Illness management and recovery: one-year follow-up of a randomized controlled trial in Danish community mental health centers: long-term effects on clinical and personal recovery

Jensen, Sofie B; Dalum, Helle Stentoft; Korsbek, Lisa; Hjorthøj, Carsten; Mikkelsen, John Hagel; Thomsen, Karin; Kistrup, Kristen; Olander, Mette; Lindschou, Jane; Mueser, Kim T.; Nordentoft, Merete; Eplov, Lene Falgaard

doi:10.1186/s12888-019-2048-0

Cited by 24 publications

(43 citation statements)

References 39 publications

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“…The recent NICE guideline recommends that local rehabilitation services should include community rehabilitation teams ( 3 ). We found few studies evaluating this model of care but consistent amongst them was the finding that the use of the Illness Management and Recovery programme did not reduce the need for inpatient services ( 35 , 37 , 39 , 40 ). Only one study investigated the effectiveness of community rehabilitation teams with regard to supporting clients to achieve successful move on to more independent accommodation ( 34 ).…”

Section: Discussionmentioning

confidence: 75%

“…Results of studies evaluating community rehabilitation teams ( 33 – 39 ) were mixed. Most investigated the effectiveness of a particular rehabilitation programme taking place in the community: Illness Management and Recovery (IMR) ( 35 , 37 , 39 , 40 ). The IMR programme primarily comprises psychoeducation and promotion of personal recovery delivered via weekly group sessions over the course of 9 months.…”

Section: Resultsmentioning

confidence: 99%

“…None of these studies found the intervention to be associated with a reduction in inpatient service use. A high quality (quality score: 100) RCT involving 198 participants comparing IMR with TAU also found no difference at 12-month follow-up in terms of functioning, symptoms or emergency room visits ( 37 ).…”

Section: Resultsmentioning

confidence: 99%

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The Effectiveness of Mental Health Rehabilitation Services: A Systematic Review and Narrative Synthesis

et al. 2021

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Introduction: Mental health rehabilitation services provide essential support to people with complex and longer term mental health problems. They include inpatient services and community teams providing clinical input to people living in supported accommodation services. This systematic review included international studies evaluating the effectiveness of inpatient and community rehabilitation services.Methods: We searched six online databases for quantitative studies evaluating mental health rehabilitation services that reported on one or both of two outcomes: move-on to a more independent setting (i.e. discharge from an inpatient unit to the community or from a higher to lower level of supported accommodation); inpatient service use. The search was further expanded by screening references and citations of included studies. Heterogeneity between studies was too great to allow meta-analysis and therefore a narrative synthesis was carried out.Results: We included a total of 65 studies, grouped as: contemporary mental health rehabilitation services (n = 34); services for homeless people with severe mental health problems (n = 13); deinstitutionalization programmes (n = 18). The strongest evidence was for services for homeless people. Access to inpatient rehabilitation services was associated with a reduction in acute inpatient service use post discharge. Fewer than one half of people moved on from higher to lower levels of supported accommodation within expected timeframes.Conclusions: Inpatient and community rehabilitation services may reduce the need for inpatient service use over the long term but more high quality research of contemporary rehabilitation services with comparison groups is required.Review registration: This review was prospectively registered on PROSPERO (ID: CRD42019133579).

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Section: Discussionmentioning

confidence: 75%

Section: Resultsmentioning

confidence: 99%

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The Effectiveness of Mental Health Rehabilitation Services: A Systematic Review and Narrative Synthesis

et al. 2021

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“…Living with mental illness can lead to isolation and fear. The risk of being overwhelmed, experiencing worsening of symptoms and facing stigma are aspects considered when engaging in daily activities [7,9,12,15]. Thus, lack of activity engagement seems to be a key dysfunction related to psychiatric disability.…”

Section: Introductionmentioning

confidence: 99%

Meaningful Activities and Recovery (MA&R): the effect of a novel rehabilitation intervention among persons with psychiatric disabilities on activity engagement—study protocol for a randomized controlled trial

Bjørkedal¹,

Bejerholm

Eplov³

et al. 2020

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Background Engagement in activities meaningful to the individual may support the process of recovery in those with mental illness. Persons with psychiatric disabilities may reduce their engagement in meaningful activities to various degrees with possible fluctuations over time. We hypothesized that activity engagement can be altered when opportunities and support are offered at an individual and a group peer-based level. Evidence is lacking regarding mental health interventions that enable engagement in meaningful activities, and powered effect studies are warranted. Methods We propose an 8-month combined individual and group peer-based intervention, Meaningful Activities and Recovery (MA&R), and a study protocol for a multicentre two-armed parallel randomized controlled trial (RCT). The trial investigates the effects of MA&R in community mental health centres in Copenhagen and municipality services in Denmark. The trial will comprise 128 participants with psychiatric disabilities who will be randomized to one of two groups: (1) MA&R in addition to standard mental healthcare or (2) standard mental healthcare alone. The primary outcome is self-reported activity engagement, measured by Profiles of Engagement in People with Severe Mental Illness. Secondary outcomes are recovery, functioning and quality of life. Data will be collected at baseline and at follow-up at the end of the intervention. Discussion This study adds new knowledge to a field with limited evidence, i.e. the clinical effectiveness of rehabilitation interventions among people with psychiatric disabilities, directly targeting activity engagement. The pragmatic design, regarding in- and exclusion criteria and settings, may allow assessment of the intervention’s effect under real-life conditions. The randomization, adequate power and fidelity monitoring allow testing of the intervention’s efficacy. The multicentre study design increases the potential for implementation in various mental health settings if the findings are positive. As the nature of the intervention does not permit blinding of the participants or staff, it may increase the risk of expectancy and performance bias. This must be considered when interpreting the findings. Trial registration ClinicalTrials.gov NCT03963245. Registered on 29 May 2019

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“…Contribution of psychoeducation programs organized on disease treatment and coping methods and interventions to improve health has been emphasized in various studies (Aşık, 2011;Attepe Özden & İçağasıoğlu Çoban, 2018;Bademli et al, 2016;Roberts & Bailey, 2011;Yıldırım & Ekinci, 2010). Likewise, it is stated that professional support to the patient and family is effective in solving problems such as caregiver burden, domestic conflicts, drug incompatibility and recurrent hospitalizations (Attepe Özden & İçağasıoğlu Çoban, 2018;Aydın et al, 2014;Bratberg Jensen et al, 2019;Çölgeçen, 2018;Donyağı, 2016;Lokman, 2016;Söğütlü et al, 2017;Valencia et al, 2002;Yıldırım & Ekinci, 2010).…”

mentioning

confidence: 99%

Views of patient relatives and health professionals about the reasons of the patients enrolled in the community mental health center to discontinue or irregularly continue the center

Guvenc

Öner

2020

Int J Soc Psychiatry

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Background: The aim of the study was to determine the views of patient relatives and health professionals about the reasons of patients enrolled in the community mental health center to discontinue or irregularly continue the center. Methods: This study is qualitative and phenomenological. The study group consisted of 17 patient relatives and eight health professionals according to the maximum variation sampling method. In the study, the data were collected using the personal information form in semi-structured interviews. The data were analyzed with the descriptive (thematic) method in the MAXQDA 2018 package program. Results: In line with the research findings, themes and codes were determined based on the statements of patient relatives and health professionals. For patient relatives, the themes were determined as disease symptoms, disease effect/coping difficulties, misbeliefs-fears, problems about the center, and social and economic causes. For health professionals, the themes were determined as reasons for not coming to the community mental health center, problems related to center health professionals, level/severity of the disease and treatment compliance, socio-economic conditions and problems experienced by health professionals. Conclusion: It can be said that the views of patient relatives and health professionals about the discontinuity of patients to the center were similar. It was seen that the problems regarding factors such as disease severity, disease effects, knowledge and beliefs of the family, stigma, functionality and promotion of the center were effective in patient’s continuity to the center. In line with the research findings, it was recommended to improve the quality of the activities in the center to increase the number of patients enrolled in the community mental health center and their continuity, develop training programs that also involve health professionals to increase the quality of service, and increase the cooperation with patient relatives.

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Illness management and recovery: one-year follow-up of a randomized controlled trial in Danish community mental health centers: long-term effects on clinical and personal recovery

Cited by 24 publications

References 39 publications

The Effectiveness of Mental Health Rehabilitation Services: A Systematic Review and Narrative Synthesis

The Effectiveness of Mental Health Rehabilitation Services: A Systematic Review and Narrative Synthesis

Meaningful Activities and Recovery (MA&R): the effect of a novel rehabilitation intervention among persons with psychiatric disabilities on activity engagement—study protocol for a randomized controlled trial

Views of patient relatives and health professionals about the reasons of the patients enrolled in the community mental health center to discontinue or irregularly continue the center

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