Biomedical subjects

E S Rogers

Publications and source records attributed to E S Rogers.

At least 19 recordsLinked to original sources

PubMed2001

Assessing readiness for change among persons with severe mental illness.

Studies focusing on the readiness of persons to change have burgeoned in recent years. Assessing readiness for change is viewed as important for interventions aimed at promoting health behaviors, such as smoking cessation and substance abuse programs. This study is the first to examine readiness for change, as conceived by Prochaska and his colleagues, among a sample of persons with severe mental illness who were about to participate in a vocational rehabilitation program. We examined the reliability, validity, and other psychometric properties of the Change Assessment Scale and its ability to predict attrition and actual change.

Adult↗

PubMed2001

Unique issues in assessing work function among individuals with psychiatric disabilities.

With the admission of people who experience psychiatric disabilities in the state-federal vocational rehabilitation system and the Social Security disability rolls in the 1960s, assessment of their capacity to work has been a major concern. Given the rising rates of claims for psychiatric disability in both the public and the private sectors, and the disappointing employment outcomes of people with psychiatric disabilities compared to those with other disabilities, there have been numerous initiatives to accurately assess their employment potential. Historically, such assessment within the Social Security Administration has relied upon evaluation of a person's medical impairment, but numerous studies suggest a weak relationship between measures of psychiatric diagnosis or symptoms and work outcome. Efforts have been undertaken to identify valid and reliable methods of assessing the ability of people with psychiatric disabilities to work. The authors review (a) methods of assessing work function for this population, and (b) the literature on predictors of work functioning and the nature of psychiatric disability, and suggest implications for disability determination policies and for future research.

Humans↗

PubMed2001

The IAPSRS toolkit: development, utility, and relation to other performance measurement systems. Members of the IAPSRS Research Committee. International Association of Psychological Rehabilitation Services.

The current climate of economic constraint in community-based mental health services has all but required psychosocial rehabilitation (PSR) programs to demonstrate their effectiveness by adopting outcome assessment systems. Agencies of disparate size and varying degrees of sophistication are now responding to mandates to systematically monitor program outcomes. In doing so, however, PSR practitioners and administrators are faced with a bewildering array of competing measures, some of which are impractical, costly, or irrelevant for capturing the outcomes of PSR services (Blankertz & Cook, 1998). To acquaint readers with issues in performance measurement in PSR, this article describes a newly developed outcome measurement system created to document the achievements of service recipients in PSR programs and to monitor progress towards recovery. We discuss principles and logistical issues in performance measurement which are important to PSR agencies and which the Toolkit has been designed to address. Results of the pilot testing of the PSR Toolkit are presented to demonstrate the feasibility of its use, logistical problems in implementation, psychometric properties of the measures, and the Toolkit's sensitivity to change. We discuss next steps in the development of the Toolkit.

Adolescent↗

PubMed1997

Prediction of vocational outcome based on clinical and demographic indicators among vocationally ready clients.

This study examined the clinical and demographic correlates of work skills and vocational outcome for persons with psychiatric disabilities. The same clinical, demographic, work skills, and vocational outcome instruments were administered to 275 persons working toward their vocational goals at three psychosocial rehabilitation centers. Data regarding vocational outcomes were collected quarterly over a period of 3 1/4 years. Using multivariate statistical techniques, clinical and demographic variables that predict work skills and future vocational outcomes were identified. The implications of the findings for program administrators, system planners, and researchers are discussed.

Adult↗

PubMed1997

A consumer-constructed scale to measure empowerment among users of mental health services.

OBJECTIVE: A scale to measure the personal construct of empowerment as defined by consumers of mental health services was developed and field tested. METHODS: After extensive development, pilot testing, and analyses, a 28-item scale to measure empowerment was tested on 271 members of six self-help programs in six states. Factor analyses were used to identify the underlying dimensions of empowerment. To establish the scale's reliability and validity, responses were factor analyzed, and other analyses were conducted. RESULTS: Analyses revealed five factors: self-efficacy-self-esteem, power-powerlessness, community activism, righteous anger, and optimism-control over the future. Empowerment was related to quality of life and income but not to the demographic variables of age, gender, ethnicity, marital status, education level, or employment status. Empowerment was inversely related to use of traditional mental health services and positively related to community activism. CONCLUSIONS: The findings set a framework for a clearer understanding of the imprecise and overused concept of empowerment. The scale demonstrated adequate internal consistency and some evidence for validity. Further testing must be done to establish whether it has discriminant validity and is sensitive to change.

Adult↗

PubMed1995

Characteristics of mental health case management: results of a national survey.

In the last several years, state mental health authorities throughout the United States have assigned a high priority to the funding, development, and operation of case management programs. Although the concept of case management has been in existence for over a decade, there is still confusion regarding the definition of case management and the identification of alternative case management approaches. Recognizing this confusion, the Center for Psychiatric Rehabilitation undertook a comprehensive study to determine the state of case management practice today. This article reports on the results of a national survey of case management programs and describes the characteristics of the programs themselves, the case managers, the clients they serve, and the systems within which they operate. Implications of these findings for a definition of case management are discussed.

Administrative Personnel↗

PubMed1995

Relationships between psychiatric symptomatology, work skills, and future vocational performance.

OBJECTIVE: Experts do not agree on what, if any, relationships exist between diagnosis, symptomatology, work skills, and the future vocational performance of persons with severe mental illness. The objective of this study was to longitudinally examine such relationships, using a sample of clients who were attending psychosocial rehabilitation programs. METHODS: Subjects were 275 clients of three psychosocial rehabilitation programs who had expressed a vocational goal. They were assessed at intake into the study and then quarterly until they left the rehabilitation program. The variables examined included symptoms, measured by the Brief Psychiatric Rating Scale; diagnosis; work skills, measured by the Griffiths Work Behavior Scale; and vocational status at end-point. RESULTS: Among subjects remaining in the study for one year, both symptomatology and work skills improved significantly. Moderately significant negative correlations were found between symptoms and work skills; subjects who became employed had lower symptom scores and higher work skills than persons who never became employed. CONCLUSIONS: Although a moderate relationship was found between symptomatology and work skills, symptoms should not be considered a proxy measure for vocational functioning among persons with severe mental illness. Participation in psychosocial rehabilitation programs appeared to have a salutary effect on symptoms and work skills.

Activities of Daily Living↗

PubMed1994

The residential needs and preferences of persons with serious mental illness: a comparison of consumers and family members.

This study reports on a systematic statewide effort to determine the residential needs and preferences of two important groups: primary consumers of mental health services and family members of consumers. Two comparable surveys regarding the residential needs of consumers were conducted. In all, 314 consumers and 459 family members participated in the survey. A comparison of the preferences of family members and consumers suggests that family members more often prefer congregate living situations and more staff support than do consumers. Consumers more often express a desire to reside by themselves without staff and without other persons who are mentally ill. While the direct comparison of preferences from these two constituencies has limitations, these data do suggest significant variability in needs and preferences voiced by consumers and their family members; discrepancies that need to be addressed by mental health policymakers and planners.

Chi-Square Distribution↗

PubMed1991

Effectiveness of technical assistance in the development of psychiatric rehabilitation programs.

Most mental health programs need technical assistance to develop effective psychiatric rehabilitation programs. This article discusses how psychiatric rehabilitation was introduced into three community mental health programs and describes the elements of a psychiatric rehabilitation program and the phases of a technical assistance process. A case study illustrates how technical assistance consultants can be trained to develop psychiatric rehabilitation programs. Barriers and facilitators to the technical assistance are discussed in the context of several other technical assistance studies.

Community Mental Health Services↗

PubMed1991

Comparison of outcomes for clients seeking and assigned to supported housing services.

As part of state-supported interventions to reduce risk of rehospitalization, seriously disabled psychiatric patients who had been involuntarily hospitalized twice in the previous three years were assigned to receive supported housing services in an Oregon community. Compared with 22 voluntary clients in the same supported housing program, the 21 involuntary (assigned) clients rated higher on risk factors such as history of suicide attempts, self-neglect, homelessness, and medication noncompliance, The involuntary clients showed a much higher utilization of supported housing services and case management, psychiatric, and shelter services during the nine months after entry into the program, and they had a higher one-year rehospitalization rate. However, they used substantially fewer inpatient days in the six months after entry in the program than in the six months before.

Adult↗

PubMed1991

A supported education program for young adults with long-term mental illness.

Fifty-two young adults with severe psychiatric disabilities were selected to participate in a university-based supported education program aimed at helping them develop the skills to choose and implement a career plan. Thirty-five of the subjects completed the four-semester program. After the intervention, 42 percent of the students were competitively employed or enrolled in an educational program, compared with 19 percent before the intervention. The number of hospitalizations experienced by the subjects in the first year of the program decreased significantly, and the subjects' self-esteem increased significantly. The results indicate that rehabilitation services on a university campus may be a viable adjunct to more traditional rehabilitation services for persons with psychiatric disabilities.

Adolescent↗

PubMed1987

The mental health needs of the severely physically disabled.

Severely physically disabled individuals, advocates for the disabled, and rehabilitation and mental health professionals were surveyed to determine their perceptions of the need for services for 12 mental health problems encountered by persons with physical disability and the kinds of services needed. All groups surveyed agreed that vocational, social-interpersonal, personal-emotional, self-concept, and marital-family problems were in greatest need of services, but their perceptions of the extent of service need for each of the 12 problems differed significantly. The groups unanimously perceived rehabilitation counseling as the most needed service but differed significantly in their perception of the extent of service need for other services that were also highly rated, such as family, group, and individual therapy; peer counseling; respite care; and social skills training. The groups unanimously agreed that services designed to treat major mental illness were the least needed.

Adaptation, Psychological↗

PubMed1987

Rehabilitation outcome of long-term hospital patients left behind by deinstitutionalization.

In 1979 a Massachusetts state hospital initiated a plan to transfer 54 long-term residents of two wards to the community through a series of increasingly independent working and living arrangements. This study assesses the patients' residential and vocational status and living skills over a five-year period beginning in February 1979. The patients demonstrated a significant increase in living independence, but only eight were able to live continuously in the community after their discharge, and 24 never left the hospital. Overall, vocational status did not improve, and living skills improved only slightly. Living skills and vocational status were predictive of living independence. The authors identify several steps that the mental health field should take to promote success among chronic patients, deinstitutionalized or not.

Activities of Daily Living↗

PubMed1986

Training mental health workers in psychiatric rehabilitation.

Staff members from nine mental health agencies were trained in psychiatric rehabilitation technology. The trainers then received intensive followup to assist them in implementing the technology in their own agencies. Evaluation of the impact of the "training of trainers" strategy suggested that mental health workers were able to acquire and apply the skills of psychiatric rehabilitation. The training strategy also appeared to be effective in helping the agencies adopt the philosophy, principles, and skills of psychiatric rehabilitation.

Community Mental Health Centers↗

PubMed1985