The impact of individualized consultation and group workshop family education interventions in ill relative outcomes.
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Adaptation, Psychological↗
Biomedical subjects
J Draine
Publications and source records attributed to J Draine.
Consumer case management and attitudes concerning family relations among persons with mental illness.
Data from 91 clients participating in a clinical trial of consumer case management services were analyzed to determine if there is a relationship between client satisfaction with family relations and the amount of community treatment services, including case management. It was found that clients' greater face to face contact with case managers was related to less satisfaction with family relations after one year of service. The analysis provides some support for the hypothesis that case managers may be serving some of the functions that have traditionally been served by the families of mentally ill clients. Another conclusion that could be supported by this analysis is that the degree of intensity of case management services has an impact on family relations.
Adult↗
The working alliance and consumer case management.
The Working Alliance Inventory was used to measure the strength of the therapeutic relationship between seriously mentally disabled case management clients and their case managers in a randomized trial of consumer-provided case management services. It was found that while there was no difference in the strength of the alliance between the consumer and nonconsumer teams of case managers, there were positive relationships between alliance and some outcomes, including quality of life, symptomatology, attitudes toward medication compliance, and satisfaction with mental health treatment.
Assertiveness↗
The efficacy of a consumer case management team: 2-year outcomes of a randomized trial.
This article reports the results of a randomized trial of a team of case managers who are mental health consumers compared to a team of nonconsumer. Using a repeated measures MANOVA design, consumer case managers were found to be as effective as a team of nonconsumer case managers in maintaining the stability of severely mentally disabled clients served over a 2-year period. Implications for the employment of consumers in mental health services and the vocational capacity of persons with mental illness are discussed.
Administrative Personnel↗
Subjective burden among family members of mentally ill adults: relation to stress, coping, and adaptation.
Among 225 family members participating in a study of psychoeducational interventions, 39% of the variance in subjective burden was explained by the severity of stressors related to the relative's illness and by mediators related to social support and coping capabilities. Interventions directed toward improving self-efficacy and coping strategies may be important mediators of subjective burden.
Adaptation, Psychological↗
Jail recidivism in a forensic case management program.
This article explores the factors related to jail recidivism among clients receiving case management services who were seriously mentally ill, homeless, and former inmates in a large urban jail. The authors interviewed six case managers about 51 clients and examined the use of treatment stipulations as a condition of probation, clients' major diagnostic and behavioral problems, and case management strategies. Clients whose case managers actively sought legal stipulations to case management as a condition of probation and parole were more likely to return to jail. Implications for service planning and future research are discussed.
Case Management↗
Adaptive coping among family members of persons with serious mental illness.
OBJECTIVE: This study sought to describe factors associated with adaptive coping by family members with a psychiatrically disabled relative. METHODS: A total of 225 family members of persons with serious mental illness were interviewed. Hierarchical regression analysis using five variables that may have contributed to adaptive coping was conducted. The five factors were demographic characteristics of the family member, severity of the relative's illness, the family member's subjective burden and grief, social support, and personal coping resources (self-efficacy and mastery). RESULTS: More extensive adaptive coping was associated with increased social support as measured by the density of the social network, the extent of affirming social support, and participation in a support group for families. Better coping was also associated with a greater sense of self-efficacy in dealing with the relative's mental illness. Adaptive coping was not associated with the severity of the relative's illness. CONCLUSIONS: The findings suggest that mental health professionals should encourage family members to use the support provided by community-based support groups and to form such groups if none are available.
Activities of Daily Living↗
Interaction of the criminal justice system and psychiatric professionals in which civil commitment standards are prohibitive.
Three case studies are the basis for a discussion of the criminalization hypothesis as it may apply to psychiatric probationers and parolees in the criminal justice system. In each of these cases, the treating psychiatrist faced the problems of noncompliance with treatment and/or restrictive civil commitment standards. The patient's status as a probationer or parolee played a pivotal role in strategies for ensuring treatment through the criminal justice system as opposed to the mental health system or civil commitment process.
Adult↗
Issues in serving the forensic client.
In the course of a study of a team model of intensive case management for people with serious mental illness who are homeless and leaving Philadelphia jails, several issues regarding the interaction of mental health and jail systems have arisen. Among these issues are continuity of care in an unpredictable jail system, extensive involvement of family members in the charges brought against clients, and the use of legal sanctions toward therapeutic outcomes. This article discusses these issues both as they have appeared in the literature and as they have affected the progress of the study. Implications for community mental health system interactions with jails in serving forensic clients are explored.
Community Mental Health Services↗
Family perceptions of consumers as case managers.
Family members of clients participating in a randomized trial of consumer delivered case management services were found to be satisfied with the service, without regard to whether or not their ill relative was served by a consumer case management team. While family members did not necessarily know that their ill relative's case manager was a consumer, the attitude toward the capabilities of consumers serving as case managers was positive.
Adult↗
Explaining attitudes toward medication compliance among a seriously mentally ill population.
Data from a clinical trial of consumer-delivered case management services were used to construct an explanatory model for attitudes toward medication compliance, focusing on psychosocial factors. A regression model explaining attitudes toward medication compliance shows that more positive attitudes toward compliance are related to older age, fewer symptoms, and a broader array of daily activities involving social relations. Participation in social activities is a practical goal of psychosocial rehabilitation services that support compliance with medication regimens and psychiatric treatment.
Activities of Daily Living↗
Satisfaction with mental health treatment in a randomized trial of consumer case management.
It was hypothesized that the clients assigned to a consumer team of case managers, because they share similar life experiences interacting with the mental health system, would have greater satisfaction with mental health treatment than clients assigned to a team of nonconsumer case managers. Ninety-one clients with serious and persistent mental illness randomly assigned to consumer and nonconsumer case management teams were interviewed after 1 year of service. While clients served by a consumer team of case managers were less satisfied with mental health treatment, personal characteristics of individual case managers were more important in explaining differences in satisfaction with treatment than whether the client was served by the consumer or nonconsumer team.
Adult↗
Predictors of reincarceration among patients who received psychiatric services in jail.
OBJECTIVE: The study sought to determine the proportion of patients treated in a jail psychiatric service who were jailed again within a year of release and to identify the factors that most effectively predicted jail recidivism in this population. METHODS: Clinical records for a random sample of 231 persons who received treatment at a jail psychiatric service were reviewed. Logistic regression analysis of 160 cases not transferred from jail to the state prison was used to identify factors, including demographic and clinical variables and prior jail detention, that predicted reincarceration within a year of release from jail. RESULTS: Younger age, a history of substance abuse, and prior jail detention were strong predictors of jail reincarceration. CONCLUSIONS: Return to jail is more likely for a subgroup of jail detainees for whom appropriate, effective treatment is less available in the community. Further research is needed to investigate the relationship between the course of substance abuse and jail reincarceration among younger psychiatric patients. Innovative treatments might be used to engage patients while in jail and follow them into the community after release.
Adolescent↗
Jail recidivism and receipt of community mental health services.
OBJECTIVE: The authors' aim was to test the relationship between receipt of desired community mental health services by homeless mentally ill forensic clients and whether the clients returned to jail within six months. METHODS: Mentally ill homeless clients leaving jail were randomly assigned to three service conditions: intensive case management provided by an assertive community treatment team, intensive case management provided by individual case managers, and referral to a community mental health center. Data on whether clients' service needs were met were analyzed using discriminant function and chi square analyses. RESULTS: Thirty-two percent of the 105 clients interviewed at six months were reincarcerated during the six-month study period. Jail recidivism was related to receipt of fewer services that clients reported they needed, specifically to receipt of fewer services for developing independent living skills. Service condition was not significantly related to return to jail. CONCLUSIONS: Case management, a flexible community-based service that does not lend itself to clearly prescribed procedures, may easily deteriorate into providing monitoring rather than rehabilitative services for forensic clients and thus may facilitate reincarceration.
Activities of Daily Living↗
An assessment of gender as a factor among severely mentally disabled case management clients.
Ninety-four clients who were receiving intensive case management services were assessed for gender differences on a variety of sociodemographic and clinical characteristics, functioning level, social network and subjective and objective quality of life. The high degree of similarities among male and female clients in the study suggests the possibility that mental disability is more socially handicapping than gender. An alternative explanation is that there is a paucity of gender sensitive measures available to evaluate mental health services. Regardless of gender, younger clients were less satisfied with their living arrangement and were less satisfied with family relations, although young women were least satisfied with family relations. The need for development of gender sensitive measures and the development and evaluation of services addressing needs of women with serious mental illness is discussed.
Adult↗