Recoveries from Severe Mental Illness

描述(申请人提供)：严重的精神疾病是个人、家庭、社会和卫生系统代价高昂的疾病，是发达国家导致残疾的主要原因之一。尽管在个人特征、病史、生活环境、疾病特征和治疗类型方面有相似之处，但一些患有这些障碍的人一生中大部分时间都在与心理健康问题作斗争，一些人成功地适应了，一些人完全康复了。到目前为止，我们对这些人的不同之处以及如何促进那些境况不佳的人的康复知之甚少。利用多种数据来源，该项目将采用定性和定量的方法，了解导致严重精神疾病患者康复的因素。该项目有三个目标：(1)确定促进康复的过程、因素、行动和经验；(2)描述精神卫生保健提供者和精神卫生保健系统在促进功能、生活满意度、生活质量和幸福感改善方面以前和现在发挥的作用；(3)确定参与研究前一年和研究进入后两年的健康计划服务使用模式，检查服务使用量和类型与参与者报告的症状水平、功能、生活困难和生活满意度之间的关系。为了实现这些目标，我们将确定一组患有严重精神疾病的HMO成员，并前瞻性地对他们进行24个月的跟踪调查。我们将采访参与者的生活历程和心理健康问题，测量他们的生活质量、生活满意度、幸福感和康复，并提取关于他们的服务和用药的健康计划数据，将这些数据与问卷和访谈数据联系起来。我们将描述参与者认为是生活满意度的重要指标的共性，以及导致他们生活和功能改善的因素，并描述参与者目前如何受到心理健康问题的影响。最后，我们将描述参与者的恢复轨迹并建立统计模型，并描绘他们在管理日常生活和遇到压力情况时使用的方法。很少有研究系统地描述康复对患有严重精神疾病的个人意味着什么，或者研究消费者认为对产生对他们重要的康复结果有影响的因素。拟议的项目将实现这两个目标，并将参与者的观点与传统的成果衡量标准进行比较。因此，拟议的项目将为促进严重精神残疾患者康复的努力提供信息。

DESCRIPTION (provided by applicant): Severe mental illnesses are costly conditions for individuals, families, societies, and health systems and are among the leading causes of disability in developed countries. Despite similarities in personal characteristics, histories, life circumstances, illness characteristics, and types of treatment, however, some individuals with these disorders struggle with mental health problems for most of their lives, some adapt successfully, and some recover completely. To date, we know little about what differentiates these individuals or about how to facilitate recovery among those who are faring less well. Using multiple data sources, this project will employ qualitative and quantitative methods to understanding of the factors that lead to recovery among people with severe mental illnesses. The project has three aims: (1) to identify processes, factors, actions, and experiences that facilitate recovery, (2) to describe the prior and current roles played by mental health care providers, and the mental health care system, in facilitating improvements in functioning, life satisfaction, quality of life, and happiness, and (3) to identify patterns in health plan service use for the year prior to study participation and two years following study entry, examining how volume and type of service use relate to participants' reports of symptom levels, functioning, life difficulties, and life satisfaction. To accomplish these aims, we will identify a group of HMO members with severe mental illnesses and follow them prospectively for 24 months. We will interview participants about the course of their lives and mental health problems, measure their quality of life, life satisfaction, happiness, and recovery, and extract health plan data about their service and medication use, linking those data to questionnaire and interview data. We will describe commonalities in what participants identify as important indicators of life satisfaction and the factors that have led to improvements in their lives and functioning, and describe how participants are currently affected by their mental health problems. Finally, we will describe and statistically model participants' recovery trajectories, and delineate the approaches they use in managing day-to-day life and the stressful situations they encounter. Few studies have systematically described what recovery means to individuals with severe mental illnesses or studied the factors consumers identify as influential in producing the recovery outcomes important to them. The proposed project will accomplish both of these goals and compare participant perspectives to traditional outcome measures. As such, proposed project will inform efforts to facilitate recovery individuals with severe psychiatric disabilities.