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The role of guardianship in the course of treatment and treatment outcome for individuals recovering from severe mental illness.

机译：监护在严重精神疾病康复者的治疗过程和治疗结果中的作用。

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The purpose of this study was to evaluate the role of guardianship in treatment and treatment outcome for people recovering from severe mental illnesses (SMI) in a psychiatric rehabilitation context. Research in the intersecting field of mental health care and the law is in its nascence. Using the unifying theory of therapeutic jurisprudence, this study investigates the clinical correlates of guardianship in a population of people with SMI. An archival database from an inpatient psychiatric rehabilitation program in a Nebraska state hospital was used in analysis. This was an ideal context and population for the study because this group of people is highly affected by the legal constructs evaluated in this investigation. The archival database contained comprehensive clinical, demographic, and outcome data for all participants. This included assessments of neurocognition, social cognition, symptomatology, behavioral functioning, and treatment compliance. In addition, outcome data regarding discharge location and rehospitalization were available. Two main hypotheses were put forth towards the overall purpose of this study. First, it was hypothesized that people with guardians would demonstrate lower overall functioning at the time of admission and throughout the course of treatment across multiple domains when compared to those without guardians. Second, it was hypothesized that people with guardians would be discharged to more restrictive community placements than those without guardians, but that they would have a lower rate of rehospitalization. Partial support for both hypotheses was obtained. Results suggest that, in Nebraska, people with guardians can be discriminated from those without guardians based on behavioral functioning. In addition, people with guardians were found to have a longer length of stay. Other areas of clinical functioning assessed---neurocognition, social cognition, symptomatology, and treatment compliance---were not found to differ between those with and without guardians. People with guardians were discharged to more restrictive settings and there is some evidence that they were rehospitalized sooner than those without guardians. This is the first known study to empirically investigate the role of guardianship in the recovery of people with SMI.
机译：这项研究的目的是评估在精神病康复背景下监护人在严重精神疾病（SMI）中康复的人的治疗和治疗结果中的作用。在精神卫生保健和法律相交领域的研究处于萌芽状态。使用治疗法学的统一理论，本研究调查了SMI人群中监护权的临床相关性。分析使用了内布拉斯加州州立医院住院精神病康复计划的档案数据库。这是该研究的理想背景和人群，因为该人群受到本次调查评估的法律架构的高度影响。档案数据库包含所有参与者的综合临床，人口统计和结果数据。这包括对神经认知，社交认知，症状，行为功能和治疗依从性的评估。此外，可获得有关出院位置和再次住院的结局数据。针对本研究的总体目的提出了两个主要假设。首先，假设与没有监护人的人相比，有监护人的人在入院时和整个治疗过程中表现出较低的整体功能。其次，假设与没有监护人的人相比，有监护人的人将被送往更具限制性的社区安置，但他们的重新住院率较低。获得了两个假设的部分支持。结果表明，在内布拉斯加州，可以根据行为功能将监护人与没有监护人的人区分开。此外，发现有监护人的人的逗留时间更长。没有发现有监护人的临床功能的其他领域-神经认知，社会认知，症状学和治疗依从性-没有区别。有监护人的人被放到更加严格的环境中，有证据表明，他们比没有监护人的人更早被送往医院。这是第一项以经验调查监护在SMI患者康复中的作用的已知研究。

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