Anthony (1993) proposed recovery as the organizing principle of the public mental health service system. This study examines the evolution of a recovery-oriented mental health system at the federal and state levels in the United States. A rapid review of gray literature analyzed federal policy statements, state mental health policies, service reforms, mental health authority reports, websites, organizational records, and other public documents. The review compiled current recovery-oriented system features in the 50 states, the District of Columbia, and Puerto Rico. Findings highlight expansive but stalled transformation to a recovery-oriented system. Policy statements have made a pronounced shift toward recovery. More recovery-oriented services are being offered. According to the Substance Abuse and Mental Health Services Administration's uniform reporting system, many outcomes have improved modestly. However, many features of a recovery orientation have not been fully embraced, implemented, and sustained. Official statements about recovery exist. Practices such as peer services are available in many states, yet the full actualization of a recovery approach remains unfulfilled. Most states would benefit from a concerted effort to fulfill their recovery visions by specifying the features of a recovery-oriented system that they currently lack and aspire to implement. Current implementation science can inform these efforts, including performance-focused, state-level evaluations using common measures tracked on a national dashboard. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Deinstitutionalization spawned numerous psychiatric rehabilitation interventions, but only a small number have endured for decades and spread widely. This article identifies a concise set of 10 criteria to examine ethical, scientific, practical, and policy elements of highly successful interventions. Based on 50 years of psychiatric rehabilitation literature, we examined three exemplary, enduring practices-assertive community treatment, Individual Placement and Support, and Housing First-for evidence related to the 10 common criteria. Psychiatric rehabilitation has had a firm grounding in ethics, client-centeredness, implementation science, and outcomes research. Policy and funding have followed. We identified 10 criteria that incorporate these values: recovery, model clarity, fidelity, effectiveness, enduring effects, cost-effectiveness, feasibility, scalability/sustainability, policy/funding, and adaptability. All three practices are guided by validated fidelity scales, have strong evidence for effectiveness, and are feasible to implement, but they vary on other criteria. In varying degrees, assertive community treatment, Individual Placement and Support, and Housing First are practices meeting most of the 10 criteria in a newly developed framework aimed at broadening the criteria for evaluating psychiatric rehabilitation programs to encompass both scientific and pragmatic, real-world considerations. This framework establishes an objective framework to guide the prioritization of services for people with mental health conditions. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Measuring the career development of individuals with psychiatric disabilities is essential for assessing their employment preparedness and the impact of educational and vocational supports and programs. The primary purpose of the two studies presented was to develop a shorter version of an established instrument, the Career Advancement Inventory (CAI), that assesses the psychological preparedness for careers and employment among individuals with psychiatric disabilities. The CAI was originally developed using a community-based participatory research approach and a combination of Classical Test Theory and Item Response Theory resulting in a 111-item scale. We utilized exploratory factor analysis, reliability coefficients, correlations, and t tests to assess the factor structure, reduce the number of items, and establish the norms of the CAI. Two diverse samples were included, an online sample (n = 500) and an in-person sample (n = 100) of individuals with psychiatric disabilities. The resultant 52-item Career Advancement Inventory-Short Version has a five-factor structure and demonstrated excellent norms with high reliability and moderate to high concurrent, divergent, and known groups validity. The Career Advancement Inventory-Short Version would be useful in assessing the career preparation of individuals with psychiatric disabilities and has implications for clinicians, rehabilitation providers, researchers, and educational and employment interventions for these populations. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

This study examines associations between patient demographics, clinical status, and linguistic features of text messages with engagement in a message-based intervention for serious mental illness. Data from a randomized controlled trial of a message-based mental health intervention were analyzed. Engagement was operationalized as total texts sent per day and total number of disengaged days. Linguistic Inquiry and Word Count identified expressions of affect, social processes, thinking styles, health, and time orientation. Generalized estimating equations assessed associations between demographic, clinical, and Linguistic Inquiry and Word Count variables with engagement across three different time intervals. Among 39 participants, most were male (n = 23, 59%), with diagnoses of schizophrenia (n = 16, 41%), schizoaffective disorder (n = 9, 23%), bipolar disorder (n = 9, 23%), and major depressive disorder (n = 5, 13%). Participants sent approximately two messages per day, with 48% of days disengaged. Race, education, and diagnosis were associated with engagement. Black participants and those with at least some college education sent more texts while individuals with schizophrenia had more disengaged days. Messages containing language about anxiety, friendship, cognitive processes, and common verbs were associated with engagement. Significant relationships between message content and future engagement were observed, particularly in the first 2 weeks, as well as in messages sent the day and week before a disengaged day. Demographic, clinical, and linguistic features are related to engagement in message-based interventions for serious mental illness. Identifying these characteristics can help tailor interventions, enhancing engagement, and reducing dropout rates in digital mental health interventions. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Explore a lived experience perspective on using antipsychotic medicine and call to action for psychiatric rehabilitation practitioners to get involved in preparing people diagnosed with serious mental illness (SMI) to have a voice and choice in antipsychotic medication treatment. A first-person account of awakening on an antipsychotic medication for the first time is used to understand the lived experience and challenges of using it. Lessons learned are amplified through de-identified queries of the CommonGround database capturing concerns about antipsychotic medication of people diagnosed with SMI in public sector mental health clinics in the United States. Lived experience of "me-on-medicine" included embodied and perceptual changes to self when taking antipsychotic medications. Discordance between the team's goal and personal goals for medication treatment interfered with recovery. Analysis of more than 100,000 concerns about antipsychotic medications expressed by 57,370 CommonGround users showed the most frequent concerns are that medication is perceived as unhelpful (21%), side effects (13%), impact on health (12%), and concerns about feeling unmotivated to use medication (8%). Among CommonGround users below age 30, low motivation to take antipsychotics was the third most prevalent concern. Among CommonGround users over age 30, concerns about the impact on health were the third most dominant. Psychiatric rehabilitation practitioners can support people diagnosed with SMI getting prepared to participate in decision making about antipsychotic medications with psychiatric care providers by identifying concerns and building skills and strategies to negotiate the new "me-on-medicine." (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Personalized dose optimization is desirable to improve subjective well-being and support rehabilitation. Therefore, N = 1 trials investigating tools to self-manage functional outcomes during dose optimization are necessary. The aim of this pilot study was to determine in two N = 1 trials whether an experience sampling method (ESM) smartphone app could be used to monitor and detect changes in subjective well-being and psychotic experiences during and after dose reduction. Two participants with a psychotic disorder in remission underwent gradual dose reduction under a longitudinal self-monitoring paradigm, accompanied by regular clinical monitoring by the attending physician. Subjective well-being was monitored with an (ESM) app through momentary affective experience (positive and negative affect) and physical well-being (tiredness, feeling unwell, and pain). Momentary psychotic experiences were assessed with four items. Time-series linear regression models were used to detect changes in reduction phases compared to baseline. Whereas significant improvements in subjective well-being and psychotic experiences during dose reduction were detected in one participant, the opposite was demonstrated for the other participant, showing worsened subjective well-being and increased psychotic experiences in the reduction phase compared to baseline. Self-monitoring with an ESM smartphone app offers a tool for detecting changes in subjective well-being and psychotic experiences during antipsychotic dose reduction. In this way, ESM may increase an individual's sense of control and empowerment. It may further facilitate dose optimization and shared decision-making at an individual level, which is required considering the high heterogeneity in psychotic disorders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The overall aim of this study was to elicit and document the recovery-related perspectives and experiences of Haredi Jews with lived experience of mental illness living in Canada. A more focused objective was to specifically explore self-identified facilitators and barriers toward recovery from mental illness in this group. We conducted a qualitative study involving semistructured interviews with 20 women who (a) identified as Haredi Jews, (b) had used mental health services in recent years, and (c) were 18+ years of age. Interviews were transcribed and analyzed using thematic analysis techniques. Four prominent themes emerged from the analysis. The first two themes were predominantly facilitators, and the last two themes were predominantly barriers. These themes were (i) a close-knit, supportive, and lively community with considerable social capital; (ii) Judaic beliefs and practices regarding Gd, daily life, and health care giving structure, meaning, and purpose; (iii) community stigma and self-stigma, often related to marriageability of self or offspring, as well as notions of perfection; and (iv) a lack of wider mental health literacy, despite participants speaking positively about mental health services such as medication and therapy. This study indicates several individual-level and community-level factors that are reported to facilitate recovery in Haredi Jews. However, problems of stigma and mental health literacy remain an issue. Targeted antistigma programs, such as co-constructed contact-based educational interventions, may be helpful in contributing to a community climate that further facilitates recovery. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The purpose of this study was to examine the characteristics of people who stay in intensive case management (ICM) for longer than 5 years. We conducted a secondary analysis of client data collected by a community mental health organization from 2012 to 2022. Using the Gelberg-Andersen Model for Access to Health Services, we conducted a logistic regression with 22 predictor variables, predicting clients in ICM for 5 years or less (N = 531) and those in ICM for longer than 5 years (N = 289). People who were older and those with psychotic disorder, co-occurring substance use disorder, dual diagnosis (with developmental disability), chronic medical condition, and also in another program in the same agency were more likely to be in ICM for longer than 5 years. People who were returning ICM clients and those who completed the ICM program (rather than withdrawing or disengaging) were more likely to be in ICM for 5 years or less. Higher dose of ICM (in contacts) predicted a shorter time in ICM. People with serious mental illness, dual diagnosis, concurrent substance use, and chronic medical conditions and those who are older may need additional supports within ICM and when transitioning out of ICM. People in ICM for a longer time have lower numbers of contacts, indicating that a less intense service may meet their needs. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

This systematic review examined community-based participatory research (CBPR) studies in which people with mental illness (PWMI) directly contributed to research projects. The purpose was to describe study characteristics, team structure and logistics, and level of involvement of in the research process. We searched the PsycINFO database from January 2000 to July 2020, identifying 1,395 records and analyzing the 31 that met inclusion criteria. Articles were eligible if they were (a) published in English in a peer-reviewed journal; (b) explicitly stated that at least one adult with mental illness assisted with the study as a CBPR team member; and (c) included a research outcome. Most studies collected qualitative data. Project length, team composition, and frequency of meetings were not specified in about one third of the articles. Twenty-nine studies reported involvement of people with mental illness in research activities such as recruitment, data collection, transcription, and analysis. Nearly half did not specify if they received any training. Individuals with mental illness were heavily involved in planning and conducting research, demonstrating the feasibility of meaningful involvement. Future research should consider how people with lived experience can assist with quantitative methods, and articles should clearly and explicitly describe characteristics of the partnership (e.g., team composition, frequency of meetings, compensation). The protocol is published in Open Science registry at https://osf.io/mshfb. (PsycInfo Database Record (c) 2024 APA, all rights reserved).