Multi-dimensional wellness interventions for older adults with serious mental illness: A systematic literature review.

Abstract

Aging persons with serious mental illness present unique challenges for community mental health services. This population is increasing in numbers in mental health treatment settings. The combination of serious mental illness with the vicissitudes of aging suggest that a broader conceptualization of this population may improve services. SAMHSA's 8 Dimension of Wellness offers a comprehensive strengths-based framework for interventions to maximize older persons' abilities and address the complex bidirectional effects of physical, emotional, social, spiritual, occupational, financial, intellectual, and environmental challenges to wellness. This systemic literature review identifies unidimensional and multidimensional wellness interventions for older adults with mental illness. Method: We conducted a systematic literature review to identify wellness interventions provided to persons with serious mental illness with a mean age of 45 or higher. Results: Twenty-six articles representing 14 distinct wellness interventions were identified. None of the articles used SAMHSA's 8 Dimensions of Wellness framework. The physical wellness (n ϭ 21) and social (n ϭ 15) dimensions were the most frequently described in the literature. There was no mention of either the intellectual or spiritual dimensions. The quality of the research of these interventions varied; 14 papers described a randomized controlled trial. Conclusions: The SAMHSA wellness framework has not been used to design interventions for older persons with serious mental illness. Interventions for aging persons should support comprehensive wellness, including the intellectual and spiritual domains. Impact and ImplicationsThis work has suggested the need for the development of a unified research agenda to systematically build knowledge of needs, preferences, and effective interventions to improve the state of the science, practices and ultimately outcomes used in helping older persons with serious mental illness continue to achieve recovery and community integration.

Old before their time: Comparisons of people with SMI and healthy older adults.

“…Existing services in supported housing and case management programs should attend to the likely early reduction of physical functioning in people with SMI to help them remain as independent as possible, improve physical functioning, and potentially improve quality of life. Given both the paucity of targeted programs for older adults with mental health conditions, and the limited implementation of existing best practice programs to support the population, it is apparent that interventions are needed to avoid institutionalization in nursing homes and premature mortality (Zechner et al, 2019). This study was limited by its archival and correlational nature.…”

Enhancing Wellbeing for Older Adults With Serious Mental Illnesses: Co-Producing a Positive Psychology Course With Certified Older Adult Peer Specialists

“…Zechner et al (2019) review found that wellness research for older adults with SMIs consistently failed to fully address the SAMHSA framework of recovery, focusing on physical and social domains, while overlooking the spiritual and intellectual. The present project focused on enhancing wellbeing as defined by PERMA theory, rather than SAMHSA’s recovery framework, however, the two models intersect significantly.…”

“…This speaks to the desire to live inside and outside of mental health recovery (Davidson, 2003) and the desire for engaging in normative aging processes that support wellbeing, such as reminiscence, rather than continual focus on illness management. Zechner et al (2019) review found that wellness research for older adults with SMIs consistently failed to fully address the SAMHSA framework of recovery, focusing on physical and social domains, while overlooking the spiritual and intellectual. The present project focused on enhancing wellbeing as defined by PERMA theory, rather than SAMHSA's recovery framework, however, the two models intersect significantly.…”

“…Despite marked disparities faced by persons with SMI and a growing evidence-base of psychosocial interventions for the population of persons with SMI in general (see e.g., Rubin et al, 2011), few interventions address aging with SMIs specifically (Cummings & Kropf, 2011; Zechner et al, 2019). Most address social skills deficits and/or use cognitive behavior therapy (CBT), with an eye toward dual health and mental health management (Cummings & Kropf, 2011).…”

Investigation of the Predictive Determinants of Social Well-Being in High School Teenagers: An Iranian Study in 2019

“…Nowadays, social well-being is a concept used beside physical health. In fact, well-being is not merely lack of a somatic disease (1) . Social well-being can be both a determinant of health and an affecting factor in health.…”