Weiner DA; Academy for Health Services Research and Health Policy. Meeting.
Abstr Acad Health Serv Res Health Policy Meet. 2000; 17: UNKNOWN.
Presented by: Dana Aron Weiner, Ph.D., Post-Doctoral Fellow, Institute for Health Services Research and Policy Studies, Northwestern University, 339 East Chicago Avenue, #705, Chicago, IL 60611. Tel: 312-503-0448; Fax 312-503-2936; email: dsaw@nwu.edu
Research Objective: Deinstitutionalization policies implemented in the 1960s and 1970s resulted in the transfer of many adults with severe and persistent mental illnesses (SPMI) to the community. Service providers and policy makers anticipated that this shift would provide the potential for improved quality of life (QOL) for adults with SPMI. A variety of factors have jeopardized this potential. Research suggests that adults with SPMI have lower QOL than the general population, and that QOL among adults with SPMI varies by demographic characteristics, symptoms, housing, and type of mental health treatment. This study investigated the relationships between these variables and QOL among adults with SPMI, focusing on understudied groups such as Spanish-speaking Latinos with SPMI and adults with comorbid substance use disorders and SPMI.Study Design: This study used a stratified random sample and a multi-site design. Twelve agencies were randomly sampled from a list of over 100 programs providing mental health services to adults with SPMI in Chicago. Six hundred adults with SPMI were randomly sampled from these sites. The sample was stratified on race, gender, and age. Subjects were interviewed about QOL (Quality of Life Interview; Lehman, 1988), psychiatric symptoms (Composite International Diagnostic Interview; World Health Organization, 1997), and housing. Multiple regression was used to test the relationships between the independent variables and the General Life Satisfaction subscale of the QOLI while controlling for the stratification variables.Population Studied: Adults with severe and persistent mental illnesses receiving mental health services in Chicago.Principal Findings: Individuals with SPMI and substance use disorders reported significantly lower general life satisfaction than the overall sample. Individuals residing in nursing homes reported significantly higher general life satisfaction than the overall sample. Spanish-speaking Latinos reported significantly lower quality of life than other racial/ethnic groups.Conclusions: Many adults with SPMI are disenfranchised. Individuals with SPMI and substance use disorders, young adults with SPMI, and non-English-speaking Latino adults with SPMI experience additional barriers to integration into the community. Individuals involved in communities or milieus, whether in residential, vocational, educational, or treatment settings, tend to be more satisfied than their peers who are less integrated into these settings. Implications for Policy, Delivery, or Practice: Service providers should offer programming that can penetrate these barriers and provide community linkages for young adults, adults with comorbid substance use disorders, and Spanish-speaking Latinos. Our findings suggest that it is important to provide opportunities for individuals with SPMI, especially those belonging to vulnerable and disenfranchised groups, to be involved in communities and to serve in diverse and satisfying roles. More research is needed to investigate the impact of housing on QOL for adults with SPMI, as earlier empirical evidence suggested that adults with SPMI are most satisfied in the least restrictive environment. Primary Funding Source: NIMH
Publication Types:
Keywords:
- Adult
- Chicago
- Chronic Disease
- Comorbidity
- Deinstitutionalization
- Ethnic Groups
- Housing
- Humans
- Interviews as Topic
- Life
- Mental Disorders
- Mental Health Services
- Personal Satisfaction
- Quality of Life
- Rehabilitation, Vocational
- Residence Characteristics
- Substance-Related Disorders
- ethnology
- rehabilitation
- hsrmtgs
Other ID:
UI: 102272258
From Meeting Abstracts