A longitudinal study of mental health consumer/survivor initiatives: Part 2—A quantitative study of impacts of participation on new members (original) (raw)
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Journal of Community Psychology, 2007
The objective of this study was to evaluate the impacts of participation in mental health Consumer/Survivor Initiatives (CSIs), organizations run by and for people with mental illness. A nonequivalent comparison group design was used to compare three groups of participants: (a) those who were continually active in CSIs over a 36-month period (n = 25); (b) those who had been active in CSIs at 9- and 18-month follow-up periods, but who were no longer active at 36 months (n = 35); and (c) a comparison group of participants who were never active in CSIs (n = 42). Data were gathered at baseline, 9-, 18-, and 36-month follow-ups. The three groups were comparable at baseline on a wide range of demographic variables, self-reported psychiatric diagnosis, service use, and outcome measures. At 36 months, the continually active participants scored significantly higher than the other two groups of participants on community integration, quality of life (daily living activities), and instrumental role involvement, and significantly lower on symptom distress. No differences between the groups were found on other outcome measures. Improvements in 36-month outcomes for people with mental illness who participated in CSIs suggest the potential value of these peer support organizations. Further research is needed to determine the replicability of these positive findings. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 655–665, 2007.
Journal of Community Psychology, 2006
Mental health consumer-run organizations are alternatives to mainstream mental health services, and they have the dual focus of supporting members and creating systems change. The existing literature suggests that these organizations have beneficial impacts on social support, community integration, personal empowerment, subjective quality of life, symptom distress, utilization of hospitals, and employment/education. However, much of this research is cross-sectional or retrospective and has not used comparison groups, thus limiting conclusions about the effectiveness of these organizations in improving the lives of members. Although many consumer-run organizations also have a focus on social systems change, there has been little research documenting either the nature of these activities or the system changes that result from such activities. We provide an overview of a longitudinal study of four mental health Consumer/Survivor Initiatives. The study examines both individual-level and systems-level activities and impacts by using both quantitative and qualitative methods with a participatory action research framework. © 2006 Wiley Periodicals, Inc.
Journal of Community Psychology, 2006
This article examines the outcomes of participation in mental health Consumer/Survivor Initiatives (CSIs) and identifies helpful qualities of CSIs through a longitudinal, qualitative study that involved in-depth interviews of people who experienced severe mental health challenges in Ontario, Canada. We used a nonequivalent control group design in which we compared active participants in CSIs ( n = 15) with nonactive participants ( n = 12) at baseline and at 9- and 18-month follow-up intervals. Compared with non-CSI participants, CSI participants reported more stable mental health, enhanced social support, sustained work, stable income, and participation in education and training at 9- and 18-month interviews. The helpful qualities of CSIs that participants reported were (1) safe environments that provide a positive, welcoming place to go; (2) social arenas that provide opportunities to meet and talk with peers; (3) an alternative worldview that provides opportunities for members to participate and contribute; and (4) effective facilitators of community integration that provide opportunities to connect members to the community at large. The findings are discussed in terms of previous research in self-help and consumer-run organizations in mental health. © 2006 Wiley Periodicals, Inc.
Journal of Community Psychology, 2006
Consumer/Survivor Initiatives (CSIs) and identifies helpful qualities of CSIs through a longitudinal, qualitative study that involved in-depth interviews of people who experienced severe mental health challenges in Ontario, Canada. We used a nonequivalent control group design in which we compared active participants in CSIs (n = 15) with nonactive participants (n = 12) at baseline and at 9-and 18-month follow-up intervals. Compared with non-CSI participants, CSI participants reported more stable mental health, enhanced social support, sustained work, stable income, and participation in education and training at 9-and 18-month interviews. The helpful qualities of CSIs that participants reported were (1) safe environments that provide a positive, welcoming place to go; (2) social arenas that provide opportunities to meet and talk with peers; (3) an alternative worldview that provides opportunities for members to participate and contribute; and (4) effective facilitators of community integration that provide opportunities to
Journal of Mental Health, 2006
Background: Mental health consumer-run organizations are becoming more prominent in mental health systems, but little is known about their nature or impacts. Aims: The objectives were to determine the nature of member participation in consumer-run organizations and how participation is related to outcomes. Method: We prospectively studied 79 new members of four consumer-run organizations in Ontario over an 18-month period. Results: Members participated most often in internal activities (e.g., social-recreational, committees) and least often in external activities (e.g., advocacy, planning, education), with an average of three activities per month. Participation did not change over time, but participation in self-help groups and external activities did vary by setting. The quality, but not the amount, of participation was significantly related to social support at 9 and 18 months and to community integration, quality of life (daily activities), and employment/education at 9 months, over and above the effects of demographic variables and baseline measures of these variables. Conclusion: The findings suggest that member participation in consumer-run organizations is both diverse and stable, and that the quality of participation does enhance short-term outcomes. Declaration of interest: This research was one of several projects funded under the Community Mental Health Evaluation Initiative (CMHEI) by the Ontario Ministry of Health and Long-Term Care through the Ontario Mental Health Foundation.
Toward the Implementation of Mental Health Consumer Provider Services
The Journal of Behavioral Health Services & Research, 2006
Encouraged by the New Freedom Commission, mental health systems such as the Veteran Administration (VA) are now becoming more recovery-oriented. Consumer providers (CPs)-those with serious mental illness who are further along in recovery who provide services to others with similar mental health problems-are viewed as a key part of this change. However, organizational change theories suggest that careful consideration of implementation issues is critical when disseminating new and sometimes controversial services into existing organizations. Therefore, to guide the dissemination of CP services, the literature on the effectiveness of CPs was reviewed, and interviews, focus groups, and a brief survey of 110 administrators, providers, and patients were conducted at three large VA clinics in Southern California. Questions focused on their perceptions of feasibility and acceptability of CP services. Using literature and study findings, an organizational change framework and other strategies to overcome potential implementation challenges of CP services are suggested.
Consumer and carer participation in mental health services
Australasian Psychiatry, 2003
To clarify the meaning of consumer and carer participation in mental health services, to identify reasons why consumer participation is important both to consumers and to services, and to discuss barriers to participation and ways of overcoming these barriers.
Activity participation patterns of community mental health consumers
British Journal of Occupational Therapy, 2020
Introduction Previous international research indicates that people with severe mental illness often experience lower levels of activity participation and may therefore be marginalized from occupational opportunities that support recovery. This study aimed to describe activity and participation patterns of consumers of mental health services living in the community and identify significant relationships with demographic characteristics. Method A cross-sectional observational study design was utilized, via data mining of the Activity and Participation Questionnaires completed while receiving services from an area mental health service. Data for 282 consumers, who submitted 333 questionnaires, were included. Results Consumers were mostly engaged in home-based and unpaid work, and their participation in these tasks significantly increased over time. Significant relationships were found between activity participation and age, gender and primary language. Consumers who were older were les...
American Journal of Community Psychology, 2008
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,