Structured Evaluation of Rehabilitation Programs Outcomes in Psychiatry: Application of a Recovery-Centered Model

Vanzetto, S.; Zabotto, Matteo; Fasciana, Federica; Varinelli, Alberto; Cirnigliaro, Giovanna; Ferrara, Luca; Dell’Osso, Bernardo; Viganò, Caterina

doi:10.1007/s11126-021-09884-0

Cited by 5 publications

(2 citation statements)

References 49 publications

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“…In Italy, the rate of employment among patients with severe mental illness ranges 75% to 90% (Vanzetto et al, 2021). Nonetheless, after the approval of the national law 68/99, the right to work for people with disability became mandatory and a set of recommendations regarding the job-placement of people affected by mental illness within the rehabilitation interventions of the national Departments of Mental Health has been released (Grillo et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Employment and Social Security/Insurance among patients affected by mental disorders in Italy: A descriptive multi-center study

Ventriglio,

Latorre,

Calabretta

et al. 2023

Int J Soc Psychiatry

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Introduction: Many mental disorders especially chronic serious ones such as schizophrenia-spectrum disorders, are disabling syndromes and impact on patients’ social and cognitive functioning, including work activity. Thus, affected patients may show a particular socio-economic vulnerability and need specific social security as well as rehabilitation interventions, including pensions or job-placements. In Italy, the Working Group named ‘Employment and Social Security/Insurance in Mental Health (ESSIMH)’ was founded in 2020 in order to collect research evidence on mental illness, employment, social security, and rehabilitation. Methods: A descriptive, observational and multi-center study has been conducted in eleven Departments of Mental Health in Italy (Foggia, Brindisi, Putignano, Rome, Bologna, Siena, Pavia, Mantova, Genova, Brescia, and Torino) and involved 737 patients affected by major mental illness and classified in five diagnostic categories: psychoses, mood disorders, personality disorders, anxiety disorders, and others. The data collection was performed in 2020 among patients aged 18 to 70 years old. Results: The rate of employment in our sample was 35.8% ( n = 264). Occupational disability in our sample was recognized in 58.0% of patients with a mean percentage of severity 51.7 ± 43.1; patients with psychoses (73%) reported higher disability followed by personality (60%) and mood disorders (47.3%) ones. In a logistic multivariate modeling, factors significantly associated with diagnosis were (a) higher level of occupational disability in psychoses; (b) higher number of job- placement programs among psychoses patients; (c) lower level of employment in psychoses; (d) more psychotherapy in personality disorder patients; and (e) more years of MHC program in psychoses patients; factors associated with sex were: (a) higher number of drive licenses among males; (b) more physical activity among males; and (c) higher number of job-placement programs among males. Conclusion: patients affected by psychoses were more likely to be unemployed, reported higher occupational disability as well as received more incentives and rehabilitation interventions. These findings confirmed that schizophrenia-spectrum disorders are disabling and patients need psychosocial support and interventions in the framework of a recovery-oriented treatment.

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Section: Introductionmentioning

confidence: 99%

Employment and Social Security/Insurance among patients affected by mental disorders in Italy: A descriptive multi-center study

Ventriglio,

Latorre,

Calabretta

et al. 2023

Int J Soc Psychiatry

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“…Few studies focused on the identification of efficient outcome measures. In a recent research, Vanzetto and colleagues identified (i) improvement in validated psychometric scales, (ii) reduction of hospitalizations, (iii) improved continuity of care, (iv) adherence to a long acting injectable (LAI) antipsychotic, and (v) a stable employment for at least 1 year after discharge as reliable outcome measures of improved global functioning ( 39 ). Another outcome measure often used in literature is the destination at discharge from the rehabilitation program, an indirect measure of global functioning that identifies if a patient can return to an independent living environment or needs further care.…”

Section: Introductionmentioning

confidence: 99%

Gender impact on the outcome of rehabilitation programs in psychiatry: Brief report from a metropolitan residential rehabilitative service

et al. 2023

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BackgroundDifferences based on gender in the presentation and outcome of many psychiatric conditions have been highlighted in the past years. Moreover, women are often underrepresented in research samples, thus leading to a poorer understanding and addressing of their needs. As regards psychiatric rehabilitation, few studies have focused on the influence of gender on the outcomes of rehabilitation programs.ObjectivesThis study aimed to analyze the impact of gender on socio-demographic and clinical characteristics, as well as on main rehabilitation outcomes, in a sample of subjects undergoing rehabilitation programs in a metropolitan residential service.MethodsWe collected socio-demographic, clinical variables and rehabilitation outcomes of all subjects discharged from the metropolitan residential rehabilitative service of the Luigi Sacco Hospital in Milan, Italy, from January 2015 to December 2021. Gender differences were analyzed through t-test and chi-square for continuous and categorical variables, respectively.ResultsIn a total sample of 129 subjects equally distributed for gender (50.4% women), all subjects improved after their rehabilitation program, as measured through specific psychometric scales. However, women had a higher proportion of discharges to their own household (52.3% vs. 25% of men). They also showed higher educational status (53.8% completed high school vs. 31.3% of men). Clinically, they showed longer duration of untreated illness (3.6 ± 7.31 vs. 1.06 ± 2.35 years) and lower frequency of substance use disorders compared to men (6.4% vs. 35.9%).ConclusionThe main result of this study shows, in light of an equal improvement in psychopathological and psychosocial functioning after the rehabilitation program, better outcomes in women compared to men, with a higher frequency of return to their own household after the completion of a rehabilitation program compared to men.

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Life is better but not without challenges: experiences following discharge from community-based residential mental health rehabilitation–a qualitative content analysis

Parker,

Chapman,

Wyder

et al. 2024

Soc Psychiatry Psychiatr Epidemiol

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Purpose Community-based residential mental health rehabilitation units for people experiencing severe and persistent mental illness are increasingly available in Australia. Research completed 20 years ago suggested that people leaving these services often experienced impoverished social lives and other challenges in the community. It is unclear whether contemporary consumers experience similar difficulties. This qualitative study explored contemporary consumers’ experiences after leaving community-based residential services. Methods An inductive qualitative content analysis of individual interviews was completed with consumers 12–18 months following discharge from three community care units (CCUs) in Queensland, Australia. The interview schedule explored three questions: (1) What does life look like after leaving the CCU, (2) Has the CCU impacted their life, and (3) How could the CCU experience be improved? A convenience sample was used, with sampling continuing until thematic saturation was achieved. A member of the research team who had relevant lived experience actively supported the analysis and interpretation. Results Seventeen interviews were completed. Three themes were identified: ‘life is better but not without challenges’, ‘the CCU helps you get ready to go out into the world’, and ‘strict rules are important but rigid expectations can be hard; things could be better’. Conclusion Consumers reflected positively on their lives post-discharge from a community-based residential rehabilitation unit and viewed the service as having supported improvements in their lives. The findings suggest the appropriateness of optimism about the possibility of sustained improvements in quality of life after leaving community-based transitional residential rehabilitation support.

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Structured Evaluation of Rehabilitation Programs Outcomes in Psychiatry: Application of a Recovery-Centered Model

Cited by 5 publications

References 49 publications

Employment and Social Security/Insurance among patients affected by mental disorders in Italy: A descriptive multi-center study

Employment and Social Security/Insurance among patients affected by mental disorders in Italy: A descriptive multi-center study

Gender impact on the outcome of rehabilitation programs in psychiatry: Brief report from a metropolitan residential rehabilitative service

Life is better but not without challenges: experiences following discharge from community-based residential mental health rehabilitation–a qualitative content analysis

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