The Young Adult Chronic Patient: Overview of a Population

Pepper, Bert; Kirshner, Michael; Ryglewicz, Hilary

doi:10.1176/appi.ps.51.8.989

Cited by 39 publications

(39 citation statements)

References 6 publications

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“…The authors found that during a 3 1 2 -year follow-up period, patients were approximately eight times more likely to die of suicide or accident than persons in the general population. This finding is in line with a greater risk of suicide among young deinstitutionalized patients served in a community mental health center (Pepper, Kirshner, and Ryglewicz 1981). In contrast, Bachrach (1996) and McGrew et al (1999) reported general improvements in the quality of life and functioning among patients discharged and treated in community settings due to the closure of state psychiatric hospitals.…”

Section: Prior Studies and Limitationsmentioning

confidence: 69%

Does Deinstitutionalization Increase Suicide?

Yoon

Bruckner

2009

Health Services Research

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Objectives. (1) To test whether public psychiatric bed reduction may increase suicide rates; (2) to investigate whether the supply of private hospital psychiatric beds—separately for not‐for‐profit and for‐profit—can substitute for public bed reduction without increasing suicides; and (3) to examine whether the level of community mental health resources moderates the relationship between public bed reduction and suicide rates. Methods. We examined state‐level variation in suicide rates in relation to psychiatric beds and community mental health spending in the United States for the years 1982–1998. We categorize psychiatric beds separately for public, not‐for‐profit, and for‐profit hospitals. Principal Findings. Reduced public psychiatric bed supply was found to increase suicide rates. We found no evidence that not‐for‐profit or for‐profit bed supply compensates for public bed reductions. However, greater community mental health spending buffers the adverse effect of public bed reductions on suicide. We estimate that in 2008, an additional decline in public psychiatric hospital beds would raise suicide rates for almost all states. Conclusions. Downsizing of public inpatient mental health services may increase suicide rates. Nevertheless, an increase in community mental health funding may be promising.

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Section: Prior Studies and Limitationsmentioning

confidence: 69%

Does Deinstitutionalization Increase Suicide?

Yoon

Bruckner

2009

Health Services Research

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“…Indeed, research suggests that clients with both psychiatric and substance abuse problems are often difficult to engage or retain in treatment (e.g., Osher and Kofoed 1989;Pepper et al 1981). Therefore, if ethnic matching helps build working alliance, perhaps for clients who have difficulty forming a strong therapeutic alliance, matching them to a clinician with a similar ethnic group may be considered as one potential treatment strategy.…”

Section: Ethnic Matching May Help Promote Working Alliancementioning

confidence: 99%

The Effects of Working Alliance and Client-Clinician Ethnic Match on Recovery Status

Chao

Steffen

Heiby

2011

Community Ment Health J

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Sixty-seven clients with severe and persistent mental illnesses (SPMI) recruited from community mental health centers were interviewed to assess their subjective quality of life, self-efficacy, importance of ethnic matching and level of working alliance (WA) with their clinicians. Results revealed that clients in the ethnically matched group reported significantly higher WA compared to the non-matched group. Clients who reported a higher level of WA also reported better recovery status. Results suggest that, in a multicultural community, ethnic matching may help augment WA and address potential barriers to treatment engagement, and identifying strategies to promote WA may enhance treatment effectiveness in programs for SPMI.

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“…While the conclusion itself is not surprising, it is striking that this conclusion continues to be just as salient today as it was when it was first reached over 25 years ago. [2][3][4] Since that time, numerous reports, reviews, and research have documented well and extensively the uneasy relationship that exists between mental health services and services for persons with addictions. [5][6][7][8][9][10][11][12][13][14][15][16] Consistent epidemiological and service utilization data collected during this same period have shown that mental illnesses and addictions co-occur within the same person as frequently as they exist independently of one another.…”

Section: Introductionmentioning

confidence: 99%

The Concept of Recovery as an Organizing Principle for Integrating Mental Health and Addiction Services

Davidson

White

2007

J Behav Health Serv Res

143

119

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Despite a range of long-standing historical, political, ideological, professional, structural, and practical barriers, there has been, and continues to be, a clear consensus that integration between mental health and addiction services is sorely needed and long overdue. This paper focuses on one dimension of the challenge of integration from among the several - the conceptual - and proposes the construct of recovery as an organizing principle for bridging the divide between the two domains. After reviewing briefly the parallel history of the two traditions and their shared need for transformation to a recovery orientation, the authors offer an integrated model of recovery for persons with co-occurring disorders. They then derive from this model the underlying values, guiding principles, key strategies, and essential ingredients of recovery-oriented systems of care that comprise a common approach across both addictions and mental illness, offering a strengths-based solution to achieving integration where pathology-focused approaches have failed.

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The Young Adult Chronic Patient: Overview of a Population

Cited by 39 publications

References 6 publications

Does Deinstitutionalization Increase Suicide?

Does Deinstitutionalization Increase Suicide?

The Effects of Working Alliance and Client-Clinician Ethnic Match on Recovery Status

The Concept of Recovery as an Organizing Principle for Integrating Mental Health and Addiction Services

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