An electronic newsletter of the Coalition's Center for Rehabilitation and Recovery
The Center for Rehabilitation and Recovery provides assistance to the New York City mental health provider community through expert trainings, focused technical assistance, evaluation, information dissemination and special projects.
We now recognize that getting rid of the positive symptoms—the hallucinations and delusions—of schizophrenia and other psychotic illnesses, is not enough to enable people to hold down jobs, and live independently. Rather, negative and cognitive symptoms, which are harder to treat, are often the key to recovery.
The good news is that skill building—a set of treatments that may be, at least in part, already familiar to you—is effective for these negative and cognitive symptoms, and has an evidence base which should satisfy clients, providers, and payers.
This year, a review of more than 100 randomized controlled trials found that skill building helps people manage their illness, and their lives. Three treatments that target specific domains, as opposed to programs focusing on particular life skills, have the most data to support them. These treatments are:
The data indicate that integrated combinations of these three services make the best foundation for rehabilitation and recovery. Such blends include Integrated Psychological Therapy, as well as New York State’s Wellness Self-Management program (an adaptation of the national best practices Illness Management and Recovery program). Skill building develops attention and memory, as well as social and daily living skills. Skill building also improves illness management, reducing symptoms and relapses.
Consequently, the review concludes that skill building is a critical part of recovery. We are thus fortunate that skill building is provided through PROS and clubhouse programs, and is also an integral part of the 1915-i services being proposed by the State through Medicaid redesign.
Additional information is available here.
Tout recovery. If people believe that individuals with a mental illness can recover, and function in society, they are more likely to say they are willing to have a person with mental illness as a neighbor, friend, in-law, and so on. This connection between belief in recovery, and the reduction in stigma, suggests that anti-stigma campaigns would benefit from showcasing recovery. Abstract
Provide reasonable accommodations. In a multi-state sample of individuals with psychiatric disabilities in supported employment, job accommodations were associated with working 7 hours longer per month. Job accommodations also appeared to decrease the risk of job termination by 13% over four years. Abstract
Integrate care for mental and physical health. A comparison of people with serious mental illness with a sample from the general population indicates that it is more difficult for the former to access medical care. This problem is most pronounced among individuals with depression, or who report difficulties in functioning. Specific burdens include longer wait times, and problems with transportation and the cost of services. The researchers conclude that the integration of mental and physical care envisioned in the Affordable Care Act might reduce the disparity in services for the more vulnerable population. Abstract
This month, the RAND Corporation published its free Examination of New York State’s Integrated Primary and Mental Health Care Services for Adults with Serious Mental Illness.
This report compares three New York State initiatives to promote integrated care for people with serious mental illness, and suggests how they can be improved. Recommendations include making it easier for mental health clinics to get licenses to provide primary care, and providing additional support for, and clarifying the roles of, peer support staff and primary care managers.
Answers to: Diagnostic overshadowing
The opinions expressed in RECOVERe-works do not necessarily reflect the views of the Editor or the Coalition of Behavioral Health Agencies.
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