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Biomedical subjects

Patricia Hanrahan

Publications and source records attributed to Patricia Hanrahan.

13 recordsLinked to original sources
PubMed2006

Limitations of system integration in providing employment services for persons with mental illness.

This study assessed the influence of service systems integration on employment outcomes for persons with mental illness. A survey was sent to all 125 key program staff that worked for community mental health treatment agencies or vocational rehabilitation agencies. The survey found that referral and employment rates were low; but that these rates were related to characteristics of the interagency systems integration. Community mental health staff referred 448 individuals for employment services. Staff from vocational rehabilitation agencies accepted only 26% of these referrals and found work for just 11%; 7% were employed six months later. Also, 39% of respondents reported that the linkage agreement between their agencies was never established. This study suggests the need for more effective strategies for integrating mental health treatment and vocational rehabilitation systems.

Community Mental Health Services↗
PubMed2006

Cost-effectiveness of atypical antipsychotic medications versus conventional medication.

For almost 50 years, typical antipsychotics were the mainstay of pharmacological treatment for schizophrenia. However, during the last decade, the widespread use of expensive atypical antipsychotic medications has led to a dramatic increase in the proportion of the direct costs of schizophrenia being allocated for medications. Although there is evidence that the atypical antipsychotic clozapine may lead to cost savings in patients with refractory schizophrenia, the cost-effectiveness of the other atypical antipsychotics remains in question. Therefore, long-term randomised, prospective cost-effectiveness studies that compared an atypical to a typical antipsychotic have been reviewed in this paper. There were serious methodological problems with all the studies. In general, those that were based on efficacy trials showed an advantage for atypicals, whereas those based on effectiveness studies found the opposite. It seems that, to the extent that studies mimic real world conditions, they fail to support the cost-effectiveness of the atypical antipsychotics.

Antipsychotic Agents↗
PubMed2006

Development of a Money Mismanagement Measure and cross-validation due to suspected range restriction.

A measure of the tendency to mismanage money was developed in an evaluation of a representative payee program for individuals with serious mental illnesses. A conceptual model was composed to guide item development, and items were tested, revised, added, and rejected in three waves of data collection. Rasch analyses were used to examine measurement properties. The resulting Money Mismanagement Measure (M3) consisted of 28 items with a Rasch person reliability at .72. Restriction of range was likely responsible for the low Rasch reliability. Validity analyses supported the construct validity of the M3. Subsequently, a cross-validation study was conducted on an untreated sample not as susceptible to range restriction. The M3 produced a Rasch person reliability = .85 with good validity. The M3 fills a gap that can facilitate research in the understudied area of money mismanagement.

Cross-Sectional Studies↗
PubMed2006

Lawyers' attitudes toward involuntary treatment.

This study examined whether lawyers' attributions of responsibility for mental illnesses affect their decisions about involuntary treatment. A survey that was mailed in 2003 to Illinois lawyers involved in involuntary commitment elicited recommendations for involuntary treatment for characters presented in vignettes. The survey also sought respondents' attributions of personal responsibility for the onset and recurrence of mental illnesses. A total of 89 lawyers responded to the survey, a response rate of 48 percent. Decisions to hospitalize persons with mental illness involuntarily increased significantly with the level of risk of harm and were significantly related to attributions of responsibility for the recurrence of mental illness. Decisions to recommend involuntary medication were not related to attributions of responsibility.

Attitude↗
PubMed2005

The mothers' project for homeless mothers with mental illnesses and their children: a pilot study.

Mothers with mental illnesses, who are homeless, as well as their children, are highly vulnerable and need specialized services. This retrospective study describes the experience of the Thresholds Mothers' Project in serving 24 homeless mothers. Benchmarks suggest that the mothers and their children benefited from the program. A year after intake, 79% were still engaged in services and were all living in either independent apartments or in supportive housing. The majority of the children in their mother's care at intake were still living with them 1 year later, 77%. The Mothers' Project provides an exemplary model of how to serve this vulnerable population.

Activities of Daily Living↗
PubMed2004

Psychiatrists' attitudes toward involuntary hospitalization.

This study examined whether psychiatrists' attributions of responsibility for mental illnesses affect their decisions about involuntary hospitalization. A survey that was mailed in 2002 to members of the Illinois Psychiatric Society elicited recommendations for involuntary commitment for vignette characters. The survey also sought respondents' attributions of personal responsibility for the onset and recurrence of mental illnesses. A total of 432 psychiatrists responded to the survey. Decisions to involuntarily hospitalize persons with mental illness increased significantly with the level of risk of harm and varied significantly between psychiatric diagnoses. Attributions of responsibility were not related to commitment decisions.

Attitude of Health Personnel↗
PubMed2004

Jail linkage assertive community treatment services for individuals with mental illnesses.

Persons with mental illnesses who are released from jail or prison are at high risk of psychiatric decompensation and re-arrest. This paper describes an ACT jail linkage program for this population that won an American Psychiatric Association Gold Award (2001). Based on interviews with its first 24 participants, we illustrate how they experience factors that contribute to recidivism and decompensation. Pre- and post-data are examined to explore program outcomes. Results suggest that it is possible to identify, engage, and retain people in treatment who struggle with many risk factors. We conclude that this program should be expanded and replicated.

Adult↗
PubMed2003

Representative payeeship and mental illness: a review.

Representative Payeeship (RP) is intended to help individuals who are unable to manage disability payments appropriately to meet their basic living needs. This paper reviews the literature on whether RP is effective among individuals with mental disorders. We also review RP's mental health effects and its use as leverage in achieving behavioral goals. RP appears to be effective in helping clients meet their basic living needs; it also may decrease hospitalization and improve treatment compliance. Finally, we propose a research design to disentangle the role of clinical leverage from the more basic money-management function of RP.

Consumer Behavior↗
PubMed2003

Palliative Excellence in Alzheimer Care Efforts (PEACE): a program description.

Hospice is the standard method for providing quality end-of-life care in the United States. However, studies reveal that persons with dementia are infrequently referred to hospice, that barriers exist to increasing hospice utilization in this population, and that patients with dementia would benefit from hospice or hospice-like services earlier in the disease course. The Palliative Excellence in Alzheimer Care Efforts (PEACE) program responds to these deficiencies, striving to improve end-of-life care of persons with dementia and to integrate palliative care into the primary care of patients with dementia throughout the course of the illness. The PEACE program is a disease management model for dementia that incorporates advance planning, patient-centered care, family support, and a palliative care focus from the diagnosis of dementia through its terminal stages. PEACE is coordinated through the primary care geriatrics practice of the University of Chicago. Patients and caregivers are interviewed every 6 months for 2 years, and a postdeath interview is conducted with caregivers. These interviews assess care domains important for the optimal care of persons with dementia and their caregivers. A nurse coordinator reviews interviews and provides feedback to physicians, facilitating enhanced individual care and continuous quality improvement for the practice. Initial feedback suggests patients have adequate pain control, satisfaction with quality of care, appropriate attention to prior stated wishes, and death occurring in the patient's location of choice. Families voiced similar high marks regarding quality of care. This program demonstrates an innovative model of providing quality palliative care for dementia patients and their caregivers.

Alzheimer Disease↗
PubMed2002

Representative payee programs for persons with mental illness in Illinois.

OBJECTIVE: Representative payee programs can improve the community tenure of persons with mental illness by ensuring that their basic needs, such as housing, are met. The authors conducted a survey to assess the extent to which representative payee programs are provided by community mental health centers and the criteria used in enrolling clients in these services. METHODS: Community mental health centers under contract to the Illinois Department of Human Services participated in a census survey. Survey questions concerned provision of representative payee programs, service characteristics, and criteria for enrollment in the programs. RESULTS: Representative payee programs were directly provided by 59 percent of the 95 community mental health centers in the sample. More than a third of clients who were receiving intensive services had a representative payee. More than three times as many such clients had a representative payee when agencies provided representative payee programs directly rather than through referrals of family members. Frequently cited criteria for enrollment in a representative payee program included a lack of financial skills (89 percent), a lack of rent money (52 percent), substance abuse (50 percent), homelessness (33 percent), and frequent (37 percent) or long-term (30 percent) hospitalization. The majority of the representative payee programs (76 percent) provided this service to clients who received representative payee services under the mandate of the Social Security Administration. CONCLUSIONS: Given the high proportion of clients of agencies that directly provided representative payee services who were assigned to a representative payee, all community mental health centers that provide intensive services should also directly provide representative payee services in order to improve access to representative payee services.

Community Mental Health Centers↗
PubMed2002

Do newborn intensive care unit staff know the gender and first names of their patients?

We studied whether or not our personnel knew the gender and first names of their neonatal patients. A volunteer high-school student interviewed 18 NICU nurses without their awareness as to the true nature of the study. While asking open-ended questions, the interviewer would listen for the newborn to be correctly or incorrectly identified by gender and first name. Of the 42 newborns, incorrect gender identification was observed for six (14%) of them. The first name was unknown for 12 (29%) of the 42 infants. When combining both gender and name recognition 11 (61%) of the 18 nurses had an incorrect response for at least one of their patients. Initial day contact and infrequent parental visitations were identified as possible reasons for lack of gender and/or name awareness. Referring to neonatal patients by both their first and last names may be helpful in improving gender and name acknowledgement.

Female↗