The Housing First (HF) approach for homeless adults with serious mental illness has gained support as an alternative to the mainstream "Treatment First" (TF) approach. In this study, group differences were assessed using qualitative data from 27 HF and 48 TF clients. Dichotomous variables for substance use and substance abuse treatment utilization were created and examined using bivariate and logistic regression analyses. The HF group had significantly lower rates of substance use and substance abuse treatment utilization; they were also significantly less likely to leave their program. Housing First's positive impact is contrasted with the difficulties Treatment First programs have in retaining clients and helping them avoid substance use and possible relapse.

Treatment adherence and nonadherence is the current paradigm for understanding why people with serious mental illnesses have low rates of participation in many evidence-based practices. The authors propose the concept of self-determination as an evolution in this explanatory paradigm. A review of the research literature led them to the conclusion that notions of adherence are significantly limited, promoting a value-based perspective suggesting people who do not opt for prescribed treatments are somehow flawed or otherwise symptomatic. Consistent with a trend in public health and health psychology, ideas of decisions and behavior related to health and wellness are promoted. Self-determination frames these decisions as choices and is described herein via the evolution of ideas from resistance and compliance to collaboration and engagement. Developments in recovery and hope-based mental health systems have shepherded interest in self-determination. Two ways to promote self-determination are proffered: aiding the rational actor through approaches such as shared decision making and addressing environmental forces that are barriers to choice. Although significant progress has been made toward self-determination, important hurdles remain.

Purpose: This article will consider the role of shared decision-making as one component of recovery-oriented care. Design/Methodology/Approach: This article is conceptual and reviews literature relevant to recovery-oriented care, person-centered recovery planning, and shared decision-making. Findings: To the degree to which shared decision-making offers tools for sharing useful information about treatment options with service users and family members or other loved ones, it can be considered a valuable addition to the recovery-oriented armamentarium. It is important to emphasize, though, that recovery-oriented practice has a broader focus on the person's overall life in the community and is not limited to formal treatments or other professionally-delivered interventions. Within the more holistic context of recovery, shared decision-making regarding such interventions is only one tool among many, which needs to be integrated within an overall person-centered recovery planning process. More emphasis is given within recovery-oriented care to activating and equipping persons for exercising self-care and for pursuing a life they have reason to value, and the nature of the relationships required to promote such processes will be identified. In describing the nature of these relationships, it will become evident that decisionmaking is only one of many processes that need to be shared between persons in recovery and those who accept responsibility for promoting and supporting that person's recovery. Originality/Value: By viewing shared decision-making within the context of recovery, this article provides a framework that can assist in the implementation of shared decision-making in routine mental health care.

Person-centered planning and collaborative documentation were associated with greater engagement in services and higher rates of medication adherence.

Nearly half of the adolescents scored positive for problematic substance use demonstrating the unmet need among this population. Future implementation efforts should focus on coordinating program demands, securing funding, integrating SBIRT into clinical workflows, retaining staff, and improving referral to treatment processes.

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With the passage of the Patient Protection and Affordable Care Act (PPACA) and ongoing health care reform efforts, this is a critical time for the social work profession. The approaches and values embedded in health care reform are congruent with social work. One strategy is to improve care for people with co-morbid and chronic illnesses by integrating primary care and behavioral health services. This paper defines integrated health and how the PPACA promotes integrated health care through system redesign and payment reform. We consider how social workers can prepare for health care reform and discuss the implications of these changes for the future of the profession.

Research has shown better prognosis rates for people with psychiatric disabilities in developing countries than in Western countries. By comparing psychosocial rehabilitation in India and the United States, this paper explores how cultual beliefs and practices impact the recovery of people with psychiatric disabilities. In India, an emphasis on interdependence, externalized locus of control, and family involvement, are significantfactors in caring for people with psychiatric disabilities. In contrast, rehabilitation goals in the United States focus upon independence and individual productivity. The paper examines the implications of these findings and the extent to which they can be applied across cultures.