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Biomedical subjects

P Barreira

Publications and source records attributed to P Barreira.

10 recordsLinked to original sources
PubMed2001

Work interest as a predictor of competitive employment: policy implications for psychiatric rehabilitation.

Consumers with serious mental illness (N = 166) enrolling in two community-based mental health programs, a vocational Program of Assertive Community Treatment and a clubhouse certified by the International Center for Clubhouse Development (ICCD), were asked about their interest in work. About one third of the new enrollees expressed no interest in working. Equivalent supported employment services were then offered to all participants in each program. Stated interest in work and receipt of vocational services were statistically significant predictors of whether a person would work and how long it would take to get a job. Two thirds of those interested in work and half of those with no initial interest obtained a competitive job if they received at least one hour of vocational service. Once employed, these two groups held comparable jobs for the same length of time. These findings demonstrate the importance of making vocational services continuously available to all people with serious mental illness, and the viability of integrating these services into routine mental health care.

Adult↗
PubMed2001

A retrospective study of clubhouse-based transitional employment.

This study of clubhouse-based transitional employment (TE) examined the ability of demographic data, diagnosis, and data on TE participation to predict TE tenure and a one-year competitive employment outcome following TE among clubhouse members. Baseline data on 138 club members who participated in TE over a 6-year period were retrospectively retrieved from a computerized database and written records. Most of the jobs held by members were maintenance or production jobs; members' average tenure on TE was 131.26 days. Older members, those with a longer club membership before their last TE job, and those working more days per week had longer average tenure on TE. Average tenure was unrelated to the severity of disability. Forty-two (30.4%) members obtained competitive employment in the one year following their last TE job. Members who worked more total hours on TE were more likely to obtain competitive employment. While aspects of the TE experience predict the move to competitive employment, further studies are needed.

Adult↗
PubMed2001

The ICCD benchmarks for clubhouses: a practical approach to quality improvement in psychiatric rehabilitation.

OBJECTIVE: The study evaluated whether the average performance of clubhouses certified by the International Center for Clubhouse Development (ICCD) should be considered valid benchmarks for clubhouse programs. METHODS: A representative sample of clubhouses more than three years old that were based on the Fountain House model participated in a 1998 mail survey. To verify that ICCD certification is a valid indicator of program quality for use in setting benchmark performance rates, 71 certified and 48 noncertified programs were compared on a variety of organizational variables. RESULTS: Even though certified and noncertified clubhouses were similar in organizational structure and resources, findings from a logistic regression analysis confirmed that certified clubhouses provided a wider array of rehabilitation services and achieved higher rates of employment. CONCLUSIONS: The findings suggest that ICCD certification is a valid indicator of program quality. The ICCD has therefore proposed that the average performance of certified U.S. clubhouses in specific domains be adopted as benchmarks for organizational performance. When tailored for programs in particular regions and with specific levels of funding, the ICCD benchmarks for clubhouse performance set fair and reasonable expectations for clubhouse programs and for the design of performance contracts between departments of mental health and ICCD clubhouses.

Benchmarking↗
PubMed2000

Linking substance abuse and serious mental illness service delivery systems: initiating a statewide collaborative.

In the past, persons with serious mental illness and substance abuse often found themselves in parallel systems of care that inadequately addressed their needs. Recent advances have seen the development of an integrated approach to care for these disorders in both the public and private sectors. While some state departments of mental health have developed integrated systems of care for public sector patients, no department appears to have developed such a system for both public and private clients, and there appears to be no published journal report of a model to induce cooperation by all stakeholders. This article outlines a two-step approach by the Massachusetts Department of Mental Health to foster stakeholder cooperation in designing an integrated system of care for both public and private clients with co-occurring disorders.

Delivery of Health Care, Integrated↗
PubMed1999

The value of program certification for performance contracting.

A survey of clubhouses listed in the 1996 ICCD Clubhouse Directory provided a research sample of 80 ICCD-certified clubhouses and 88 non-certified clubhouses with which to test the discriminant validity of ICCD certification. A statistically significant logistic regression model revealed that ICCD certification status could be clearly predicted for 78% of the clubhouses in the survey sample on the basis of director-reported compliance with representative measures of the Standards for Clubhouse Programs. The predictive power of compliance with the Standards was obtained even while controlling for other organizational variables, including clubhouse age, total staff salaries, and receipt of Medicaid funding. These findings provide support for the practical utility of adopting program certification as a performance indicator in an era of managed care, as well as the specific value of relying on ICCD certification as a quality assurance indicator.

Certification↗
PubMed1984

Development of tolerance to the therapeutic effect of amantadine on akathisia.

Four patients with akathisia as a result of neuroleptic administration were treated with amantadine. Although substantial improvement occurred initially, all four patients developed tolerance to this therapeutic effect within 1 week. An increase in dosage also had only a transient effect. The rapid development of tolerance significantly limits the usefulness of amantadine in the treatment of akathisia. One patient who suffered from akathisia and drug-induced parkinsonism experienced significant attenuation of both movement disorders in response to treatment with amantadine. Although she became tolerant to the effect of amantadine on her akathisia within the first week of treatment, her parkinsonism did not recur. The possibility that these two neuroleptic-induced extrapyramidal syndromes are pharmacologically separable is discussed.

Adult↗