Determinants of mental health providers' expectations of patients' improvement

Jeffrey A. Alexander, Richard Lichtenstein, Thomas D'Aunno, Richard McCormick, Naoko Muramatsu, Esther Ullman

Research output: Contribution to journalArticle

Abstract

Objective: Characteristics of individual mental health providers and of treatment settings were examined to determine their effects on providers' expectations about the improvement of patients with serious mental illness. Methods: The sample consisted of 1,567 treatment providers working in 107 inpatient and outpatient units or programs in 29 Veterans Affairs mental health facilities. They completed a questionnaire about their prognostic expectations and a broad range of attitudes toward job satisfaction, professional relations, and team functioning. Unit or program directors of all 107 units completed another questionnaire about the average functional ability of patients, unit workload, and unit size. Hierarchical linear modeling was used to assess the effects of both individual and unit-level attributes on providers' expectations of improvement in clinical symptomatology and social-functional skills of patients in their care. Results: The providers had generally low expectations about the improvement of patients with serious mental illness. Expectations were higher among staff in units or programs that were smaller and that had an outpatient focus, a greater proportion of staff involved in the treatment team, and higher- functioning patients. Individual characteristics significantly associated with prognostic expectations were occupation, age, and membership on the treatment team. Conclusions: Prognostic expectations among providers of care to persons with serious mental illness vary with identifiable individual and unit or program characteristics. The latter may be amenable to manipulation and intervention to improve mental health providers' prognostic expectations.

Original languageEnglish (US)
Pages (from-to)671-677
Number of pages7
JournalPsychiatric Services
Volume48
Issue number5
StatePublished - May 1997

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Mental Health
mental health
determinants
mental illness
Outpatients
Aptitude
Job Satisfaction
Health Facilities
Veterans
Therapeutics
Workload
Occupations
Inpatients
staff
questionnaire
job satisfaction
workload
manipulation
director
occupation

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Health Professions(all)

Cite this

Alexander, J. A., Lichtenstein, R., D'Aunno, T., McCormick, R., Muramatsu, N., & Ullman, E. (1997). Determinants of mental health providers' expectations of patients' improvement. Psychiatric Services, 48(5), 671-677.

Determinants of mental health providers' expectations of patients' improvement. / Alexander, Jeffrey A.; Lichtenstein, Richard; D'Aunno, Thomas; McCormick, Richard; Muramatsu, Naoko; Ullman, Esther.

In: Psychiatric Services, Vol. 48, No. 5, 05.1997, p. 671-677.

Research output: Contribution to journalArticle

Alexander, JA, Lichtenstein, R, D'Aunno, T, McCormick, R, Muramatsu, N & Ullman, E 1997, 'Determinants of mental health providers' expectations of patients' improvement', Psychiatric Services, vol. 48, no. 5, pp. 671-677.
Alexander JA, Lichtenstein R, D'Aunno T, McCormick R, Muramatsu N, Ullman E. Determinants of mental health providers' expectations of patients' improvement. Psychiatric Services. 1997 May;48(5):671-677.
Alexander, Jeffrey A. ; Lichtenstein, Richard ; D'Aunno, Thomas ; McCormick, Richard ; Muramatsu, Naoko ; Ullman, Esther. / Determinants of mental health providers' expectations of patients' improvement. In: Psychiatric Services. 1997 ; Vol. 48, No. 5. pp. 671-677.
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