Stephania Hayes | University of California, Berkeley (original) (raw)

Papers by Stephania Hayes

Research paper thumbnail of Leadership and Characteristics of Nonprofit Mental Health Peer-Run Organizations Nationwide

Psychiatric Services, Apr 1, 2015

Objective-Mental health peer-run organizations are nonprofits providing venues for support and ad... more Objective-Mental health peer-run organizations are nonprofits providing venues for support and advocacy among people diagnosed as having mental disorders. It has been proposed that consumer involvement is essential to their operations. This study reported organizational characteristics of peer-run organizations nationwide and how these organizations differ by degree of consumer control. Methods-Data were from the 2012 National Survey of Peer-Run Organizations. The analyses described the characteristics of the organizations (N = 380) on five domains of nonprofit research, comparing results for organizations grouped by degree of involvement by consumers in the board of directors. Results-Peer-run organizations provided a range of supports and educational and advocacy activities and varied in their capacity and resources. Some variation was explained by the degree of consumer control. Conclusions-These organizations seemed to be operating consistently with evidence on peerrun models. The reach of peer-run organizations, and the need for in-depth research, continues to grow. Mental health peer-run organizations are community-based organizations and programs with a mission to promote recovery for people diagnosed as having mental disorders (1). There is extensive and varied research on the effectiveness of peer support in traditional mental health services (2). In addition, there is growing literature on peer support in independent peer-run organizations (3), including empirical research on how the model of peer-run organizations affects outcomes, consensus research on the key characteristics of the organizational model (4-6), and a fidelity scale developed by the Substance Abuse and Mental Health Services Administration for consumer-operated service programs (7). These organizations build social support, a protective factor for health. The organizational structure itself contributes to community building and stigma reduction by encouraging inclusive membership rather than passive acceptance of services (8,9). Members are encouraged to The authors report no financial relationships with commercial interests.

Research paper thumbnail of Consumer-run services research and implications for mental health care

Epidemiology and Psychiatric Sciences, Apr 27, 2016

Mental health consumers/survivors developed consumer-run services (CRSs) as alternatives to disem... more Mental health consumers/survivors developed consumer-run services (CRSs) as alternatives to disempowering professionally run services that limited participant self-determination. The objective of the CRS is to promote recovery outcomes, not to cure or prevent mental illness. Recovery outcomes pave the way to a satisfying life as defined by the individual consumer despite repetitive episodes of disorder. Recovery is a way of life, which through empowerment, hope, self-efficacy, minimisation of self-stigma, and improved social integration, may offer a path to functional improvement that may lead to a better way to manage distress and minimise the impact of illness episodes. 'Nothing about us without us' is the defining objective of the process activity that defines self-help. It is the giving of agency to participants. Without such process there is a real question as to whether an organisation is a legitimate CRS or simply a non-governmental organisation run by a person who claims lived experience. In considering the effectiveness of CRSs, fidelity should be defined by the extent to which the organisation's process conveys agency. Unidirectional helping often does for people what they can do for themselves, stealing agency. The consequence of the lack of fidelity in CRSs to the origins of the self-help movement has been a general finding in multisite studies of no or little difference in outcomes attributable to the consumer service. This, from the perspective of the research summarised herein, results in the mixing of programmatic efforts, some of which enhance outcomes as they are true mutual assistance programmes and some of which degrade outcomes as they are unidirectional, hierarchical, staff-directed helping efforts making false claims to providing agency. The later CRS interventions may provoke disappointment and additional failure. The indiscriminate combining of studies produces the average: no effect.

Research paper thumbnail of Skin picking behaviors: An examination of the prevalence and severity in a community sample

Journal of Anxiety Disorders, Apr 1, 2009

Body-focused repetitive behaviors (BFRBs) have recently gained attention in the psychiatric liter... more Body-focused repetitive behaviors (BFRBs) have recently gained attention in the psychiatric literature given their prevalence, considerable associated impairment (Bohne, Wilhelm, Keuthen,

Research paper thumbnail of Testing assumptions about peer support specialists’ susceptibility to stress

Psychological Services, Nov 1, 2022

Peer support specialists (PSs) have mental health recovery experience and are hired to assist oth... more Peer support specialists (PSs) have mental health recovery experience and are hired to assist others with similar challenges. This study is among the first to characterize stress among PSs, compared to data on other groups. Seven hundred and thirty-eight PSs working in U.S. mental health settings completed a cross-sectional online survey that included the Maslach Burnout Inventory, the Secondary Traumatic Stress Scale, and the Perceived Stress Scale (PSS). Participants' scores were compared with those obtained in prior samples of nonreferred adults and nonpeer clinicians. Comparisons are stratified by PSs' level of current symptoms, assessed with the Brief Symptom Inventory. As a group, PSs experienced low to moderate levels of general and work-related stress. PSs endorsed modestly lower levels of general stress (d = -.25) than a normative sample of community residents. Although PSs endorsed lower levels of secondary trauma (d = -.15) than social workers and greater emotional exhaustion (d = .13) than nonpeer clinicians, effect sizes are "smaller than small." A small subgroup (21.6%) of PSs with significant current symptoms experienced substantially greater general stress, secondary trauma, and emotional exhaustion than comparisons (d = 0.77, 1.04, and 1.12, respectively); despite having work conditions similar to other PSs respondents. Overall, PSs appear no more susceptible to general stress and work-related stress than relevant comparison groups of community residents and clinicians. A small subgroup of PSs experience both significant stress and symptoms-as is the case in other populations, given the well-established association between these constructs. Implications for supporting PSs and other clinicians with periods of work stress are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Research paper thumbnail of Consumer-run services research and implications for mental health care

Epidemiology and Psychiatric Sciences, 2016

Mental health consumers/survivors developed consumer-run services (CRSs) as alternatives to disem... more Mental health consumers/survivors developed consumer-run services (CRSs) as alternatives to disempowering professionally run services that limited participant self-determination. The objective of the CRS is to promote recovery outcomes, not to cure or prevent mental illness. Recovery outcomes pave the way to a satisfying life as defined by the individual consumer despite repetitive episodes of disorder. Recovery is a way of life, which through empowerment, hope, self-efficacy, minimisation of self-stigma, and improved social integration, may offer a path to functional improvement that may lead to a better way to manage distress and minimise the impact of illness episodes. ‘Nothing about us without us’ is the defining objective of the process activity that defines self-help. It is the giving of agency to participants. Without such process there is a real question as to whether an organisation is a legitimate CRS or simply a non-governmental organisation run by a person who claims liv...

Research paper thumbnail of Leadership and Characteristics of Nonprofit Mental Health Peer-Run Organizations Nationwide

Psychiatric Services, 2015

Mental health peer-run organizations are nonprofits providing venues for support and advocacy amo... more Mental health peer-run organizations are nonprofits providing venues for support and advocacy among people diagnosed as having mental disorders. It has been proposed that consumer involvement is essential to their operations. This study reported organizational characteristics of peer-run organizations nationwide and how these organizations differ by degree of consumer control. Methods: Data were from the 2012 National Survey of Peer-Run Organizations. The analyses described the characteristics of the organizations (N5380) on five domains of nonprofit research, comparing results for organizations grouped by degree of involvement by consumers in the board of directors. Results: Peer-run organizations provided a range of supports and educational and advocacy activities and varied in their capacity and resources. Some variation was explained by the degree of consumer control. Conclusions: These organizations seemed to be operating consistently with evidence on peer-run models. The reach of peer-run organizations, and the need for in-depth research, continues to grow.

Research paper thumbnail of Fear of Adverse Treatment Experiences Scale

Research paper thumbnail of Testing assumptions about peer support specialists’ susceptibility to stress

Research paper thumbnail of The utility of outpatient commitment: Reduced-risks of victimization and crime perpetration

European Psychiatry

Background:Outpatient civil commitment (OCC) provisions, community treatment orders (CTOs) in Aus... more Background:Outpatient civil commitment (OCC) provisions, community treatment orders (CTOs) in Australia and Commonwealth nations, are part of mental health law worldwide.This study considers whether and by what means OCC provides statutorily required “needed-treatment” addressing two aspects of its legal mandate to protect the safety of self (exclusive of deliberate-self-harm) and others.Method:Over a 12.4-year period, records of hospitalized-psychiatric-patients, 11,424 with CTO-assignment and 16,161 without CTO-assignment were linked to police-records. Imminent-safety-threats included perpetrations and victimizations by homicides, rapes, assaults/abductions, and robberies. “Need for treatment” determinations were validated independently by Health of the Nations Scale (HoNOS) severity-score-profiles. Logistic regressions, with propensity-score- adjustment and control for 46 potential confounding-factors, were used to evaluate the association of CTO-assignment with occurrence-risk o...

Research paper thumbnail of The utility of outpatient commitment: acute medical care access and protecting health

Social psychiatry and psychiatric epidemiology, 2018

This study considers whether, in an easy access single-payer health care system, patients placed ... more This study considers whether, in an easy access single-payer health care system, patients placed on outpatient commitment-community treatment orders (CTOs) in Victoria Australia-are more likely to access acute medical care addressing physical illness than voluntary patients with and without severe mental illness. For years 2000 to 2010, the study compared acute medical care access of 27,585 severely mentally ill psychiatrically hospitalized patients (11,424 with and 16,161 without CTO exposure) and 12,229 never psychiatrically hospitalized outpatients (individuals with less morbidity risk as they were not considered to have severe mental illness). Logistic regression was used to determine the influence of the CTO on the likelihood of receiving a diagnosis of physical illness requiring acute care. Validating their shared and elevated morbidity risk, 53% of each hospitalized cohort accessed acute care compared to 32% of outpatients during the decade. While not under mental health sys...

Research paper thumbnail of The Utility of Outpatient Commitment: II. Mortality Risk and Protecting Health, Safety, and Quality of Life

Psychiatric services (Washington, D.C.), 2017

This study assessed the contribution of a form of outpatient commitment-community treatment order... more This study assessed the contribution of a form of outpatient commitment-community treatment orders (CTOs)-to mortality risk and quality of life of patients with severe mental illness. Data (2000--2012) were obtained from the Australian National Death Index, Victoria Department of Health, Victoria police records, and National Outcomes and CaseMix Collection quality-of-life records for patients in the Victorian Psychiatric Case Register/RAPID with a history of psychiatric hospitalization: CTO cohort, N=11,424; non-CTO cohort, N=16,161. The contribution of CTOs to mortality risk associated with CTO facilitation of access to general medical care and prevention of criminal involvement was assessed with logistic regression models. Cohort differences in quality of life were also examined. A total of 2,727 patients (10%) in the overall sample died, and the sample had a higher mortality risk than the general population. Probability of death by any cause was 9% lower in the CTO cohort than in...

Research paper thumbnail of The Utility of Outpatient Commitment: I. A Need for Treatment and a Least Restrictive Alternative to Psychiatric Hospitalization

Psychiatric services (Washington, D.C.), 2017

This study examined whether psychiatric patients assigned to community treatment orders (CTOs), o... more This study examined whether psychiatric patients assigned to community treatment orders (CTOs), outpatient commitment in Victoria, Australia, have a greater need for treatment to protect their health and safety than patients not assigned to CTOs. It also considered whether such treatment is provided in a least restrictive manner-that is, in a way that contributes to reduced use of psychiatric hospitalization. The sample included 11,424 patients first placed on a CTO between 2000 and 2010, and 16,161 patients not placed on a CTO. Need for treatment was independently assessed with the Health of the Nation Outcome Scales (HoNOS) at hospital admission and at discharge. Ordinary least-squares and Poisson regressions were used to assess savings in hospital days attributable to CTO placement. HoNOS ratings indicated that at admission and discharge, the CTO cohort's need for treatment exceeded that of the non-CTO cohort, particularly in areas indicating potential dangerous behavior. Whe...

Research paper thumbnail of Fear of Adverse Mental Health Treatment Experiences: Initial Psychometric Properties of a Brief Self-Report Measure

Psychological Assessment, 2016

Research paper thumbnail of The Utility of Outpatient Commitment: II. Mortality Risk and Protecting Health, Safety, and Quality of Life

Psychiatric services (Washington, D.C.), 2017

This study assessed the contribution of a form of outpatient commitment-community treatment order... more This study assessed the contribution of a form of outpatient commitment-community treatment orders (CTOs)-to mortality risk and quality of life of patients with severe mental illness. Data (2000--2012) were obtained from the Australian National Death Index, Victoria Department of Health, Victoria police records, and National Outcomes and CaseMix Collection quality-of-life records for patients in the Victorian Psychiatric Case Register/RAPID with a history of psychiatric hospitalization: CTO cohort, N=11,424; non-CTO cohort, N=16,161. The contribution of CTOs to mortality risk associated with CTO facilitation of access to general medical care and prevention of criminal involvement was assessed with logistic regression models. Cohort differences in quality of life were also examined. A total of 2,727 patients (10%) in the overall sample died, and the sample had a higher mortality risk than the general population. Probability of death by any cause was 9% lower in the CTO cohort than in...

Research paper thumbnail of Leadership and Characteristics of Nonprofit Mental Health Peer-Run Organizations Nationwide

Objective: Mental health peer-run organizations are nonprofits providing venues for support and a... more Objective:
Mental health peer-run organizations are nonprofits providing venues for support and advocacy among people diagnosed as having mental disorders. It has been proposed that consumer involvement is essential to their operations. This study reported organizational characteristics of peer-run organizations nationwide and how these organizations differ by degree of consumer control.

Methods:
Data were from the 2012 National Survey of Peer-Run Organizations. The analyses described the characteristics of the organizations (N=380) on five domains of nonprofit research, comparing results for organizations grouped by degree of involvement by consumers in the board of directors.

Results:
Peer-run organizations provided a range of supports and educational and advocacy activities and varied in their capacity and resources. Some variation was explained by the degree of consumer control.

Conclusions:
These organizations seemed to be operating consistently with evidence on peer-run models. The reach of peer-run organizations, and the need for in-depth research, continues to grow.

Research paper thumbnail of Skin Picking Behaviors: An Examination of the Prevalence and Severity In a Community Sample

Journal of anxiety disorders, Jan 1, 2009

Research paper thumbnail of Leadership and Characteristics of Nonprofit Mental Health Peer-Run Organizations Nationwide

Psychiatric Services, Apr 1, 2015

Objective-Mental health peer-run organizations are nonprofits providing venues for support and ad... more Objective-Mental health peer-run organizations are nonprofits providing venues for support and advocacy among people diagnosed as having mental disorders. It has been proposed that consumer involvement is essential to their operations. This study reported organizational characteristics of peer-run organizations nationwide and how these organizations differ by degree of consumer control. Methods-Data were from the 2012 National Survey of Peer-Run Organizations. The analyses described the characteristics of the organizations (N = 380) on five domains of nonprofit research, comparing results for organizations grouped by degree of involvement by consumers in the board of directors. Results-Peer-run organizations provided a range of supports and educational and advocacy activities and varied in their capacity and resources. Some variation was explained by the degree of consumer control. Conclusions-These organizations seemed to be operating consistently with evidence on peerrun models. The reach of peer-run organizations, and the need for in-depth research, continues to grow. Mental health peer-run organizations are community-based organizations and programs with a mission to promote recovery for people diagnosed as having mental disorders (1). There is extensive and varied research on the effectiveness of peer support in traditional mental health services (2). In addition, there is growing literature on peer support in independent peer-run organizations (3), including empirical research on how the model of peer-run organizations affects outcomes, consensus research on the key characteristics of the organizational model (4-6), and a fidelity scale developed by the Substance Abuse and Mental Health Services Administration for consumer-operated service programs (7). These organizations build social support, a protective factor for health. The organizational structure itself contributes to community building and stigma reduction by encouraging inclusive membership rather than passive acceptance of services (8,9). Members are encouraged to The authors report no financial relationships with commercial interests.

Research paper thumbnail of Consumer-run services research and implications for mental health care

Epidemiology and Psychiatric Sciences, Apr 27, 2016

Mental health consumers/survivors developed consumer-run services (CRSs) as alternatives to disem... more Mental health consumers/survivors developed consumer-run services (CRSs) as alternatives to disempowering professionally run services that limited participant self-determination. The objective of the CRS is to promote recovery outcomes, not to cure or prevent mental illness. Recovery outcomes pave the way to a satisfying life as defined by the individual consumer despite repetitive episodes of disorder. Recovery is a way of life, which through empowerment, hope, self-efficacy, minimisation of self-stigma, and improved social integration, may offer a path to functional improvement that may lead to a better way to manage distress and minimise the impact of illness episodes. 'Nothing about us without us' is the defining objective of the process activity that defines self-help. It is the giving of agency to participants. Without such process there is a real question as to whether an organisation is a legitimate CRS or simply a non-governmental organisation run by a person who claims lived experience. In considering the effectiveness of CRSs, fidelity should be defined by the extent to which the organisation's process conveys agency. Unidirectional helping often does for people what they can do for themselves, stealing agency. The consequence of the lack of fidelity in CRSs to the origins of the self-help movement has been a general finding in multisite studies of no or little difference in outcomes attributable to the consumer service. This, from the perspective of the research summarised herein, results in the mixing of programmatic efforts, some of which enhance outcomes as they are true mutual assistance programmes and some of which degrade outcomes as they are unidirectional, hierarchical, staff-directed helping efforts making false claims to providing agency. The later CRS interventions may provoke disappointment and additional failure. The indiscriminate combining of studies produces the average: no effect.

Research paper thumbnail of Skin picking behaviors: An examination of the prevalence and severity in a community sample

Journal of Anxiety Disorders, Apr 1, 2009

Body-focused repetitive behaviors (BFRBs) have recently gained attention in the psychiatric liter... more Body-focused repetitive behaviors (BFRBs) have recently gained attention in the psychiatric literature given their prevalence, considerable associated impairment (Bohne, Wilhelm, Keuthen,

Research paper thumbnail of Testing assumptions about peer support specialists’ susceptibility to stress

Psychological Services, Nov 1, 2022

Peer support specialists (PSs) have mental health recovery experience and are hired to assist oth... more Peer support specialists (PSs) have mental health recovery experience and are hired to assist others with similar challenges. This study is among the first to characterize stress among PSs, compared to data on other groups. Seven hundred and thirty-eight PSs working in U.S. mental health settings completed a cross-sectional online survey that included the Maslach Burnout Inventory, the Secondary Traumatic Stress Scale, and the Perceived Stress Scale (PSS). Participants' scores were compared with those obtained in prior samples of nonreferred adults and nonpeer clinicians. Comparisons are stratified by PSs' level of current symptoms, assessed with the Brief Symptom Inventory. As a group, PSs experienced low to moderate levels of general and work-related stress. PSs endorsed modestly lower levels of general stress (d = -.25) than a normative sample of community residents. Although PSs endorsed lower levels of secondary trauma (d = -.15) than social workers and greater emotional exhaustion (d = .13) than nonpeer clinicians, effect sizes are "smaller than small." A small subgroup (21.6%) of PSs with significant current symptoms experienced substantially greater general stress, secondary trauma, and emotional exhaustion than comparisons (d = 0.77, 1.04, and 1.12, respectively); despite having work conditions similar to other PSs respondents. Overall, PSs appear no more susceptible to general stress and work-related stress than relevant comparison groups of community residents and clinicians. A small subgroup of PSs experience both significant stress and symptoms-as is the case in other populations, given the well-established association between these constructs. Implications for supporting PSs and other clinicians with periods of work stress are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Research paper thumbnail of Consumer-run services research and implications for mental health care

Epidemiology and Psychiatric Sciences, 2016

Mental health consumers/survivors developed consumer-run services (CRSs) as alternatives to disem... more Mental health consumers/survivors developed consumer-run services (CRSs) as alternatives to disempowering professionally run services that limited participant self-determination. The objective of the CRS is to promote recovery outcomes, not to cure or prevent mental illness. Recovery outcomes pave the way to a satisfying life as defined by the individual consumer despite repetitive episodes of disorder. Recovery is a way of life, which through empowerment, hope, self-efficacy, minimisation of self-stigma, and improved social integration, may offer a path to functional improvement that may lead to a better way to manage distress and minimise the impact of illness episodes. ‘Nothing about us without us’ is the defining objective of the process activity that defines self-help. It is the giving of agency to participants. Without such process there is a real question as to whether an organisation is a legitimate CRS or simply a non-governmental organisation run by a person who claims liv...

Research paper thumbnail of Leadership and Characteristics of Nonprofit Mental Health Peer-Run Organizations Nationwide

Psychiatric Services, 2015

Mental health peer-run organizations are nonprofits providing venues for support and advocacy amo... more Mental health peer-run organizations are nonprofits providing venues for support and advocacy among people diagnosed as having mental disorders. It has been proposed that consumer involvement is essential to their operations. This study reported organizational characteristics of peer-run organizations nationwide and how these organizations differ by degree of consumer control. Methods: Data were from the 2012 National Survey of Peer-Run Organizations. The analyses described the characteristics of the organizations (N5380) on five domains of nonprofit research, comparing results for organizations grouped by degree of involvement by consumers in the board of directors. Results: Peer-run organizations provided a range of supports and educational and advocacy activities and varied in their capacity and resources. Some variation was explained by the degree of consumer control. Conclusions: These organizations seemed to be operating consistently with evidence on peer-run models. The reach of peer-run organizations, and the need for in-depth research, continues to grow.

Research paper thumbnail of Fear of Adverse Treatment Experiences Scale

Research paper thumbnail of Testing assumptions about peer support specialists’ susceptibility to stress

Research paper thumbnail of The utility of outpatient commitment: Reduced-risks of victimization and crime perpetration

European Psychiatry

Background:Outpatient civil commitment (OCC) provisions, community treatment orders (CTOs) in Aus... more Background:Outpatient civil commitment (OCC) provisions, community treatment orders (CTOs) in Australia and Commonwealth nations, are part of mental health law worldwide.This study considers whether and by what means OCC provides statutorily required “needed-treatment” addressing two aspects of its legal mandate to protect the safety of self (exclusive of deliberate-self-harm) and others.Method:Over a 12.4-year period, records of hospitalized-psychiatric-patients, 11,424 with CTO-assignment and 16,161 without CTO-assignment were linked to police-records. Imminent-safety-threats included perpetrations and victimizations by homicides, rapes, assaults/abductions, and robberies. “Need for treatment” determinations were validated independently by Health of the Nations Scale (HoNOS) severity-score-profiles. Logistic regressions, with propensity-score- adjustment and control for 46 potential confounding-factors, were used to evaluate the association of CTO-assignment with occurrence-risk o...

Research paper thumbnail of The utility of outpatient commitment: acute medical care access and protecting health

Social psychiatry and psychiatric epidemiology, 2018

This study considers whether, in an easy access single-payer health care system, patients placed ... more This study considers whether, in an easy access single-payer health care system, patients placed on outpatient commitment-community treatment orders (CTOs) in Victoria Australia-are more likely to access acute medical care addressing physical illness than voluntary patients with and without severe mental illness. For years 2000 to 2010, the study compared acute medical care access of 27,585 severely mentally ill psychiatrically hospitalized patients (11,424 with and 16,161 without CTO exposure) and 12,229 never psychiatrically hospitalized outpatients (individuals with less morbidity risk as they were not considered to have severe mental illness). Logistic regression was used to determine the influence of the CTO on the likelihood of receiving a diagnosis of physical illness requiring acute care. Validating their shared and elevated morbidity risk, 53% of each hospitalized cohort accessed acute care compared to 32% of outpatients during the decade. While not under mental health sys...

Research paper thumbnail of The Utility of Outpatient Commitment: II. Mortality Risk and Protecting Health, Safety, and Quality of Life

Psychiatric services (Washington, D.C.), 2017

This study assessed the contribution of a form of outpatient commitment-community treatment order... more This study assessed the contribution of a form of outpatient commitment-community treatment orders (CTOs)-to mortality risk and quality of life of patients with severe mental illness. Data (2000--2012) were obtained from the Australian National Death Index, Victoria Department of Health, Victoria police records, and National Outcomes and CaseMix Collection quality-of-life records for patients in the Victorian Psychiatric Case Register/RAPID with a history of psychiatric hospitalization: CTO cohort, N=11,424; non-CTO cohort, N=16,161. The contribution of CTOs to mortality risk associated with CTO facilitation of access to general medical care and prevention of criminal involvement was assessed with logistic regression models. Cohort differences in quality of life were also examined. A total of 2,727 patients (10%) in the overall sample died, and the sample had a higher mortality risk than the general population. Probability of death by any cause was 9% lower in the CTO cohort than in...

Research paper thumbnail of The Utility of Outpatient Commitment: I. A Need for Treatment and a Least Restrictive Alternative to Psychiatric Hospitalization

Psychiatric services (Washington, D.C.), 2017

This study examined whether psychiatric patients assigned to community treatment orders (CTOs), o... more This study examined whether psychiatric patients assigned to community treatment orders (CTOs), outpatient commitment in Victoria, Australia, have a greater need for treatment to protect their health and safety than patients not assigned to CTOs. It also considered whether such treatment is provided in a least restrictive manner-that is, in a way that contributes to reduced use of psychiatric hospitalization. The sample included 11,424 patients first placed on a CTO between 2000 and 2010, and 16,161 patients not placed on a CTO. Need for treatment was independently assessed with the Health of the Nation Outcome Scales (HoNOS) at hospital admission and at discharge. Ordinary least-squares and Poisson regressions were used to assess savings in hospital days attributable to CTO placement. HoNOS ratings indicated that at admission and discharge, the CTO cohort's need for treatment exceeded that of the non-CTO cohort, particularly in areas indicating potential dangerous behavior. Whe...

Research paper thumbnail of Fear of Adverse Mental Health Treatment Experiences: Initial Psychometric Properties of a Brief Self-Report Measure

Psychological Assessment, 2016

Research paper thumbnail of The Utility of Outpatient Commitment: II. Mortality Risk and Protecting Health, Safety, and Quality of Life

Psychiatric services (Washington, D.C.), 2017

This study assessed the contribution of a form of outpatient commitment-community treatment order... more This study assessed the contribution of a form of outpatient commitment-community treatment orders (CTOs)-to mortality risk and quality of life of patients with severe mental illness. Data (2000--2012) were obtained from the Australian National Death Index, Victoria Department of Health, Victoria police records, and National Outcomes and CaseMix Collection quality-of-life records for patients in the Victorian Psychiatric Case Register/RAPID with a history of psychiatric hospitalization: CTO cohort, N=11,424; non-CTO cohort, N=16,161. The contribution of CTOs to mortality risk associated with CTO facilitation of access to general medical care and prevention of criminal involvement was assessed with logistic regression models. Cohort differences in quality of life were also examined. A total of 2,727 patients (10%) in the overall sample died, and the sample had a higher mortality risk than the general population. Probability of death by any cause was 9% lower in the CTO cohort than in...

Research paper thumbnail of Leadership and Characteristics of Nonprofit Mental Health Peer-Run Organizations Nationwide

Objective: Mental health peer-run organizations are nonprofits providing venues for support and a... more Objective:
Mental health peer-run organizations are nonprofits providing venues for support and advocacy among people diagnosed as having mental disorders. It has been proposed that consumer involvement is essential to their operations. This study reported organizational characteristics of peer-run organizations nationwide and how these organizations differ by degree of consumer control.

Methods:
Data were from the 2012 National Survey of Peer-Run Organizations. The analyses described the characteristics of the organizations (N=380) on five domains of nonprofit research, comparing results for organizations grouped by degree of involvement by consumers in the board of directors.

Results:
Peer-run organizations provided a range of supports and educational and advocacy activities and varied in their capacity and resources. Some variation was explained by the degree of consumer control.

Conclusions:
These organizations seemed to be operating consistently with evidence on peer-run models. The reach of peer-run organizations, and the need for in-depth research, continues to grow.

Research paper thumbnail of Skin Picking Behaviors: An Examination of the Prevalence and Severity In a Community Sample

Journal of anxiety disorders, Jan 1, 2009