The psychiatric rehabilitation of African Americans with severe mental illness.
ABSTRACT African Americans make up approximately 12% of the U.S. population, a total of around 36 million people. Evidence suggests that African Americans suffer from significant and persistent disparities within the mental health system. African Americans with severe mental illness are less likely than Euro-Americans to access mental health services, more likely to drop out of treatment, more likely to receive poor-quality care, and more likely to be dissatisfied with care. Dominant patterns of treatment for African Americans with psychiatric disabilities are often least suited to long-term rehabilitation. To be successful, interventions must simultaneously target three levels: macro, provider, and patient. Five domains are posited that cut across these levels. These are cross-cultural communication, discrimination, explanatory models, stigma, and family involvement. These need appropriate research and action to enhance the psychiatric rehabilitation of African Americans. Potential solutions to overcome barriers raised within these domains are suggested.
SourceAvailable from: Ademola Adeponle01/2012: pages 109-132; Oxford University Press.
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ABSTRACT: OBJECTIVE Competitive employment may improve life quality for adults with severe mental illness, but it is not known for whom or under what circumstances. On the basis of previous research demonstrating benefits of family contact for African-American adults with severe mental illness, it was hypothesized that frequent family contact would moderate (enhance) a positive association between competitive employment and global quality of life for a rural sample of predominantly African-American adults. METHODS In a secondary analysis of data collected from a randomized trial of supported employment, a series of nested random regression analyses was conducted to test the hypothesized moderating effect of face-to-face family contact on the association between competitive employment and global quality of life, controlling for severity of psychiatric symptoms and satisfaction with family relations. RESULTS Most of the 143 study participants spent time with a family member at least once a month (80%)-and most at least weekly (60%). Participants who held a competitive job and had face-to-face contact with family members at least weekly reported higher global quality of life than all other study participants. CONCLUSIONS In this rural sample of African-American adults with severe mental illness, competitive work was associated with higher global quality of life only for those who frequently spent time with family members. Research is needed to test the generalizability of this finding to other geographic settings and cultures, as well as the feasibility and effectiveness of formal inclusion of family members in psychosocial rehabilitation interventions.Psychiatric services (Washington, D.C.) 09/2013; 64(12). DOI:10.1176/appi.ps.201200553 · 1.99 Impact Factor
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ABSTRACT: The support and understanding of families, relatives, friends, and others can be of great importance in the treatment and recovery of people with mental illness (known hereafter as “service participants.”). However, behavioral health provider programs vary widely in the extent to which they contact, engage, and utilize these “significant people” (SPs) of behavioral health service participants in productive ways that are also supportive of SPs. Organizations and individuals who provide support and education for participants’ SPs in the Philadelphia area formed the Family Resource Network (FRN), acquired city funding, and developed a set of specific family involvement (FI) standards for providers. However, even with extensive city support and clear standards, most service providers have been slow to make a policy of contacting all identified SPs designated on signed release forms to elicit their concerns and discuss ways they can help their loved ones in their recovery. The authors review the barriers to implementing the FRN FI standards, and describe a new strategy underway to promote changes in provider FI practices through family involvement pilot projects with provider programs.American Journal of Psychiatric Rehabilitation 01/2012; 15(1):81-96. DOI:10.1080/15487768.2012.655644