ADHERENCE AND EMPOWERMENT: Service Participation and Meaningful Outcomes

描述(申请人提供)：尽管有证据表明，许多精神科服务可以帮助严重精神病患者控制病情，实现他们的人生目标，但一些可能从这些服务中受益的人在开始治疗后选择不参与或不完全参与。坚持治疗是一个复杂的概念，有时也是一个有争议的概念，几十年来一直在讨论，以解释未能充分参与和受益于服务。在同一时期，心理健康消费者、服务提供者和研究人员已开始围绕赋权概念制定框架，强调消费者在治疗和服务方面的选择。我们提议的干预措施和/或服务研究发展中心(DCISR)的目标是更好地了解这些现象之间的关系，并审查加强赋权和遵守的变革战略，这反过来又影响对个人有意义的服务的参与和目标的实现。治疗依从性研究有丰富的经验基础，不幸的是，在理论或治疗概念方面几乎没有提供什么(可能除了关于延长或强化监测的研究)。相比之下，赋权文献发展了强大的概念和理论方法，但缺乏太多的实证测试或发展。我们认为，在这两个领域都可以通过有意识地努力制定一个全国性的研究计划来促进这两个领域的积极发展，该计划的基础是富有成效的研究人员的努力。这样的研究计划将支持开发活动，这些活动产生可经经验检验的新兴理论框架，以及有助于新知识的理论驱动的研究。这些知识可能会推动公共卫生政策朝着改善精神疾病患者生活的新的、积极的方向发展。相关性(见说明)：服务研究的一个突出目标是确定以证据为基础的做法(EBP)，以帮助严重精神疾病患者实现这些结果。许多可能从EBPS和其他精神科服务中受益的人决定不去寻求他们，也不完全参与他们。服务参与可能被理解的一种方式是，根据可能从精神服务中受益但从未寻求他们的人数。

DESCRIPTION (provided by applicant): Despite evidence that suggests many psychiatric services help people with serious mental illness manage their illness and attain their life goals, some individuals who might benefit from these services opt not to participate or not to fully engage after beginning treatment. Treatment adherence is a complex and sometimes contentious concept that has been discussed for decades to explain failures to fully participate in and benefit from services. In this same time period, mental health consumers, service providers and researchers have begun to develop frameworks around concepts of empowerment, which emphasize consumer choice in treatment and services. The goal of our proposed Developing Center for Interventions and/or Services Research (DCISR) is to better understand relationships among these phenomena and to examine change strategies that enhance empowerment and adherence, which, in turn, influence participation in quality services and achievement of personally meaningful goals. Treatment adherence research has a rich empirical base which, unfortunately, offers little in terms of theory or treatment concepts (except perhaps for research on extended or intensive monitoring). The empowerment literature, by comparison, have developed a strong conceptual and theoretical approach but lack much empirical testing or development. We contend that generative, positive development in both these fields can be fostered by the intentional effort to develop a national scale research program, grounded in the efforts of productive investigators. Such a research program would support developmental activities that produce emergent theoretical frameworks that can be empirically tested, and theoretically driven research that contributes to new knowledge. Such knowledge could drive public health policy towards new, pro-active directions that improve the lives of people with mental illness. RELEVANCE (See instructions): One prominent goal of services research is to identify evidence-based practices (EBPs) that help people with serious mental illness achieve these outcomes. Many people who might benefit from EBPs and other psychiatric services decide not to seek them out or fully participate in them. One way in which service participation may be understood is in terms of the number of people who might benefit from psychiatric services but never seek them out.