Severe Mental Illness

Overview

Severe Mental Illness, Prevalence, & Treatment

The concept of severe mental illness refers to those disorders associated with severe symptoms and major functional impairment. Typically included in this category are illnesses such as schizophrenia, bipolar disorder, and major depression. It has been estimated that up to 5% of the American adult population suffers from these illness and there is clear evidence that they constitute one of the leading causes of disability among all healthcare problems.

Historically, there has been both public and professional pessimism about the prognosis for individuals with these disorders. However, research has revealed the many faces of recovery from severe mental illness and there is a broad and expanding array of treatments that have been proven effective.

Workforce Issues and Problems

Despite the prevalence of individuals with severe mental illness, there have been numerous problems in developing a workforce to meet their needs. Within many of the professional disciplines , the care of this population has not been of major interest to educators or trainees. Few academic training programs have provided in-depth specialty training on the treatment of individuals with severe mental illness and, not surprisingly, a small proportion of graduates pursue this area of work.

A large percentage of the care for this population is delivered in public sector settings by non-degreed or bachelor-degreed providers who have had no formal training in the diagnosis or treatment of individuals with severe mental illness. Their training is often limited to “mandatory” topics, such as infection control and restraint and seclusion. Opportunities for training among this segment of the workforce appear to have eroded over the past decade as provider organizations, under growing economic pressure, have eliminated training positions and reduced the amount of “release time” for training among staff.

Consumers and families constitute a major portion of the “workforce” for those with severe mental illness, providing considerable self-care, peer support, and care for family members. While there are innovative initiatives to strengthen the care-giving roles of consumers and families, most still receive little educational support about these illnesses and are not trained in illness self management techniques, strategies for navigating systems of care, or approaches to providing support to others. Peer support, through voluntary positions or paid employment, remains a small proportion of services available nationwide. Finally, there is the opportunity, too often missed, to engage consumers and families as educators of the workforce about the experience of illness, treatment, and recovery.

Promising Initiatives

While there are enormous concerns about workforce needs for individuals with severe mental illness, there are many promising initiatives and areas of development. Research continues to test and demonstrate the effectiveness of various treatments. The press to identify and disseminate evidence-based practices has led to greater clarity about the range of effective practices and to development of tool kits to foster their implementation. Essential workforce competencies have been identified by numerous groups, while training programs have been developed specific to this population for various professional and paraprofessional segments of the workforce. Innovative consumer and family interventions are also available, focusing on educational support, training in illness self-management, and the provision of peer support. These are but a few of the promising directions.
                   

Resources

Catalog of Clinical Training Opportunities:  Best Practices for Recovery and Improved Outcomes for People with Serious Mental Illness
A catalog of best practice initiatives that are immediately available for residency, graduate, in-service, and continuing education training, complete with contact information for training resources. Developed by the American Psychological Association Task Force on Serious Mental Illness.

Click here

Georgia Certified Peer Specialists Project
Georgia was the first state in the country to bill Medicaid for a service called "Peer Support" and train a workforce of more than 200 Certified Peer Specialists. This links to the Georgia CPS Project website.
www.gacps.org

Center for Mental Health Policy & Services Research: Standards & Competencies
A national consensus project that developed standards and competencies for effective service delivery to multiple populations, including adults with severe mental illness. To download an overview of the entire project click here:
Behavioral Health Standards and Competencies

For an overview of the entire project and links to all reports visit:
http://www.med.upenn.edu/cmhpsr/standards.html

 

 

 

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