No description available.

No description available.

No / The use of serious games and gamification to promote learning has a long history. More recently, serious games and gamification have been used in clinical settings to promote treatment and recovery. Yet there is little evidence to support their use with populations that experience serious mental illness. A scoping review was used to answer the following research question, What is the current state of knowledge about how games and gamification are used to promote treatment of serious mental illness? Scoping reviews clarify, define, and develop conceptual boundaries within a topic area. Twenty studies were identified and reviewed by using thematic content analysis. A range of game types, formats, and technology were assessed. Six themes emerged from analysis. Serious games and the use of gamification to promote treatment have potential to engage persons with serious mental illness in game content and promote treatment outcomes. Game design that supported clear instruction, a coherent narrative, a smooth interface between mechanics and play, and service user involvement early in the process of game design were important for the successful promotion of engagement and learning. Games reviewed offered the opportunity for problem solving, collaboration, and goal-oriented activity that supported the delivery of therapeutic outcomes. The use of serious games and gamification to promote treatment of serious mental illness had high levels of feasibility and acceptability among both users and providers. The potential treatment value of games, however, is dependent on key features related to the games’ design, operation, and rationale.

Background Type 2 diabetes mellitus (T2DM) and serious mental illness involves major public health problems in the world. People with severe mental illness have an increased risk of metabolic abnormalities and obesity, leading to an increased incidence for T2DM. District nurses with advanced training in diabetes care will in their profession give support to lifestyle changes and healthy living habits. Aim The purpose of this study was to illuminate district nurses´ experience of how they can support people with T2DM and serious mental illness.Method A qualitative methodology based on individual interviews analyzed with qualitative content analysis was used. Twelve informants were part of the study. Results The individual meeting with mutual relations and respect for individuals was important. During periods of worsening mental health of the patient, the district nurses provide support and monitoring, adjusted to the patients' ability. The district nurses felt inadequacy and frustration when the patients' physical and mental health were deteriorating. The strategy was to acknowledge progress when small improvements were made and extended contacts with nurses in out-patient psychiatry were requested. Conclusion Support was designed as respectful treatments and individual meetings were prioritized. District nurses' strategies were to guide the patient by positive attitudes according to the individual, and by giving support adapted to the needs of the patient. Despite feelings of insufficiency the district nurses never gave up and conveyed the message to never let go. Cooperation and extended contact with open psychiatry were desirable to exchange knowledge, giving accordance in decisions and messages.

The purpose of this qualitative study was to understand the meaning of formerly homeless Veteran’s male relationships to better understand their participation in intervention programs relying on interpersonal support. Interpretive phenomenological analysis was used to interpret five semi-structured interviews with previously homeless Veterans between the ages of 45-65 with serious mental illness. These men were participating in a peer-support based housing program. Analysis yielded the following five major themes and fourteen subordinate themes: Internalized Role Conflict i) internal conflict, Masculinity as a Barrieri) restricted emotions between men, ii) pride, iii) dominance, and iv) fear of other men, Building Supportive Relationships between Men i) negotiating masculinity, and ii) balancing power in men’s relationships, Experience Accepting Support i) de-shaming, ii) emotional relief, and iii) insight. Experience Giving Support i) strengthen self by supporting other man, and ii) use personal experience to support other men. Implications for providers and programs are discussed, as well as areas for future research.

Since de-institutionalization, numerous community based treatment modalities have been implemented to provide treatment for individuals diagnosed as seriously and persistently mentally ill. CTOs are a recent addition to the community mental health care system designed to provide outpatient mental health services to seriously mentally ill clients and using legal mechanisms to enforce a contractual obligation to participate in those services. Although there is a growing body of literature on CTOs and other mandated outpatient treatment programs for people diagnosed with mental illnesses, the research predominantly focuses on the perspectives of service providers and family members. Little attention has been given to how clients view the experience of receiving the treatment and no attention has been given to the experience of clients who are of ethno-racial minority background. As Ontario is a racially and ethnically diverse environment in which many people of minority backgrounds are placed on CTOs. This study, utilizing a phenomenological methodology, interviewed twenty-four participants of ethno-racial minority background who are either on CTOs or have been on a CTO in the past. The focus of the study was to explore the views and lived experience of the participants regarding the treatment. The outcome of the study showed that the participants did not experience the treatment as racially motivated but felt it was necessary and beneficial. The participants discussed the impact of power in the treatment process. Implications of the study were that it would enhance the mental health literature by providing an understanding of serious mental illness among individuals of ethno-racial minority background. The study would provide insight for policy makers and practitioners on providing effective support for the marginalized.

Since de-institutionalization, numerous community based treatment modalities have been implemented to provide treatment for individuals diagnosed as seriously and persistently mentally ill. CTOs are a recent addition to the community mental health care system designed to provide outpatient mental health services to seriously mentally ill clients and using legal mechanisms to enforce a contractual obligation to participate in those services. Although there is a growing body of literature on CTOs and other mandated outpatient treatment programs for people diagnosed with mental illnesses, the research predominantly focuses on the perspectives of service providers and family members. Little attention has been given to how clients view the experience of receiving the treatment and no attention has been given to the experience of clients who are of ethno-racial minority background. As Ontario is a racially and ethnically diverse environment in which many people of minority backgrounds are placed on CTOs. This study, utilizing a phenomenological methodology, interviewed twenty-four participants of ethno-racial minority background who are either on CTOs or have been on a CTO in the past. The focus of the study was to explore the views and lived experience of the participants regarding the treatment. The outcome of the study showed that the participants did not experience the treatment as racially motivated but felt it was necessary and beneficial. The participants discussed the impact of power in the treatment process. Implications of the study were that it would enhance the mental health literature by providing an understanding of serious mental illness among individuals of ethno-racial minority background. The study would provide insight for policy makers and practitioners on providing effective support for the marginalized.

Rationale: Consumers of the mental health system with serious mental illness have been deprived of meaningful occupations since de-institutionalization began in the late 20th century.Community mental health policy has failed to focus on the meaningful occupational lives of this group of service users. Given the disparity in activity and meaningful time use for people with serious mental illness when compared to the general population, it is clear that a treatment that draws attention to occupational balance and engagement is needed. As balanced time use has been shown to increase community adjustment and life satisfaction, it is an important area of focus. Objectives: The purpose of this study was to pilot test the efficacy of a new occupational time use intervention, provisionally titled “Action over Inertia,” designed to increase occupational balance and engagement in the lives of people with serious mental illness living in the community. Methods: A prospective, multi-centre randomized controlled trial of the intervention, involving 5 Assertive Community Treatment (ACT) teams in southeastern Ontario,ran in Fall 2007/Winter 2008. 18 ACT clients took part in the 12 week intervention, which was delivered by the ACT team occupational therapists. Results: Time use, used as a measure of occupational balance, shifted away from sleep to increased general activity in the treatment group(p=0.05). Treatment and control groups did not differ on occupational engagement measures after the completion of the trial. Feedback on the clinical utility of the intervention was very positive from both therapists and treatment participants. Conclusions: This pilot test revealed initially positive data on the efficacy and clinical utility of the intervention.Further study of the “Action over Inertia” intervention is needed on a larger scale, potentially with a longer treatment timeline to further investigate its usefulness. / Thesis (Master, Rehabilitation Science) -- Queen's University, 2008-09-22 14:36:47.279

People with serious mental illness are genetically predisposed to diabetes. Their risk is heightened with the use of atypical antipsychotic medications. Contextual conditions also influence diabetes care and outcomes. There is a lack of research on diabetes care for the mentally ill in residential care facilities. Therefore, there is little understanding of the social relations that contribute to this group’s health disparities. Institutional ethnography was chosen to explore this phenomenon in a group of 26 women in a rural for-profit group home in southern Ontario. Work activities of residents and providers were examined to map out the social organization of health inequities. Interviewees included residents with diabetes, care providers, field workers, and health professionals. Observations and analysis of coordinating texts were further methods used to reveal disjunctures between discourses embedded within diabetes care guidelines and the actualities of living within imposed constraints of group home care. The overarching State interest in cost containment creates rationing that limits the care afforded residents, resulting in poor dietary intake and lack of quality of life opportunities. Further, group home policies regulate systems of safety, reporting, and financial accountability, but do not promote health. The medical and psychiatric divide also contributes to health disparities. Diabetes care provision supports ‘self-care,’ which is challenging for this group, and health providers lack understanding of contextual constraints. Combined, these social circumstances perpetuate disease development and make illness management difficult. These findings warrant the need for State financial support and policy changes that give primacy to illness prevention, health promotion, and medical management so the mentally ill can realize health and wellbeing. A linkage between mental and physical health care is also crucial. Further, health providers are urged to be critical of social ideologies that sustain health inequalities, and to deliver services that are sensitive to unique particularities.

People with serious mental illness are genetically predisposed to diabetes. Their risk is heightened with the use of atypical antipsychotic medications. Contextual conditions also influence diabetes care and outcomes. There is a lack of research on diabetes care for the mentally ill in residential care facilities. Therefore, there is little understanding of the social relations that contribute to this group’s health disparities. Institutional ethnography was chosen to explore this phenomenon in a group of 26 women in a rural for-profit group home in southern Ontario. Work activities of residents and providers were examined to map out the social organization of health inequities. Interviewees included residents with diabetes, care providers, field workers, and health professionals. Observations and analysis of coordinating texts were further methods used to reveal disjunctures between discourses embedded within diabetes care guidelines and the actualities of living within imposed constraints of group home care. The overarching State interest in cost containment creates rationing that limits the care afforded residents, resulting in poor dietary intake and lack of quality of life opportunities. Further, group home policies regulate systems of safety, reporting, and financial accountability, but do not promote health. The medical and psychiatric divide also contributes to health disparities. Diabetes care provision supports ‘self-care,’ which is challenging for this group, and health providers lack understanding of contextual constraints. Combined, these social circumstances perpetuate disease development and make illness management difficult. These findings warrant the need for State financial support and policy changes that give primacy to illness prevention, health promotion, and medical management so the mentally ill can realize health and wellbeing. A linkage between mental and physical health care is also crucial. Further, health providers are urged to be critical of social ideologies that sustain health inequalities, and to deliver services that are sensitive to unique particularities.