Homelessness and Mental Illness in a Professional- and Peer-Led Cocaine Treatment Clinic

Galanter, Marc; Dermatis, Helen; Egelko, Susan; Leon, George De

doi:10.1176/ps.49.4.533

Cited by 23 publications

(20 citation statements)

References 8 publications

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“…IPS can be either mentorship support or mutual support (Bradstreet 2006; Faulkner et al 2012). Thus, studies that are using IPS may be using peers as client mentors or adjunct to services provided, such as combining peers and professionals in the delivery of services (e.g., Galanter et al 1998). IPS models are quite diverse, organisations not only utilise peers in multiple ways, but peers may or may not be trained and/or paid for their work.…”

Section: Introductionmentioning

confidence: 99%

Experts by Experience: Peer Support and its Use with the Homeless

Barker

Maguire

2017

Community Ment Health J

113

100

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The homeless population has complex needs. Peers with experience of homelessness offer unique perspectives in supporting those experiencing homelessness. Peer support fostered and developed by professional organisations, termed intentional peer support (IPS), formalises this process. This review aims to assess the effectiveness of IPS as an intervention with young adults and adult homeless persons (including streetdwelling and those within services). PyscINFO, Web of Science, MEDLINE, and CINAHL were searched, resulting in ten studies, involving 1,829 participants. Peer support has significant impacts on quality of life, drug/alcohol use, and social support. Common elements of peer support are identified, suggesting possible processes that underlie effective peer support. Shared experiences, role modelling, and social support are suggested to be vital aspects of peer support and moderate changes in homeless clients. One study was deemed to have moderate/high quality; the remaining studies had low and moderate quality. Limitations of each are discussed.

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Section: Introductionmentioning

confidence: 99%

Experts by Experience: Peer Support and its Use with the Homeless

Barker

Maguire

2017

Community Ment Health J

113

100

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“…Adults with SMI, such as schizophrenia, bipolar and re-occurring major depressive disorders suffer from high rates of SUDs, with lifetime rates as high as 50% (Regier et al, 1990). Relative to people with only one of these conditions, individuals with co-occurring SMIs and SUDs have more severe substance use and psychiatric symptoms (RachBeisel et al, 1999), poorer treatment adherence (Bennett et al, 2001), increased homelessness (Galanter et al, 1998), and higher rates of smoking (de Leon et al, 2007), HIV infection (RachBeisel et al, 1999), psychiatric hospitalization (Haywood et al, 1995), emergency room use (Bartels et al, 1993) and incarceration (Abram and Teplin, 1991). The high rates of SUDs among individuals with SMI, and the consequences of this comorbidity, directly contribute to the high economic cost of SMI in the U.S., which is estimated to be well over $400 billion (2013 USD) annually (Insel, 2008).…”

Section: Introductionmentioning

confidence: 99%

An economic evaluation of a contingency-management intervention for stimulant use among community mental health patients with serious mental illness

Murphy¹,

McDonell²,

McPherson³

et al. 2015

Drug and Alcohol Dependence

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Background This study examines the cost-effectiveness of contingency-management (CM) for stimulant dependence among community mental health patients with serious mental illness (SMI). Methods Economic evaluation of a 12-week randomized controlled trial investigating the efficacy of CM added to treatment-as-usual (CM+TAU), relative to TAU without CM, for treating stimulant dependence among patients with a SMI. The trial included 176 participants diagnosed with SMI and stimulant dependency who were receiving community mental health and addiction treatment at one community mental health center in Seattle, Washington. Participants were also assessed during a 12-week follow-up period. Positive and negative syndrome scale (PANSS) scores were used to calculate quality-adjusted life-years (QALYs) for the primary economic outcome. The primary clinical outcome, the stimulant-free year (SFY) is a weighted measure of time free from stimulants. Two perspectives were adopted, those of the provider and the payer. Results At 12-weeks neither the provider ($2,652, p=.74) nor the payer ($2,611, p=.99) cost differentials were statistically significant. This was also true for the payer at 24-weeks (-$125, p=1.00). QALYs gained were similar across groups, resulting in small, insignificant differences (0.04, p=0.23 at 12-weeks; .01, p=0.70 at 24 weeks). CM+TAU experienced significantly more SFYs, 0.24 (p<0.001) at 12 weeks and 0.20 (p=0.002) at 24 weeks, resulting in at least an 85% chance of being considered cost-effective at a threshold of $200,000/SFY. Conclusion Contingency management appears to be a wise investment for both the provider and the payer with regard to the clinical outcome of time free from stimulants.

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“…For example, programs in which peers provide outreach, emotional/social support, or educational services result in improved eating habits among women at risk for diabetes (Auslander et al 2002), decreased cocaine use Galanter et al 1998), improved health among persons with heart and lung disease or diabetes (Lorig and Holman 2003), reduced smoking among cancer survivors (Emmons et al 2005), decreased high-risk behaviors associated with HIV exposure (Kegeles et al 1996;Wright et al 1998), and improved usage of HIV medications (Broadhead et al 2002;Lyon et al 2003;Williams et al 2006).…”

Section: Introductionmentioning

confidence: 99%

Family Support in Children’s Mental Health: A Review and Synthesis

Hoagwood

Cavaleri

Olin

et al. 2009

Clin Child Fam Psychol Rev

213

208

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A comprehensive review of structured family support programs in children's mental health was conducted in collaboration with leadership from key national family organizations. The goals were to identify typologies of family support services for which evaluation data existed and identify research gaps. Over 200 programs were examined; 50 met criteria for inclusion. Programs were categorized by whether they were delivered by peer family members, clinicians, or teams. Five salient components of family support were identified: (a) informational, (b) instructional, (c) emotional, (d) instrumental, and (e) advocacy. Clinician-led programs were heavily represented (n = 33, 66%), followed by family-led (n = 11, 22%), and team-delivered (n = 6, 12%) programs. Key differences between programs delivered by clinicians or by peer family members were found in the degree of emphasis, research methodology, and outcomes. However, the content of the components was similar across all three program types. There are both important differences in emphasis across typologies of family support provided by clinicians, family members, or teams as well as important similarities in content. Family-delivered support may be an important adjunct to existing services for parents, although the research base remains thin. A research agenda to promote more rigorous evaluations of these services especially those delivered by peer family members is critical.

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Homelessness and Mental Illness in a Professional- and Peer-Led Cocaine Treatment Clinic

Cited by 23 publications

References 8 publications

Experts by Experience: Peer Support and its Use with the Homeless

Experts by Experience: Peer Support and its Use with the Homeless

An economic evaluation of a contingency-management intervention for stimulant use among community mental health patients with serious mental illness

Family Support in Children’s Mental Health: A Review and Synthesis

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