Search

Objective: This paper examines common barriers to IPS supported employment implementation from the perspective of various stakeholders for IPS. Stakeholders describe the strategies used within their state to minimize or eliminate those problems. Methods: Six stakeholders reported barriers they encountered while implementing IPS and strategies they found helpful in overcoming those issues. The stakeholders included two senior planners from state mental health, one senior planner from state vocational rehabilitation, a mental health agency executive director, a client advocate, and a family member advocate. Barriers examined in this paper include program fee schedules that promote the use of traditional vocational assessments, difficulties funding IPS services, practitioner attitudes that conflict with IPS principles, client and family fears regarding loss of disability benefits or increased symptoms related to a return to work, and difficulties related to effective program implementation and sustainability. Conclusions: Although many service delivery systems have barriers to IPS implementation, these can be managed or eliminated through leadership from stakeholders such as state mental health and vocational rehabilitation senior planners, client and family advocates, and agency directors. [ABSTRACT FROM AUTHOR]

Pathways' Housing First represents a radical departure from traditional programs that serve individuals experiencing homelessness and co-occurring psychiatric and substance use disorders. This paper considered two federally funded comparison studies of Pathways' Housing First and traditional programs to examine whether differences were reflected in the perspectives of frontline providers. Both quantitative analysis of responses to structured questions with closed-ended responses and qualitative analysis of open-ended responses to semistructured questions showed that Pathways providers had greater endorsement of consumer values, less endorsement of systems values, and greater tolerance for abnormal behavior that did not result in harm to others than their counterparts in traditional programs. Comparing provider perspectives also revealed an “implementation paradox;” traditional providers were inhibited from engaging consumers in treatment and services without housing, whereas Housing First providers could focus on issues other than securing housing. As programs increasingly adopt a Housing First approach, implementation challenges remain due to an existing workforce habituated to traditional services. [ABSTRACT FROM PUBLISHER]

The Recovery-Oriented Decisions for Relatives' Support (REORDER) intervention is an innovative, manualized protocol utilizing shared decision-making principles with military veterans who have serious mental illnesses to promote recovery and encourage consideration of family involvement in care. This treatment study by Dixon et al. (2014) compared REORDER to enhanced treatment as usual in a randomized design. This qualitative sub-study sought to understand the nuances of the decision-making process of including family members through in-depth interviews with veterans who were randomized to REORDER. The qualitative themes support the willingness of the interviewed veterans who have previously not included family members to situate themselves at the center of their care and deliberate through facilitated conversation, the pros and cons of involving family. REORDER brings a fresh perspective to adapting recovery principles into family-based interventions. [ABSTRACT FROM AUTHOR]