Physician Assistant Student Attitudes About People With Serious Mental Illness.

PURPOSE: This study explored the attitudes of physician assistant (PA) students toward the future care of individuals with serious mental illness (SMI). Physician assistant student education offers a unique opportunity to confront and reduce bias toward individuals with SMI. However, no previous literature has documented PA student attitudes toward SMI. METHODS: Preclinical students (n = 7) from a single PA program were invited to participate in 2 focus groups exploring attitudes toward the future care of patients with SMI. The focus groups lasted approximately 60 minutes and were conducted by non-PA faculty using a question guide. RESULTS: Four themes emerged from interviews: perceptions about the population, knowledge of mental health conditions, approach to care, and program curriculum input. CONCLUSION: Several themes aligned with the participant's level of training. Participants demonstrated didactic knowledge yet lacked clinical exposure to provide context. Future studies should focus on developing interactive learning techniques to prepare students for patients with SMI.

Dental pre-doctoral student perceptions about serious mental illness: Concerns and role clarification.

PURPOSE/OBJECTIVES: Little is understood about dental student perspectives providing care to people with serious mental illness (SMI), a population with significant oral health disparities. This study explored student perceptions, questions and beliefs about people with SMI using the Social Ecological Model as a framework to better understand perspectives and identify potential educational needs in dental medicine curricula for providing care to this population. METHODS: Survey data was collected in spring of 2021 from predoctoral dental students (n = 126) enrolled in a required course at a mid-Atlantic university. Ninety-nine percent of the students completed the survey. The IRB approved qualitative study examined student responses to a six question survey using content analysis. An iterative coding process was used and included reflexivity memos, data dictionaries and consensus building among the four coding researchers to identify recurring concepts and ultimately identify themes. RESULTS: Four primary themes were identified: Concerns and Stereotypes; Uncertainties; Professional Role and Responsibilities; and Learning Preferences. Participants expressed fear and discomfort in working with people with SMI. They also noted multiple questions about providing clinical care, referrals and the interaction of oral health and mental health. Lastly, they offered ideas about educational strategies to improve learning on the topic. CONCLUSION(S): Pre-doctoral dental students have concerns about providing care to people with SMI and limited understanding of dental professional role and responsibilities about care for this vulnerable population. Predoctoral dental curriculum should be expanded to address professional roles when working with this population to improve student competency and comfort, and ultimately improve care to people with SMI.

Old before their time: Comparisons of people with SMI and healthy older adults.

OBJECTIVE: Compare physical functional measures of people with severe mental illness (SMI) to standardized geriatric values. METHOD: Retrospective analysis of physical functioning sample data of middle-aged people with SMI was compared to standardized older adult data. Compared: Sit to Stand Test (STS; n = 68), 6 min Walk Test (6MWT; n = 71), and Single Legged Stance Test (SLS; n = 55). One sample t tests were computed, using standardized values for older adult healthy populations, to identify differences for the group. RESULTS: STS (M = 11.3 SD = 5.36), for the sample were comparable to 80-89 year old. The 6MWT values were significantly worse than 80-89-year-old range for women, t(28) = -2.88, p < .01, and men, t(40) = -5.32, p =. 00. SLS values for women and men were comparable to the 70-79-year-old range in the general population. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: People with SMI have functional fitness levels that are older than chronological age, and should be assessed regularly for physical functioning to support independent living. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Multidimensional wellness for people aging with mental health conditions: A proposed framework.

OBJECTIVE: This project aimed to develop a synthesized framework of multidimensional wellness for people aging with serious mental health conditions (SMHC) using existing frameworks to serve as a guide for policy and interventions to address the unique needs, experiences, and strengths of the population. METHOD: A concept analysis compared a widely used wellness approach (Swarbrick, 1997) for people with SMHC and one for older adults (Fullen, 2019) to synthesize into a practical framework for people aging with SMHC. RESULTS: Nine dimensions were proposed for conceptualizing the wellness of this population including: (a) Developmental, (b) Intellectual/Cognitive, (c) Physical, (d) Emotional, (e) Social, (f) Occupational, (g) Spiritual, (h) Environmental, and (i) Financial. Practical suggestions for implementation are identified. CONCLUSIONS AND IMPLICATION FOR PRACTICE: People aging with SMHC require rehabilitation services that address their unique perspectives, strengths, and challenges. The proposed adapted wellness framework offers a guide to comprehensively address well-being in people aging with SMHC. Placing the model in the context of external factors of resources and supports available, and the impact of societal perspectives about each dimension, further delineates a holistic model of wellness that considers well-being and successful living. This model can offer structure and practical application for services, and consideration of future needs of people aging with SMHC to support psychiatric rehabilitation services, as well as offer strategies to encourage positive aging and recovery. Future work should explore the impact of multidecade experiences of mental health conditions and the mental health system to better support individual recovery. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Tools for Moving On: Adapting an Evidence-Based Housing Curriculum for Individuals Receiving Services in an Inpatient Psychiatric Setting to Prepare for Community Living.

Individuals with serious mental illness transitioning from state psychiatric hospitals to community living need specialized skills to enter community housing programs. There are few examples of best practice hospital group programs to improve community living skills. To address this gap, the authors developed a community skills training and discharge readiness program, Tools for Moving On (TFMO), adapted from materials from the Substance Abuse and Mental Health Services Administration Permanent Supportive Housing: Tools for Tenants toolkit. The new program uses facilitator and participant handouts, implementation recommendations, and covers four topics, including housing choices, housing preferences, tenancy skills, and support needs. Adapting existing evidence-based practices for individuals in state psychiatric hospitals may aid in successful discharge and community living and support nurses in their efforts for discharge. [Journal of Psychosocial Nursing and Mental Health Services, 57(8), 23-29.].

Multi-dimensional wellness interventions for older adults with serious mental illness: A systematic literature review.

OBJECTIVE: Aging persons with serious mental illness present unique challenges for community mental health services. This population is increasing in numbers in mental health treatment settings. The combination of serious mental illness with the vicissitudes of aging suggest that a broader conceptualization of this population may improve services. SAMHSA's 8 Dimension of Wellness offers a comprehensive strengths-based framework for interventions to maximize older persons' abilities and address the complex bidirectional effects of physical, emotional, social, spiritual, occupational, financial, intellectual, and environmental challenges to wellness. This systemic literature review identifies unidimensional and multidimensional wellness interventions for older adults with mental illness. METHOD: We conducted a systematic literature review to identify wellness interventions provided to persons with serious mental illness with a mean age of 45 or higher. RESULTS: Twenty-six articles representing 14 distinct wellness interventions were identified. None of the articles used SAMHSA's 8 Dimensions of Wellness framework. The physical wellness (n = 21) and social (n = 15) dimensions were the most frequently described in the literature. There was no mention of either the intellectual or spiritual dimensions. The quality of the research of these interventions varied; 14 papers described a randomized controlled trial. CONCLUSIONS: The SAMHSA wellness framework has not been used to design interventions for older persons with serious mental illness. Interventions for aging persons should support comprehensive wellness, including the intellectual and spiritual domains. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Sensitizing Inpatient Mental Health Staff to the Challenges of Aging.

Although the aging inpatient population in state psychiatric hospitals is growing significantly, there are few examples of available training to improve staff knowledge and practice. The current article describes a 10-week training series developed through a university and psychiatric hospital collaboration. Training was attended by 135 direct care nursing and rehabilitation staff and focused on improving aging awareness, problem solving, using person-centered therapeutic techniques, and engaging older adults. Staff reported improvements in therapeutic techniques, knowledge, concrete strategies for providing care, and stress management skills. Specialized training to improve understanding of aging processes and communication with older adults may also improve inpatient staff knowledge and skills. As the aging inpatient population in state psychiatric hospitals continues to grow, future work should develop manualized training initiatives to address communication needs of older adults and intervention strategies that can be used by mental health nursing staff when working with this population. [Journal of Psychosocial Nursing and Mental Health Services, 56(4), 12-16.].

Predictors of physical activity in persons with mental illness: Testing a social cognitive model.

OBJECTIVE: This study examined whether the social cognitive theory (SCT) model can be used to explain the variance in physical exercise among persons with serious mental illnesses. METHOD: A cross-sectional, correlational design was employed. Participants from community mental health centers and supported housing programs (N = 120) completed 9 measures on exercise, social support, self-efficacy, outcome expectations, barriers, and goal-setting. RESULTS: Hierarchical regression tested the relationship between self-report physical activity and SCT determinants while controlling for personal characteristics. The model explained 25% of the variance in exercise. Personal characteristics explained 18% of the variance in physical activity, SCT variables of social support, self-efficacy, outcome expectations, barriers, and goals were entered simultaneously, and they added an r2 change value of .07. Gender (ß = -.316, p = .001) and Brief Symptom Inventory Depression subscale (ß = -2.08, p < .040) contributed significantly to the prediction of exercise. In a separate stepwise multiple regression, we entered only SCT variables as potential predictors of exercise. Goal-setting was the single significant predictor, F(1, 118) = 13.59, p < .01), r2 = .10. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: SCT shows promise as an explanatory model of exercise in persons with mental illnesses. Goal-setting practices, self-efficacy, outcome expectations and social support from friends for exercise should be encouraged by psychiatric rehabilitation practitioners. People with more depressive symptoms and women exercise less. More work is needed on theoretical exploration of predictors of exercise. (PsycINFO Database Record