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Long-Term Clinical Strategies for Psychiatric Rehabilitation
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Long-Term Clinical Strategies for Psychiatric Rehabilitation

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (24 December 2024) | Viewed by 5037

Special Issue Editors

Dr. Lisette Van der Meer

E-Mail Website
Guest Editor
1. Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
2. Department of Rehabilitation, Lentis Psychiatric Institute, Zuidlaren, The Netherlands
Interests: psychiatry; clinical psychology; clinical neuropsychology
Prof. Dr. Helen Killaspy

E-Mail Website
Guest Editor
Division of Psychiatry, University College London, London, UK
Interests: rehabilitation psychiatry; mental health

Special Issue Information

Dear Colleagues,

People with the most complex mental health problems (also termed severe mental illness, which refers to the group of people with a diagnosis of a psychotic illness such as schizophrenia or bipolar affective disorder with associated social, cognitive, and functional impairments) often require long-term treatment and support from mental health and social care services that are provided in inpatient units and community settings. Internationally, a variety of approaches have been employed to provide the care that this group requires, including well-defined ‘care pathways’ that support people in moving from more intensively supported settings (such as inpatient units or highly supported housing) to more independent settings over time, and specialist psychiatric rehabilitation programs that deliver evidence-based biopsychosocial interventions. These may include, for example, complex medication regimes, cognitive remediation, social skills training, and various forms of supported employment. Increasingly, it is acknowledged that services supporting people’s rehabilitation should adopt a recovery-based orientation that works collaboratively with service users to identify and achieve their goals.

Accordingly, this Special Issue seeks empirical, practical, and review studies focused on psychiatric rehabilitation interventions, implementation strategies, and service developments that aim to improve clinical and social outcomes for people with complex mental health problems.

Dr. Lisette Van der Meer
Prof. Dr. Helen Killaspy
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • psychiatric rehabilitation
  • complex mental health problems
  • recovery-oriented care
  • implementation
  • clinical psychology
  • mental health

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Published Papers (3 papers)

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Research

17 pages, 580 KiB  
Article
Screening for Alcohol Use Disorder Among Hospitalised Patients: Learning from a Retrospective Cohort Study in Secondary Care
by Mohsan Subhani, Dipaka Rani Nath, Usman Talat, Aqsa Imtiaz, Amardeep Khanna, Awais Ali, Guruprasad P. Aithal, Stephen D. Ryder and Joanne R. Morling
J. Clin. Med. 2024, 13(24), 7617; https://doi.org/10.3390/jcm13247617 - 13 Dec 2024
Viewed by 1292
Abstract
Background: Excessive alcohol consumption is among the leading causes of hospitalisation in high-income countries and contributes to over 200 medical conditions. We aimed to determine the prevalence and characteristics of alcohol use disorder (AUD), describe the distribution of AUD in ICD-10 discharge diagnosis [...] Read more.
Background: Excessive alcohol consumption is among the leading causes of hospitalisation in high-income countries and contributes to over 200 medical conditions. We aimed to determine the prevalence and characteristics of alcohol use disorder (AUD), describe the distribution of AUD in ICD-10 discharge diagnosis groups and ascertain any relationship between them in secondary care. Methods: The study group was a retrospective cohort of adult patients admitted to Nottingham University Hospital (NUH) between 4 April 2009 and 31 March 2020. Uni- and multivariable analysis was performed to determine the relationship between AUD and covariable high-risk characteristics and describe the distribution of AUD in ICD-10 discharge diagnosis groups defined by an alcohol-attributable fraction. Results: A total of 44,804 patients (66,440 admissions) were included, with a mean age of 63.1 years (SD ± 19.9); of these, 48.0% (n = 20,863) were male and 71.2% were (n = 30,994) white. AUDIT-C was completed in 97.1% (n = 43,514) of patients, and identified 16.5% (n = 7164) as having AUD, while 2.1% (n = 900) were found to be alcohol-dependent. In patients with AUD, 4.0% (n = 283) had an ICD-10 diagnosis that was alcohol-specific and 17.5% (n = 1255) were diagnosed with alcohol-related disorders; the remainder were not diagnosed with either disorder. Two-thirds (64.7%) of the patients with AUD had associated mental and behavioural disorders. Multivariable logistic regression analysis revealed that patients aged 60–69 had the highest risk of AUD (OR 4.19, 95% CI 3.53–4.99). Being single (OR 1.18, 95% CI 1.11–1.26) and a history of emergency admission (OR 1.21, 95% CI 1.14–1.29) were associated with increased odds of AUD. Conversely, females compared to males (OR 0.34, 95% CI 0.35–0.39), individuals from minority ethnic backgrounds compared to white Caucasians (OR 0.39, 95% CI 0.35–0.45), and those from more deprived areas (IMD quintile 1: OR 0.79, 95% CI 0.74–0.86) had lower odds of AUD. Conclusions: One in six admitted patients had AUD, with a higher risk in males, ages 60–69, and emergency admissions. Mental disorders are highly prevalent among hospitalised patients with AUD. The performance of the AUDIT-C score varied among hospitalised patients based on their ICD-10 diagnosis, which should be considered when implementing universal alcohol screening in these settings. Full article
(This article belongs to the Special Issue Long-Term Clinical Strategies for Psychiatric Rehabilitation)
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16 pages, 262 KiB  
Article
From Model to Practice: A Qualitative Study on Factors Influencing the Implementation of the Active Recovery Triad (ART) Model in Long-Term Mental Health Care
by Lieke Zomer, Lisette van der Meer, Jaap van Weeghel, Guy Widdershoven and Yolande Voskes
J. Clin. Med. 2024, 13(12), 3488; https://doi.org/10.3390/jcm13123488 - 14 Jun 2024
Viewed by 1117
Abstract
Background: The Active Recovery Triad (ART) model provides a framework for recovery-oriented care in the long-term mental health setting. The aim of this study is to gain insight into factors influencing the implementation process of the ART model. Methods: Focus groups [...] Read more.
Background: The Active Recovery Triad (ART) model provides a framework for recovery-oriented care in the long-term mental health setting. The aim of this study is to gain insight into factors influencing the implementation process of the ART model. Methods: Focus groups were conducted with fourteen multidisciplinary teams that were in the process of implementing the ART model. Data were thematically analyzed. Results: Three phases of implementation were identified. In the first phase, getting started, support from both the top of the organization and the care workers, sufficient information to care workers, service users, and significant others, and creating momentum were considered crucial factors. In the second phase, during implementation, a stable team with a good team spirit, leadership and ambassadors, prioritizing goals, sufficient tools and training, and overcoming structural limitations in large organizations were seen as important factors. In the third phase, striving for sustainability, dealing with setbacks, maintaining attention to the ART model, and exchange with other teams and organizations were mentioned as core factors. Conclusions: The findings may support teams in making the shift from traditional care approaches towards recovery-oriented care in long-term mental health care. Full article
(This article belongs to the Special Issue Long-Term Clinical Strategies for Psychiatric Rehabilitation)
14 pages, 941 KiB  
Article
Epistemic Trust Is a Critical Success Factor in Psychosomatic Rehabilitation—Results from a Naturalistic Multi-Center Observational Study
by David Riedl, Hanna Kampling, Johannes Kruse, Tobias Nolte, Karin Labek, Christina Kirchhoff, Vincent Grote, Michael J. Fischer, Alexander Knipel and Astrid Lampe
J. Clin. Med. 2024, 13(1), 177; https://doi.org/10.3390/jcm13010177 - 28 Dec 2023
Cited by 6 | Viewed by 1739
Abstract
Knowledge about critical success factors underpinning beneficial treatment outcomes in psychosomatic inpatient rehabilitation is scarce. The aim of this study was to evaluate the influence of patients’ epistemic stance in relation to the improvement of psychological distress during rehabilitation. In this naturalistic longitudinal [...] Read more.
Knowledge about critical success factors underpinning beneficial treatment outcomes in psychosomatic inpatient rehabilitation is scarce. The aim of this study was to evaluate the influence of patients’ epistemic stance in relation to the improvement of psychological distress during rehabilitation. In this naturalistic longitudinal observational study, n = 771 patients completed routine assessments for psychological distress (BSI-18), health-related quality of life (HRQOL; WHODAS), and epistemic trust (ETMCQ) before (T1) and after (T2) psychosomatic rehabilitation. Patients were grouped as best, average, and worst responders based on their mean BSI-18 changes during treatment, and their mean change in epistemic trust, mistrust, and credulity was compared using repeated measures analyses of variance (rANOVAs). No associations of performance with sex (p = 0.09), age (p = 0.11), or relationship status (p = 0.58) were found. Best responders reported significantly improved epistemic trust (p = 0.001) and reduced epistemic mistrust (p < 0.001), whereas worst responders reported a significant increase in epistemic mistrust (p < 0.001) and credulity (p < 0.001). Average responders did not change for either epistemic trust (p = 0.11), mistrust (p > 0.99), or credulity (p = 0.96). Our results underscore the role of the epistemic stance in psychosomatic and psychotherapeutic treatments. These results help to better understand what might determine psychosomatic rehabilitation outcomes and indicate the role of epistemic trust as a critical success factor. Full article
(This article belongs to the Special Issue Long-Term Clinical Strategies for Psychiatric Rehabilitation)
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