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U.S. Department of Health and Human Services Department of Health and Human Services
Substance Abuse and Mental Health Services Administration

Substance Abuse & Mental Health Services Administration

Last Updated: 6/22/2012

SAMHSA’s Resource Center to Promote Acceptance,
Dignity and Social Inclusion Associated with
Mental Health (ADS Center)


Books, Articles and Research

Community-Partnered Cluster-Randomized Comparative Effectiveness Trial of Community Engagement and Planning or Resources for Services to Address Depression Disparities
This study sought to bridge a gap in understanding of outcomes of quality improvement (QI) healthcare programs across diverse health and human services sectors. QI programs in health care involve "systematic and continuous actions that lead to measurable improvement in health care services and the health status of targeted patient groups" (Health Resources and Services Administration, 2011, Specifically, this study compared the effectiveness of two programs, Community Engagement and Planning (CEP) and Resources for Services, in supporting implementation of depression QI programs to improve clients' quality of life as it pertains to their mental health and increase their use of services. They found that the CEP programs were more effective in increasing mental health and well-being, physical activity, and use of services while decreasing homelessness risk factors, behavioral health hospitalization rates, and medication visits. These findings support the importance of community engagement for underserved populations in efforts to decrease health disparities.

Improving the Physical Health of Adults with Serious Mental Illness
This 3-year study looked at the impact of 56 programs funded by the Substance Abuse and Mental Health Services Administration's Primary and Behavioral Health Care Integration grants. One type of impact this study examined was how the 56 programs through their use of integrated primary care and behavioral health services made a difference in the physical health of people with mental health problems like schizophrenia, bipolar disorder, and major depression. The study found mixed success in each location's ability to successfully integrate behavioral health and primary care services, but that, once people were enrolled in the program, they were more likely to receive primary care services. Investigators found that health outcomes did improve for some chronic conditions, including diabetes, cholesterol, and hypertension, but outcomes did not improve for obesity and smoking. Researchers found that three traits were associated with greater access to care among program participants: co-location of services, integration of practices, and staff perception of themselves as being part of a team.

Evidence-Based Tools Improve Functioning of People with Bipolar Disorder
This press release announces findings from a study of an evidence-based clinical program, Advancing Standards of Care for People with Bipolar Disorder. Program participants at 10 pilot sites experienced significant improvements in their productivity, social networking skills, coping skills, health practices, communication, money management, problem solving, and leisure enjoyment. The program involves two components: a group curriculum to give participants better understanding and information on independent management of their mental health issues, and a functional assessment tool that measures everyday functioning. The study had an attrition rate of 50 percent.

Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis
This article describes a systematic review of published descriptions and models of personal recovery that researchers conducted to create a synthesized conceptual framework of people's experiences of recovery. Their goal was to increase understanding of common elements of recovery to be used in recovery-oriented research and practice. They used 97 papers to create this framework, which, according to the article abstract, includes "(a) 13 characteristics of the recovery journey; (b) five recovery processes comprising: connectedness; hope and optimism about the future; identity; meaning in life; and empowerment (giving the acronym CHIME); and (c) recovery stage descriptions which mapped onto the transtheoretical model of change." Additionally, researchers found that studies focused on certain ethnicities were more likely to show a greater emphasis on spirituality and discrimination, along with other culturally specific aspects of recovery.

Social Inclusion of People With Severe Mental Illness Living in Community Housing Programs
As part of a large-scale cross-sectional study seeking to assess institutes for residential care in the Netherlands, this study sought to determine if individuals living in supported independent living versus those in residential care experienced any differences in social inclusion on a variety of measures. Researchers found that while individuals in supported independent living situations were more likely to participate in activities and to have visitors, there was no difference in vocational participation between the groups. Based on these findings, they concluded that it is important that vocational programs be made available for individuals in both types of housing settings. This study's findings also highlight the success of mental health policies often supported across Western Europe that aim to rehabilitate individuals in community-based facilities and support them in being active participants in their communities.

Consumer and Family Psychoeducation: Assessing the Evidence
This literature review sought to examine the body of research assessing the impact of individual, group, and family psychoeducation models on various aspects of recovery including treatment adherence, relapse, and hospitalization rates. There was significant evidence to demonstrate that psychoeducation models, which are based on providing information regarding mental health and recovery to consumers, were effective in helping to promote positive recovery outcomes. The authors reviewed several studies that focused on multifamily psychoeducation groups, which they found to be linked to positive outcomes including greater problem-solving ability and lessened burden on families. The authors used these studies to make the case for psychoeducation services to be covered by insurance.

The Police-Based Crisis Intervention Team (CIT) Model: I. Effects on Officers? Knowledge, Attitudes, and Skills
This study sought to determine the officer-level outcomes of Crisis Intervention Training (CIT), which is designed to help police officers improve their responses to individuals experiencing mental health crises. Officers who took the CIT training were compared to officers who had not taken the training and were found, according to the abstract, to have "consistently better scores on knowledge, diverse attitudes about mental illnesses and their treatments, self-efficacy for interacting with someone with psychosis or suicidality, social distance stigma, deescalation skills, and referral decisions."

Telehealth Therapy Stacks Up When Compared to Standard Care
This blog post introduces telehealth therapy and discusses the promising findings of a study done to compare this therapy to standard care in its ability to reduce depressive symptoms. The study was a meta-analysis, a kind of study in which researchers review other similar studies that have been done and look at overall findings. Telehealth therapy uses technology, such as video or telephone conferencing, to connect consumers and providers for therapy sessions. This allows individuals access to treatment that may have been difficult to attain otherwise due to lack of time or considerable geographical distance between consumers and providers. It is especially valuable in reaching rural areas, which generally have more limited mental healthcare resources. The study found that there was no significant difference in treatment outcomes for those in telehealth therapy and those in therapy conducted in person in traditional settings. The author hopes that this method of utilizing technology may prove to be a valuable means of meeting the demands for increased access to mental health care.

Mental Health Crisis May Be Better Served in Homelike Environment Instead of Traditional ER, Says Study
This article describes a new concept in psychiatric emergency treatment through the Living Room, a program funded by the Illinois Department of Mental Health and provided as an alternative to utilizing a hospital emergency room for support during emotional distress. This drop-in support center is set up like a living room in a person's house and is staffed by a licensed professional counselor, registered nurse, and trained peer counselors who create a calm and respectful environment, focusing on recovery for the individual in crisis. In a study, they found that individuals came to the center for psychiatric issues similar to those for which they might otherwise have visited an emergency room. However, this setting was shown to be much more effective in providing needed support in comparison to typically hectic emergency room settings and received more positive feedback from consumers using the service.

New Clinical Recommendations Released for Traumatic Brain Injuries
This January 2014 press release announced the release of the Progressive Return to Activity Following Acute Concussion/Mild Traumatic Brain Injury: Guidance for the Primary Care Manager and the Rehabilitation Provider in Deployed and Non-deployed Setting Clinical Recommendations by the Defense and Veterans Brain Injury Center. This document is the first of its kind to provide clinical recommendations to providers as they assist patients who have experienced traumatic brain injury (TBI) as they return to activities. These guidelines were developed with input from military, academic, and sports concussion experts in an effort to standardize the medical approach to recovery following TBIs.

Building Partnerships: Conversations with the Hmong about Mental Health Needs and Community Strengths
This resource from the UC Davis Center for Reducing Health Disparities discusses mental health needs and unique requirements that providers and policymakers need to address to ensure that healthcare systems best address the needs of Hmong communities in the United States, many of which were formed by refugees who fled Southeast Asia starting in 1975 as a result of the Vietnam War or during a second wave of immigration starting in 2004. This publication outlines findings from a project that engaged a spectrum of underserved populations in California to gain community perspectives as to what the mental health system could do to more effectively reach out to Hmong people in the United States and their communities. For these communities, these issues revolve around severe social disadvantages as a result of their resettlement in a completely new culture and society. These disadvantages include low levels of education, high poverty rates, and low English proficiency. The publication includes direct quotes and considerations gathered from project participants.

Building Partnerships: Conversations with Native Americans about Mental Health Needs and Community Strengths
Produced by the UC Davis Center for Reducing Health Disparities, this report discusses mental health needs and unique cultural considerations that providers and policymakers need to address to ensure that healthcare systems can more effectively serve Native American populations. Based on findings from a California project to engage underserved populations, the greatest concerns for Native Americans were the loss of their cultural roots, violence, substance use, depression, and suicide. The publication includes direct quotes and considerations gathered from project participants.

Building Partnerships: Conversations with African Americans about Mental Health Needs and Community Strengths
This report produced by the UC Davis Center for Reducing Health Disparities discusses mental health concerns and unique requirements that providers and policymakers need to address to ensure that healthcare systems can better serve African American communities. Researchers partnered with agencies, individuals, and advocates within the African American community to give them an opportunity to express their view of what is needed in their community with the goal of helping counties develop their plans and programs for the prevention of mental disorders. The greatest concerns voiced revolved around experiences of violence, family disruption, substance use, suicide, and homelessness.

Building a Community-Academic Partnership: Implementing a Community-Based Trial of Telephone Cognitive Behavioral Therapy for Rural Latinos
This paper discusses the shortage of evidence-based practices for ethnic minorities within community healthcare systems and the reasons for this shortage. It proposes that partnerships be built between researchers and community practitioners to help run clinical trials and further develop and implement culturally relevant programs. The paper also reports on the process involved in building such partnerships, as well as the results of a pilot test implemented by a community-academic partnership. In this randomized clinical trial, cognitive behavioral therapy by telephone was adapted to serve a primarily Spanish-speaking patient base. The development and outcomes of the program are presented.

Prevention is Primary: Strategies for Community Wellbeing, Second Edition
The Prevention Institute's Prevention is Primary: Strategies for Community Wellbeing text presents effective methods and tools for preventing mental health and substance use problems, as well as other health problems, and improving the health of communities. It serves as a resource for health care providers and educators, as well as community-based organizations. This text discusses various social issues and also addresses mental health needs of returning veterans.

WHO Comprehensive Mental Health Action Plan Adopted by World Health Assembly
This article discusses the World Health Organization's adoption of the draft Comprehensive Mental Health Action Plan 2013-2020. This plan provides guidelines for entities including national governments, agencies that support economic and governmental development around the world, mental health organizations, colleges and universities, research institutions, and society as a whole. The article identifies four key objectives of the plan:
- "Strengthen effective leadership and governance for mental health,
- Provide comprehensive, integrated and responsive mental health and social care services in community-based settings,
- Implement strategies for promotion and prevention in mental health and
- Strengthen information systems, evidence and research for mental health."
The plan is available for download at the following link:

Grounded in Faith: Resources on Mental Health and Gun Violence
This report serves as a tool to help ensure that the current debate on gun control does not perpetuate stereotypes and harmful beliefs regarding individuals with mental health issues. It includes a section with statistics on mental health and gun violence and specific faith-based resources for members of the Interfaith Disability Advocacy Coalition (IDAC) and others.

Pathways to Recovery (PTR): Impact of Peer-Led Group Participation on Mental Health Recovery Outcomes
In this study, researchers used peer-led groups to explore positive effects on recovery outcomes for individuals with mental health issues. Based on Pathways to Recovery: A Strengths Recovery Self-Help Workbook, the strengths-based model used helped participants feel better about themselves and their lives by supporting them in developing and working toward goals based on their personal and environmental strengths. This research highlights the importance of using peer-led groups to help with the recovery process.

What is needed to deliver collaborative care to address comorbidity more effectively for adults with a severe mental illness?
This paper examines collaborative care services for people with severe mental disorders that have worked to address comorbidity and the relationship of mental disorders to homelessness, substance use disorders, unemployment, and other health issues in Australia. Researchers identified many key program components that help make integration of care most effective: shared treatment plans and client records, promotion of a "housing first approach," education for staff about comorbidity, and cross-sector collaboration among agencies when serving shared clients. Cross-sector collaboration is described as a real benefit for consumers and staff and as an effective strategy to move Australia toward having more holistic, socially inclusive mental health care.

NAMI in our own voice and NAMI smarts for advocacy: Self-narrative as advocacy tool
In this column, the author examines the need for advocacy among mental health professionals and researchers and the role it could play in issues related to mental health disorders and other mental health professionals. The author discusses sharing one's recovery story as a means of raising awareness and educating others about mental disorders. He mentions two programs of the National Alliance on Mental Illness (NAMI), NAMI In Our Own Voice and NAMI Smarts for Advocacy.

Morbidity and mortality in people with serious mental illness
With individuals with serious mental illnesses dying 25 years earlier than individuals from the general population, this report explores contributing causes to this disparity, like smoking, obesity, and inadequate access to medical care. It also outlines recommendations for improvement. Some suggested solutions for addressing this public health problem include the implementation of care standards for prevention, screening, and treatment; better access and integration with physical healthcare services; and ongoing support for educational resources, such as toolkits, to encourage healthy choices and promote personal responsibility. This report also addresses provider agencies directly, highlighting the important role of a hopeful message of recovery and the support of wellness and personal empowerment to help promote individual recovery efforts.

Under the microscope. Peer support: A valued part of recovery, wellness and health reform
This article by the National Association of County Behavioral Health and Developmental Disability Directors (NACBHDD) discusses the value of peer support and its role in demonstrating that recovery is attainable. This article recognizes peer support as not only a movement but also as a form of delivering care and an evidence-based practice. It also discusses the importance of expanding the ways peer support is utilized and incorporating peer support services into various types of reform, such as insurance and quality reform. In addition, it lists potential action steps to help advance peer support services, provides recommendations and solutions for what can be done at the national and State level to address health disparities, and discusses the importance of integrating behavioral health and primary care services, including the challenges and opportunities involved.

Final report of the World Conference on Social Determinants of Health
The World Conference on Social Determinants of Health, brought together in 2011 in Brazil by the World Health Organization (WHO), was a global conference that sought to encourage action on the social determinants of health. This event provided an opportunity for stakeholders to share their experiences with strategies for reducing health inequities and to discuss potential next steps of the WHO Commission on Social Determinants of Health. This final report, available for download, provides a full summary of this important conference.

Recovery of evidence-based practice
This research paper explores various aspects of evidence-based practice (EBP), including methodologies, outcomes measures, and evidence standards, from a consumer recovery point of view. Through their examination, researchers worked to critique, inform, and support the expansion of EBP and reshape the study of EBP with the goal of encouraging service providers to provide recovery-oriented support for individuals with mental disorders.

Supporting workers with mental health problems to retain employment: Users' experiences of a UK job retention project
Researchers set out to gain a deeper understanding of the connections between challenges experienced in the workplace by people with mental disorders, support received during employment, and job retention. This study showed that feelings of guilt and self-blame among consumers are barriers to job retention but that, with support, individuals are able to improve communication with their employer including communication to seek accommodations, and experience increased confidence in their self-advocacy abilities. Individual interviews were used to collect data that revealed that peer support groups were a useful intervention that helped individuals with mental disorders retain employment. Researchers concluded that interventions that focus on the employee, his or her work, and the workplace offer more hope than those that focus solely on the individual for improving employment among individuals with mental disorders.

United Nations convention on the rights of persons with disabilities: A roadmap for change
This study examines the United Nations Convention on the Rights of Persons with Disabilities as a means of advancing the social inclusion of individuals with mental disorders or intellectual disabilities. This convention focused on many social barriers that impact the full social participation of people with disabilities while also providing guidance on ways of incorporating disability policy in different countries. The researcher of this study goes on to discuss ways the mental health community will need to work on moving toward creating a new disability discussion that looks at services and supports needed to help people with mental disorders gain complete access to society.

Reaching out to the LGBT population
In this article, the Executive Director of Rainbow Heights Club, a New York program for individuals with mental disorders who identify with the lesbian, gay, bisexual, and transgender (LGBT) community, shares his thoughts on what they have learned about providing support to LGBT people. He cites the U.S. Surgeon General's estimate that 2.6 percent of adults in general are living with a serious mental disorder and adds that this estimate combined with other statistics suggests that 11,000 LGBT adults with mental disorders live in New York City alone. The author goes on to describe the negative attitudes and harmful beliefs that Rainbow Heights Club members have faced, their use of support groups to address these obstacles, and the overall success of the Rainbow Heights approach to supporting LGBT people with mental disorders. Many of these successes involve high levels of consumer appreciation reflected in satisfaction surveys, increases in funding, and decreases in the need for hospitalization among Rainbow Heights Club members.

100 ways to support recovery: A guide for mental health professionals
This report was developed through the collaboration of Rethink and Mike Slade, a clinical psychologist who researched recovery practices throughout Europe, the U.S., and Australia. It includes recommendations to help mental health professionals incorporate recovery-oriented services into their work with individuals with mental disorders. The report outlines the foundations of recovery-oriented mental health services transforming the mental health system, and ways mental health staff can help individuals develop an action plan and recovery goals. The goal of the report is to translate the concept of the Personal Recovery Framework into practice.

Initial outcomes of a mental illness self-management program based on Wellness Recovery Action Planning
In this study, researchers set out to examine psychosocial outcomes in individuals participating in Wellness Recovery Action Planning (WRAP), a peer-led, self-management intervention for mental disorders that focuses on holistic health, strengths, and social support. The 80 individuals who completed surveys before and after WRAP participation showed significant improvement in symptoms, recovery, feelings of hopefulness, self-advocacy, and physical health. Researchers go on to highlight the effectiveness of the WRAP model and its potential to increase self-management and lead to recovery for individuals with mental disorders.

Effects of a peer-run course on recovery from serious mental illness: A randomized controlled trial
This study examined how peer-run services impact the recovery of individuals with mental disorders. At the end of a 12-week course, Recovery Is Up to You, researchers found that the course had improved participants' hopefulness, senses of personal effectiveness, and empowerment, even 3 months after the course had been completed. Researchers' findings show that the role of peer-run services in recovery is a positive one with the potential to improve the recovery journey significantly.

A randomized controlled trial of effects of wellness recovery action planning on depression, anxiety, and recovery
This study examined how effective Wellness Recovery Action Planning (WRAP) sessions were in reducing anxiety and depression and increasing self-perceived recovery among participants with a serious mental health problem. The study included 519 people who took part either in eight WRAP sessions given by certified WRAP educators in recovery or in usual treatment. Researchers found that training in WRAP diminished depression and anxiety and boosted participants' perceived recovery over time. Results suggested that WRAP is an important evidence-based and recovery-focused intervention.

A study of the impact of social support development on job acquisition and retention among people with psychiatric disabilities
In this study, researchers explored the connection between methods for developing social support and employment-related outcomes among people with mental health problems receiving Supported Employment services. Researchers found that individuals with higher numbers of unpaid supporters were more likely to be employed for longer periods of time. Person-Centered Planning was noted as an effective technique in building support; it is a way of building natural, unpaid social supports to promote continued employment.

Study shows physical and mental health benefits of sports participation in adolescents
This article describes the results of a study on the benefits that sports can have for adolescents. Research shows that 12- to 14-year-olds who play team sports and are physically active feel healthier and are happier with their lives. The study concludes that participation in youth sports not only has the potential to increase satisfaction with life at a key time in development but also to improve school connectedness, social support, and bonding with peers.

Empowerment in supported employment research and practice: Is it relevant?
Researchers in this study explored the connection between empowerment and quality of life of individuals with mental disorders entering supported employment. This study also examined empowerment's relationship to engagement in community life and individuals' experience with negative attitudes and beliefs. Results reaffirmed the value of empowerment in the supported employment setting and the importance in considering social and community integration benefits of having a job.

Prevalence and risk of violence against adults with disabilities: A systematic review and meta-analysis of observational studies
In this article, researchers report on findings from a review of prior studies examining the prevalence and risk of violence against individuals with disabilities in comparison to people who are not disabled. Although the types of disability and violence explored in the earlier studies varied, the authors of this article found that "adults with disabilities are at a higher risk of violence than are non-disabled adults, and those with mental illnesses could be particularly vulnerable."

Asset development for people with psychiatric disabilities: The essential roles of financial security in recovery
The University of Illinois at Chicago's National Research and Training Center on Psychiatric Disability conducted the study described in this report. The study examined how effectively asset development programs called individual development accounts (IDAs) in combination with other support programs helped individuals with severe mental disorders to recover. Researchers conducted a literature review and provided findings from an IDA program providing general financial education to individuals with mental disorders. After highlighting the success of IDA programs for people with mental disorders and the need for increased access to such programs, researchers share recommendations for program development and future research.

Shared decision-making in mental health care: Practice, research, and future directions
This report discusses the overall concept and value of the practice of shared decision-making (SDM) in the treatment of mental disorders. SDM is an approach that recognizes the importance of consumers' assuming an active role in communicating with care providers about their needs and preferences and ultimately assuming responsibility for making decisions about their own care. Researchers describe SDM as having the potential to enhance care and recovery. Research on SDM is explored in depth, and future steps and recommendations for policy and practice are discussed.

Housing for people with mental illness: Update of a report to the President's New Freedom Commission
This article summarizes many of the issues associated with the high rates of homelessness for individuals with mental disorders, all of which were reviewed by the Subcommittee on Housing and Homelessness of the President's New Freedom Commission. The article examines key subcommittee recommendations, as well as other topics related to preventing and responding to the issue of homelessness among people with mental disorders.

Dismantling the poverty trap: Disability policy for the twenty-first century
This article explores the high rate of poverty and unemployment that many individuals with disabilities experience and the role that economic reforms can play in addressing these issues. Researchers share recommendations for guiding such reforms.

Building partnerships: Conversations with communities about mental health needs and community strengths
This report produced by the UC Davis Center for Reducing Health Disparities examines the needs of underserved communities, strategies to prevent mental disorders, and ways to address mental health needs specifically while also identifying strengths within the community. Researchers partnered with agencies, members, and advocates within specific communities to give them an opportunity to express their view of what is needed in their community with the goal of helping counties develop their plans and programs for the prevention of mental disorders. Participants' responses highlighted a number of key factors within these communities, including the prevalence of violence and trauma, the role of social conditions such as poverty and unemployment as being a hindrance to community well-being, and the lack of affordable services available in communities.

Substance abuse prevention dollars and cents: A cost-benefit analysis
This report explores the importance of supporting substance abuse prevention programs. It analyzes substance use, including that of youth, costs of substance abuse to the country, and some potential cost savings of successful prevention programs and policies.

Poverty, social inequality and mental health
In this article, researchers note the role that poverty plays in suffering and inequality around the world and explore the direct and indirect impacts of poverty. They also examine the development of emotional, behavioral, and psychiatric problems in the context of the growing disparities between rich and poor, with special emphasis on the problems experienced by children. 

Adults traumatized by child abuse: What survivors need from community-based mental health professionals
In this study, researchers seek to gain an in-depth understanding of the impact of childhood abuse from the adults who have experienced it. They then describe the interventions and trauma treatment approaches that are the most effective. Study participants highlighted the need for trauma-based treatment that is easily accessible and for community-based therapists who are informed about trauma issues.

Psychiatry and recovery-oriented practice: A situational analysis
This report provides an overview of a collaborative project of the American Psychiatric Association, the American Association of Community Psychiatrists, and an advisory group comprising psychiatrists, other mental health professionals, and consumers. This project worked to develop and share educational materials for psychiatrists to encourage their use of recovery-oriented practices. SAMHSA's 10 recovery components are discussed and barriers, strengths, and opportunities associated with this approach are examined. Also, in this report, psychiatrists' current understanding and use of recovery-oriented practices is explored.

Population mental health: Evidence, policy, and public health practice
This book explores the evidence base for including issues related to mental disorders as a priority in the public health agenda. It discusses the connection between physical and mental disorders, the impact of health policies on the care of people with mental disorders, some of the barriers to developing a revised public health approach to mental disorders, and the use of public health intervention models.

Promoting mental well-being and social inclusion through art: Evaluation of an arts and mental health project
Researchers in this study review the benefits reported by consumers following their participation in introductory art courses offered by an arts and mental well-being project. Questionnaires used at the start and end of courses showed that participants recognized improvements in well-being and social inclusion.

Effectiveness of peer support in reducing readmissions of persons with multiple psychiatric hospitalizations
This study explored the feasibility and effectiveness of employing peer support as a means of decreasing reoccuring psychiatric hospitalizations. Based on study results, researchers concluded that using peer mentors is an effective approach to reducing both the frequency and length of hospitalizations for individuals with high likelihoods of being readmitted.

Mental health crisis: What do service users need when in crisis?
Researchers in this study explored the crisis needs of individuals seeking support services for mental disorders. One goal of the study was to learn whether there was strong support for the development of residential crisis services, an alternative to hospitalization. Study results indicated that 93 percent of both consumers and providers supported the idea of residential crisis services. In addition, participants' responses suggested that being able to express concerns and participating in decisions during treatment were also important.

What do consumers say they want and need during a psychiatric emergency?
This article is based on results of a survey seeking consumer perspectives and recommendations on enhancing emergency psychiatric care. Most participants had had negative experiences in hospital emergency rooms and suggested that specialized psychiatric emergency services be developed. Additional recommendations from consumer participants for improving emergency care included the incorporation of verbal interventions, taking a collaborative approach where consumers would be treated with respect and involved in treatment decisions, and an increase in the use of peer support services.

A case study of the peer-run crisis respite organizing process in Massachusetts
This case study examined the experiences of a group of consumers working to implement peer-run crisis respites (PRCRs) in Massachusetts. It includes information on the evidence base supporting PRCRs and different models of PRCRs as well as the grassroots organizing process used by the group to advocate for implementation of PRCRs in Massachusetts. The goal is to help inform groups in other communities interested in gaining support for and implementing PRCRs.

The Community Defined Evidence Project (CDEP)
This project is a collaborative effort between the National Latino Behavioral Health Association (NLBHA) and National Network to Eliminate Disparities in Behavioral Health (NNED) to advance understanding of effective community-based practices for Latinos. The project plans to develop an evidence base that uses key cultural and community indicators and to use this information to influence research, evaluation, policymakers, and funders to support efforts to implement and use community-based practices to reduce disparities and improve both access and quality of care for Latinos..

Reaching Out: An Action Plan on Social Exclusion
The Action Plan described in this article works to counter the experiences of many who have been socially excluded in the UK. The plan shifts from focusing on treatment to focusing on prevention to break the cycle of disadvantage. This plan has five key guiding principles: to develop better identification and earlier intervention; to systematically identify successful approaches; to promote collaboration among agencies; to tailor programs of support developed based on those in need; and to support achievement and manage underperformance.

The Imperative of a New Approach to Warrior and Veteran Care
Recognizing the alarming rates of depression, brain injury, and suicide among active service members and veterans, this policy brief describes the need for: a new model for dispersing federal funds; changes to the relationship between the Department of Defense (DOD) and Department of Veterans Affairs (VA); and inclusion of private-sector stakeholders, such as nonprofit organizations, in addressing these issues. It provides current statistics on service member and veteran mental and substance use disorders and recommendations for the White House, the DOD, and the VA to improve care.

Introduction to "Building communities from the inside out: A path toward finding and mobilizing a community's assets"
This publication is an introduction to a guide on rebuilding troubled communities that emphasizes identifying and building upon community strengths rather than focusing on deficits within the community. It includes success stories of communities that have thrived and the role that the asset-based community development strategy has played in developing steps toward community growth. This introduction explores ways the traditional approach has failed communities, identifies problems, and discusses solutions and assets of a community, including those of individuals, associations, and institutions.

Evidence-based practices and multicultural mental health
Current trends in the behavioral health field show a significant increase in the promotion of evidence-based practices (EBPs) and requirement that they be incorporated into health and behavioral health care services. This emphasis reflects efforts to increase quality and accountability in services provided. This article not only addresses the use of EBPs and what it means for health and behavioral health services but also how they relate to better care for multicultural populations. Some key factors discussed include the history of EBPs, cultural competence and adaptations of EBPs, and recommendations for policy.

Leading Change: A Plan for SAMHSA's Roles and Actions 2011-2014
This publication describes SAMHSA's plans for 2011 through 2014 to help people with behavioral health problems and their families. Their main focus is to help in developing strong communities, prevent behavioral health problems, and promote better health for all Americans. This plan is outlined by the eight new Strategic Initiatives that will guide SAMHSA's work, each Initiative with its own purpose, specific goal, action step, and measure for determining success.

"A disease like any other?" A decade of change in public reactions to schizophrenia, depression, and alcohol dependence
Over the last 15 years, behavioral health conditions have increasingly been described as medical diseases by behavioral health professionals, advocates, and policy makers as a way to counter lack of service use and negative and harmful attitudes and misconceptions. This study examined the effects that this neurobiological explanation has had on the rate of those seeking treatment and on the general public's attitude toward people with mental health challenges during the period of 1996-2006. Results suggest that this medical disease approach to understanding behavioral health problems has led to increased support for services but has not significantly reduced negative and harmful beliefs and attitudes. Researchers suggest that to reduce negative attitudes and discrimination, providers and advocates must shift to an emphasis on competence and inclusion.

Child wellness and social inclusion: Values for action
This article discusses various approaches to promoting inclusion of youth through Participatory Action Research (PAR). Recognizing the immense contributions that inclusion has on wellness, researchers address specific values of social inclusion on child wellness and the action needed to implement these values.

A common purpose: Recovery in future mental health services
This paper seeks to define recovery and discuss what recovery means for the development of future behavioral health services. It addresses ways the recovery approach can be beneficial for individuals' overall health and for social care services, i.e. services which address needs associated with the health and welfare of the population. The paper encourages mental health professionals, consumers, and friends and family of consumers to work toward enhancing current standards and making recovery a key component of developing services.

Does the scientific evidence support the recovery model?
The recovery model is a social movement that has continued to impact the development of mental health services worldwide. Some of its basic principles include optimism about outcome from psychosis, empowerment of individuals with behavioral health problems, and collaborative decision-making regarding treatment. This editorial highlights data that suggest positive outcomes for consumers with schizophrenia when optimism is incorporated into recovery. The editorial discusses how empowering individuals throughout recovery can enhance the process. The research shows that employment helps people recover from psychosis and demonstrates the importance of addressing the negative, internalized perceptions of behavioral health problems during recovery. This editorial goes on to address other ways in which these basic recovery model principles are supported by scientific research.

Housing First: The Pathways Model to End Homelessness for People with Mental Illness and Addiction
This manual provides a strong basis for introducing the evidence-based Housing First approach in addressing homelessness. It includes guidance in developing policies and programs. The DVD offered with this manual demonstrates the concepts shared, also including success stories of clients, model teams in action, and useful tips.

Shelter from the storm: Trauma-informed care in homelessness services settings
As the field of homeless services has advanced, providers have increasingly realized the importance of addressing long-term healing for people who have experienced homelessness, many of whom are trauma survivors. Trauma-Informed Care (TIC) provides a framework that can be used to support trauma survivors in homeless service settings and represents a promising area for increasingly effective and sensitive service approaches for highly vulnerable people. This paper explores the evidence for TIC within homelessness service settings and examines implications for providers, programming, policy, and research.

Transforming the nation's health: Next steps in mental health promotion
In this commentary, A. Kathryn Power, Director of the SAMHSA Center for Substance Abuse Prevention, advocates for a public health approach to behavioral health promotion and behavioral disorder prevention. She discusses the relationship of behavioral health to overall health and presents a strategy to build resilience at the individual, family, and community levels. She also describes SAMHSA's work to attain the goals within the strategy.

Mental health, social exclusion and social inclusion
This article outlines a social systems approach to understanding social exclusion of people with behavioral health problems. The author notes that social exclusion and inclusion are not opposites and offers an alternative way of thinking about them both. She asserts that society needs policy initiatives to eliminate structural barriers that lead to social exclusion and to challenge negative ideas and misconceptions about people with behavioral health problems.

Housing first services to people who are homeless with co-occurring and mental illness and substance abuse
This article details a study in which researchers contrasted outcomes for two groups of adults with co-occuring mental and substance use disorders who had been homeless. One group was in a Housing First program, the other in standard care. Housing First provides consumers with permanent, independent housing without requiring them beforehand to attain sobriety and enter treatment. Standard care requires participants to enter treatment before being placed in housing. After 48 months, researchers found no statistically significant differences in alcohol and drug use between the groups.

Housing First for long-term shelter dwellers with psychiatric disabilities in a suburban county: A four-year study of housing access and retention
This article describes a study in which behavioral health consumers with long histories of shelter use were assigned to a Housing First program or a control group. Housing First provides consumers with permanent, independent housing without being required beforehand to attain sobriety and enter into treatment. In the study, outcomes over four years were better for the group in the Housing First program.

Empowerment and peer support: Structure and process of self-help in a consumer-run center for individuals with mental illness
This study found that having social supports and developing a sense of self-esteem were factors that motivated people with behavioral health problems to continue to attend a self-help drop-in center. Findings from the study also suggest that people with behavioral health problems benefit from helping their peers.

Effects of participation in consumer-operated service programs on both personal and organizationally mediated empowerment: Results of multisite study
This study explores the effectiveness of consumer-operated service programs (COSPs). The authors explain that more evidence is needed to determine whether COSPs are effective and how they can be improved. However, they found some evidence to suggest that these programs empower consumers, and they explain that consumers who attend more often show more improvement. The authors also explain that studies of COSPs are complicated by the different types of COSPs available and by differing definitions of "empowerment." They conclude that researchers should continue to study COSPs but should more specifically study components of COSPs rather than whole programs.

WHO report on mental health and development: Targeting people with mental health conditions as a vulnerable group
This report from the World Health Organization asserts that people with behavioral health problems are often unfairly marginalized during development efforts around the world. To address this issue, the report emphasizes the need to consider people with behavioral health problems when planning a development agenda. Some of the recommendations include mainstreaming behavioral health services within the general health system, rebuilding behavioral health services during and after emergencies, and including people with behavioral health problems in the development process.

Towards an agenda for disability research in Europe: Learning from disabled people's organizations
This policy statement from the European Research Agendas for Disability Equality (EuRADE) project makes the case for including people with disabilities at every stage of social policy research, from the planning stages to completion. The authors assert that disability must be mainstreamed in research and disability-related research must be grounded in the social model of disability. The statement notes the challenges and opportunities for integrating people with disabilities into European research and outlines ways to promote acceptance and disability equality in research.

Mental health self-help: Consumer and family initiatives
This book includes an overview of the mental health self-help movement, which is a movement for behavioral health consumers and advocates to provide or improve treatment for people experiencing behavioral health problems. The authors provide a history of the movement, consider issues in training and funding for treatment, and suggest future directions for the movement. This book will be useful for community, clinical psychology, and public health researchers, as well as clinicians, counselors, social workers, case managers, and policymakers.

Average earnings significantly affected by serious mental illness
MedWire News reports on findings of a new study showing that people with mental health problems earn significantly lower wages. The study, published in the British Journal of Psychiatry, uses survey data collected by the World Health Organization.

Development of mental health first aid guidelines on how a member of the public can support a person affected by a traumatic event: a Delphi study
This article provides guidelines for assisting a child or adult who has experienced a traumatic event in hopes of preventing potential mental health problems. The authors describe the process they used to identify these guidelines, which included conducting a literature search, developing a questionnaire, and recruiting experts to vet potential guidelines. While the resulting list would benefit from an evaluation of effectiveness, it is useful to those developing a first aid or trauma intervention curriculum and to individuals assisting survivors of trauma.

Poverty and social exclusion in the WHO European Region: Health systems respond
This report from the World Health Organization includes studies from several countries, each examining the relationship between poverty and health, including mental health. The report includes information about how this relationship influences access to care and provides suggestions for addressing the needs of people experiencing poverty or social exclusion.

Warrior resilience training in Operation Iraqi Freedom: Combining rational emotive behavior therapy, resiliency, and positive psychology
The article's author describes his experience teaching Warrior Resilience Training (WRT) to service members deployed to Operation Iraqi Freedom. This training is offered in the combat zone to increase the resilience of combat personnel, and the author provides feedback related to WRT, as well as suggestions for better integrating and marketing behavioral health services through leaders on the front line.

Psychological resilience and postdeployment social support protect against traumatic stress and depressive symptoms in soldiers returning from Operations Enduring Freedom and Iraqi Freedom.
This article outlines the methods, results, and conclusions of a study showing that interventions to increase psychological resilience and social support may protect against mental health problems among service members returning from Operations Enduring Freedom and Iraqi Freedom.

Pillars of peer support: Transforming mental health systems of care through peer support services
This report summarizes the results and findings of the Pillars of Peer Support Services Summit, held at The Carter Center in November 2009. The Summit brought together representatives from States that currently provide formal training and certification for peer providers working in mental health systems. The purpose was to examine the multiple levels of support States need to provide in order to create a strong and vital peer workforce that is able to engage in mental health systems transformation.

Evolving definitions of mental illness and wellness
This article stresses the importance of adopting a more integrated view of mental and physical wellness and translating this view into concrete changes to our country's overall care delivery model. The article discusses the positive benefits that can be achieved through implementing linked approaches.

Shunned: Discrimination against people with mental illness
Thornicroft's book explores how negative perceptions affect the lives of people with mental health problems.

The Importance of Community Development For Health and Well-Being
This report examines the key role that environmental and community forces play in promoting health and preventing disease. In addition, the authors assert that social and public works programs will be more successful if people living in impacted neighborhoods are afforded the opportunity to participate in the creation and management of the initiatives that affect them.

Evaluation of a middle school mental health education program: Executive summary
Wahl details his findings that the "Breaking the Silence" curriculum may help prevent the formation of negative attitudes and foster more accurate understanding and acceptance of people with psychiatric disorders among middle school aged children.

Action towards healthy living-for all
This journal article suggests that remedial measures are necessary to ensure that public policies become more closely aligned with the findings of biomedical and social research regarding the key essentials of health and well-being.

Fair society, healthy lives: Strategic review of health inequalities in England post 2010
This paper describes British issues in health equity, social determinants of health, and UK-style societal interventions in both mental health and overall health with mental health playing a critical role.

Low Socioeconomic Status Affects Cortisol Levels in Children Over Time
A new study from Edith Chen and colleagues suggests that there is a positive correlation between low socio-economic factors and low cortisol levels in children. This may have implications in future susceptibility to physical illness and mental health problems.

Work transitions for peer support providers in traditional mental health programs: unique challenges and opportunities.
Peer support is gaining recognition as a valuable component of mental health service delivery and as a meaningful employment opportunity for mental health consumers. Despite the potential benefits of peer support, there continue to be many barriers to the development and funding of peer positions. This article reports on the results of a multisite project whose goal was to build capacity for employment of trained peer providers in local, community-based mental health programs.

Using Situation Testing to Document Employment Discrimination Against Persons with Psychiatric Disabilities
The authors of this article note that research has suggested that discrimination toward, and inaccurate perceptions of, people with mental health problems may cause people with these problems to be unemployed or underemployed. However, when this article was published, research had not yet looked closely at exclusionary and discriminatory employer behavior. In this article, the authors examine employment among people with mental health problems; review ways to determine how discrimination affects people with mental health problems on the job; and propose a new methodology, situation testing, which they write allows for a better understanding of workplace discrimination toward people with mental health challenges.

Towards social inclusion in mental health?
This article explores the uses of the terms "social exclusion" and "social inclusion" in a mental health context. Focusing on social inclusion as a remedy for the ills of social exclusion, this article discusses implications for contemporary mental health policy, practice, and research and concludes that a better theoretical understanding of causal mechanisms is needed to enable the development of more socially inclusive mental health services.

Vision and Progress: Social Inclusion and Mental Health
This report examines the progress of the National Social Inclusion Programme as it works to implement the activities outlined by the 2004 Mental Health and Social Exclusion Report. Details are given on the progress made so far and on the work still to be done.

Mental Health and Social Exclusion: Social Exclusion Unit Report
This report examines the impact mental health problems have on increasing social exclusion. The report also developed a 27-point action plan to address this problem.

Closing the gap in a generation: Health equity through action on the social determinants of health
This report examines the final findings from the World Health Organization's Commission on Social Determinants of Health.

A randomized trial of a mental health consumer-managed alternative to civil commitement for acute psychiatric crisis
This abstract describes a study in which researchers compared outcomes for nearly 400 people with serious psychiatric problems who participated in either a consumer-managed crisis residential program or in services in a locked inpatient treatment facility. Participants were randomly assigned to the consumer-managed program or the inpatient facility. They were interviewed within 3 days of starting the program or inpatient treatment, and then 30 days, six months, and 1 year later. Researchers found significantly greater improvements among people in the consumer-managed program in signs of mental health problems, both those identified by interviewers and those the people reported in themselves. People in the consumer-managed program also expressed much higher levels of satisfaction with the services in which they participated. This study provides research support for the idea that consumer-run programs may be as or more effective than hospitalization for people facing civil (involuntary) commitment for mental health problems. The full article is available at

History of Childhood Maltreatment Linked to Higher Rates of Unemployment, Poverty: Outcomes of Aubuse and Neglect Impost Significant Cost to Individual and Society
This article discusses the results of a study that examined the long-term impacts of childhood maltreatment, both for the individual and for society.

The Role of Social Network and Support in Mental Health Service Use: Findings From the Baltimore ECA Study
A significant number of people with mental illness do not use mental health services to receive treatment for their symptoms. This study examined the hypothesis that social network and social support affect mental health service use. Increased contact with the social network and higher levels of social support were associated with greater use of general medical services. However, more social support was associated with use of fewer services within the specialty psychiatric sector.

Compeer friends: A qualitative study of a volunteer friendship programme for people with serious mental illness
This study explored the benefits and drawbacks of an intentional friendship programme (Compeer, Inc), which develops new social relationships for people with serious mental illness by matching them in one-to-one relationships with community volunteers for weekly social activities.

The meaning and importance of employment to people in recovery from serious mental illness: Results of a qualitative study
Given the high rates of unemployment and underemployment among individuals with psychiatric disabilities, only a small number of studies have investigated the role work has in the lives of people who have been successful vocationally during their recovery from serious mental illness. This study sought to add to existing literature by determining how individuals perceive work and its effect on their recovery.

Social relationships as a decisive factor in recovering from severe mental illness
Recovery research often describes recovery from mental illness as a complex individual process. In this article a social perspective on recovery is developed. Researchers aim to ascertain which factors people regard as decisive to their own recovery and what makes them beneficial.

Passing for "normal": Features that affect the community inclusion of people with mental illness
The purpose of this study was to investigate specific features that indicate to community members that a person has a mental illness and the emotional reactions elicited by these features, in hopes of understanding barriers to the community integration of people living with mental illnesses.

Attitudes toward mental health services: age-group differences in Korean American adults
The present study examined the attitudes toward mental health services held by younger and older groups of Korean Americans. The findings provide important implications for interventions targeted to improve access to mental health care among minority populations. Based on the similarities and differences found between young and old, both general and age-specific strategies need to be developed in order to increase effectiveness of these programs.

Addressing Recovery from Severe Mental Illness in Clinical Supervision of Advanced Students
This article begins a dialogue about the need to incorporate emerging knowledge about recovery as an attainable outcome for individuals with mental illness in academic curricula. The author proposes that clinical supervision from a recovery model is faced with at least four semi-distinct challenges: the discovery and avoidance of negative misconceptions, the setting of consensually valid and personally relevant goals, the development of a therapeutic relationship, and the assessment of barriers to recovery and outcomes.

So I wouldn't feel like I was excluded: The learning experience in computer education for persons with psychiatric disabilities.
This paper describes an exploratory, qualitative examination of factors that aid in the acquisition of computer skills by 12 adults across 2 settings: a structured, professionally-taught program and a less structured peer-taught setting. These pilot findings highlighted the importance to teaching effectiveness of striking a balance between flexibility and structure, with computer knowledge having broader implications for social inclusion.

Perceived helpfulness of websites for mental health information : A national survey of young Australians
Despite the high risk of developing a mental disorder during adolescence, many young people fail to receive appropriate treatment from mental health professionals. Recent studies have found certain mental health information websites have improved mental health literacy and reduced symptoms of depression. However, studies exploring young people's perceptions of such resources still remain scarce. The current paper compared young people's preference for a website with self-help books and two face-to-face services-counselling and mental health services.

Desire for social distance from people with mental disorders.
The review examines measurement of social distance; characteristics of people who desire greater social distance; experiences that affect social distance; characteristics of people that elicit social distance; the effects of psychiatric labelling; the effects of causal explanations for mental disorders; and interventions to reduce social distance.

SESAMI study of employment support for people with severe mental health problems: 12-month outcomes
In the context of UK policy to promote employment for people with disability as a means to greater social inclusion, this study investigated how people with severe mental health problems fare in existing supported employment agencies. The aim of the study was to identify factors associated with successful placement in work and to test the impact of working on psychological well-being in this group.

Patient ethnicity and perceptions of families and friends regarding depression treatment
Black Americans are less likely than white Americans to seek professional treatment for depression. Whether treatment recommendations are sought and implemented by patients will be influenced by the role families and friends play in diagnostic acceptance and treatment decisions. Researchers investigated the association of ethnicity with the perceived need for treatment of depression by family and friends of older primary care patients.

Impact of a mental health teaching programme on adolescents
This study examines the positive impact of a six lesson study course on mental health issues given to a class of 14 and 15 year olds versus a control class who did not receive the lessons. Researchers found the lessons were successfully able to increase understanding and acceptance of mental health issues in peers while promoting disclosure among these adolescents along with prosocial behaviors. Participating pupils had positive reactions to the lessons and recognized the importance of learning about mental health.

Physicians-in-training attitudes toward caring for and working with patients with alcohol and drug abuse diagnoses
This study is designed to identify the progression of attitudinal shifts over time of physicians-in-training toward caring for people who receive substance abuse treatment.

Shame, not guilt, related to substance-abuse problems; Reducing feelings of shame may be key to more effective treatment
This study included three groups of participants with different levels of alcohol and drug problems. Two groups were primarily female college students about 20 years of age. The third group was comprised of predominantly male inmates from a metropolitan area jail who were, on average, 31 years of age.It appears that individuals who are prone to shame when dealing with a variety of life problems may also have a tendency to turn toward alcohol and other drugs to cope with this feeling.

Self-labeling and its effects among adolescents diagnosed with mental disorders
This study uses mixed-method interviews with 54 US adolescents receiving integrated mental health services in a mid-sized mid-Western city to examine: (1) the extent to which they use psychiatric terms to refer to their problems ("self-label"), and (2) the relationships between adolescents' self-labeling and indicators of psychological well-being. Researchers found that adolescents who self-labelled had more negative attitudes towards themselves and were more likely to suffer from depression. Additionally, correlations were found between the likelihood to self-label with higher perceived negative public attitudes, younger age of diagnosis, and higher socio-economic status.

Increasing social support for individuals with serious mental illness: evaluating the compeer model of intentional friendship
In this study, the authors conducted a quasi-experimental study of Compeer, which matches community volunteers and people with SMI to increase social support.

Soldier attitudes toward mental health screening and seeking care upon return from combat
This study examined soldier attitudes about postdeployment mental health screening, treatment, barriers to care, strategies for overcoming barriers, and settings, personnel and timing for conducting postdeployment mental health screening.

Community integration of transition-age individuals: views of young with mental health disorders
This qualitative study examines the perceptions of young adults with mental health disorders of community integration.Implications of the study discuss roles for behavioral health services in encouraging empowerment, choices, and connections so that young people with mental health disorders may achieve their preferred levels of community integration.

How does being female assist help-seeking for mental health problems?
The aim of the present study was to examine a number of attitudinal factors that may influence different help-seeking behaviors for mental health problems between men and women. Men scored higher on measures of stoicism and negative self attitudes associated with mental health problems than women, and compared to women had lower scores on the facets of openness to experience. Researchers believe these differences contribute to lower rates of help-seeking behaviors in men compared to women.

Chapter 5 of "Mental health: A report of the Surgeon General": Older adults and mental health
This chapter of the Surgeon General's report on mental health addresses various areas of interest for the older adult population, specifically considering mental disorders in older people - their diagnosis and treatment, and the various risk factors that may complicate the course or outcome of treatment.

Evaluating the effectiveness of a consumer-provided mental health recovery education presentation
The current study investigated the effectiveness of the In Our Own Voice (IOOV) mental health education program in improving knowledge and attitudes about mental illnesses.  

Solutions to discrimination in work and housing identified by people with mental illness
This study examines perceived solutions to discrimination in housing and employment situations.

No comfort in the rural south: Women living depressed
An article discussing the opportunities for research and strategy that exist for providing mental health services to women in a rural area.

Social network's healing power is borne out in poorer nations
This article describes the findings of a 3-decade-long study by the World Health Organization (WHO) which found that mental health consumers in poorer countries have higher rates of recovering from schizophrenia. Key findings described explore the role that family support, culture, and other social networks have on individuals with schizophrenia. This article discusses the differences in the roles of doctors, the invaluable role of families, and the importance of integrating social and cultural supports with medicine to achieve more positive outcomes.

American with Disabilities Act of 1990
The current text of the Americans with Disabilities Act of 1990 ["ADA"], as amended.

President's New Freedom Commission on Mental Health
The Commission's mission was to study the United States mental health service delivery system, including both private and public sector providers. The Commission advised the President on methods to improve the system. The Commission's goal was to recommend improvements that will enable adults with a serious mental illness and children with a serious emotional disturbance to live, work, learn, and participate fully in their communities.

An attribution model of public discrimination towards persons with mental illness
In this study, researchers build on previous work by developing and estimating a model of the relationships between causal attributions (e.g., controllability, responsibility), familiarity with mental illness, dangerousness, emotional responses (e.g., pity, anger, fear), and helping and rejecting responses. The results from this study also suggest that familiarity with mental illness reduces discriminatory responses.

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