Early intervention services for psychosis and time until application for disability income support: a survival analysis.

Ensuring the financial security of individuals recovering from first episode psychosis is imperative, but disability income programs can be powerful disincentives to employment, compromising the social and occupational aspects of recovery. Survival analysis and Cox regression analysis were used to examine the rate at which individuals served by early intervention for psychosis (EIP) services apply for government disability income benefits and factors that predict rate of application. Health records for 558 individuals served by EIP programs were reviewed. Within the first year of receiving services 30% will make application for disability income; 60% will do so by 5 years. Rate of application is predicted by rate of hospital admission, financial status and engagement in productivity roles at the time of entry to EIP service. The findings suggest the need to examine the extent to which the recovery goals of EI services are undermined by early application for government income support. They also suggest the need to develop best practice guidelines related to ensuring the economic security of individuals served.

Practical Guidelines and Case Examples for Adapting an Evidence-based Intervention in a Complex Community Setting.

THE PROBLEM: Evidence-based interventions are often tested in specific, structured settings, but may need modification to meet the complex needs of vulnerable youth in real-world settings. Nonetheless, past research has not provided practical guidelines to help community partners make decisions about how to adapt evidence-based interventions to their settings. PURPOSE OF ARTICLE: We identify barriers in implementing a mental health promotion and violence prevention intervention with youth in a complex community setting to provide practice examples of how the program was adapted to address different challenges. These adaptation decisions are framed within guidelines that are grounded in a wider evidence base. KEY POINTS: The guidelines underscore the importance of trauma-informed practice, emphasizing confidentiality, tailoring content to meet individual youth's clinical risk and responsivity factors, adjusting dosage and content to meet the group's needs, aligning programming with case planning, being flexible with format, and attending to contextual factors. CONCLUSIONS: Evidence-based interventions need to be adapted to meet the needs of both individual participants and groups. The guidelines and case examples presented here demonstrate how this adaptation was undertaken in an intentional and evidence-driven way in one agency in the context of a community-based research partnership.

Transitioning into the Community: Outcomes of a Pilot Housing Program for Forensic Patients.

The Transitional Rehabilitation Housing Pilot (TRHP) was designed to transition hospitalized forensic patients to the community. Twenty clients and their clinicians in two Ontario cities completed measures on functioning, substance use, recovery, social support, and quality of life at admission to the program and then every 6 months until 18 months post-admission. Clients also responded to open-ended questions on the impact of the program and living in the community on their recovery. Three (15%) clients re-offended. Eleven clients (55%) experienced rehospitalization; however, brief rehospitalization was seen as part of the recovery process. Level of community functioning was stable across time and 35% of clients had a decrease in the restrictiveness of their disposition order. Clients described numerous characteristics of community living that contributed to improvements in functioning, such as integration into the community, social contact, and newfound independence. Some aspects of TRHP that encouraged recovery included developing new skills and knowledge, staff support, and the programming that engaged clients in treatment and recovery-oriented activities. Findings suggest that forensic patients can transition successfully into the community with appropriate support and housing.