Phyllis Solomon

Peer support/peer provided services underlying processes, benefits, and critical ingredients.

The article defines peer support/peer provided services; discusses the underlying psychosocial processes of these services; and delineates the benefits to peer providers, individuals receiving services, and mental health service delivery system. Based on these theoretical processes and research, the critical ingredients of peer provided services, critical characteristics of peer providers, and mental health system principles for achieving maximum benefits are discussed, along with the level of empirical evidence for establishing these elements.

Community Integration of Persons with Psychiatric Disabilities in Supportive Independent Housing: A Conceptual Model and Methodological Considerations

Despite the consensus regarding community integration as a major goal of mental health policy and the emergence of supportive independent housing as a critical component of community mental health services, mental health services research has not examined the extent to which housing and service characteristics are associated with community integration of persons with psychiatric disabilities in supportive independent housing. The main goal of this paper is to propose a conceptual model of factors influencing community integration that takes into account the differential configuration of housing setting and support structure in supportive independent housing. The conceptual model encompasses a multidimensional conceptualization of community integration and considers an array of housing and service characteristics that are potentially relevant determinants of community integration. On the basis of the proposed model, this paper outlines the methodological considerations for future research with regard to measurement, research designs, and statistical models.

The efficacy of case management services for severely mentally disabled clients.

A comprehensive review of published and unpublished research studies of case management for severely mentally disabled adults was undertaken. This yielded 20 studies of four models of case management, Full Support, Personal Strengths, Rehabilitation and Expanded Broker Models. This article reviews these models, the research studies, the outcomes of these studies and conclusions that can be drawn regarding the efficacy of case management services for severely mentally disabled adults. Future directions for research in this area are recommended.

The working alliance and consumer case management

The Working Alliance Inventory was used to measure the strength of the therapeutic relationship between seriously mentally disabled case management clients and their case managers in a randomized trial of consumer-provided case management services. It was found that while there was no difference in the strength of the alliance between the consumer and nonconsumer teams of case managers, there were positive relationships between alliance and some outcomes, including quality of life, symptomatology, attitudes toward medication compliance, and satisfaction with mental health treatment.

The efficacy of a consumer case management team: 2-year outcomes of a randomized trial.

This article reports the results of a randomized trial of a team of case managers who are mental health consumers compared to a team of nonconsumers. Using a repeated measures MANOVA design, consumer case managers were found to be as effective as a team of nonconsumer case managers in maintaining the stability of severely mentally disabled clients served over a 2-year period. Implications for the employment of consumers in mental health services and the vocational capacity of persons with mental illness are discussed.

One-Year Outcomes of a Randomized Trial of Case Management with Seriously Mentally Ill Clients Leaving Jail

It was hypothesized that clients receiving case management services will improve to a moderate extent in terms of a variety of psychosocial and clinical outcomes compared with clients served by the usual system of care. It was further hypothesized that clients served by an Assertive Community Treatment (ACT) team will have significantly greater improvement than clients served by forensic case managers working individually. Two hundred seriously mentally ill inmates leaving jail were assigned to three conditions, and 94 remained in the study at 1 year. One-year outcomes were analyzed by service condition, using a hierarchical block discriminant function analysis. Contrary to the hypothesis, more clients in the experimental condition returned to jail within a year. No differences were found among the three conditions in social or clinical outcomes. Greater jail recidivism among clients receiving the more intensive service raises questions concerning tendencies to emphasize monitoring with this population.

Family Violence among Adults with Severe Mental Illness A Neglected Area of Research

Violence against family caregivers by their adult relatives with severe mental illness is a taboo area of public discourse and scientific research because of fears of further stigmatizing this population. Yet, these families experience violence at a rate estimated to be between 10% and 40%, which is considerably higher than the general population. This article reviews the limited research on violence of adults with severe mental illness against their family caregivers and proposes a conceptual framework that can further stimulate study in an area that has been neglected too long by both mental health and family violence investigators. Research on this topic is essential in developing effective policy and practice interventions.

Self-help groups for families of persons with mental illness: perceived benefits of helpfulness.

Self-help groups have become important resourcesfor families of persons with mental illness. The presentstudy was an attempt to understand the factors perceivedby group members as helpful using Yaloms factors in clarifying the dynamics of groups.Members (N = 202) of the Alliance for the Mentally Illof Pennsylvania (AMI of PA), an association of self-helpgroups for families of the mentally ill, were recruited and responded to a self-administeredquestionnaire. Hierarchical block multiple regressionindicated that those AMI members who felt informationprovision and gaining support and self-understanding from the group process was helpful and werelonger term participants in their group were more likelyto perceive benefit from belonging to the group. Thefindings may provide the basis for evaluating and improving self-help group effectiveness andcontribute to understanding process factors within aself-help group which members find beneficial.Implications for how these groups can attract andmaintain members are discussed.

Satisfaction with mental health treatment in a randomized trial of consumer case management.

It was hypothesized that the clients assigned to a consumer team of case managers, because they share similar life experiences interacting with the mental health system, would have greater satisfaction with mental health treatment than clients assigned to a team of nonconsumer case managers. Ninety-one clients with serious and persistent mental illness randomly assigned to consumer and nonconsumer case management teams were interviewed after 1 year of service. While clients served by a consumer team of case managers were less satisfied with mental health treatment, personal characteristics of individual case managers were more important in explaining differences in satisfaction with treatment than whether the client was served by the consumer or nonconsumer team.

The varieties of readmission: the case against the use of recidivism rates as a measure of program effectiveness.

The many kinds and functions of rehospitalization--frequently having little, if anything, to do with the recidivists psychiatric status per se--are examined. It is suggested that the use of recidivism rates may blind evaluators, program planners, and practitioners to the multiplicity of dynamics involved in the rehospitalization process.