Patterns of recovery from severe mental illness: a pilot study of outcomes.
We performed a pilot study examining the patterns of recovery from severe mental illness in a model integrated service delivery system using measures from the Milestones of Recovery Scale (MORS), a valid and reliable measure of recovery outcomes which ranges from 1 to 8 (8 levels). For purposes of presentation, we constructed an aggregate MORS (6 levels) where the levels are described as follows: (1) extreme risk; (2) unengaged, poorly self-coordinating; (3) engaged, poorly self-coordinating; (4) coping and rehabilitating; (5) early recovery, and (6) self reliant. We analyzed MORS data on individuals followed over time from The Village in Long Beach, California (658 observations). Using Markov Chains, we estimated origin-destination transition probabilities, simulating recovery outcomes for 100 months. Our models suggest that after 12 months only 8% of "extreme risk" clients remain such. Over 40% have moved to "engaged, poorly self-coordinating." After 2 years, almost half of the initial "extreme Risk" clients are "coping/rehabilitating", "early recovery" or "Self reliant." Most gains occur within 2 years.
Miller
Leonard
L
Petris Center on Health Care Markets and Consumer Welfare, University of California at Berkeley, 2150 Shattuck Avenue, Suite 525, Berkeley, CA 94704, USA.
Brown
Timothy T
TT
Pilon
David
D
Scheffler
Richard M
RM
Davis
Monica
M
D000223:Adaptation, Psychological; D019033:Delivery of Health Care, Integrated; D006801:Humans; D008390:Markov Chains; D001523:Mental Disorders / Q000523:psychology* / Q000534:rehabilitation / Q000628:therapy; D008605:Mental Health Services / Q000592:standards; D017063:Outcome Assessment, Health Care / Q000592:standards; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D012074:Remission Induction; D012307:Risk Factors