Evaluation of Ongoing Participation of People with Schizophrenia in a Mutual Support Group as a Complementary Intervention to Outpatient Psychiatric Treatment.

This study aims to evaluate a group of people with schizophrenia undergoing outpatient treatment and who participate in a mutual support intervention, compared to another group of people with the same diagnosis, but attending only the usual outpatient treatment. This is a prospective study, with two measurements between six months. The mutual support group was initially composed of 16 people and the treatment as usual group was composed of 15 people. Clinical (medication adherence and functioning) and Recovery (hope, well-being, recovery and internalized stigma) outcomes were assessed. Nonparametric tests were used to verify differences in measurements between groups and between two moments. A higher level of internalized stigma and a decrease in the adherence to drug treatment in the treatment as usual group were verified. When comparing the pre-post difference between groups, there was a greater increase in adherence to drug treatment in the mutual support group. Our data point to more favorable results in the mutual support group, showing that ongoing participation in these groups is an important tool for the recovery process and for the treatment itself.

The welcome basket revisited: Testing the feasibility of a brief peer support intervention to facilitate transition from hospital to community.

OBJECTIVE: This paper describes outcome and feasibility findings for a novel, brief intervention to facilitate discharge from lengthy psychiatric hospitalization. The examination of such transitional interventions is important given the suboptimal outcomes for many individuals with severe mental illness at discharge, particularly in the first month. METHOD: In this study a mixed methods design was used to examine a 6-week peer support worker-provided transitional intervention called the 'Welcome Basket.' The intervention involves contact on hospital wards immediately prior to discharge and 1-1 community contacts along with the provision of a 'welcome basket' of needed/desired items and environmental supports to facilitate greater independence and illness self-management. The study took place in a large Canadian city. RESULTS: Thirty-one individuals with severe mental illness were referred and 23 completed the intervention. Pre-post analysis indicated no change in psychiatric symptoms but improvement in community functioning, community integration, and quality of life. Compared with mean rehospitalization rates for referring inpatient units, significant differences in rates for the study participants were not observed. Qualitative feasibility and process findings were very positive and suggested domains for improvement. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: These findings suggest that this brief transitional intervention is feasible and promising, although further investigation is warranted. Study findings also support the need for transitional interventions to address the service disconnects at the time of discharge for people with severe mental illness. (PsycINFO Database Record

The development of peer support in the Netherlands, Brazil, and Israel.

My recent communication and travels related to peer support efforts in The Netherlands, Brazil, and Israel provide a glimpse of the integration of peer support into existing mental health services in these three countries. Country by country, peer support is evolving in unique ways specific to each culture. Based on my communication with peers and colleagues, peer support is fairly well established in The Netherlands, but has not gained as strong a foothold in countries like Brazil and Israel, where governments and mental health authorities have yet to fully embrace the concepts and practice of peer support. Also volunteerism, so essential in the start-up of peer support and self-help groups in the United States in the early 1970s, does not yet exist in Brazil or Israel where there are not as well established nongovernmental (nonprofit) organizations. After speaking with informed advocates of peer support in these three countries, the question, for me, remains whether peer support will take root in countries other than English-speaking countries. Can these voluntary, grass roots, democratic associations have a viable future in countries like the Netherlands, Brazil, and Israel? The hope is that once mental health officials see the success of peer support programs and gain confidence in peer leaders, they will provide the funding and support necessary for peer support programs to grow and thrive.

Recovery narratives: 'see how far i've come' / Narrativas de recuperação: 'veja onde cheguei'

As the paradigm shift towards a recovery-oriented mental health system becomes more prominent, individuals with lived experience of mental illness will continue to write and speak their narratives of mental illness and recovery. This article discusses the social reality of people with mental illness: how they are stigmatized by the media and how competing narratives within the mental health system afflict people with this disability. It also discusses the empowering process of constructing a narrative that enables the narrator/speaker to find meaning in her/his experience while putting a realistic 'face' on mental illness and recovery for the general public. It further describes how telling a narrative to diverse audiences, including a college class of 'people in recovery' enhances the author's personal recovery by giving his life new meaning and purpose.

Na medida em que a mudança de paradigma para um sistema de saúde mental orientado à recuperação se torna mais proeminente, indivíduos com experiências de vivência de doença mental continuarão a escrever e contar suas historias de doença mental e recuperação. Este artigo discute a realidade social das pessoas com doenças mentais: como elas são estigmatizadas pela imprensa e como outras linhas discursivas dentro do sistema de saúde mental as afetam. O artigo também discute o processo de capacitação que a construção da narrativa oferece ao narrador/palestrante, possibilitando-o a encontrar um significado para sua experiência ao mesmo tempo em que fornece uma 'face' realista à doença mental e recuperação para o público em geral. O artigo também descreve como o processo de contar a narrativa a audiências variadas, inclusive uma turma de faculdade de 'pessoas em recuperação', acentua a recuperação pessoal do autor na medida em que dá à sua vida um novo sentido e propósito.

Calculated risk-taking and other recovery processes for my psychiatric disability.

In his new book, Living Outside Mental Illness: Qualitative Studies of Recovery from Schizophrenia, Larry Davidson, PhD, has opened up a very important arena for consumers writing of their recoveries. While consumers have written of recovery as an experience, an attitude and a vision, they have not reported the actual processes of how they got there, according to Professor Davidson (Davidson, 2003). In this article, I would like to begin to bridge that gap Professor Davidson has pointed out by describing three methods and strategies that have been crucial for building a new life for myself in recovery.

Moving beyond illness to recovery: the recovery is for everyone Grants Program (RIFE).

The RIFE Grants Program offers funding to individuals in recovery from mental health and substance abuse problems for innovative projects to help them take steps toward achieving their life aspirations. Twenty-one people who received awards participated in an evaluation using the MDS and EPQ with significant increases in items related to empowerment from the beginning to mid study and a decrease in the empowerment factor from mid to end study. Ninety-one percent of participants reported improvements in daily life, 82% in thoughts of self, 80% in belief in capabilities, 60% in social roles, 80% in socializing, and 50% in values.

Brazil's mental health adventure.

This is an account of my trips to Brazil in 2001 where I worked on a series of mental health projects with Brazilian colleagues. I first got interested in Brazil after I graduated from college when I was a Peace Corps volunteer in Northeast Brazil (Bahia state). After I got out of the Peace Corps I moved to Rio de Janeiro and went to work for United Press International (UPI) in their Rio bureau. I was UPI foreign news correspondent for a year and a half. Those years in Brazil were probably the happiest years of my life. Later on, after I became ill in the U.S., my Brazilian connection played an important role in my recovery. Raised in a Victorian family in a small town in the Midwest, and schooled in a traditional boarding school for boys and then at an all men's college, Brazil's lively Latino culture served as a healthy antidote for my tendency to be reserved and often depressed. My contact with Brazilians and Brazilian culture always beckoned me on. I maintained contact with my friends in Brazil and they stuck by me through my illness years. What seemed like my emotional and intellectual "excess" to me, was easily accepted by my Brazilian friends. I felt much more myself interacting with Brazilians and connected to a larger sense of self I developed in Brazil. I traveled to Brazil at every opportunity and made friends with Brazilians I met in the States. I initiated Portuguese classes at John Carroll University in Cleveland, Ohio in the early 1990s and then was invited to teach Brazilian culture to undergraduates. These appointments and my own resilience moved me past one depression and a dysthymia condition and into the wider community. I regained my confidence as a teacher, a role I had before and during the years of my illness. From this position, I organized a club for Brazilian students studying in the Cleveland area. After this teaching stint, I felt ready to pursue full time employment and began a job search that would eventually land me in New Haven at the Connecticut Mental Health Center. Since 1997, I've spent my vacations traveling and working in Brazil as an Outside Consultant on mental health projects with colleagues in Rio and Sao Paulo. In my travels I've been befriended and supported by adherents of a social movement, not unlike the U.S. Civil Rights Movement, that has struggled for many years to close Brazil's long-term psychiatric hospitals, create community-based services and expand the rights of mental patients. Now I see my Brazilian connection as part of my ongoing recovery. I see myself as having the opportunity to be a link between the mental health worlds of the U.S. and Brazil. I believe the two countries have much to offer each other when it comes to mental health.