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Mayview Discharge Study. University of Pittsburgh. The Pitt Study. Goals of this presentation Recap findings Identify and focus on potential areas for improvement. Methods. 65 people (75% of a random sample) participated in a two-year follow up study of:

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mayview discharge study

Mayview Discharge Study

University of Pittsburgh

the pitt study
The Pitt Study
  • Goals of this presentation
    • Recap findings
    • Identify and focus on potential areas for improvement
methods
Methods
  • 65 people (75% of a random sample) participated in a two-year follow up study of:
    • Standardized assessments of major indicators of quality of life and recovery
    • Qualitative observations and interviews
  • We met with people every three months
    • 45-50 participants at each time point
  • 225 standardized assessments and 138 “check-ins” over two years
major qualitative findings
Major qualitative findings
  • Participants like their new residences and were comfortable with the discharge process
  • With new-found freedom, a few people get in trouble
  • Many people have staff as their primary contacts, and some find their lives rather monotonous
  • Housing is an on-going concern
people are satisfied with their new residences
People are satisfied with theirnew residences
  • New residences are preferred to the hospital
    • No comparison. It’s better. It’s the freedom factor
    • I’m free. I go more places. I do what I want to do.
  • People feel safe and comfortable
    • Here, I am much more relaxed
    • I am much more comfortable
    • There are less people. If residents don’t get along, it gets taken care of by staff
potential perils of freedom
Potential perils of freedom
  • A small number of people became re-involved with criminal activity, usually illegal substance use, and experienced negative consequences
progress needed on community integration
Progress needed on community integration
  • Many participants would welcome more varied activities
    • Q: What do you do? A: Sleep. Get up and watch TV. Come out here and smoke.
    • Q: What is there to do? A: Sleeping. Groups. That’s about all.
    • I don’t go anywhere. I don’t have any money.
  • Some participants are very active
    • I am in the process of getting prepared to get a job. I’ll see what kinds of things I want to do.
staff are often the primary social contacts
Staff are often the primary social contacts
  • Many people report that they depend mostly on staff
    • No one has visited me besides my peer mentor and CTT
    • My case manager is my best friend, guardian, big sister. I have 24-hour access to her.
    • I can talk to CTT any time if there’s something going on or I need them to advocate for me
housing is a continuing concern
Housing is a continuing concern
  • Some people adjust well to supervised housing situations designed for short stays (e.g., CRRs), and find the need to relocate again problematic
  • Most participants are poor, and will rely on public housing as they become more independent
    • Public housing is not always available
    • When available, the quality and safety of public housing is variable
major quantitative findings
Major quantitative findings
  • Psychiatric symptoms go down over time
    • 50% of people meet a recently published criterion for symptom remission at the 2-year time point
  • Contact with friends and social adjustment go up over time
  • No quantitative indicator deteriorated over time
criteria for remission
Criteria for remission
  • Remission of BRPS-rated psychotic symptoms
    • Seven symptoms related to psychosis
      • Grandiosity, suspiciousness, unusual thought content, hallucinations, conceptual disorganization, blunted affect
    • Rated 3 (mild) or less for six months
  • Additional criterion:
    • Overall BPRS < 31 for six months
  • 50 participants had at least two standardized assessments in Year 2 of the study
    • We examined their last two observations
remission
Remission
  • 30 of 50 (60%) were in remission from psychotic symptoms
  • 24 of 50 (48%) were in remission and also had low overall BPRS scores
how do participants compare to other groups
How do participants compare to other groups?
  • Quality of life and Progress towards Recovery
    • Did not change over time
    • Compared favorably to other populations for whom data have been published
  • Perceptions of Care
    • Did not change over time
    • Were somewhat lower than the major published benchmark
conclusions
Conclusions
  • The closing was successful
  • Possible areas for continued discussion are:
    • How to bring variety and community integration into people’s lives
    • Housing
      • Is there enough
      • Can it be stable, supportive, and recovery-oriented
    • Perceptions are care
      • Can satisfaction with providers be improved
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“The best experience has been knowing that I can make it in the real world. Not as hard as I projected it to be.”

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