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Psychosis in public mental health

Provider perspectives on clinical relationships and barriers to the improvement of services

Bibliographic Data

ID9051362
AuthorsNev Jones (0000-0002-4177-0621, University of South Florida), Cherise Rosen (0000-0002-4667-8269, University of Illinois Chicago), Shirley Helm (Thresholds), Sheila O'Neill (Thresholds), L Davidson (0000-0003-1183-8047, Institute for Health and Recovery), Mona Shattell (0000-0002-3169-061X, Rush University)
Year2019
Volume89
Issue1
Pages95-103
Publication date2019-01-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Orthopsychiatry (JOURNAL)
Journal identifiersISSN: 0002-9432 • E-ISSN: 1939-0025
PublisherAmerican Psychological Association (APA) (PUBLISHER)
DOI10.1037/ort0000341
PMID30010365
OpenAlexW2884307839
LanguageEN
References cited5

Whereas a growing literature has sought to understand challenges involved in the dissemination and implementation of specific evidence-based practices (EBP), few studies have centered on the perspectives of front-line community providers regarding best practices, clinical ideals and barriers to quality improvement for clients with psychosis. The goal of this project was to lay a foundation for future work aimed at improving the overall quality and impact of the multifaceted services typically provided to adults with psychosis served by the public mental health system. The findings reported here draw on a series of in-depth interviews and focus groups with 34 clinicians based at multiple inner-city community mental health sites. The project was participatory and service user co-led. Analyses focus on participant's perspectives concerning optimal services for clients with psychosis and perceived barriers to improving services. Providers strongly underscored the centrality of relationship quality versus mastery of specialized techniques and of deeper experiential engagement with the subjective meaning of the experience of psychosis. Asked about barriers to quality improvement, they described both macrolevel social forces, including chronic underfunding and overreliance on manualized approaches to distress, as well as cross-cutting clinical challenges not typically captured in the literature on more specific, targeted interventions. Our discussion focuses on the implications of these findings with respect to research and quality improvement and concludes with a call to increase investment and attention to the perspectives of front-line providers and the issue of workforce and organizational capacity vis-à-vis psychosis. (PsycINFO Database Record (c) 2019 APA, all rights reserved)

Focus group · Mental health · Political science · Psychiatry · Psychological intervention · Public health · Public relations · Sociology · Workforce · Medicine · Mental Health and Patient Involvement · Mental Health and Psychiatry · Nursing · Psychology · Schizophrenia research and treatment

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Citation velocityhistorical
Highly citedNo
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