Care Management for Serious Mental Illness: A Systematic Review and Meta-Analysis

Lim, Christopher T; Caan, Marissa P; Kim, Clara H.; Chow, Clifton; Leff, H. Stephen; Tepper, Miriam C.

doi:10.1176/appi.ps.202000473

Cited by 12 publications

(8 citation statements)

References 57 publications

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“…We could show a positive effect on quality of life as well but with only a small effect size not reaching statistical significance. These findings go along with previous findings in the international literature and study results from Germany with corresponding care services [ 8 , 9 , 11 , 12 , 22 , 23 , 26 ].…”

Section: Discussionsupporting

confidence: 90%

“…And a recent systematic review on personal continuity of the Swedish Agency for Health Technology Assessment points out the advantages on patients with severe mental illness but states their still low certainty of evidence [ 19 ]. Studies reporting better outcomes in continuously treated patients show an improvement in the level of social functioning measured using the GAF (Global Assessment of Functioning) [ 8 , 9 , 20 , 21 ], quality of life [ 11 , 12 , 21 – 23 ] and symptom severity [ 11 , 12 , 22 , 23 ]. Besides effectiveness, the efficiency of psychiatric treatment can be increased.…”

Section: Introductionmentioning

confidence: 99%

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Association between continuity of care and treatment outcomes in psychiatric patients in Germany: a prospective cohort study

et al. 2023

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Background Continuity of care is considered an important treatment aspect of psychiatric disorders, as it often involves long-lasting or recurrent episodes with psychosocial treatment aspects. We investigated in two psychiatric hospitals in Germany whether the positive effects of relational continuity of care on symptom severity, social functioning, and quality of life, which have been demonstrated in different countries, can also be achieved in German psychiatric care. Methods Prospective cohort study with a 20-months observation period comparing 158 patients with higher and 165 Patients with lower degree of continuity of care of two psychiatric hospitals. Patients were surveyed at three points in time (10 and 20 months after baseline) using validated questionnaires (CGI Clinical Global Impression rating scales, GAF Global Assessment of Functioning scale, EQ-VAS Euro Quality of Life) and patient clinical record data. Statistical analyses with analyses of variance with repeated measurements of 162 patients for the association between the patient- (EQ-VAS) or observer-rated (CGI, GAF) outcome measures and continuity of care as between-subject factor controlling for age, sex, migration background, main psychiatric diagnosis group, duration of disease, and hospital as independent variables. Results Higher continuity of care reduced significantly the symptom severity with a medium effect size (p 0.036, eta 0.064) and increased significantly social functioning with a medium effect size (p 0.023, eta 0.076) and quality of life but not significantly and with only a small effect size (p 0.092, eta 0.022). The analyses of variance suggest a time-independent effect of continuity of care. The duration of psychiatric disease, a migration background, and the hospital affected the outcome measures independent of continuity of care. Conclusion Our results support continuity of care as a favorable clinical aspect in psychiatric patient treatment and encourage mental health care services to consider health service delivery structures that increase continuity of care in the psychiatric patient treatment course. In psychiatric health care services research patients’ motives as well as methodological reasons for non-participation remain considerable potential sources for bias. Trial registration This prospective cohort study was not registered as a clinical intervention study because no intervention was part of the study, neither on the patient level nor the system level.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Association between continuity of care and treatment outcomes in psychiatric patients in Germany: a prospective cohort study

et al. 2023

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“…They highlighted the importance of taking a recovery-oriented approach and the need to focus on functioning (i.e., what an individual client can and cannot do) rather than on symptoms and diagnoses (Dixon et al, 2016; Williams et al, 2016). In addition, providers discussed tangible supports through recovery-oriented services and case management as conducive to client engagement with clinical benefits (Lim et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

Asian American providers’ experiences of working with Asian Americans diagnosed with serious mental illnesses.

Maru,

Millner,

Wong

et al. 2024

Asian American Journal of Psychology

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Despite cultural adaptations of evidence-based practices and increased cultural competency programs, Asian American communities chronically underutilize mental health services and have significantly high early treatment dropout rates. Often these communities delay accessing treatment unless there is a diagnosis of serious mental illness in the family. While Asian communities have been known to prefer providers of similar ethnicities, ethnic concordance has been presented as a singular solution to address the underutilization of mental health services among these communities. However, little is known about the experiences of Asian American providers working with Asian Americans diagnosed with serious mental illnesses and their families within mental health system in the United States. The purpose of this qualitative study was to explore the experiences and perspectives of Asian American providers working with these communities. Sixteen providers from diverse Asian backgrounds working at two community mental health centers in the East and West Coasts of the United States participated in two sets of focus groups conducted by Asian American researchers. Framework analysis methodology revealed challenges experienced by providers related to client engagement, managing boundaries, communication, and organizational challenges. In addition, providers described strategies used that focused on recovery and rehabilitation, cultural responsiveness, family engagement, and organizational supports. These results have important implications.

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“…These disorders are chronic, meaning that they persist and require treatment over long periods of time [2]. The term encompasses diagnoses such as major depressive disorder, schizophrenia, and bipolar disorder [3], which are the focus of the present research. Patients with an SMI are at high risk for both nutritional deficiencies and obesity [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of a Food Frequency Questionnaire for Evaluating the Nutritional Status of Patients with Serious Mental Illnesses (DIETQ-SMI) in Bahrain

Jahrami,

Saif,

Ammar

et al. 2024

Brain Sciences

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General food frequency questionnaires (FFQs) have not been tailored for or validated in individuals with psychiatric disorders. Given the unique eating behaviors of patients with serious mental illnesses (SMIs), custom-made tools are needed. Therefore, we developed and validated an FFQ customized to individuals with SMIs. A total of 150 adults with SMIs (schizophrenia, bipolar disorder, or major depression) were recruited from Bahrain. The participants completed the 50-item Dietary Intake Evaluation Questionnaire for Serious Mental Illness (DIETQ-SMI) FFQ and a 3-day food record (FR). The validity of the FFQ was assessed by comparing nutrient intake to FR intake using correlation and reliability statistics. The DIETQ-SMI demonstrated a good ranking validity compared to the FR based on correlation coefficients (rho 0.33 to 0.92) for energy and macro- and micronutrients. The FFQ had high internal consistency (McDonald’s omega = 0.84; Cronbach’s alpha = 0.91) and test–retest reliability (ICC > 0.90). The FFQ tended to estimate higher absolute intakes than the FR but adequately ranked the intakes. The FFQ value was correlated with the FR for all the items (p < 0.001). The DIETQ-SMI is a valid and reliable FFQ for ranking dietary intake in individuals with an SMI. It can help assess nutritional status and, subsequently, guide interventions in high-risk psychiatric populations.

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Care Management for Serious Mental Illness: A Systematic Review and Meta-Analysis

Cited by 12 publications

References 57 publications

Association between continuity of care and treatment outcomes in psychiatric patients in Germany: a prospective cohort study

Association between continuity of care and treatment outcomes in psychiatric patients in Germany: a prospective cohort study

Asian American providers’ experiences of working with Asian Americans diagnosed with serious mental illnesses.

Development and Validation of a Food Frequency Questionnaire for Evaluating the Nutritional Status of Patients with Serious Mental Illnesses (DIETQ-SMI) in Bahrain

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