Biomedical subjects

Philip T Yanos

Publications and source records attributed to Philip T Yanos.

11 recordsLinked to original sources

PubMed2006

Beyond "Landscapes of Despair": the need for new research on the urban environment, sprawl, and the community integration of persons with severe mental illness.

The purpose of this commentary is to discuss important trends in the housing of people with severe mental illness in the past 20 years that require the attention of mental health geographers and other experts on the effects of place on mental health. Issues that are worthy of consideration in new research include: assessing the impact of place effects on community integration, the impact of sprawl, and the emergence of the independent scatter-site housing model. Possible implications of these trends for the effects of place on people with severe mental illness are discussed.

Adult↗

PubMed2006

Toward understanding the insight paradox: internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders.

Research has paradoxically linked awareness of illness to both better function outcomes and lesser hope and self-esteem. One possible explanation for these findings is that acceptance of having schizophrenia may impact outcomes differently depending on the meanings the person attaches to this acceptance, particularly whether he or she accepts stigmatizing beliefs about mental illness. To explore this possibility we performed a cluster analysis of 75 persons with schizophrenia spectrum disorders based on single measures of insight using the Positive and Negative Syndrome Scale, internalized stigma using the Internalized Stigma of Mental Illness Scale, and compared groups on concurrent assessments of hope and self-esteem. Three groups were produced by the cluster analyses: low in sight/mild stigma (n = 23), high insight/minimal stigma (n = 25), and high insight/moderate stigma (n = 27). As predicted, analysis of variance-comparing groups revealed that the high insight/moderate stigma group had significantly the lowest levels of hope on the Beck Hopelessness Scale and self-esteem using the Multidimensional Self-esteem Inventory. As predicted, the high insight/minimal stigma group also had significantly less impaired social function than the other groups. Implications for assisting persons to come to cope with awareness of illness and stigma are discussed.

Adaptation, Psychological↗

PubMed2006

Coping with psychosis: an integrative developmental framework.

One important way in which persons with severe mental illness, such as schizophrenia, can influence the recovery process is by coping with the profoundly negative effects of mental illness. Despite accumulating evidence on the active role of the person in his or her recovery, there remains much conceptual confusion regarding the nature and categorization of the concept of coping. The present article constructs a clinically useful framework of coping that describes parallel and consecutive types of coping processes by applying Schwarzer's proactive coping theory to severe mental illness. Four coping modes including reactive, anticipatory, preventive, and proactive are described, and the role of meaning making is elaborated on as an integrative framework. Future research can be directed at validating the presented model and investigating the relationship between these types of coping and other relevant dimensions such as symptoms, functioning, and recovery.

Adaptation, Psychological↗

PubMed2006

The patient-oriented clinician-researcher: advantages and challenges of being a double agent.

The number of clinically trained individuals who perform research is declining. Although it is often observed that the clinician-researcher is necessary, the reasons are rarely discussed. In this article, the authors critically consider the complexities of the role of the patient-oriented clinician-researcher at the interface of behavioral health treatment and research. The authors note that patient-oriented clinician-researchers can serve as effective "bridgers" between the research and practice communities and can facilitate both the development of clinically relevant research and the dissemination of evidence-based treatments into routine clinical services. However, care needs to be taken to address the potential for ethical and role conflicts. Programs can encourage trainees to become clinician-researchers by providing opportunities for them to meet with patient-oriented clinician-researchers and by including coursework that raises their awareness of ethical and role conflicts and provides them with the skills needed to be effective "bridgers."

Curriculum↗

PubMed2006

Efficacy of the team solutions program for educating patients about illness management and treatment.

OBJECTIVE: Despite the demonstrated efficacy of psychosocial approaches to schizophrenia treatment that include a psychoeducational component, such as illness management, the implementation of these approaches into routine mental health treatment has been slow. The authors sought to examine the efficacy of a comprehensive, modularized, psychoeducational program called Team Solutions, which was designed to educate patients with major mental illnesses about their illness and how to manage it. Team Solutions was chosen for study because it is available over the Internet and other venues at no cost and is used by mental health agencies across the United States and Canada. METHODS: Seventy-one persons with schizophrenia or schizoaffective disorder from three day treatment settings participated in this randomized, single-blind study. Participants were randomly assigned to attend one of two interventions: the Team Solutions intervention, which consisted of participating in a 24-week psychoeducational group focused on illness management, or treatment as usual. RESULTS: For participants who attended the experimental group, significant improvement was observed in knowledge about schizophrenia. In addition, client satisfaction was high. However, no changes were observed in symptoms or functioning. CONCLUSIONS: Results indicated that participation in the Team Solutions psychoeducational group improved participants' knowledge. However, participation in the program did not demonstrate superiority over treatment as usual with respect to secondary and tertiary outcomes, such as symptom severity, treatment adherence, and global functioning.

Adult↗

PubMed2005

Psychological Research With Administrative Data Sets: An Underutilized Strategy for Mental Health Services Research.

A key element in the identity of professional psychologists is their commitment to base practice on the best knowledge available about a problem being tackled. Although administrative data (e.g., records of provider billing and procedures) can often shed light on the dark areas of the complex U.S. health care system, psychologists make notably little use of them. Experience teaches that decisions must often be made despite the absence of "gold standard" knowledge from the well-designed, controlled studies learned in graduate school. Increased involvement of psychologists in work using administrative data can improve service provision but requires that psychologists adopt unaccustomed approaches to research. The authors discuss administrative data's strengths and limitations, recent progress made in using them, how psychologists can acquire and use low-cost information from administrative data, and examples of questions that can be answered.

Journal Article↗

PubMed2004

Community integration in the early phase of housing among homeless persons diagnosed with severe mental illness: successes and challenges.

The present investigation used qualitative methods to explore the response to housing and experience of community integration of formerly homeless individuals diagnosed with severe mental illness recently housed in both independent and staffed residential settings. Findings indicate that entering into housing after a long period of homelessness is associated with improvements in community integration for most individuals diagnosed with severe mental illness. However, for a meaningful minority, the adaptation to housing may also be associated with challenges that can complicate the integration process. Implications of findings are discussed in the context of how best to tailor programs to meet the complex needs of persons diagnosed with severe mental illness and to maximize community integration.

Adult↗

PubMed2004

Correlates of health insurance among persons with schizophrenia in a statewide behavioral health care system.

This study explored the demographic and service use correlates of insurance status among 539 persons with schizophrenia-spectrum disorders by using the administrative data set of a statewide behavioral health care system. Lack of health insurance was prevalent in the sample (20 percent) and was associated with younger age, Latino ethnicity, and male sex. Persons who did not have insurance were less likely to use a community-based service and more likely to use only crisis or emergency services than persons who had public or private insurance. The findings are consistent with the results of previous research demonstrating that lack of insurance is associated with decreased use of community-based services among persons with severe mental illness.

Adolescent↗

PubMed2003

Managed care and clinical decision-making in child and adolescent behavioral health: provider perceptions.

This study investigated how managed care affects clinical decision-making in a behavioral health care system. Providers serving children and adolescents under both managed and unmanaged care (n = 28) were interviewed about their awareness of differences between the benefit arrangements, how benefits affect clinical decision-making, outcomes and quality of care; and satisfaction with care. Quantitative and qualitative findings indicated that providers saw both advantages and disadvantages to managed care. Although most providers recognized the advantages of managed care in increasing efficiency, many were concerned that administrative pressures associated with managed care compromise service quality.

Adolescent↗

PubMed2003

A new measure of coping with symptoms for use with persons diagnosed with severe mental illness.

The purpose of the present investigation was to develop and field test a measure of coping with symptoms specifically designed for use with persons diagnosed with severe mental illness. Findings are reported on both the development of the Coping with Symptoms Checklist and the initial field trial (n = 91) conducted to examine reliability and validity. Reliability was assessed by computing coefficient alpha, and validity was assessed by examining convergent and discriminant correlations (n = 79 for many analyses). Findings suggest that the measure is a generally reliable and valid way of assessing how persons diagnosed with severe mental illness cope with their symptoms.

Adaptation, Psychological↗

PubMedDate not supplied

Aging and outpatient service use among persons with schizophrenia-spectrum disorders in a statewide behavioral healthcare system.

This investigation explored the demographic and service use correlates of age among young, midlife, and older adults diagnosed with schizophrenia-spectrum disorders (N = 513), using the administrative data set of a statewide behavioral healthcare system. More African Americans persons were represented in the younger groups (age 18-35, 36-44) than in the older group (age 45 and older). Nearly two thirds of persons with schizophrenia-spectrum disorders seeking outpatient treatment were younger than 45. With the exception of crisis/emergency department services, persons in different age groups did not differ in the amount and type of outpatient service utilized and in the likelihood of dropping out of services early. However, persons aged between 18 and 44 used significantly more crisis/emergency department services than did those aged 45 and older. The findings suggest the importance of relapse prevention for persons aged 18-44 treated in outpatient settings.

Adult↗