A Randomized Trial of a Mental Health Consumer-Managed Alternative to Civil Commitment for Acute Psychiatric Crisis (original) (raw)

2008, American Journal of Community Psychology

This experiment compared the effectiveness of an unlocked, mental health consumer-managed, crisis residential program (CRP) to a locked, inpatient psychiatric facility (LIPF) for adults civilly committed for severe psychiatric problems. Following screening and informed consent, participants (n=393) were randomized to the CRP or the LIPF and interviewed at baseline and at 30-day, 6-month, and 1-year post admission. Outcomes were costs, level of functioning, psychiatric symptoms, selfesteem, enrichment, and service satisfaction. Treatment outcomes were compared using hierarchical linear models. Participants in the CRP experienced significantly greater improvement on interviewerrated and self-reported psychopathology than did participants in the LIPF condition; service satisfaction was dramatically higher in the CRP condition. CRP-style facilities are a viable alternative to psychiatric hospitalization for many individuals facing civil commitment. Keywords Serious mental illness; consumer-managed services; recovery; mutual help; randomized trial Consumer-managed programs have a long history in the psychiatric services field, beginning around the middle of the 20 th century with organizations such as Recovery Incorporated and Fountain House (Beard, Propst, & Malamud, 1982; Lee, 1995). In more recent decades, such programs have received increased visibility and support through the efforts of governmental (e.g., The Community Support Program of the Center for Mental Health Services) and community-based organizations (e.g., The National Empowerment Center). In the U.S. today, mental health consumers operate or play a major role in a wide range of programs including self-help groups, drop-in centers, clubhouses, independent living centers, advocacy organizations, case management services, employment agencies, supported housing, and information and referral lines (Chamberlin,