ADHERENCE AND EMPOWERMENT: Service Participation and Meaningful Outcomes

描述（由申请人提供）：尽管有证据表明许多精神科服务可以帮助患有严重精神疾病的人控制他们的疾病并实现他们的生活目标，但一些可能从这些服务中受益的人选择不参与或在开始治疗后不完全参与。治疗依从性是一个复杂的，有时是有争议的概念，已经讨论了几十年，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，这些概念强调消费者在治疗和服务方面的选择。我们提议的干预和/或服务研究发展中心（DCISR）的目标是更好地理解这些现象之间的关系，并研究增强赋权和坚持的变革战略，这反过来又影响参与高质量服务和实现个人有意义的目标。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提供的很少（可能除了对扩展或强化监测的研究）。相比之下，授权文献已经发展了强有力的概念和理论方法，但缺乏大量的实证检验或发展。我们认为，在这两个领域中，建设性的、积极的发展可以通过有意识地努力发展一个全国性的研究项目来促进，该项目以富有成效的研究者的努力为基础。这样的研究项目将支持发展活动，这些活动可以产生可以经过经验检验的新兴理论框架，并在理论上推动有助于新知识的研究。这些知识可以推动公共卫生政策朝着新的、积极的方向发展，从而改善精神疾病患者的生活。相关性（见说明）：服务研究的一个突出目标是确定帮助严重精神疾病患者实现这些结果的循证实践（ebp）。许多可能从ebp和其他精神科服务中受益的人决定不去寻求或完全参与其中。服务参与的一种方式可能是根据可能从精神科服务中受益但从未寻求他们的人数来理解的。

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.