PubMed Health⌕ Search

Biomedical subjects

Charles A Rapp

Publications and source records attributed to Charles A Rapp.

9 recordsLinked to original sources
PubMed2005

Recovery principles and evidence-based practice: essential ingredients of service improvement.

The two of the most commonly advocated service improvement proposals for adults with severe mental illnesses are to redesign services based on recovery principles and to increase the availability of services with strong research support. The two improvement strategies complement and inform each other much more than they conflict. To improve, the field needs the insights of people who have personally experienced severe mental illnesses and it needs the scientific process. Applied together, the two strategies can guide the development of an optimal service system: The kind of service system that most people would want for themselves or their family should they have the need.

Adult↗
PubMed2004

How evidence-based practices contribute to community integration.

Since the groundbreaking work of the Robert Wood Johnson Conference in 1998 identifying six evidence-based practices (EBPs) for people with severe mental illness (SMI), the mental health field has moved in the direction of re-examination and redesign of service systems. Surprisingly, one area that has not been fully explicated is the role that EBPs play in promoting community integration. In this paper, we explain how community integration is a unifying concept providing direction and vision for community mental health for people with SMI. As one crucial aspect of the recovery process, community integration clarifies the link between EBPs and recovery. We propose an alternate view, grounded in the empirical literature, to the assertion by Anthony, Rogers, and Farkas [2003, Community Mental Health Journal, 39, 101-114] that "EBP research has rarely demonstrated a positive impact on recovery related outcomes."

Community Mental Health Centers↗
PubMed2004

The principles of effective case management of mental health services.

This paper identifies ten principles or active ingredients of case management that are common to interventions that produced statistically significant positive outcomes for people with serious psychiatric disabilities. Twenty-two studies employing experimental or quasi-experimental designs were selected for inclusion in this review. The use of the principles for systems design is briefly discussed. The term case management is used throughout this article because it is the term that is used in the studies reviewed. We acknowledge that this term is considered pejorative to many people with psychiatric disabilities. People with psychiatric disabilities are not "cases" and they do not need to be "managed." A more accurate reflection of what this service entails is that it is the services or resources that are managed in order to help people reach their goals. Until a more appropriate title becomes globally recognized, the term should be used with sensitivity to the negative connotations it carries.

Case Management↗
PubMed2004

Organizational factors differentiating high performing from low performing supported employment programs.

This study sought to uncover the factors that contributed to differences in competitive employment rates for adults with severe mental illness between high and low performing programs. The five programs with the highest competitive employment rates were compared to the four lowest performing programs. Using qualitative methods, researchers used site visits and in-depth interviews with program directors and supervisors, consumers, and front line staff. Using a combination of constant comparative methods and content analysis, the study found notable and consistent differences between the two groups in administrative practices and the roles of ease managers and therapists. The role of administration has been largely overlooked in the supported work literature yet it may be the administrator's efforts to shape an organizational culture that is the driving force behind the implementation of evidence-based structures and practices.

Adult↗
PubMed2003

Evidence-based practices: setting the context and responding to concerns.

After nearly 20 years of progress in general medicine, the evidence-based practice movement is becoming the central theme for mental health care reform in the first decade of 2000. Several leaders in the movement met to discuss concerns raised by six stakeholder groups: consumers, family members, practitioners, administrators, policy makers, and researchers. Recurrent themes relate to concerns regarding the limits of science, diversion of funding from valued practices, increased costs, feasibility, prior investments in other practices, and shifts in power and control. The authors recommend that all stakeholder groups be involved in further dialog and planning to ensure that practices emerge that represent the integration of the best research evidence with clinical expertise and consumer values.

Community Participation↗
PubMed2003

The Kansas Excellence in Client-Centered Supervision Program: design and initial results.

Supervisors in community support services are perceived as important to the performance of their teams or programs. Research on training as a means of improving skills has been discouraging. This paper describes a program designed to improve outcomes by providing multiple supports, including training, to CSS supervisors. Results after one year of operation are reported.

Community Mental Health Services↗
PubMed2003

Practices differentiating high-performing from low-performing supported employment programs.

This paper reports on a qualitative study designed to uncover the practices that differentiate programs producing high rates of competitive employment from those with low rates. The study found 13 differentiating practice factors in three areas: building consumer interest in working, getting a job, and maintaining a job. The congruence between these findings and current definitions of "best practice" is discussed.

Employment, Supported↗
PubMed2003

The New Hampshire financing policy.

OBJECTIVE: This study sought to describe the New Hampshire incentive financing policy and report on its results over the first seven years. METHODS: The description of the policy was based on reviewing state documents and interviews with state officials. The data were obtained from state records. RESULTS: On the targeted outcomes of employment and psychiatric hospitalization the statewide improvement was dramatic. The service system concurrently became more efficient. CONCLUSION: The results suggest the incentive financing based on client outcomes may be a potent state strategy for improving service system performance.

Health Policy↗