Socially Valued Roles, Self-Determination, and Community Participation among Individuals Living with Serious Mental Illnesses.

Decades after deinstitutionalization, individuals living with serious mental illnesses remain isolated, socially disengaged, and devalued members of communities. Burgeoning research and services need conceptual clarity to improve such social conditions. This qualitative inquiry used grounded theory and participatory approaches to conduct an in-depth exploration of community participation for individuals living with serious mental illnesses based on key stakeholder perspectives (n = 45). Results revealed that community participation is a multifaceted construct with layers of meaning for individuals living with serious mental illnesses. Overarching themes are contextualized in Self-Determination Theory and presented with deidentified illustrations. Implications for services, research, and policy are discussed.

Exploring the work lives of adults with serious mental illness from a vocational psychology perspective.

Current vocational services for adults with serious mental illness remain largely atheoretical and disconnected from mainstream vocational psychology research and practice. This study explored the perspectives on work of adults with serious mental illness, compared perspectives of young and older adults, and assessed these perspectives for the applicability of a well-established theory of vocational psychology. A national sample of 76 individuals with mental illness engaged in the workforce completed a semistructured questionnaire. We applied the principles of a participatory approach to consensual qualitative research methodology in the study design and data analysis. Results yielded a large number of categories, which clustered under domains representative of the primary constructs of social cognitive career theory (SCCT; Lent, 2013). These domains included the antecedents of self-efficacy, namely, personal accomplishments, vicarious learning, social persuasion, and physical or emotional states as well as additional constructs of outcome expectations, personal goals, and contextual barriers. The SCCT model will likely provide a useful framework to bridge the gap between career development theory and vocational services for individuals with mental illness.

Barriers to and facilitators of the acceptance process for individuals with serious mental illness.

The process of acceptance of mental illness is a central component of recovery and has been linked to functioning, illness management, and quality of life. A number of barriers and facilitators have been theorized as impacting this process. This study was conducted with 30 participants with serious mental illness (a major psychiatric disorder with impairment in multiple areas of functioning) to elicit the barriers to and facilitators of the acceptance of mental illness. Grounded theory methodology was utilized to analyze the 30 semistructured interviews. Results revealed barriers to and facilitators of acceptance of mental illness at the micro level (cognitive, emotional, behavioral, identity-related), meso level (relational), and macro level (cultural, systemic). Clinical and research implications are discussed with regard to facilitating acceptance of mental illness.

Impact of the COVID-19 pandemic on the career development of individuals with psychiatric disabilities.

OBJECTIVE: The purpose of this preliminary exploratory study was to explore the impact of the COVID-19 pandemic on the career development of diverse individuals with psychiatric disabilities. METHODS: Four hundred sixty-nine individuals with psychiatric disabilities and 147 individuals without psychiatric disabilities completed survey questions regarding their employment and educational experiences during the pandemic. We utilized chi-square analyses to explore the differences between those with and without psychiatric disabilities and between racial groups. RESULTS: Our results indicated that individuals with psychiatric disabilities, especially Black, Indigenous, and other people of color (BIPOC), experienced greater employment-related uncertainty during the COVID-19 pandemic than the population without psychiatric disabilities. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Individuals with psychiatric disabilities, particularly BIPOC, need access to more stable employment and supports to maintain their employment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Development of a comprehensive inventory of community participation for individuals with psychiatric disabilities.

OBJECTIVE: The social lives of individuals with psychiatric conditions are often characterized by isolation and a lack of meaningful engagement in communities of their choice. The purpose of this study was to develop and test a comprehensive and multidimensional measure of community participation for use in research, evaluation, and service provision. METHOD: We conducted this study in phases beginning with conceptual activities and culminating in the psychometric testing of the reliability and validity of the Inventory of Community Participation for individuals with Mental Health conditions (ICP-MH). Data were collected from a total of 301 participants using a variety of legacy and newly constructed items as well as a subscale using narrative vignettes, all designed to assess levels of community participation. Data were analyzed using both classical test and item response theory approaches. RESULTS: Statistical analyses suggest excellent internal consistency, convergent and divergent validity. The novel approach of vignettes to depict community participation was well-received and suggests a subscale with excellent psychometric properties. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: We conceptualized, operationalized and assessed tested a multidimensional scale of community participation utilizing both traditional and novel assessment methods. The ICP-MH assesses essential objective and subjective factors of community participation and can provide valuable data to test the effectiveness of community-oriented interventions, as well as information which can be used to guide treatment and services. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Concordance of assessments of clients' mental and behavioral health with in vivo assessment of work performance.

BACKGROUND: Assessing functioning and disability among individuals with mental and behavioral health disorders has historically relied on deriving accurate psychiatric diagnoses and assessing symptoms. However, growing empirical evidence suggests that this approach is inadequate to determine real world performance, particularly with respect to work. OBJECTIVE: We examined a performance-based approach to the assessment of work functioning and its relationship to mental and behavioral health status. METHODS: A cross-sectional study was conducted at two mental health programs. Trained employment providers conducted performance-based assessments of work function and ratings of mental and behavioral health while study participants self-reported their mental/behavioral health functioning. We hypothesized that participant and provider ratings of mental/behavioral health would be moderately correlated with performance-based assessments of work function. RESULTS: We found no significant correlation between participants' self-report of their mental and behavioral health and performance-based assessments of work. Employment providers' ratings of participants' mental/behavioral health were moderately correlated with performance-based measures of work. Finally, we found low concordance between employment providers and study participants' with respect to ratings of their mental/behavioral health. CONCLUSIONS: Contrary to our hypotheses, ratings of mental/behavioral health were only moderately correlated with performance-based measures of work. Results confirm earlier research suggesting that it is difficult to predict work performance from participants' self-reports of their mental/behavioral health alone. Performance-based assessments of work capacity as well as ratings of mental and behavioral health may both be needed for a more complete and complimentary picture of the ability of individuals with mental and behavioral health disorders to function in the work place.

Acceptance of mental illness: core components of a multifaceted construct.

The recovery movement has identified acceptance of mental illness as critical to quality of life and illness management. However, there is a general lack of research on the acceptance of mental illness. The present qualitative study was conducted with 30 participants with mental illness to clarify the construct of acceptance. Grounded theory methodology is utilized to analyze the 30 semistructured interviews. Results in the present study reveal acceptance to be a multifaceted construct composed of several core characteristics, including the: (1) identity component, (2) cognitive component, (3) emotional component, (4) behavioral component, and (5) relational component. In addition, when asked to define acceptance of mental illness, some participants noted negative connotations to acceptance. Implications for psychological services and future research will be discussed to guide additional study and practice in this area.