The Meaning and Impact of Limited Literacy for People with Serious Mental Illness

描述（由申请人提供）：尽管事实上，有限的读写能力已被发现是跨人群和健康状况的健康结果和卫生保健利用模式的有力预测因素，但有限的研究已经检查了读写能力和严重精神疾病之间的关系。增加我们对各种精神疾病患者中读写能力有限的模式和流行程度的理解，是我们理解读写能力有限对精神疾病患者生活的影响和意义的必要步骤。虽然明确阐述了“人人享有社区生活”的愿景（卫生和公众服务部，2003年），但康复和社区全面参与的障碍仍然存在。作为这样一个障碍，有限的读写能力所起的作用一直没有得到充分的研究。加深我们对读写能力有限的作用的理解，将有助于我们理解严重精神疾病（SMI）患者所经历的差异，并努力减少这些差异。这些知识还将为治疗和服务的发展提供信息，以最好地满足识字能力有限的人的需要，并最终提高精神疾病患者改善健康和支持社区充分参与的能力。本研究的目的是增加我们对使用公共城市精神卫生门诊服务的人群中有限识字率的患病率的理解，并检查告知我们理解这些关系的机制。我们将研究有限的读写能力如何影响患有严重精神疾病的人的生活。具体目标是

DESCRIPTION (provided by applicant): Despite the fact that limited literacy has been found to be a strong predictor of health outcomes and health care utilization patterns across populations and health conditions limited research has examined the relationships among literacy and serious mental illness. Increasing our understanding of the patterns and prevalence of limited literacy among people living with the full range of psychiatric disorders is a necessary step to our understanding of the impact and meaning of limited literacy in the lives of people with mental illness. While the vision of "a life in the community for all" has been clearly articulated (Department of Health and Human Services, 2003) barriers to recovery and full community participation remain. The role of limited literacy, as one such barrier, has been poorly examined. Increasing our understanding of the role of limited literacy will inform our understandings of disparities experienced by people with serious mental illness (SMI) and efforts to reduce these disparities. This knowledge will also inform the development of treatment and service provision to best meet the needs of those with limited literacy and ultimately improve the capabilities of people living with mental illness to improve health and support full community participation. The goal of this study is to increase our understanding of the prevalence of limited literacy among people using public, urban mental health outpatient services and to examine mechanisms that inform our understanding of these relationships. We will examine the ways in which limited literacy affects the lives of people living with serious mental illness. The specific aims are: Aim 1: to more fully assess the domains of literacy, including reading, aural, and numeracy, among people receiving services at public, urban outpatient mental health clinics. Aim 2: to understand the relationships, and explore mechanisms, among psychiatric disorders, limited literacy and mental health service utilization Aim 3: to examine the impact of limited literacy on the lives and recovery of people living with mental illness. The results of this study will inform and expand multiple fields of research including mental health services research, psychiatric rehabilitation and recovery, and literacy and education. In addition, these findings will provide needed knowledge to be used by those developing programs for people with mental illness and policies to promote health, wellness and participation for people with mental illness. PUBLIC HEALTH RELEVANCE: Inadequate attention has been paid to the role of limited literacy as a barrier to recovery and participation among people with serious mental illness (SMI). The proposed study, relies upon a mixed-methods, service-user informed, research design to examine the multiple domains of limited literacy among people with serious mental illness using public, urban, mental health outpatient clinics. Relationships among limited literacy (reading, aural and numeracy), psychiatric disorder, mental health service utilization and other salient mechanisms will be examined. Finally, the meaning and impact of limited literacy in the lives of people with SMI will be examined.