Mental Health Peer Support

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Roles of Peer Providers in Integrated Health

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Strengths Peer Providers Add to the Integrated Health Workplace

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Peer providers bring unique strengths and qualities to the integrated care team. These strengths include:

• Personal experience with whole health recovery that includes addressing wellness of both mind and body
• Insight into the experience of internalized stigma and how to combat it
• Compassion and commitment to helping others, rooted in a sense of gratitude
• Can take away the “you do not know what it’s like” excuse
• Experience of moving from hopelessness to hope
• In a unique position to develop a relationship of trust, which is especially helpful in working with people in trauma recovery
• A developed skill in monitoring their illness and self-managing their lives holistically

Models of advance directives in mental health care

Springer Link  References Social Psychiatry and Psychiatric Epidemiology 

August 2004, Volume 39, Issue 8, pp 673–680 J. M. AtkinsonEmail authorH. C. GarnerW. H. Gilmour

1.

Scottish Executive (2001a) Report on the Review of the Mental Health (Scotland) Act 1984. Edinburgh: Scottish Executive

Google Scholar

2.

Scottish Executive (2001b) Renewing Mental Health Law Policy Statement. Edinburgh: Scottish Executive

Google Scholar

3.

Department of Health (1999) Report of the Expert Committee, Review of the Mental Health Act. London: Department of Health

Google Scholar

4.

Department of Health and Home Office (2000) Reforming the Mental Health Act.London: Department of Health and Home Office 2000

Google Scholar

5.

Curran C, Grimshaw C (1999) Advance Directives. OpenMind 99 Sept/Oct pp 24

Google Scholar

6.

Rethink (2000) Policy Statements 25 & 26 http://www.rethink. org/news + campaigns/policies/

Google Scholar

7.

Manic Depression Fellowship (2001) Planning ahead for people with manic depression. London: Manic Depression Fellowship

Google Scholar

8.

Papageorgiou A, King M, Janmohamed A, Davidson O, Dawson J (2002) Advance directives for patients compulsorily admitted to hospital with serious mental illness. Br J Psychiatry 181:513–551

CrossRefPubMedGoogle Scholar

9.

Sutherby K, Szmukler GI, Halpern A, Alexander M, Thornicroft G, Johnson C, Wright S (1999) A study of ‘crisis cards’ in a community psychiatric service. Acta Psychiatr Scand 100:56–61

PubMedGoogle Scholar

10.

Scottish Parliament (2002) Official Report Health and Community Care Committee, Friday 4th October 2002 Edinburgh: Stationery Office

Google Scholar

11.

Scottish Parliament (2002) Official Report Health and Community Care Committee, Wednesday 30th October 2002 Edinburgh: Stationery Office

Google Scholar

12.

Scottish Parliament (2003) Mental Health Care and Treatment (Scotland) Act 2003 Edinburgh: Stationery Office

Google Scholar

13.

Department of Health (2002) Draft Mental Health Bill London: HMSO

Google Scholar

14.

Dobson R (2003) Mental health bill will be subject to pre-legislative scrutiny Br Med J 327:1304

CrossRefGoogle Scholar

15.

Szasz TS (1982) The Psychiatric Will: a New Mechanism for Protecting Persons Against ‘Psychosis’ and Psychiatry. Am Psychol 37:762–770

PubMedGoogle Scholar

16.

Appelbaum PS (1991) Advance Directives for Psychiatric Treatment. Hosp Comm Psychiatry 42:983–984

Google Scholar

17.

Kapp MB (1994) Implications of the Patient Self-Determination Act for psychiatric practice. Hosp Comm Psychiatry 45:355–358

Google Scholar

18.

Backlar P (1997) Ethics in Community Mental Health Care: Anticipatory Planning for Psychiatric Treatment Is Not Quite the Same as Planning for End-of-Life Care. Comm Ment Health J 33:261–268

CrossRefGoogle Scholar

19.

Atkinson JM, Garner HC, Patrick H, Stuart S (2003) Issues in the development of advance directives in mental health care. J Ment Health 12:463–474

Google Scholar

20.

Atkinson JM, Garner HC, Stuart S, Patrick H (2003) The development of potential models of advance directives in mental health care. J Ment Health 12:575–584

CrossRefGoogle Scholar

21.

Institute of Healthcare Management Yearbook 2000/2001 Stationery Office 2000

Google Scholar

22.

Atkinson JM (2004) Ulysses’ crew or Circe? – the implications of advance directives in mental health for psychiatrists. Psychiatr Bull 28:3–4

Google Scholar

23.

Sutherby K, Szmukler GI (1998) Crisis cards and self-help crisis initatives. Psychiatr Bull 22:4–7

Google Scholar

24.

Winston ME, Winston SM, Appelbaum P, Rhoder N (1982) Can a Subject Consent to a ‘Ulysses Contract’? Case Study Commentary. The Hastings Center Report, University of Toronto Faculty of Law Review 12:26–28

Google Scholar

25.

Dresser R (1984) Bound to Treatment: The Ulysses Contract. The Hastings Center Report, pp 13–16

Google Scholar

26.

Somerville MA (1985) Changes in mental health legislation as indicators of changing values and policies. In: Roth M, Bluglass R (eds.) Psychiatry, human rights and the law. Cambridge: Cambridge University Press, pp 156–214

Google Scholar

27.

British Medical Association (1995) Advance Statements about Medical Treatment. London: BMJ Publishing Group

Google Scholar

28.

Humphreys M (1998) Consultant psychiatrists’ knowledge of mental health legislation in Scotland. Med Sci Law 38:237–241

PubMedGoogle Scholar

29.

Peay J, Roberts C, Eastman N (2001) Legal knowledge of mental health professionals: Report of a national survey. J Ment Health Law, pp 44–55

Google Scholar

30.

Sales GN (1993) The health care proxy for mental illness: can it work and should we want it to? Bull Am Acad Psychiatry Law 21(2):161–179

PubMedGoogle Scholar

31.

Scottish Parliament (2000) Adults with Incapacity (Scotland) Act 2000 Edinburgh: Stationery Office

Google Scholar

Copyright information

Groundwork for a Publicly Available Repository of Randomized Controlled Trial Data

TECHNICAL BRIEFMay 14, 2019 Download PDF1.5 MB

Download Final Appendix E[XLSX · 271.6 KB]Download Final Appendix F[XLSX · 556.2 KB]

This report is available in PDF and XLSX only (Final Report [PDF, 1.5 MB]; Final Appendix E [XLSX, 271.6 MB], Final Appendix F [XLSX, 556.2 MB]). People using assistive technology may not be able to fully access information in these files. For additional assistance, please contact us.

The purpose of this project was to identify and abstract data from randomized controlled trials (RCTs) of posttraumatic stress disorder (PTSD) interventions to support the development of a publicly accessible data repository by the National Center for Posttraumatic Stress Disorder.

• We abstracted data from 318 RCTs, including psychotherapeutic interventions (55%), pharmacologic interventions (30%), and complementary and integrative or nonpharmacologic biological treatments (15%).
• Studies included community (57%) and military/veteran (43%) populations.
• Less than half of the studies reported on the loss of PTSD diagnosis or clinically meaningful response/remission of symptoms. Reporting was incomplete for many data elements.
• Information on gaps in the evidence may inform future research.

Background. Posttraumatic stress disorder (PTSD) reduces quality of life and functioning. People with PTSD have symptoms such as intrusive thoughts, nightmares, flashbacks, avoidance of trauma-related stimuli, negative beliefs about themselves and/or others, and hypervigilance. The symptoms may be due to direct or indirect exposure to trauma, such as witnessing actual or threatened death, injury, or violence, including sexual violence and threats of harm. Although recent clinical practice guidelines and reviews exist, providing a single, updatable source of PTSD treatment trials would be useful for clinicians, researchers, and policymakers.

Purpose. To provide detailed information on PTSD treatment research, we systematically abstracted data from randomized controlled trials (RCTs) of PTSD interventions. The National Center for Posttraumatic Stress Disorder (NCPTSD) intends to use the data to develop a publicly available data repository. The NCPTSD is part of the U.S. Department of Veterans Affairs.

Data sources. We searched PTSDpubs (formerly PILOTS), Ovid® MEDLINE®, Cochrane CENTRAL, PsycINFO®, Embase®, CINAHL®, and Scopus® for eligible RCTs and reviewed reference lists of selected systematic reviews and clinical practice guidelines.

Methods. In consultation with NCPTSD, we established inclusion criteria for RCTs and specific data elements to be abstracted. We dually reviewed citations from the literature search, and then the full text of potentially includable articles for eligibility, resolving any disagreements using consensus. One team member abstracted data from included RCTs into evidence tables, and a second reviewer checked abstracted data for accuracy and completeness. The primary publication for each RCT was abstracted; data and citations from any secondary publications (i.e., companion papers) appear in the same record.

Findings. We identified 318 RCTs of PTSD interventions for abstraction (106 pharmacologic studies and 212 nonpharmacologic studies) published from 1988 to 2018, with a peak number of publications (31) in 2015. Psychotherapeutic interventions were the most commonly studied (55%), whereas 30 percent evaluated pharmacologic interventions. Most studies were conducted in the United States (61%), and most had sample sizes in the range of 25 to 100 participants (60% of studies), with a relatively small number of studies enrolling fewer than 25 participants (18%). More studies enrolled participants from a community population (57%) than from a military, veteran, or other population, and the majority of studies were conducted in the outpatient setting (67%). Studies most often enrolled participants with a mix of trauma types (51%), followed by studies of participants with combat-related trauma (20%).

Although there was wide variation, the most commonly used PTSD assessment methods were the Clinician-Administered PTSD Scale (CAPS) and the Structured Clinical Interview for DSM (SCID). Less than half of the studies reported loss of PTSD diagnosis or clinically meaningful response/remission of symptoms. Several other data elements were infrequently reported, including the number of participants with a history of traumatic brain injuries and the number of trauma types.

Conclusions. The data abstracted from 318 RCTs of treatments for PTSD can be used to create a publicly available data repository. By identifying important gaps in the research, such a data repository can inform future study design and conduct.

Suggested citation: O'Neil M, McDonagh M, Hsu F, Cheney T, Carlson K, Holmes R, Ramirez S, Hart E, Murphy K, Graham E, Chou R. Pharmacologic and Nonpharmacologic Treatments for Posttraumatic Stress Disorder: Groundwork for a Publicly Available Repository of Randomized Controlled Trial Data. Technical Brief No. 32. (Prepared by the Pacific Northwest Evidence-based Practice Center under Contract No. 290-2015-00009-I.) AHRQ Publication No. 19-EHC018-EF. Rockville, MD: Agency for Healthcare Research and Quality; May 2019. Posted final reports are located on the Effective Health Care Program search page. DOI: https://doi.org/10.23970/AHRQEPCTB32." target="_blank">https://effectivehealthcare.ahrq.gov/sites/all/themes/ehc/images/icons/exit_disclaimer.png"/>.