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Blajeski S, Smith MJ, Harrington M, Johnson J, Ross B, Weaver A, Razzano LA, Pashka N, Brown A, Prestipino J, Nelson K, Lieberman T, Jordan N, Oulvey EA, Mueser KT, McGurk SR, Bell MD, Smith JD. A Mixed-Methods Implementation Evaluation of Virtual Reality Job Interview Training in IPS Supported Employment. Psychiatr Serv 2024; 75:228-236. [PMID: 37644829 PMCID: PMC10902191 DOI: 10.1176/appi.ps.20230023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
OBJECTIVE Employment rates among individuals with serious mental illness may be improved by engagement in the individual placement and support (IPS) model of supported employment. Results from a recent randomized controlled trial (RCT) indicate that virtual reality job interview training (VR-JIT) improves employment rates among individuals with serious mental illness who have been actively engaged in IPS for at least 90 days. This study reports on an initial implementation evaluation of VR-JIT during the RCT in a community mental health agency. METHODS A sequential, complementary mixed-methods design included use of qualitative data to improve understanding of quantitative findings. Thirteen IPS staff trained to lead VR-JIT implementation completed VR-JIT acceptability, appropriateness, and feasibility surveys. Participants randomly assigned to IPS with VR-JIT completed acceptability (N=42) and usability (N=28) surveys after implementation. The authors also conducted five focus groups with IPS staff (N=11) and VR-JIT recipients (N=13) and semistructured interviews with IPS staff (N=9) and VR-JIT recipients (N=4), followed by an integrated analysis process. RESULTS Quantitative results suggest that IPS staff found VR-JIT to be highly acceptable, appropriate for integration with IPS, and feasible for delivery. VR-JIT was highly acceptable to recipients. Qualitative results add important context to the quantitative findings, including benefits of VR-JIT for IPS staff as well as adaptations for delivering technology-based interventions to individuals with serious mental illness. CONCLUSIONS These qualitative and quantitative findings are consistent with each other and were influenced by VR-JIT's adaptability and perceived benefits. Tailoring VR-JIT instruction and delivery to individuals with serious mental illness may help optimize VR-JIT implementation within IPS.
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Affiliation(s)
- Shannon Blajeski
- School of Social Work, Portland State University School of Social Work, Portland, Oregon (Blajeski); School of Social Work, University of Michigan, Ann Arbor (M. J. Smith, Harrington, Ross, Weaver); United States Army, Nashville (Johnson); Department of Psychiatry, University of Illinois-Chicago, Chicago (Razzano); Thresholds, Chicago (Razzano, Pashka, Brown, Prestipino, Nelson, Lieberman); Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago (Jordan); Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois (Jordan); State of Illinois Department of Human Services, Chicago (Oulvey); Center for Psychiatric Rehabilitation, Boston University, Boston (Mueser, McGurk); Department of Psychiatry, Yale School of Medicine, New Haven (Bell); Department of Population Health Sciences, University of Utah Eccles School of Medicine, Salt Lake City (J. D. Smith)
| | - Matthew J Smith
- School of Social Work, Portland State University School of Social Work, Portland, Oregon (Blajeski); School of Social Work, University of Michigan, Ann Arbor (M. J. Smith, Harrington, Ross, Weaver); United States Army, Nashville (Johnson); Department of Psychiatry, University of Illinois-Chicago, Chicago (Razzano); Thresholds, Chicago (Razzano, Pashka, Brown, Prestipino, Nelson, Lieberman); Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago (Jordan); Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois (Jordan); State of Illinois Department of Human Services, Chicago (Oulvey); Center for Psychiatric Rehabilitation, Boston University, Boston (Mueser, McGurk); Department of Psychiatry, Yale School of Medicine, New Haven (Bell); Department of Population Health Sciences, University of Utah Eccles School of Medicine, Salt Lake City (J. D. Smith)
| | - Meghan Harrington
- School of Social Work, Portland State University School of Social Work, Portland, Oregon (Blajeski); School of Social Work, University of Michigan, Ann Arbor (M. J. Smith, Harrington, Ross, Weaver); United States Army, Nashville (Johnson); Department of Psychiatry, University of Illinois-Chicago, Chicago (Razzano); Thresholds, Chicago (Razzano, Pashka, Brown, Prestipino, Nelson, Lieberman); Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago (Jordan); Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois (Jordan); State of Illinois Department of Human Services, Chicago (Oulvey); Center for Psychiatric Rehabilitation, Boston University, Boston (Mueser, McGurk); Department of Psychiatry, Yale School of Medicine, New Haven (Bell); Department of Population Health Sciences, University of Utah Eccles School of Medicine, Salt Lake City (J. D. Smith)
| | - Jeffery Johnson
- School of Social Work, Portland State University School of Social Work, Portland, Oregon (Blajeski); School of Social Work, University of Michigan, Ann Arbor (M. J. Smith, Harrington, Ross, Weaver); United States Army, Nashville (Johnson); Department of Psychiatry, University of Illinois-Chicago, Chicago (Razzano); Thresholds, Chicago (Razzano, Pashka, Brown, Prestipino, Nelson, Lieberman); Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago (Jordan); Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois (Jordan); State of Illinois Department of Human Services, Chicago (Oulvey); Center for Psychiatric Rehabilitation, Boston University, Boston (Mueser, McGurk); Department of Psychiatry, Yale School of Medicine, New Haven (Bell); Department of Population Health Sciences, University of Utah Eccles School of Medicine, Salt Lake City (J. D. Smith)
| | - Brittany Ross
- School of Social Work, Portland State University School of Social Work, Portland, Oregon (Blajeski); School of Social Work, University of Michigan, Ann Arbor (M. J. Smith, Harrington, Ross, Weaver); United States Army, Nashville (Johnson); Department of Psychiatry, University of Illinois-Chicago, Chicago (Razzano); Thresholds, Chicago (Razzano, Pashka, Brown, Prestipino, Nelson, Lieberman); Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago (Jordan); Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois (Jordan); State of Illinois Department of Human Services, Chicago (Oulvey); Center for Psychiatric Rehabilitation, Boston University, Boston (Mueser, McGurk); Department of Psychiatry, Yale School of Medicine, New Haven (Bell); Department of Population Health Sciences, University of Utah Eccles School of Medicine, Salt Lake City (J. D. Smith)
| | - Addie Weaver
- School of Social Work, Portland State University School of Social Work, Portland, Oregon (Blajeski); School of Social Work, University of Michigan, Ann Arbor (M. J. Smith, Harrington, Ross, Weaver); United States Army, Nashville (Johnson); Department of Psychiatry, University of Illinois-Chicago, Chicago (Razzano); Thresholds, Chicago (Razzano, Pashka, Brown, Prestipino, Nelson, Lieberman); Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago (Jordan); Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois (Jordan); State of Illinois Department of Human Services, Chicago (Oulvey); Center for Psychiatric Rehabilitation, Boston University, Boston (Mueser, McGurk); Department of Psychiatry, Yale School of Medicine, New Haven (Bell); Department of Population Health Sciences, University of Utah Eccles School of Medicine, Salt Lake City (J. D. Smith)
| | - Lisa A Razzano
- School of Social Work, Portland State University School of Social Work, Portland, Oregon (Blajeski); School of Social Work, University of Michigan, Ann Arbor (M. J. Smith, Harrington, Ross, Weaver); United States Army, Nashville (Johnson); Department of Psychiatry, University of Illinois-Chicago, Chicago (Razzano); Thresholds, Chicago (Razzano, Pashka, Brown, Prestipino, Nelson, Lieberman); Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago (Jordan); Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois (Jordan); State of Illinois Department of Human Services, Chicago (Oulvey); Center for Psychiatric Rehabilitation, Boston University, Boston (Mueser, McGurk); Department of Psychiatry, Yale School of Medicine, New Haven (Bell); Department of Population Health Sciences, University of Utah Eccles School of Medicine, Salt Lake City (J. D. Smith)
| | - Nicole Pashka
- School of Social Work, Portland State University School of Social Work, Portland, Oregon (Blajeski); School of Social Work, University of Michigan, Ann Arbor (M. J. Smith, Harrington, Ross, Weaver); United States Army, Nashville (Johnson); Department of Psychiatry, University of Illinois-Chicago, Chicago (Razzano); Thresholds, Chicago (Razzano, Pashka, Brown, Prestipino, Nelson, Lieberman); Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago (Jordan); Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois (Jordan); State of Illinois Department of Human Services, Chicago (Oulvey); Center for Psychiatric Rehabilitation, Boston University, Boston (Mueser, McGurk); Department of Psychiatry, Yale School of Medicine, New Haven (Bell); Department of Population Health Sciences, University of Utah Eccles School of Medicine, Salt Lake City (J. D. Smith)
| | - Adrienne Brown
- School of Social Work, Portland State University School of Social Work, Portland, Oregon (Blajeski); School of Social Work, University of Michigan, Ann Arbor (M. J. Smith, Harrington, Ross, Weaver); United States Army, Nashville (Johnson); Department of Psychiatry, University of Illinois-Chicago, Chicago (Razzano); Thresholds, Chicago (Razzano, Pashka, Brown, Prestipino, Nelson, Lieberman); Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago (Jordan); Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois (Jordan); State of Illinois Department of Human Services, Chicago (Oulvey); Center for Psychiatric Rehabilitation, Boston University, Boston (Mueser, McGurk); Department of Psychiatry, Yale School of Medicine, New Haven (Bell); Department of Population Health Sciences, University of Utah Eccles School of Medicine, Salt Lake City (J. D. Smith)
| | - John Prestipino
- School of Social Work, Portland State University School of Social Work, Portland, Oregon (Blajeski); School of Social Work, University of Michigan, Ann Arbor (M. J. Smith, Harrington, Ross, Weaver); United States Army, Nashville (Johnson); Department of Psychiatry, University of Illinois-Chicago, Chicago (Razzano); Thresholds, Chicago (Razzano, Pashka, Brown, Prestipino, Nelson, Lieberman); Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago (Jordan); Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois (Jordan); State of Illinois Department of Human Services, Chicago (Oulvey); Center for Psychiatric Rehabilitation, Boston University, Boston (Mueser, McGurk); Department of Psychiatry, Yale School of Medicine, New Haven (Bell); Department of Population Health Sciences, University of Utah Eccles School of Medicine, Salt Lake City (J. D. Smith)
| | - Karley Nelson
- School of Social Work, Portland State University School of Social Work, Portland, Oregon (Blajeski); School of Social Work, University of Michigan, Ann Arbor (M. J. Smith, Harrington, Ross, Weaver); United States Army, Nashville (Johnson); Department of Psychiatry, University of Illinois-Chicago, Chicago (Razzano); Thresholds, Chicago (Razzano, Pashka, Brown, Prestipino, Nelson, Lieberman); Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago (Jordan); Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois (Jordan); State of Illinois Department of Human Services, Chicago (Oulvey); Center for Psychiatric Rehabilitation, Boston University, Boston (Mueser, McGurk); Department of Psychiatry, Yale School of Medicine, New Haven (Bell); Department of Population Health Sciences, University of Utah Eccles School of Medicine, Salt Lake City (J. D. Smith)
| | - Tovah Lieberman
- School of Social Work, Portland State University School of Social Work, Portland, Oregon (Blajeski); School of Social Work, University of Michigan, Ann Arbor (M. J. Smith, Harrington, Ross, Weaver); United States Army, Nashville (Johnson); Department of Psychiatry, University of Illinois-Chicago, Chicago (Razzano); Thresholds, Chicago (Razzano, Pashka, Brown, Prestipino, Nelson, Lieberman); Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago (Jordan); Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois (Jordan); State of Illinois Department of Human Services, Chicago (Oulvey); Center for Psychiatric Rehabilitation, Boston University, Boston (Mueser, McGurk); Department of Psychiatry, Yale School of Medicine, New Haven (Bell); Department of Population Health Sciences, University of Utah Eccles School of Medicine, Salt Lake City (J. D. Smith)
| | - Neil Jordan
- School of Social Work, Portland State University School of Social Work, Portland, Oregon (Blajeski); School of Social Work, University of Michigan, Ann Arbor (M. J. Smith, Harrington, Ross, Weaver); United States Army, Nashville (Johnson); Department of Psychiatry, University of Illinois-Chicago, Chicago (Razzano); Thresholds, Chicago (Razzano, Pashka, Brown, Prestipino, Nelson, Lieberman); Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago (Jordan); Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois (Jordan); State of Illinois Department of Human Services, Chicago (Oulvey); Center for Psychiatric Rehabilitation, Boston University, Boston (Mueser, McGurk); Department of Psychiatry, Yale School of Medicine, New Haven (Bell); Department of Population Health Sciences, University of Utah Eccles School of Medicine, Salt Lake City (J. D. Smith)
| | - Eugene A Oulvey
- School of Social Work, Portland State University School of Social Work, Portland, Oregon (Blajeski); School of Social Work, University of Michigan, Ann Arbor (M. J. Smith, Harrington, Ross, Weaver); United States Army, Nashville (Johnson); Department of Psychiatry, University of Illinois-Chicago, Chicago (Razzano); Thresholds, Chicago (Razzano, Pashka, Brown, Prestipino, Nelson, Lieberman); Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago (Jordan); Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois (Jordan); State of Illinois Department of Human Services, Chicago (Oulvey); Center for Psychiatric Rehabilitation, Boston University, Boston (Mueser, McGurk); Department of Psychiatry, Yale School of Medicine, New Haven (Bell); Department of Population Health Sciences, University of Utah Eccles School of Medicine, Salt Lake City (J. D. Smith)
| | - Kim T Mueser
- School of Social Work, Portland State University School of Social Work, Portland, Oregon (Blajeski); School of Social Work, University of Michigan, Ann Arbor (M. J. Smith, Harrington, Ross, Weaver); United States Army, Nashville (Johnson); Department of Psychiatry, University of Illinois-Chicago, Chicago (Razzano); Thresholds, Chicago (Razzano, Pashka, Brown, Prestipino, Nelson, Lieberman); Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago (Jordan); Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois (Jordan); State of Illinois Department of Human Services, Chicago (Oulvey); Center for Psychiatric Rehabilitation, Boston University, Boston (Mueser, McGurk); Department of Psychiatry, Yale School of Medicine, New Haven (Bell); Department of Population Health Sciences, University of Utah Eccles School of Medicine, Salt Lake City (J. D. Smith)
| | - Susan R McGurk
- School of Social Work, Portland State University School of Social Work, Portland, Oregon (Blajeski); School of Social Work, University of Michigan, Ann Arbor (M. J. Smith, Harrington, Ross, Weaver); United States Army, Nashville (Johnson); Department of Psychiatry, University of Illinois-Chicago, Chicago (Razzano); Thresholds, Chicago (Razzano, Pashka, Brown, Prestipino, Nelson, Lieberman); Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago (Jordan); Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois (Jordan); State of Illinois Department of Human Services, Chicago (Oulvey); Center for Psychiatric Rehabilitation, Boston University, Boston (Mueser, McGurk); Department of Psychiatry, Yale School of Medicine, New Haven (Bell); Department of Population Health Sciences, University of Utah Eccles School of Medicine, Salt Lake City (J. D. Smith)
| | - Morris D Bell
- School of Social Work, Portland State University School of Social Work, Portland, Oregon (Blajeski); School of Social Work, University of Michigan, Ann Arbor (M. J. Smith, Harrington, Ross, Weaver); United States Army, Nashville (Johnson); Department of Psychiatry, University of Illinois-Chicago, Chicago (Razzano); Thresholds, Chicago (Razzano, Pashka, Brown, Prestipino, Nelson, Lieberman); Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago (Jordan); Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois (Jordan); State of Illinois Department of Human Services, Chicago (Oulvey); Center for Psychiatric Rehabilitation, Boston University, Boston (Mueser, McGurk); Department of Psychiatry, Yale School of Medicine, New Haven (Bell); Department of Population Health Sciences, University of Utah Eccles School of Medicine, Salt Lake City (J. D. Smith)
| | - Justin D Smith
- School of Social Work, Portland State University School of Social Work, Portland, Oregon (Blajeski); School of Social Work, University of Michigan, Ann Arbor (M. J. Smith, Harrington, Ross, Weaver); United States Army, Nashville (Johnson); Department of Psychiatry, University of Illinois-Chicago, Chicago (Razzano); Thresholds, Chicago (Razzano, Pashka, Brown, Prestipino, Nelson, Lieberman); Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago (Jordan); Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois (Jordan); State of Illinois Department of Human Services, Chicago (Oulvey); Center for Psychiatric Rehabilitation, Boston University, Boston (Mueser, McGurk); Department of Psychiatry, Yale School of Medicine, New Haven (Bell); Department of Population Health Sciences, University of Utah Eccles School of Medicine, Salt Lake City (J. D. Smith)
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Jiménez-Solomon O, Primrose R, Moon I, Wall M, Galfalvy H, Méndez-Bustos P, Cruz AG, Swarbrick M, Laing T, Vite L, Kelley M, Jennings E, Lewis-Fernández R. Financial Hardship, Hope, and Life Satisfaction Among Un/Underemployed Individuals With Psychiatric Diagnoses: A Mediation Analysis. Front Psychiatry 2022; 13:867421. [PMID: 35935422 PMCID: PMC9352864 DOI: 10.3389/fpsyt.2022.867421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 06/21/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Individuals with psychiatric diagnoses who are unemployed or underemployed are likely to disproportionately experience financial hardship and, in turn, lower life satisfaction (LS). Understanding the mechanisms though which financial hardship affects LS is essential to inform effective economic empowerment interventions for this population. AIM To examine if subjective financial hardship (SFH) mediates the relationship between objective financial hardship (OFH) and LS, and whether hope, and its agency and pathways components, further mediate the effect of SFH on LS among individuals with psychiatric diagnoses seeking employment. METHODS We conducted structured interviews with participants (N = 215) of two peer-run employment programs using indicators of OFH and SFH and standardized scales for hope (overall hope, hope agency, and hope pathways) and LS. Three structural equation models were employed to test measurement models for OFH and SFH, and mediational relationships. Covariates included gender, age, psychiatric diagnosis, race/ethnicity, education, income, employment status, SSI/SSDI receipt, and site. RESULTS Confirmatory factor analysis (CFA) for items measuring OFH and SFH supported two separate hypothesized factors. OFH had a strong and significant total effect on SFH [standardized beta (B) = 0.68] and LS (B = 0.49), and a weak-to-moderate effect on hope (B = -0.31). SFH alone mediated up to 94% of the effect of OFH on LS (indirect effect B = -0.46, p < 0.01). The effect of SFH on LS through hope was small (indirect effect B = -0.09, p < 0.05), primarily through hope agency (indirect effect B = -0.13, p < 0.01) and not hope pathways. Black and Hispanic ethno-racial identification seemed to buffer the effect of financial hardship on hope and LS. Individuals identifying as Black reported significantly higher overall hope (B = 0.41-0.47) and higher LS (B = 0.29-0.46), net of the effect of OFH and SFH. CONCLUSION SFH is a strong mediator of the relationship between OFH and LS in our study of unemployed and underemployed individuals with psychiatric diagnoses. Hope, and particularly its agency component, further mediate a modest but significant proportion of the association between SFH and LS. Economic empowerment interventions for this population should address objective and subjective financial stressors, foster a sense of agency, and consider the diverse effects of financial hardship across ethno-racial groups.
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Affiliation(s)
- Oscar Jiménez-Solomon
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States.,Center on Poverty and Social Policy, School of Social Work, Columbia University, New York, NY, United States
| | - Ryan Primrose
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States.,Teacher's College, Columbia University, New York, NY, United States
| | - Ingyu Moon
- Nyack College, New York, NY, United States
| | - Melanie Wall
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States.,Department of Biostatistics, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, United States.,Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Hanga Galfalvy
- Department of Biostatistics, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, United States.,Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Pablo Méndez-Bustos
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States.,Department of Psychology, Faculty of Health Sciences, Catholic University of Maule, Talca, Chile
| | - Amanda G Cruz
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States.,Department of Psychology, Clark University, Worcester, MA, United States
| | - Margaret Swarbrick
- Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers University - The State University of New Jersy, Piscataway, NJ, United States.,Collaborative Support Programs of New Jersey, Freehold, NJ, United States
| | - Taína Laing
- Baltic Street AEH, Inc., Brooklyn, NY, United States
| | - Laurie Vite
- Baltic Street AEH, Inc., Brooklyn, NY, United States
| | - Maura Kelley
- Mental Health Peer Connection, Western New York Independent Living, Buffalo, NY, United States
| | | | - Roberto Lewis-Fernández
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States.,Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States
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