https://onlinelibrary.wiley.com/doi/pdf/10.1002/wps.20384

Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas

Mental health and substance use disorders affect approximately 20 percent of Americans and are associated with significant morbidity and mortality. Although a wide range of evidence-based psychosocial interventions are currently in use, most consumers of mental health care find it difficult to know whether they are receiving high-quality care. Although the current evidence base for the effects of psychosocial interventions is sizable, subsequent steps in the process of bringing a psychosocial intervention into routine clinical care are less well defined. Psychosocial Interventions for Mental and Substance Use Disorders details the reasons for the gap between what is known to be effective and current practice and offers recommendations for how best to address this gap by applying a framework that can be used to establish standards for psychosocial interventions. The framework described in Psychosocial Interventions for Mental and Substance Use Disorders can be used to chart a path toward the ultimate goal of improving the outcomes. The framework highlights the need to (1) support research to strengthen the evidence base on the efficacy and effectiveness of psychosocial interventions; (2) based on this evidence, identify the key elements that drive an intervention's effect; (3) conduct systematic reviews to inform clinical guidelines that incorporate these key elements; (4) using the findings of these systematic reviews, develop quality measures - measures of the structure, process, and outcomes of interventions; and (5) establish methods for successfully implementing and sustaining these interventions in regular practice including the training of providers of these interventions. The recommendations offered in this report are intended to assist policy makers, health care organizations, and payers that are organizing and overseeing the provision of care for mental health and substance use disorders while navigating a new health care landscape. The recommendations also target providers, professional societies, funding agencies, consumers, and researchers, all of whom have a stake in ensuring that evidence-based, high-quality care is provided to individuals receiving mental health and substance use services.

Psychosocial Interventions for Mental and Substance Use Disorders: A Framework for Establishing Evidence-Based Standards

Comprehensive coordinated specialty care programs for first-episode psychosis have been widely implemented in other countries but not in the United States. The National Institute of Mental Health’s Recovery After an Initial Schizophrenia Episode (RAISE) initiative focused on the development and evaluation of first-episode treatment programs designed for the U.S. health care system. This article describes the background, rationale, and nature of the intervention developed by the RAISE Early Treatment Program project—known as the NAVIGATE program—with a particular focus on its psychosocial components. NAVIGATE is a team-based, multicomponent treatment program designed to be implemented in routine mental health treatment settings and aimed at guiding people with a first episode of psychosis (and their families) toward psychological and functional health. The core services provided in the NAVIGATE program include the family education program (FEP), individual resiliency training (IRT), supported employment an...

/pdf/the-navigate-program-for-first-episode-psychosis-rationale-2kz3mtfn4b.pdf

The NAVIGATE Program for First-Episode Psychosis: Rationale, Overview, and Description of Psychosocial Components

https://research-information.bris.ac.uk/files/164458803/1_s2.0_S0140673618314703_main.pdf

Peer-supported self-management for people discharged from a mental health crisis team: a randomised controlled trial.

S3-Leitlinie Psychosoziale Therapien bei schweren psychischen Erkrankungen

Illness Management and Recovery (IMR) was developed as a way to pull together evidence-based practices regarding self-management of serious mental illness into a single program. More than a decade later, studies from the United States and around the world have provided encouraging evidence that the IMR package leads to positive consumer outcomes. This literature review summarizes research indicating the effectiveness of IMR and describes facilitators and barriers uncovered in IMR implementation studies.

/pdf/illness-management-and-recovery-a-review-of-the-literature-18ixqh9gds.pdf

Illness Management and Recovery: A Review of the Literature

Objective Illness management and recovery (IMR) is an evidence-based practice that assists consumers in managing their illnesses and pursuing personal recovery goals. Although research has examined factors affecting IMR implementation facilitated by multifaceted, active roll-outs, the current study attempted to elucidate factors affecting IMR implementation outside the context of a research-driven implementation. Methods Semi-structured interviews with 20 local recovery coordinators and 18 local IMR experts were conducted at 23 VA medical centers. Interviews examined perceived and experienced barriers and facilitators to IMR implementation. Data were analyzed via thematic inductive/deductive analysis in the form of crystallization/immersion. Results Six factors differed between sites implementing IMR from those not providing IMR: awareness of IMR, importer-champions, autonomy-supporting leadership, veteran-centered care, presence of a sensitive period, and presence of a psychosocial rehabilitation and recovery center. Four factors were common in both groups: recovery orientation, evidence-based practices orientation, perceived IMR fit within program structure, and availability of staff time. Conclusions and implications for practice IMR can be adopted in lieu of active implementation support; however, knowledge dissemination appears to be key. Future research should examine factors affecting the quality of implementation.

Factors affecting implementation of an evidence-based practice in the Veterans Health Administration: Illness management and recovery.

Illness management and recovery (IMR) is an evidence-based practice that assists consumers in managing their illnesses and pursuing personal recovery goals. Although previous research has examined factors affecting IMR implementation facilitated by multi-faceted, active roll-outs, little is known about IMR diffusion in absence of such a roll-out. We conducted semi-structured interviews with 20 local recovery coordinators and 18 local IMR experts at 23 VA medical centers. Interviews examined perceived and experienced barriers and facilitators to IMR implementation. Six factors differed between sites implementing IMR from those not providing IMR: awareness of IMR, importer-champions, autonomy-supporting leadership, Veterancentered care, presence of a sensitive period, and presence of a psychosocial rehabilitation and recovery center. Four factors were common in both groups: recovery orientation, evidence-based practices orientation, perceived IMR fit within program structure, and availability of staff time. IMR can be adopted in lieu of active implementation support; however, knowledge dissemination appears to be key. Future research should examine factors affecting the quality of implementation. FACTORS AFFECTING IMR IMPLEMENTATION 3 Factors Affecting Implementation of an Evidence-Based Practice in the VA: Illness Management and Recovery Illness management and recovery (IMR) is an evidence-based practice that provides a comprehensive package of self-management treatments for people with severe mental illness (SMI; Mueser, 2006). The standardized intervention helps participants progress towards achieving personal recovery goals while learning skills to better manage their illnesses. The effectiveness of IMR has been demonstrated through numerous trials which provide evidence that IMR can improve illness self-management, as well as symptoms assessed by objective raters (McGuire et al., 2014). Despite IMR’s effectiveness, IMR implementation can vary widely. In the National Implementing Evidence-based Practices (EBPs) Project, only half of the programs providing IMR reached “successful” levels of fidelity (Bond, Drake, McHugo, Rapp, & Whitley, 2009) and subsequent multi-site studies showed substantial variation in fidelity (Hasson-Ohayon, Roe, & Kravetz, 2007; Salyers, Godfrey, et al., 2009). Importantly, higher program fidelity was associated with better consumer outcomes in one trial (Hasson-Ohayon et al., 2007). Similarly, consumer graduation and dropout rates have varied substantially between sites in previous studies (McGuire et al., 2014). IMR implementation can be affected by factors at various contextual levels. In empirical examinations of IMR trainees (Salyers, Rollins, McGuire, & Gearhart, 2009), and as reported by the National Implementing Evidence-Based Practices Project (Whitley, Gingerich, Lutz, & Mueser, 2009), agency-level factors were mentioned most often. Particular factors include agency culture (Aarons & Sawitzky, 2006) such as policies and procedures, supervision specific to IMR (Bartholomew & Kensler, 2010; Bond et al., 2009; Rychener, Salyers, Labriola, & FACTORS AFFECTING IMR IMPLEMENTATION 4 Little, 2009; Salyers, Rollins, et al., 2009; Whitley et al., 2009), and adoption of clinical documentation to support IMR (Bartholomew & Kensler, 2010; Rychener et al., 2009; Salyers, Rollins, et al., 2009). Moreover, an agency’s embrace of a recovery orientation and fit with other programming may affect IMR implementation (Isett et al., 2007). Factors external to the agency implementing IMR have also been identified as important, including state-wide consensus building (Magnabosco, 2006), technical assistance (Salyers, Rollins, et al., 2009), and funding (Rychener et al., 2009). The Veterans Health Administration (VHA) is an important setting for the implementation of IMR and for psychosocial rehabilitation more broadly. VHA is a large provider of mental health care: 3.4% of Veterans served by VHA are diagnosed with schizophrenia and, more generally, severe mental illness (SMI) accounts for 11.7% of VA healthcare costs (Yu et al., 2003). In total, about 242,000 patients with a psychotic disorder diagnosis are treated in the VHA in a given year (Blow et al., 2009). With the mental health needs of consumers with SMI expected to expand in the future, the VA system will continue to grow as leading provider of services for individuals with SMI. Accordingly, VHA is underway with a transformative effort to promote evidence-based, recovery-oriented mental health services (U.S. Department of Veterans Affairs, 2004) through the establishment of psychosocial rehabilitation and recovery centers (PRRCs) designed to “provide a therapeutic and supportive learning environment for veterans in [and] maximize functioning in all domains” (p. 28). Illness self-management services such as IMR are required within PRRCs. However, a recent survey found less than 50% of Veterans Affairs Medical Centers (VAMCs) have adopted IMR and only about 37% of clinicians providing IMR have received IMR specific training (McGuire, White, White, & Salyers, 2013). FACTORS AFFECTING IMR IMPLEMENTATION 5 The limited adoption of IMR within the VHA system, a setting that embraces the ideals of rehabilitation and recovery, and has goals for IMR implementation, points to the importance of understanding the barriers and facilitators to IMR within this system. Previous studies of IMR implementation have taken place outside the VHA, in the context of intensive, multifaceted implementation strategies involving training, IMR-specific supervision, technical assistance, and fidelity monitoring (McGuire et al., 2014). Such an implementation strategy, while ideal, is often not possible. Research has yet to fully examine the situation within VHA, in which the practice is mandated, but there is not active roll-out or implementation support. Given that such a situation is common in other settings, research focused on implementation within VHA is needed to not only provide insights into the VHA system, but also as guidance for other rehabilitation and recovery centers. As noted by Greenhalgh and colleagues (Greenhalgh, Robert, Macfarlane, Bate, & Kyriakidou, 2004), the factors affecting implementation of a practice occur at multiple organizational levels and “interact in a complex, un-predictable, and non-generalizable way” (p. 606). Because of the complex, dynamic, and partially idiosyncratic nature of these relationships, qualitative methods can be particularly useful for examining program implementation. Qualitative methods can provide a richer and nuanced view of implementation within a given setting, which can provide guidance for subsequent implementation interventions. Therefore, we conducted semi-structured qualitative interviews with key stakeholders across VAMCs regarding the barriers and facilitators to IMR implementation in order to elucidate factors affecting IMR implementation outside the context of a research-driven implementation. FACTORS AFFECTING IMR IMPLEMENTATION 6

Factors Affecting Implementation of an Evidence-Based Practice in the VA: Illness Management and Recovery

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Daniel J. Gilbride

Author Tools

Chat about Author

Papers

Illness Management and Recovery: A Review of the Literature

Factors affecting implementation of an evidence-based practice in the Veterans Health Administration: Illness management and recovery.

Factors Affecting Implementation of an Evidence-Based Practice in the VA: Illness Management and Recovery