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Objective:As part of a study of health status among 457 adults with diagnostically heterogeneous serious mental illnesses served by the public mental health system in four U.S. states, we assessed predictors of current cigarette smoking.Methods:We examined bivariate relationships between smoking status and risks for drug and alcohol use disorders, residential setting, parental status, and employment. Finally, we used multivariable logistic regression to predict current smoking, controlling for significant confounds.Results:Of the total sample, 44% of participants reported that they currently smoked and most (62%) were moderately to severely nicotine-dependent. Those at high risk for drug use disorders were more than three times as likely and those at high risk for alcohol use disorders were more than twice as likely to smoke, compared to their counterparts with little or no drug or alcohol use disorder risk. Controlling for all other model variables including drug and alcohol disorder risk, current smokers were less likely to be parents and more likely to reside in supervised settings than nonsmokers. Younger people and those without a college degree were more likely to smoke, controlling for all other model variables.Conclusions:Given the high degree of comorbidity of smoking, alcohol disorders, and drug use disorders, the authors highlight the need for integrated interventions that address these issues simultaneously. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to assess the impact of a mental illness self-management intervention, called Wellness Recovery Action Planning (WRAP), on the use of and need for mental health services over time compared with nutrition and wellness education. Method: Participants were recruited from outpatient community mental health settings in Chicago, Illinois. Using a single-blind, randomized controlled trial design, 143 individuals were assigned to WRAP or to a nutrition education course and assessed at baseline and at 2-month and 8-month follow-up. The WRAP intervention was delivered by peers in recovery from serious mental illness who were certified WRAP educators over nine weekly sessions lasting 2.5 hrs. The nutrition education curriculum was taught by trained non-peer educators using the same schedule. Mixed-effects random regression analysis tested for differences between the two interventions in (a) self-reported use of 19 clinical, rehabilitation, peer, emergent, and ancillary services; and (b) self-reported need for these services. Results: Results of mixed-effects random regression analysis indicated that, compared with controls, WRAP participants reported significantly greater reduction over time in service utilization (total, individual, and group), and service need (total and group services). Participants in both interventions improved significantly over time in symptoms and recovery outcomes. Discussion: Training in mental illness self-management reduced the self-reported need for and use of formal mental health services over time. This confirms the importance of WRAP in an era of dwindling behavioral health service availability and access. [ABSTRACT FROM AUTHOR]

Nurses can play an important role in community-based health screenings, which are a practical resource to empower people living with mental and substance use disorders to make positive lifestyle changes. The experiences, struggles, and strengths of screening participants provides insights for nurses to engage people in health and wellness dialogues. [Journal of Psychosocial Nursing and Mental Health Services, 57(12), 22-28.] [ABSTRACT FROM AUTHOR]

The article presents a study on the prevalence of mental and substance use disorders among single mothers receiving Temporary Assistance for Needy Families (TANF) in Cook County, Illinois. The study involves 333 female TANF recipients and Cook County residents during the remaining 24 months of their TANF eligibility. It uses the World Health Organization's CIDI 2.1 Auto Version (Composite International Diagnosis Interview), a comprehensive fully standardized battery that evaluated mental disorders defined by the DSM-IV criteria. It shows that the lifetime prevalence of CIDI disorders was 61% while the lifetime prevalence of mental disorders was 53.2%. It concludes that many single mothers remain untreated despite the widespread psychiatric and substance use disorders in the population.

The purpose of this study was to determine whether parents participating in 14 National Alliance for the Mentally Ill-affiliated support groups in Illinois had significantly lower caregiver burden than a comparison group of parents not participating in support groups. Respondents included 120 parents: 86 participants and 34 nonparticipants. Ordinary least squares regression analysis revealed that caregiver burden was significantly lower among support group participants, those with lower depression, and those whose offspring had fewer unmet needs and days hospitalized. [ABSTRACT FROM AUTHOR]

Focuses on the important challenges in providing high-quality community-based services for persons with severe mental illness in Illinois. Use of the service delivery model of assertive community treatment by mental health providers; Evaluation of the didactic educational component; Safety tips for delivering mental health services.

The article presents information on a study which compares the support groups for families of persons with mental illness in the Chicago metropolitan and Southern Illinois region. The present study was part of a longitudinal investigation of family support groups in the Chicago metropolitan and southern Illinois regions. The 14 local groups surveyed in the present study were local affiliates of two larger organizations for persons with mental illness and their families. In this study participants and non-participants of support groups for families of persons with mental illness were compared on demographic characteristics, level of disability of the relative with mental illness, and family support resources. The support group participants are more likely to be White, educated, middle-aged, and middle income. Their relative with mental illness is more likely to be living at home, have a diagnosis of schizophrenia, and have experienced multiple hospitalizations. The main reasons participants reported attending groups were to receive emotional support and to obtain information about mental illness.

The article discusses various reports published within a special section in the issue including one by Pickett and Diehl on a peer-education program, one on the financial aspects of recovery from psychiatric disability by Burke-Miller and Swarbrick and one by Cook and Copeland on recovery self-management strategies.

Topic: This article describes a curricular transformation initiative, the Recovery Education in the Academy Program (REAP), spearheaded by the University of Illinois at Chicago's National Research and Training Center on Psychiatric Disability. Purpose: REAP is designed to integrate principles of recovery, self-determination, and other evidence-based practices for people with psychiatric disabilities into medical, social, and behavioral sciences curricula. The principles on which the curricula transformation efforts are based, the instructional activities employed, early outcomes of the endeavor, and future plans for replication are delineated. Sources used: As described in this paper, REAP builds on a theoretical framework derived from the evidence-based literature, multiple technical reports, and curricular initiatives, including the Institute of Medicine, the Annapolis Coalition for Behavioral Workforce Development, and the Final Report of President's New Freedom Commission on Mental Health. Conclusions: REAP has delivered state-of-the-science education to over 1,000 trainees, including medical students, psychiatry residents, psychology and social work interns, and rehabilitation counselors, pre/post-doctoral students and professionals within a variety of academic settings. REAP serves as a replicable structure to successfully integrate recovery education into existing, accredited academic programs and curricula using the parameters outlined by multiple experts and stakeholders. Barriers to curricular transformation and strategies to overcome these barriers are highlighted. [ABSTRACT FROM AUTHOR]

Topic: Studies indicate that asset development programs such as Individual Development Accounts (IDAs) can enhance the economic security of low-income populations; however, only a handful of asset development programs have been implemented specifically to serve people with psychiatric disabilities, and larger programs have not collected disability-specific information. Purpose: The purpose of this article is to increase our knowledge about the use of IDAs to enhance selfdetermination and recovery for people with psychiatric disabilities. Sources used: Background information about IDAs is presented followed by case studies of two IDA programs that serve people with psychiatric disabilities. Conclusions: The use of IDA programs in enhancing self-determination among people with psychiatric disabilities is discussed, along with barriers and future directions. [ABSTRACT FROM AUTHOR]

Objective: Adults with serious mental illness have high rates of general medical comorbidity and encounter challenges in dealing with multiple health conditions. Chronic illness self-management programs may help them more effectively cope with comorbid illnesses, especially when instructors are certified peer specialists. This study assessed the longitudinal effectiveness of a peer-delivered health promotion program., Methods: Community mental health program clients in Georgia and Illinois with serious mental illness and health impairments were randomly assigned to receive either Whole Health Action Management (WHAM), a medical illness self-management program led by peer specialists, or care as usual, resulting in a sample of N=139 (WHAM N=68, control N=71). Assessments were conducted at study baseline and at 3 and 6 months. Generalized estimating equations were used to examine change over time in the primary outcome of patient activation and secondary outcomes of general health, hope, and employment., Results: Longitudinal analysis indicated that compared with control participants, WHAM participants demonstrated significantly greater improvement over time in patient activation for health care. Intervention participants also demonstrated greater improvement in their self-assessed general health, overall hopefulness, and paid employment. Reactions to the WHAM program were positive, with 97% reporting being very or somewhat satisfied, and almost two-thirds (63%) reporting that their health was better than before they joined the program., Conclusions: The WHAM program improved patient activation, perceived general medical health, hopefulness, and likelihood of paid employment among people with serious mental illness and co-occurring medical conditions. Results suggest that peer-delivered health self-management education is effective and well received by participants.

Background: This study examined the prevalence and treatment of 17 co-occurring physical health conditions among adults with serious mental health disorders, and factors associated with prevalence of the 5 most common medical co-morbidities., Methods: Data were collected from 457 adults attending publicly funded mental health programs who participated in community health screenings held in 4 U.S. states. Face-to-face interviews included standardized items from the National Health Interview Survey and the National Health and Nutrition Examination Survey. Ordinary least squares regression analysis examined associations between prevalence of the 5 most common co-morbid conditions and respondents' demographic, clinical, attitudinal, and health insurance statuses., Results: Compared to the U.S. population, prevalence was significantly higher for 14 out of 17 medical conditions assessed. The 5 most common were hyperlipidemia (45%), hypertension (44%), asthma (28%), arthritis (22%), and diabetes (21%). Controlling for age, study site, and Medicaid status, racial/ethnic minorities were almost twice as likely as Caucasians to be diagnosed with hypertension and diabetes; women were almost twice as likely as men to be diagnosed with diabetes; and people with schizophrenia were around half as likely as those with other disorders to be diagnosed with hypertension and arthritis. Age was positively related to all conditions except asthma. Treatment prevalence was below 70% for approximately half of ongoing conditions., Conclusions: These results suggest a high level of medical vulnerability and need for coordination of health and mental health services in this population. Associations with age, minority status, and gender point to the need for targeted health care strategies., (Copyright © 2014 Elsevier B.V. All rights reserved.)