Willingness to Ask Tor Help Among Persons with Severe Mental illness: Call for Research.

There are times when people with severe mental illness (SMI) must be willing to ask for help (e.g., with managing symptoms). But what makes one person ask for help and another decide to go it alone? We used logistic regression to assess willingness to request assistance among 150 people with SMI. Hispanics were more likely (OR 8.51, CI 2.05-35.36, p < .01) than Caucasians to be willing to ask for help, and people with the highest incomes (relative to the lowest) were more likely (OR 7.23, CI 1.76-29.97, p > .01). Individuals with the most social support (relative to the least) were more likely (OR 12.36, CI 3.01-50.85, p < .001) to be willing to request assistance, and people who were willing to ask for help were more likely (OR 2.07, CI 1.01-4.26, p < .05) than less willing individuals to report being happy. More research is needed in order to better understand predisposition to seek aid, and interventions are needed that promote it.

Loneliness Among Persons With Severe Mental Illness.

Although studies show that loneliness increases risk of illness and hastens death, it is poorly understood among persons with severe mental illness (SMI). Using data on 150 people with SMI, we used logistic regression to predict (1) loneliness from sociodemographic and clinical characteristics, and (2) psychiatric hospitalization from presence of loneliness. We also examined mediating effects. Study participants who were most willing to ask for help were 70% less likely (odds ratio [OR], 0.30; confidence interval [CI], 0.09-0.99; p < 0.05) to be lonely than those who were least willing, and participants with high levels of internalized stigma were 9.25 times as likely (CI, 9.25; OR, 2.29-37.32; p < 0.01) as other participants to be lonely. Participants who were most lonely were 2.69 times (CI, 1.03-7.04, p < 0.05) as likely to be placed in psychiatric hospitals as those who were less lonely. Loneliness mediates the association between internalized stigma and psychiatric hospitalization (OR, 1.30; CI, 1.04-1.73). Findings can be used to help prevent inpatient stay.

A comparison of competitive employment outcomes for the clubhouse and PACT models.

OBJECTIVE: This study determined whether the clubhouse model of community support and psychiatric rehabilitation can produce competitive employment outcomes that are comparable or superior to those of the Program of Assertive Community Treatment (PACT) model. METHODS: This longitudinal study followed a group of 170 individuals with severe mental illness who were randomly assigned either to the experimental design, a clubhouse program (N=86), or to the control design, a PACT team (N=84). Study participants were tracked for 30 months, and employment outcome data were collected. RESULTS: After 30 months, 72 clubhouse and 76 PACT participants remained active in the project. After 30 months, 74 percent of PACT participants and 60 percent of clubhouse participants had been placed in at least one job. The average clubhouse participant worked 21.8 weeks per job and earned $7.38 per hour, whereas the average PACT participant worked 13.1 weeks per job and earned $6.30 per hour. CONCLUSIONS: Participants from both the PACT and clubhouse models achieved high employment levels, with no significant differences in weekly employment or 30-month job placement rates over the course of the study. During this time, clubhouse participants earned significantly higher wages and remained competitively employed for significantly more weeks per job than PACT participants.