Session number: 1108
Abstract title: Improving public sector mental health care through the use of consumers
Author(s):
MJ Chinman - VISN 22 MIRECC
AS Young - VISN 22 MIRECC
Objectives: Research has often demonstrated that the usual care for patients with serious
mental illness (SMI) in public sector settings is of low quality. Studies
outside the VHA have shown that the use of various consumer based interventions
such as consumer providers, consumer run services, and mutual support groups
can often improve public care. All are based on the mutual support philosophy;
participants share personal experiences, serve as role models to facilitate
the learning of problem-solving skills, and provide hope for recovery.
Involving consumers in mental healthcare parallels substance abuse treatment,
which often utilizes people in recovery from their own addictions due to their
first-hand knowledge and credibility as role models. Although consistent with
the VHA's emphasis on hiring veterans, the use of mentally ill veterans to
provide mental health services appears not to be common. Therefore, we present
a review of the literature and original empirical work in order to examine how
to begin to consider this model for the VHA in order to improve SMI services
for veterans.
Methods: Several research databases were searched for studies using consumer-based
services. Studies' methods and results were reviewed. The empirical work
involved about 1000 homeless mentally clients from a national homeless
outreach demonstration program. We compared those who received services from
consumer case managers to those who received services from case managers who
were not consumers with a series of one-way Repeated Measures of Analyses of
Variance analyses across three timepoints on several clinical, social, and
functioning outcomes.
Results: The literature reviewed showed that employing consumers and mutual support
groups are feasible, show positive client outcomes, and can improve care.
In the consumer provider study, both groups of clients improved significantly
over time on almost every outcome measure. There were no significant Time by
Case Manager Type interactions. Staff age, race, or gender did not
significantly alter the pattern of these results.
Conclusions: The review of the literature and the empirical results show the ability of
consumers to become involved in providing mental health services.
Impact statement: Incorporating consumers into the VHA mental health system has promise to
improve services for veterans with SMI.