Design and initial results from a supported education initiative: the Kansas Consumer as Provider program

Unlocking Academic Success: Mechanisms of Supported Education Programs for Persons with Severe Mental Disorders - A Realist Review

PURPOSE

Supported Education Programs (SEPs) are innovative initiatives to empower persons with Severe Mental Disorders (SMDs) to successfully reintegrate into the educational system. The purpose of this study is to determine how, for whom, why, and in what circumstances SEPs help in academic reintegration of persons with SMDs.

MATERIALS AND METHODS

Realist synthesis was conducted in keeping with the six steps of Realist and Meta narrative Evidence Synthesis Evolving Standards (RAMESES) guidelines by using four databases (PubMed, ProQuest, EBSCO host, OVID). The analysis focused on building an explanatory framework of what works, for whom, in what context, and how in SEPs for people with SMDs.

RESULTS

SEPs were comprehensive and focused on participants' academic and psychosocial aspects. Mechanisms that worked for the success of SEPs were integrated approaches, bridge programs, augmenting cognitive remediation, psychosocial interventions as part of SEPs, and collaboration with education, health, employment, and rehabilitation - integration of classroom teaching and internship, availability and accessibility of a multidisciplinary team, availability of funding.

DISCUSSION

SEPs are an essential intervention under the ambit of psychosocial rehabilitation for persons with SMDs. This review provides compelling evidence of mechanisms for the effectiveness of SEPs in addressing the multifaceted needs of individuals with SMDs. By fostering academic success, vocational stability, and psychosocial well-being.

CONCLUSIONS

SEPs would be delivered through an individualized case management approach. Tailored to each client's specific context and needs, mechanisms must be implemented to facilitate academic reintegration under contexts.

Mental Health Recovery: The Effectiveness of Peer Services in the Community

Peer recovery services are a community-based treatment option for people suffering from mental illness and/or substance use problems. Peer services provide an alternative to inpatient care and can help decrease costs associated with hospitalization or incarceration of the mentally ill. Yet, scant research has explored the effect of these services, particularly in rural communities. The current study assesses the impact of peer services on peer mentees' and mentors' recovery capital, quality of life, and general wellness. Consumers of peer services completed three surveys every three months for approximately 18 months. Quantitative analyses demonstrated that subjects had a marginal change in their recovery capital, but quality of life and general wellness were unaffected. Peer providers' experiences were also explored through interviews. Qualitative analyses revealed that providers have a positive outlook regarding peer services but would benefit from greater resources and additional training. Policy and community implications are also discussed.

A clinical trial of peer-based culturally responsive person-centered care for psychosis for African Americans and Latinos

BACKGROUND

Providing culturally competent and person-centered care is at the forefront of changing practices in behavioral health. Significant health disparities remain between people of color and whites in terms of care received in the mental health system. Peer services, or support provided by others who have experience in the behavioral health system, is a promising new avenue for helping those with behavioral health concerns move forward in their lives.

PURPOSE

We describe a model of peer-based culturally competent person-centered care and treatment planning, informed by longstanding research on recovery from serious mental illness used in a randomized clinical trial conducted at two community mental health centers.

METHODS

Participants all were Latino or African American with a current or past diagnosis within the psychotic disorders spectrum as this population is often underserved with limited access to culturally responsive, person-centered services. Study interventions were carried out in both an English-speaking and a Spanish-speaking outpatient program at each study center. Interventions included connecting individuals to their communities of choice and providing assistance in preparing for treatment planning meetings, all delivered by peer-service providers. Three points of evaluation, at baseline, 6 and 18 months, explored the impact of the interventions on areas such as community engagement, satisfaction with treatment, symptom distress, ethnic identity, personal empowerment, and quality of life.

CONCLUSIONS

Lessons learned from implementation include making cultural modifications, the need for a longer engagement period with participants, and the tension between maintaining strict interventions while addressing the individual needs of participants in line with person-centered principles. The study is one of the first to rigorously test peer-supported interventions in implementing person-centered care within the context of public mental health systems.

A collaboration of student nurse coaches and students with mental illnesses in a college preparation project

OBJECTIVE

With refined diagnostic tools, earlier recognition, new pharmacological and other treatment modalities, individuals living with mental illnesses are able to experience considerable recovery. Some individuals require support and guidance to build confidence and to manage in everyday situations. Previous to their illness, many had been functioning and able to meet their needs in most aspects of their lives, including academics, but, following illness, lacked confidence or skill to continue their education. This pilot program was designed to socialize students with a mental illness to life at college.

METHODS

To develop the pilot concept, college departments including nursing faculty and community mental health personnel collaborated together. Potential students attended informational sessions where those interested, applied for entry into the pilot. Each student was paired with a coach, a third year nursing student, with whom they established and evaluated goals geared towards registering independently in a college course the following semester.

RESULTS

Evaluation of the program was measured in terms of attendance, registration in a college course for the following semester or job readiness, and focus group evaluation sessions. By the end of the semester, 12 of the 13 students completed the program.

CONCLUSIONS

With support and guidance of their coaches, students gained confidence, developed a social support network and learned skills needed to be able to navigate the college system. This type of college preparation program is effective in assisting students with mental illness to access college courses and it is recommended that there be further similar programs offered as an orientation at the college level for students with mental illness in preparation for their registration and attendance at college. To minimize cost factors and gain administrative support, practitioners wishing to replicate this study would do well to consider sources of funding, as well as resource personal or volunteers in order to keep costs to a minimum.

The employment of consumers in mental health services: politically correct tokenism or genuinely useful?

OBJECTIVE

The aim of this paper is to examine the role of consumers as service providers and to describe the successful employment of peer support workers in a public mental health service.

CONCLUSIONS

The Peer Support Worker program in Adelaide, South Australia is consistent with evidence obtained from previous research in demonstrating the successful training and employment of consumers as peer workers in a public mental health service.