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Community Mental Health Journal
Published in: Community Mental Health Journal 7/2016

01-10-2016 | Original Paper

Why do mental health consumers who receive rehabilitation services, are not using them? A Qualitative Investigation of Users’ Perspectives in Israel

Authors: Galia S. Moran, Yael Baruch, Faissal Azaiza, Max Lachman

Published in: Community Mental Health Journal | Issue 7/2016

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Abstract

A recovery-oriented approach to mental health involves creating person centered services and enhancing engagement in psychiatric rehabilitation. Israel’s Rehabilitation in the Community of Persons with Mental Disabilities Law is a progressive initiative that shifted the locus of psychiatric care to community care supporting individualized rehabilitation and recovery-oriented processes. Yet over a quarter of applicants do not implement their assigned rehabilitation plans and services. This qualitative study investigated reasons and experiences related to lack of utilization from applicants’ perspectives. Fifteen service users were interviewed face to face in semi-structured interviews analyzed using Grounded theory approach. Seven categories emerged: (1) Lack of knowledge and orientation; (2) Negative perceptions about rehabilitation services (3) Lack of active participation/shared decision-making; (4) Not feeling heard by the committee; (5) Lack of congruence between participants’ goals and committee’s final decisions; (6) Lack of escorting professionals’ competencies; and (7) Family members’ influence. The results are interpreted at the structural and human process levels. Suggestions are provided for augmenting systemic procedures and human interactions processes.
Literature
Adams, N., & Grieder, D. (2005). Treatment planning for person-centered care: The road to mental health and addiction recovery. San Diego, California: Elsevier Academic Press.
Angell, B., & Mahoney, C. (2007). Reconceptualizing the case management relationship in intensive treatment: A study of staff perceptions and experiences. Administration and Policy in Mental Health and Mental Health Services Research, 34, 172–188.CrossRefPubMed
Anthony, W. A. (1993). Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal, 16(4), 11–23.CrossRef
Aviram, U. (2010). Promises and pitfalls on the road to a mental health reform in Israel. Israel Journal of Psychiatry and Related Sciences, 3, 171–194.
Aviram, U., Guy, D., & Sykes, I. (2007). Risk avoidance and missed opportunities in mental health reform: The case of Israel. International Journal of Law and Psychiatry, 30, 163–181.CrossRefPubMed
Belling, R., Whittock, M., McLaren, S., Burns, T., Catty, J., et al. (2011). Achieving continuity of care: Facilitators and barriers in community mental health teams. Implementation Science, BioMed Central, 6, 23.CrossRef
Bond, G. R., Campbell, K., & Becker, D. R. (2012). A test of the occupational matching hypothesis for rehabilitation clients with severe mental illness. Journal of Occupational Rehabilitation,. doi:10.​1007/​s10926-012-9388-7.
Borg, M., Karlsson, B., Tondora, J., & Davidson, L. (2009). Implementing person-centered care in psychiatric rehabilitation: What does this involve? Israeli Journal of Psychiatry and Related Sciences, 46(2), 84–93.
Boyer, C. A., McAlpine, D. D., Pottick, K. J., & Olfson, M. (2000). Identifying risk factors and key strategies in linkage to outpatient psychiatric care. American Journal of Psychiatry, 157(10), 1592–1598.CrossRefPubMed
Corrigan, P. W. (2002). Empowerment and serious mental illness: Treatment partnerships and community opportunities. Psychiatric Quarterly, 73, 217–228.CrossRefPubMed
Davidson, L., Ridgway, P., Wieland, M., & O’Connell, M. (2009a). A capabilities approach to mental health transformation: A conceptual framework for the recovery era. Canadian Journal of Community Mental Health, 28(2), 35–44.CrossRef
Davidson, L., Tondora, J., O’Connell, M. J., Kirk, T., Rockholz, P., & Evans, A. C. (2007). Creating a recovery-oriented system of behavioral health care: Moving from concept to real. Psychiatric Rehabilitation Journal, 31, 23–31.CrossRefPubMed
Davidson, L., Tondora, J., O’Connell, M. J., Lawless, M. S., & Rowe, M. (2009b). A practical guide to recovery-oriented practice: Tools for transforming mental health care. New York, N.Y.: Oxford University Press.
Deegan, P. E. (1993). Recovering our sense of value after being labeled mentally ill. Journal of Psychosocial Nursing and Mental Health Services, 31, 7–11.PubMed
Deegan, P. E. (1996). Recovery as a journey of the heart. Psychiatric Rehabilitation Journal, 19(3), 91–97.CrossRef
Denzin, N. K., & Lincoln, Y. S. (2000). Introduction: The discipline and practice of research. In N. K. Denzin & Y. S. Lincoln (Eds.), Handbook of qualitative research (2nd ed., pp. 1–28). London: Sage.
Drake, R. E. (2000). Introduction to a special series on recovery. Community Mental Health Journal, 36(2), 207–208.CrossRef
Drake, R. E., Hogan, M. F., Slade, M., & Thornicroft, G. (2011). Editorial: Commentary on Israel’s Psychiatry Rehabilitation Law. Israel Journal of Psychiatry Relations Science, 48(4), 227–229.
Farkas, M., & Anthony, W. (2009). Developing readiness: Psychiatric rehabilitation practitioners tools. Boston, MA: Boston University.
Farkas, M., & Anthony, W. (2010). Psychiatric rehabilitation interventions: A review. International Review of Psychiatry, 22(2), 114–129.CrossRefPubMed
Farkas, M., Gagne, C., Anthony, W., & Chamberlin, J. (2005). Implementing recovery oriented evidence based programs: Identifying the critical dimensions. Community Mental Health Journal, 41(2), 141–158.CrossRefPubMed
Farkas, M., Soydan, A., & Gagne, C. (2000). Introduction to rehabilitation readiness center for psychiatric rehabilitation. Sargent college of health and rehabilitation sciences. MA: Boston University.
Fischer, E. P., McCarthy, J. F., Ignacio, R. V., Blow, F. C., Barry, K. L., Hudson, T. J., et al. (2008). Longitudinal patterns of health system retention among veterans with schizophrenia or bipolar disorder. Community Mental Health Journal, 44, 321–330.CrossRefPubMed
Fischer, E. P., Shumway, M., & Owen, R. R. (2002). Priorities of consumers, providers, and family members in the treatment of schizophrenia. Psychiatric Services, 53, 724–729.CrossRefPubMed
Glaser, B., & Strauss, A. (1967). The discovery of grounded theory. New York: Aldine.
Goldman, H. H., & Frank, R. G. (2012). Beyond the trends: Policy considerations in psychiatric rehabilitation. Israel Journal of Health Policy Research, 1(25), 1–5. doi:10.​1186/​2045-4015-1-25.
Green, C., Estroff, S. E., Yarborough, B. J. H., Spofford, M., Solloway, M. R., Kitson, R. S., & Perrin, N. A. (2014). Directions for future patient-centered and comparative effectiveness research for people with serious mental illness in a learning mental health care system. Schizophrenia Bulletin, 40(Suppl 1), S1–S94. doi:10.​1093/​schbul/​sbt170.CrossRefPubMed
Green, C. A., Polen, M. R., Janoff, S. L., Castleton, D. K., Wisdom, J. P., Vuckovic, N., & Perrin, N. A. (2008). Understanding how clinician-patient relationships and relational continuity of care affect recovery from serious mental illness: STARS study results. Psychiatric Rehabilitation Journal, 32, 9–22.CrossRefPubMedPubMedCentral
Green, C. A., Wisdom, J. P., Wolfe, L., & Firemark, A. (2012). Engaging youths with serious mental illnesses in treatment: STARS study consumer recommendations. Psychiatric Rehabilitation Journal, 35(5), 360–368.CrossRefPubMedPubMedCentral
Hoge, M., Tondora, J., & Marrelli, A. F. (2005). The fundamentals of workforce competency: Implications for behavioral health. Administration and Policy in Mental Health and Mental Health Services Research, 32(5–6), 509–531.CrossRefPubMed
Hornik- Lurie, Z., Zilber, N., & Lerner, Y. (2012). Trend in the use of rehabilitation services in the community by people with mental disabilities in Israel; the factors involved. Israel Journal of Health Policy Research, 1(24), 1–26.
Hunt, M. G., & Stein, C. H. (2012). Valued social roles and measuring mental health recovery: Examining the structure of the tapestry. Psychiatric Rehabilitation Journal, 35(6), 441–446.CrossRefPubMedPubMedCentral
Israel National Council. (2009). For the Rehabilitation in the community of persons with mental disabilities, annual report, 2008–2009, In National Councils for Health, Annual Report, 2009, pp. 97–103(In Hebrew).
Kreyenbuhl, J., Nossel, I. R., & Dixon, L. B. (2009). Disengagement from mental health treatment among individuals with schizophrenia and strategies for facilitating connections to care: A review of the literature. Schizophrenia Bulletin, 35(4), 696–703. doi:10.​1093/​schbul/​sbp046.CrossRefPubMedPubMedCentral
Lecomte, T., Wallance, C. J., Perreault, M., & Caron, J. (2005). Consumer’s goals in psychiatric rehabilitation and their concordance with existing services. Psychiatric Services, 56(2), 205–211.CrossRef
Lefley, H. P., & Johnson, L. D. (2002). Family Intervention in mental illness: International perspective. Westport, CT: Praeger Publishers.
Lerner, Y., Hornik-Lurie, T., & Zilber, N. (2012). The effect of the implementation of the rehabilitation of the mentally disabled in the community law in Israel on the pattern of psychiatric hospitalizations. International Journal of Mental Health, 41(3), 45–59. doi:10.​2753/​IMH0020-7411410303.CrossRef
Lincoln, Y. S. & Guba, E. G. (1985). Naturalistic inquiry. Newbury Park, CA: Sage Publications.
Linhorst, D. M., & Eckert, A. (2003). Conditions for empowering people with severe mental illness. Social Service Review, 77(2), 279–305.CrossRef
Linhorst, D. M., Hamilton, G., Young, E., & Eckert, A. (2002). Opportunities and barriers to empowering persons with severe mental illness through participation in treatment planning. Social Work, 47(4), 425–434.CrossRefPubMed
Malinovsky, I., Lehrer, P., Silverstein, S. M., Shankman, S. A., O’Brien, W., Samuelson, T., & van Nostrand, G. (2013). An empirical evaluation of recovery transformation at a large community psychiatric rehabilitation organization. Psychological Services, 10(4), 428–441.CrossRefPubMed
Mancini, A. D. (2008). Self-determination theory: A framework for the recovery paradigm. Advanced Psychiatric Treatment, 14, 358–365.CrossRef
Matthias, M. S., Salyers, M. P., Rollins, A. L., & Frankel, R. M. (2012). Decision making in recovery-oriented mental health care. Psychiatric Rehabilitation Journal, 35(4), 305–314.CrossRefPubMedPubMedCentral
Melamed, S. (2001). Permission: A conceptual tool for treating mentally Ill patient and their families. Journal of Family Psychotherapy, 12(2), 29–42.CrossRef
Mind, (2009). Personalization in mental health: A review of the evidence. London: Mental health in Israel Statistical Annuals.
Ministry of Health. (2009). Mental Health Services in Israel. Jerusalem: Department of Information and Evaluation.
Ministry of Health. (2013). Mental health services in Israel, statistical annual 2012. Jerusalem: Department of Information and Evaluation.
Moran, G., Mashiach-Eizenberg, M., Roe, D., Berman, Y., Shalev, A., Kaplan, Z, & Epstein, P. G. (2014). Investigating the anatomy of the helping relationship in the context of psychiatric rehabilitation: The relation between working alliance, providers’ recovery competencies and personal recovery. Psychiatry Research, 220(1–2), 592–597.CrossRefPubMed
Moran, G. S., & Nemec, P. (2013). What positive psychology can contribute to psychiatric rehabilitation. Psychiatric Rehabilitation Journal, 36(3), 202–208.CrossRefPubMed
Moran, G. S., Russinova, Z., Yim, J. Y., & Sprauge, C. (2013). What drives internal motivation to work as a mental health peer provider? A qualitative study using Self-determination theory. Journal of Occupational Rehabilitation,. doi:10.​1007/​s10926-013-9440-2.
O’Brien, A., Fahmy, R., & Singh, S. P. (2009). Disengagement from mental health services: A literature review. Social Psychiatry and Psychiatric Epidemiology, 44, 558–568.CrossRefPubMed
Oades, L. G., Crow, T. P., & Nguyen, M. (2009). Leadership coaching transforming mental health systems from the inside out: The collaborative recovery model as a person centered strength based coaching psychology. International coaching psychology review, 4(1), 25–36.
Olfson, M., Mojtabai, R., Sampson, N. A., Druss, B., Wang, P. S., Wells, K. B., et al. (2009). Dropout from outpatient mental health care in the United States. Psychiatric Services, 60, 898–907.CrossRefPubMedPubMedCentral
Padgett, D. K., Henwood, B., Abrams, C., & Andrew, D. (2008). Engagement and retention in services among formerly homeless adults with co-occurring mental illness and substance abuse: Voices from the margins. Psychiatric Rehabilitation Journal, 31, 226–233.CrossRefPubMed
Palinkas, L. A., Horwitz, S. M., Green, C. A., Wisdom, J. P., Duan, N., & Hoagwood, K. (2013). Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Administration and Policy In Mental Health,. doi:10.​1007/​s10488-013-0528-y.
Patton, M. Q. (1990). Qualitative evaluation and research methods. Newbury Park: Sage Publications.
Patton, M. Q. (1999). Enhancing the quality and credibility of qualitative analysis. Health Services Research, 34(5), 1189–1204.PubMedPubMedCentral
Pratt, C. V., Gill, K. J., Barrett, N. M., & Roberts, M. M. (2007). Psychiatric rehabilitation. San Diego, CA: Academic Press.
Priebe, S., Watts, J., Chase, M., & Matanov, A. (2005). Processes of disengagement and engagement in assertive outreach patients: Qualitative study. British Journal of Psychiatry, 187, 438–443.CrossRefPubMed
Roberts, M. M., & Pratt, C. W. (2010). A Construct validity study of employment readiness in persons with severe mental illness. American Journal of Psychiatric Rehabilitation, 13(1), 40–54.CrossRef
Roe, D., Lachman, M., & Mueser, K. T. (2010). Editorial: A decade of the Israeli psychiatric rehabilitation law. Israeli Journal of Psychiatry Relations Sciences, 47(3), 164–165.
Rogers, E. S., Martin, R., Anthony, W., Massro, J., Danley, K. J., Crean, T., & Penk, W. (2001). Assessing readiness for change among persons with severe mental illness. Community Mental Health Journal, 37(2), 97–112.CrossRefPubMed
Russinova, Z., Rogers, E. S., Ellison, M. L., & Lyass, A. (2011). Recovery promoting professional competencies: Perspective of mental health consumers. Consumer-Provider and Providers. Psychiatric Rehabilitation Journal, 34(3), 177–185.CrossRef
Schwartz, R., Estein, O., Komaroff, J., Lamb, J., Myers, M., Stewart, J., et al. (2013). Mental health consumers and providers dialogue in an institutional setting: A participatory approach to promoting recovery-oriented care. Psychiatric Rehabilitation Journal, 36(2), 113–115.CrossRefPubMed
Sheldon, K. M., & Elliot, A. J. (1999). Goal striving, need, satisfaction, and longitudinal well-being: The self-concordance model. Journal of Personality and Social Psychology, 76, 482–497.CrossRefPubMed
Shershevsky, Y. (2006). Rehabilitation package of services for mentally disabled persons in the community. In U. Aviram & Y. Ginath (Eds.), Mental health services in Israel: Trends and issues (pp. 357–387). Tel-Aviv: Cherikover. (in Hebrew).
Slade, M. (2010). Mental illness and well-being: The central importance of positive psychology and recovery approaches. BMC Health services research, 10(26), 1–14.
Slade, M., Adams, N., & O’Hagan, M. (2012). Recovery: Past progress and future challenges. International Review of Psychiatry, 24, 1–4.CrossRefPubMed
Slade, M., Amering, M., Farkas, M., Hamilton, B., O’Hagan, M., Panther, G., et al. (2014). Uses and abuses of recovery: Implementing recovery-oriented practices in mental health systems. World Psychiatry, 3(1), 12–20. doi:10.​1002/​wps.​20084.CrossRef
Smith, T. E., Easter, A., Pollock, M. Gogel, Pope, L., & Wisdom, J. P. (2013). Disengagment from care: Perspectives of individuals with serious mental illness and of service providers. Psychiatric Services, 64(8), 770–775.CrossRefPubMed
Smith, T. E., Stein, B. D., Donahue, S. A., Sorbero, M. J., Karpati, A., Marsik, T., et al. (2014). Reengagement of high-need individuals with serious mental illness after discontinuation of services. Psychiatric Services,. doi:10.​1176/​appi.​ps.​201300549.
Solomon, P. (2012). Family involvement in services for individuals with mental illness. American Journal of Psychiatric Rehabilitation, 15(1), 1–4.CrossRef
Spandler, H., & Vick, N. (2006). Opportunities for independent living using direct payments in mental health. Health and Social Care in the Community, 14(2), 107–115.CrossRefPubMed
Spaniol, L. (2010). The pain and the possibility: The family recovery process. Community Mental Health Journal, 46, 482–485.CrossRefPubMed
Strauss, A., & Corbin, J. (1990). Basic of qualitative research: Grounded theory procedure and techniques. London: Sage.
Strauss, A., & Corbin, J. (1994). Grounded theory methodology. In N. K. Denzin & Y. S. Lincoln (Eds.), Handbook of qualitative research (pp. 273–283). Thousand Oaks, CA: Sage.
Struch, N., Shershevsky, Y., & Naon, D. (2009). People with severe mental disorders in Israel: An integrated view of the service system. Research report (549-09). Jerusalem, Meyers-JDCBrookdale Institute and Ministry of Health, Mental Health Services, (In Hebrew).
Tondora, J. Miller, R., Davidson, L. (2012). The top ten concerns about person-centered care planning in mental health systems. The international journal of person centered medicine, 2(3).
Walker, D., & Myrick, F. (2006). Grounded theory: An exploration of process and procedure. Qualitative Health Research, 16(4), 547–559.CrossRefPubMed
Ware, N. C., Tugenberg, T., & Dickey, B. (2004). Practitioner relationships and quality of care for low-income persons with serious mental illness. Psychiatric Services, 55, 555–559.CrossRefPubMed
Whitley, R., & Siantz, E. (2012). Recovery centers for people with a mental illness: An emerging best practice? Psychiatric Services, 63, 10–12.CrossRefPubMed
Yeaman, C., Craine, W. H., Gorsek, J., & Corrigan, P. W. (2000). Performance improvement teams for better psychiatric rehabilitation. Administration and Policy in Mental Health and Mental Health Services Research, 27(3), 113–127.CrossRefPubMed
Zayas, L. E., Curtis McMillen, J., Lee, M. Y., & Books, S. J. (2013). Challenges to quality assurance and improvement efforts in behavioral health organizations: A qualitative assessment. Administration and Policy In Mental Health, 40, 190–198. doi:10.​1007/​s10488-011-0393-5.CrossRefPubMed
Metadata
Title
Why do mental health consumers who receive rehabilitation services, are not using them? A Qualitative Investigation of Users’ Perspectives in Israel
Authors
Galia S. Moran
Yael Baruch
Faissal Azaiza
Max Lachman
Publication date
01-10-2016
Publisher
Springer US
Published in
Community Mental Health Journal / Issue 7/2016
Print ISSN: 0010-3853
Electronic ISSN: 1573-2789
DOI
https://doi.org/10.1007/s10597-015-9905-1

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