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This article describes a quality assurance effort aimed at defining the characteristics of the patient population of the Connecticut Mental Health Center, a state‐funded agency that provides comprehensive clinical and rehabilitative services to persons with mental illness. Also described is how this information guided management decisions in both caseload distribution and clinical service development. This “Patient Profile Project” was informed by research principles which view evaluation as continual, rather than terminal activity that involves key stakeholders from all levels within the mental health system of care and makes maximum use of data in ongoing performance improvement initiatives. The service‐need index that the project produced represents our first efforts to accurately capture service need and use it in clinical decision making. This review of the Connecticut Mental Health Center Patient Profile Project illustrates the utility of a continuous evaluation system in promoting improvements in a large mental health treatment system.

This article aims to describe continuous quality improvement (CQI) for substance abuse prevention and treatment programs in a community‐based organization setting.

CQI (e.g., plan‐do‐study‐act cycles (PDSA)) applied in healthcare and industry was adapted for substance abuse prevention and treatment programs in a community setting. The authors assessed the resources needed, acceptability and CQI feasibility for ten programs by evaluating CQI training workshops with program staff and a series of three qualitative interviews over a nine‐month implementation period with program participants. The CQI activities, PDSA cycle progress, effort, enthusiasm, benefits and challenges were examined.

Results indicated that CQI was feasible and acceptable for community‐based substance abuse prevention and treatment programs; however, some notable resource challenges remain. Future studies should examine CQI impact on service quality and intended program outcomes.

The study was conducted on a small number of programs. It did not assess CQI impact on service quality and intended program outcomes.

This project shows that it is feasible to adapt CQI techniques and processes for community‐based programs substance abuse prevention and treatment programs. These techniques may help community‐based program managers to improve service quality and achieve program outcomes.

This is one of the first studies to adapt traditional CQI techniques for community‐based settings delivering substance abuse prevention and treatment programs.

Neuroleptic non-compliance remains a serious challenge for the treatment of psychosis. Non-compliance is predominantly attributed to side effects, lack of illness insight, reduced well-being or poor therapeutic alliance. However, other still neglected factors may also play a role. Further, little is known about whether psychiatric patients without psychosis who are increasingly prescribed neuroleptics differ in terms of medication compliance or about reasons for non-compliance by psychosis patients. As direct questioning is notoriously prone to social desirability biases, we conducted an anonymous survey. After a strict selection process blind to results, 95 psychiatric patients were retained for the final analyses (69 participants with a presumed diagnosis of schizophrenia psychosis, 26 without psychosis). Self-reported neuroleptic non-compliance was more prevalent in psychosis patients than non-psychosis patients. Apart from side effects and illness insight, main reasons for non-compliance in both groups were forgetfulness, distrust in therapist, and no subjective need for treatment. Other notable reasons were stigma and advice of relatives/acquaintances against neuroleptic medication. Gain from illness was a reason for non-compliance in 11-18% of the psychosis patients. Only 9% of all patients reported no side effects and full compliance and at the same time acknowledged that neuroleptics worked well for them. While pills were preferred over depot injections by the majority of patients, depot was judged as an alternative by a substantial subgroup. Although many patients acknowledge the need and benefits of neuroleptic medication, non-compliance was the norm rather than the exception in our samples.

The purpose of this paper is to consider the role of shared decision making (SDM) as one component of recovery-oriented care.

This paper is conceptual and reviews the literature relevant to recovery-oriented care, person-centered recovery planning (PCRP), and SDM.

To the degree to which SDM offers tools for sharing useful information about treatment options with service users and family members or other loved ones, it can be considered a valuable addition to the recovery-oriented armamentarium. It is important to emphasize, though, that recovery-oriented practice has a broader focus on the person’s overall life in the community and is not limited to formal treatments or other professionally delivered interventions. Within the more holistic context of recovery, SDM regarding such interventions is only one tool among many, which needs to be integrated within an overall PCRP process. More emphasis is given within the recovery-oriented care to activating and equipping persons for exercising self-care and for pursuing a life they have reason to value, and the nature of the relationships required to promote such processes will be identified. In describing the nature of these relationships, it will become evident that decision making is only one of many processes that need to be shared between persons in recovery and those who accept responsibility for promoting and supporting that person’s recovery.

By viewing SDM within the context of recovery, this paper provides a framework that can assist in the implementation of SDM in routine mental health care.

While evidence-based parenting interventions (EBPIs) are proven effective at addressing numerous emotional and behavioral health challenges for children and youth, and reduce rates of child maltreatment, they are often not well implemented in the real-world settings. Even with the state-of-the art training, many practitioners do not deliver the intervention, or do so at a reduced capacity. The purpose of this paper is to examine system-contextual implementation factors that predict timely initiation of use of an EBPI (i.e. within the first six months following training). A secondary purpose is to document additional impacts of training.

Repeated measures were used to collect predictors and the dependent variable. The relationship between participant characteristics and use of the Triple P program was estimated using exact logistic regression.

The results from 37 practitioners across three communities indicated approximately 54 percent delivered the intervention with at least one family within the first six months following training. Practitioner self-efficacy immediately following training and general attitudes toward evidence-based practices were the most significant predictors of timely use of the model. The vast majority of practitioners, regardless of implementation status, generalized learning from the training to other aspects of their work.

Prospective examination of the predictive value of implementation factors helps to refine targeted approaches to support implementation.

Previous studies have pointed the need for more research, which explores how peer provision brings about change associated with recovery. This study aims to test Leamy’s framework, which consists of five recovery processes: connectedness, hope, identity, meaning and empowerment (also known as the CHIME framework) within the peer provision context.

This mixed-methods study was completed in two stages. A total of 13 face-to-face interviews were conducted with peers and the transcripts were analysed thematically. A short online questionnaire was completed by 12 peers and analysed with both descriptive statistics and thematic analysis.

The participants spoke about the value of peer providers (PPs) in building connectedness, fostering hope and optimism, growing identity, enhancing meaning and empowerment (CHIME). However, their connectedness was hindered by external circumstances and the intrapersonal capacities of their PP.

The CHIME framework was useful in highlighting stages in which peers moved through their recovery and its corresponding PP involvement. PPs were also found to promote motivation, which was a key driver in their peers’ recoveries. Further research is needed to test frameworks that account for wider systemic issues and the role PPs play in enhancing motivation.

This study has identified the usefulness of the CHIME framework in describing peer provision. It contributes to our understanding of how peer provision can promote recovery in persons with mental health challenges. It lays the groundwork for future research into examining the role of peer provision in recovery and its distinctiveness from other forms of mental health support.

Restorative practice programs in the USA and Western elementary and secondary schools have been the focus of intensive, large scale field research that reports positive impacts on school climate, pro-social student behavior and aggressive behavior. This paper aims to contribute to a gap in the research by reporting a case study of transformation of an urban middle school in a multi-year implementation of restorative practices.

This paper reports how Creative Response to Conflict (CRC) supported the transformation of Middle School 217, in Queens, NY, from a school with one of the highest suspension rates in New York City to a model restorative school. CRC’s model, which incorporates the themes of cooperation, communication, affirmation, conflict resolution, mediation, problem-solving, bias awareness, bullying prevention and intervention, social-emotional learning and restorative practices, helped shift the perspective and practice of the entire school community from punitive to restorative.

Implementation of a full school advisory program using restorative circles for all meetings and classes and development of a 100% respect program committing all school community members to dignified and respectful treatment aided the transformation. Key to MS 217’s success was the collaboration of multiple non-profit organizations for provision of peer mediation training, after-school follow-up work, staff coaching and preventative cyberbullying training through the Social Media-tors! Program.

Challenges to the restorative practices implementation are reviewed with attention to the implementation online during COVID-19.

Next steps in the program post-COVID are articulated as a best practice model for other schools interested in adopting MS 217’s commitment, creativity and community-building to become a model restorative school.