How Evidence-Based Practices Contribute to Community Integration

Department of Psychology, Indiana University-Purdue University, Indianapolis, 402 N. Blackford St., LD 124, Indianapolis, IN 46202-3275, USA.
Community Mental Health Journal (Impact Factor: 1.03). 01/2005; 40(6):569-88. DOI: 10.1007/s10597-004-6130-8
Source: PubMed


Since the groundbreaking work of the Robert Wood Johnson Conference in 1998 identifying six evidence-based practices (EBPs) for people with severe mental illness (SMI), the mental health field has moved in the direction of re-examination and redesign of service systems. Surprisingly, one area that has not been fully explicated is the role that EBPs play in promoting community integration. In this paper, we explain how community integration is a unifying concept providing direction and vision for community mental health for people with SMI. As one crucial aspect of the recovery process, community integration clarifies the link between EBPs and recovery. We propose an alternate view, grounded in the empirical literature, to the assertion by Anthony, Rogers, and Farkas [2003, Community Mental Health Journal, 39, 101-114] that "EBP research has rarely demonstrated a positive impact on recovery related outcomes."

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Available from: Gary R Bond
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    • "Assertive Community Treatment (ACT) is a well-studied, evidence-based, intensive and comprehensive treatment that provides community psychiatric services for persons who suffer from severe and persistent mental illness, such as schizophrenia (Marshall and Lockwood 2000). Many studies have shown that ACT services led to significant reductions in relapse rates and symptoms, as well as improvement in quality of life (Bond et al. 2004; McGrew et al. 2002). The effectiveness of ACT specifically designed for cultural diverse clients has also been demonstrated (Yang et al. 2005). "
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    ABSTRACT: This study evaluates the incorporation of Multi-Family Psycho-education Group (MFPG) to an Assertive Community Treatment Team developed to serve culturally diverse clients who suffers from severe mental illness. Participants included Chinese and Tamil clients and their family members. Family members' well-being, perceived burden, and acceptance of clients were assessed before and after the intervention. Focus group interviews with clinicians were conducted to qualitatively examine MFPG. Family members' acceptance increased after MFPG. Regular attendance was associated with reduction in perceived family burden. Culturally competent delivery of MFPG enhanced family members' understanding of mental illness and reduced stress levels and negative feelings towards clients.
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    • "Second, shared decision making constitutes a core principle of many effective mental health practices and may, in part, explain their effectiveness.12,31-33 For example, honoring the client's preference for type of job is a fundamental principle of supported employment, and the entire model follows the client's decisions about when to search for a job, how many hours to work, whether or not to disclose illness to the potential employer, supports on the job, manner of follow-up, and so on.34 "
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    ABSTRACT: This paper describes the shared decision-making model, reviews its current status in the mental health field, and discusses its potential impact on personalized medicine. Shared decision making denotes a structured process that encourages full participation by patient and provider. Current research shows that shared decision making can improve the participation of mental health patients and the quality of decisions in terms of knowledge and values. The impact of shared decision making on adherence, illness self-management, and health outcomes remains to be studied. Implementing shared decision making broadly will require re-engineering the flow of clinical care in routine practice settings and much greater use of information technology. Similar changes will be needed to combine genomic and other biological data with patients' values and preferences and with clinicians' expertise. The future of personalized medicine is clearly linked with our ability to create the infrastructure and cultural receptivity to these changes.
    Full-text · Article · Dec 2009 · Dialogues in clinical neuroscience
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    • "Community integration and the need to advance methods that investigate context Community integration research has emerged as a high priority among a growing group of researchers studying serious mental illness. For example, Bond et al., 2004 refer to community integration as " a unifying concept providing direction and vision in community mental health for people with severe mental illness " (p.570). Similarly, Yanos (2007) instructs that " first and foremost, it is important that community integration be placed on the agenda of researchers who study the effects of place on people with mental illness " (p.673). "
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    ABSTRACT: Community integration research explores community contexts and factors that encourage or hinder individuals with serious mental illness (SMI) from actively participating in community life. This research agenda can be advanced by using mixed-methods that better document the relationships between contextual factors and individual experience. Two such methods were applied to a mixed-methods study of 40 adults with SMI living in independent housing in the Southeastern United States. Their contextualized experiences of community integration were measured by applying innovative participatory mapping and Geographic Information Systems (GIS) mapping techniques. Use of these methods in conjunction with one another facilitated the creation of activity spaces, which can measure geographic accessibility and help to represent an individual's experience of place and degree of mobility. The utility of these newly applied methods for better understanding community integration for persons with SMI is explored and implications for using these measures in research and practice are discussed.
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