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he implementation of deinstitutional-ization in the 1960s and 1970s, and the increasing ascendance of the community support system concept and the practice of psychiatric rehabilitation in the 1980s, have laid the foundation for a new 1990s vision of service delivery for people who have mental illness. Recovery from mental illness is the vision that will(More)
OBJECTIVES This study tested a psychiatric rehabilitation approach for organizing and delivering services to street-dwelling persons with severe mental illness. METHODS Street-dwelling persons with severe mental illness were randomly assigned to the experimental program (called Choices) or to standard treatment in New York City. We assessed study(More)
In the decades of the 1990s many mental health programs and the systems that fund these programs have identified themselves as recovery-oriented. A program that is grounded in a vision of recovery is based on the notion that a majority of people can grow beyond the catastrophe of a severe mental illness and lead a meaningful life in their own community.(More)
The use of seclusion and physical restraint is viewed as a practice incompatible with the vision of recovery, and its therapeutic benefit remains unsubstantiated. This Open Forum describes an initiative that began in 1999 at two crisis centers that was designed to completely eliminate the practice of seclusion and restraint. Seclusion and restraint(More)
The challenge of bridging science to service is increasingly visible in the healthcare field, with emphasis on the influence of evidence-based knowledge on both policy and practice. Since its inception more than 40 years ago, the Rehabilitation Research and Training Center (RRTC) program has provided grants for both research and training activities designed(More)
This article describes a model for integrating psychiatric rehabilitation services in a managed behavioral health care structure. Psychiatric rehabilitation and managed care are two distinct developments in the provision of mental health services that have proceeded independently though they can have compatible methods and outcomes. Descriptive detail is(More)
Many mental health systems are trying to promote the adoption of what has come to be known as evidence-based practices while incorporating a recovery vision into the services they provide. Unfortunately, much of the existing, published, research on evidence-based practices was conceived without an understanding of the recovery vision and/or implemented(More)
The relationship between symptoms and functioning of patients with bipolar disorder who were hospitalized for a manic episode was examined in a prospective study. At six-month follow-up, symptomatic outcome was clearly superior to functional outcome. Almost 80 percent of patients were symptom free or mildly symptomatic. However, only 43 percent of patients(More)
With the recognition that most psychiatric disorders are associated with severe and persisting disability and the development of effective procedures for improving the long-term outcome of patients, the term "psychiatric rehabilitation" is becoming routinely used in the mental health field. Psychiatric rehabilitation has begun to take its place as a viable,(More)
This study compared supported employment services in 2 contrasting programs: (a) Group Skills Training, a professional rehabilitation agency outside of the mental health center that provided pre-employment skills training and support in obtaining and maintaining jobs, or (b) the Individual Placement and Support (IPS) model, which integrated clinical and(More)