Community Living with Mental Illness: A Sensory Health Initiative (2025-2026)
Background
The U.S. Department of Justice has entered a settlement agreement with the state of North Carolina for failing to provide mental health services in the least restrictive environment as required by the U.S. Supreme Court decision Olmstead v. L.C. As part of the settlement, the state is engaged in widespread efforts to transition adults with serious mental illness to independent living.
Living independently in the community requires stable housing. Obtaining and maintaining stable housing requires mastery of many activities of daily living necessary for successful home management (e.g., bill paying, cooking, shopping, managing transportation). Individuals with severe mental illness (SMI) often experience significant cognitive and sensory processing challenges that prevent them from successfully completing activities of daily living necessary for maintaining a home.
Supporting the activities of daily living of adults with severe mental illness should be a high priority in policy change. However, there is no existing evidence-based tool to screen adults in this community for challenges with these activities and help identify intervention targets relevant to their independent living and community integration. Preliminary screens for living skills and sensory health have been developed by a previous team, but they must be tested to ensure they meet their goal of enabling health providers across the state to quickly identify which supports are needed for their clients.
Project Description
This project team will partner with diverse stakeholders to support the independent living and community integration of adults with SMI. They will adopt an implementation science approach using collaborative participatory methods to enhance the feasibility, acceptability and usability of the living skills and sensory health screens developed by previous teams, as well as developing manuals for the implementation of these tools.
The team will recruit expert stakeholders and facilitate three working groups: one group of peer support specialists (adults with SMI who are in recovery and have received training to work with their peers), one group of community mental health providers and one group of occupational therapists. These working groups will provide feedback on the screening tools and field test them in their respective settings. The team will then work to improve the screens and associated materials and draft a manuscript to report the findings of the working groups.
Anticipated Outputs
Manuals and trainings for the use of screening tools; data on the feasibility, acceptability and usability of the screens; refinements of the screens and manuals; a peer-reviewed manuscript; community resources based on stakeholder input
Student Opportunities
Ideally, this project team will include 2 graduate students and 8 undergraduate students interested in disciplines such as psychology, anthropology, sociology, computer science and the humanities. The team will particularly seek graduate students from Duke’s occupational therapy doctorate program.
As members of this team, students will participate in working groups with stakeholders to share their expertise and learn processes of facilitating communication among diverse experts. Students will provide their input regarding the research questions and study protocols that emerge from the working groups. They will also have opportunities to participate in drafting manuscripts and developing products for dissemination (e.g., drafting web-based resources, helping to create a team website, recording content videos, etc.).
Through weekly meetings, team members will participate in a journal club to discuss content related to the project. Students may also be invited to participate in activities beyond the project period (e.g., drafting a grant proposal, conducting further research).
In Fall 2025, the team will meet on Tuesdays from 1:30-2:30 p.m.
A graduate student will be selected to serve as a project manager.
Timing
Fall 2025 – Spring 2026
- Fall 2025: Journal club and literature review; draft manuals for using screens, conduct first working group meeting; test and refine screens and trainings
- Spring 2026: Conduct second working group meeting; continue to refine screens and trainings; develop community resources; draft manuscript
Crediting
Academic credit available for fall and spring semesters
See earlier related team, Community Living With Mental Illness: A Sensory Health Initiative (2024-2025).