved from a more radical view in the early days, to participatory involvement in systems, to returning to alternative models of care that are more independent. Now as more peer specialists work in systems, there is an increased emphasis on non-medical alternatives and the cycle continues. Regardless, recovery, self-determination, choice, etc. are always at the centre. This paper notes the interesting cycles of recovery-orientation and how they spin around the values/tenets of the movement’s early roots.
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Lack of comprehensive medical care coverage and mental health symptoms were associated with increased odds of perceived difficulties in accessing medical care; personal empowerment was negatively associated with perceived difficulties attributed to stigma; education was positively associated. The findings highlight unmet need for medical care in this population and the need to recognize stigma as a barrier medical care. Interventions to empower patients and educate medical providers about wellness for people with serious mental illness could help to reduce barriers.
Read MoreThis study examined the relationship between the culturally determined beliefs and expectations of four ERD groups (African Americans, Latinos, Portuguese-speakers, and Haitians, total N = 160) and the technical quality of treatment for depression provided in four “culturally-specific” primary care clinics. Using data from the Experiences of Care and Health Outcomes survey, chart reviews and focus groups, the study addressed a set of questions related to the psychometric properties of perceived care measures and the technical quality of care. The groups differed in preferred cultural elements except all preferred inclusion of religion. They did not differ in overall perceived quality.
Read MoreTwo research companies, Live & Learn Inc. and Human Services Research Institute, worked with HOPE (Helping Our Peers Emerge) staff to conduct an evaluation to understand and report the impact of the HOPE program on participants, in addition to Whole Person Pilot-required data. HOPE is a peer-run program in San Mateo, California. HOPE supports Peer Participants in transition from psychiatric hospitalization to community integration through Peer Mentoring, Family Partnership, and Supportive Employment Coordination. It was created as a Whole Person Pilot program under California's Medicaid Section 1115 waiver.
Read MoreMad In America’s Peter Simons interviews Laysha Ostrow about her mental health research and consulting company, the inclusion of peer specialists in mental health care, and her personal experience with the mental health system.
Read MoreEvery two years beginning in 2010, Live & Learn staff and partners have conducted a Peer Respites Essential Features (PREF) survey. All peer respites in the U.S. are invited to participate. Since the first survey in 2010, the number has grown substantially, as reflected in our Peer Respite Directory. This effort creates nationwide, longitudinal data that documents trends in organizational development and program policy so that communities and states can learn from each other as the number of peer respites grows nationwide. Results from the 2018 PREF Survey examine changes in peer respite operations, funding, staffing, and guest experience between 2014-2018. In 2018, the results are reported in two separate reports.
Read MoreThe first peer respites arose around 2000, said Laysha Ostrow, CEO of Live & Learn, which conducts behavioral health research. The approach seems to be expanding. Live & Learn counts 33 peer respites today in the U.S., up from 19 six years ago. All are overseen and staffed by people with histories of psychiatric disorders.
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Erika Miranda-Bartlett, Outreach Specialist with Live & Learn, Inc., discusses what brought her to the Certified Peer Specialist Career Outcomes Study and what it means to her.
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Reclaiming Employment is an interactive online platform that provides self-employment resources for people who have experienced mental health-related challenges around work. Our approach to developing Reclaiming Employment uses real-word wisdom, peer support, and the science of online learning to help users achieve their vision of small business success. Reclaiming Employment is developed by people who’ve run their own businesses while facing major life challenges, many of whom are featured in this promotional video.
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