No abstract

Roadblocks to recovery of individuals with severe mental illness include stigma, poverty, and victimization. Stigma creates barriers to accessing safe housing, employment, and community integration. Poverty decreases ability to meet needs and increases risk for victimization. Victimization occurs as direct violence, exploitation, neglect, and abuse by care providers. It results in worsening of psychiatric disorders, increased need for care, decreased quality of life, revictimization, and perpetration of violence. Effects of stigma, poverty, and victimization should be included in patient assessment and treatment planning. Psychiatric nurses promote recovery through direct interventions that target victimization and advocacy that targets stigma and poverty. J Am Psychiatr Nurses Assoc, 2007; 13(5), 285-295. DOI: 10.1177/1078390307307830

Based on the theory of modeling and role-modeling, the effect of unmet needs of persons with chronic mental illnesses upon their quality of life, psychiatric emergency room visits, and rehospitalization was studied among 73 members of the Erie Alliance for the Mentally III through use of a questionnaire that elicited their perceptions of need satisfaction and Lehman's Life Satisfaction Scale to measure quality of life. Needs were conceptualized as Hansell's essential attachments to basic supplies, self-identity, a friend, group membership, money, role, and meaning to life, as well as illness related needs--psychiatric care, case management, personal safety, information, and help. Most frequently cited unmet needs were for a friend, role, group membership, and self-identity. Quality of life was strongly affected by lack of information and help (experienced as stigma), poor self-identity (sequelae of illness), and lack of employment. Rehospitalization and emergency room visits were affected by unmet needs for safety, money, and employment.

Knowledge about women with SMI and their health problems will enable nurse practitioners to better meet the needs of this vulnerable population.

Among persons with severe mental illness, more than half identify problems with loneliness and social isolation. This study examines the demographic characteristics of 34 psychosocial club members and their readiness to participate in a nurse-facilitated support group as a potential means of increasing affiliation. Readiness is represented by the presence of Stone's postulated deterrents to group participation by persons with severe mental illness--unmet survival needs, crises, disinterest in increasing affiliation, satisfaction with life as is, and unwillingness to share information about themselves and their problems. Relationships between these variables and willingness to join, and later to participate, in a group were examined. Despite impaired social/vocational functioning and high levels of potential deterrents, two-thirds of the participants indicated a willingness to join and one-third actually did participate when groups subsequently were offered. Level of social support was positively correlated with both willingness to join and actual participation. That those scoring low on perceived social support were less willing to join a support group suggests that nurses must actively encourage and facilitate participation.