Investigators: Sharon E. Carpinello, Ph.D., Edward Knight, Ph.D., Lynn Videka-Sherman, Ph.D., Carla Sofka, Ph.D., and Fred Markowitz, Ph.D.
PROJECT GOALS
This study examines the determinants and distribution of self-selection and choice of
self-help strategies in a population of adults diagnosed with a major mental illness.
Self-help strategies are alternatives to traditional mental health services and include
participation in organized self-help groups and recipient-operated services.
The specific goals of this two-part study are to:
RESEARCH ACTIVITIES AND RESULTS
Two sub-studies investigated the decision making process that leads to the use of
self-help strategies: a cross-sectional survey and a cohort study. The cross-sectional
design was used to examine variables hypothesized to be related to participation and
nonparticipation in self-help. Respondents (N = 554) were sampled from mental
health service sites and self-help groups in the western region of New York State.
Sixty-seven percent were from self-help groups and the remainder were from mental health
programs. About one-third of the respondents were dually diagnosed with an addictive
disorder and a major mental illness.
The cohort study, which was qualitative in nature, addressed the question: Will adults self-select to a self-help group when barriers are reduced, when information and referral sources are provided, and when support networks are established and sustained? A peer advocate interviewer met with individuals (N = 14) at the time of their discharge from a psychiatric hospital and every month following the initial contact. The peer advocate interviewed the participants, shared information about self-help, provided transportation to meetings, and held meetings to introduce study participants to self-help group leaders and to inform participants of specific self-help group information, such as locations and meeting times.
Findings from the cross-sectional study indicate that participants in self-help groups tended to be older, white, and married, and to have a higher level of education. A participant's diagnosis and symptoms were not related to participation. Sixty-four percent of survey respondents (N = 347) reported that they were currently participating in at least one self-help group. Of this number, 65% (N = 224) were currently involved in a mental health designated group. The amount of time spent with family and friends had no relationship to a person's participation in groups. Results also indicate that participants in self-help groups were less likely than nonparticipants to have been hospitalized in the last five years. Additionally, findings suggest that participation may vary by the type of self-help group.
Participants in the cohort study differed from participants in the cross-sectional study in that those in the cohort study were more likely to be younger, less well, and male. None of the study participants became solidly affiliated with self-help groups. Thirty-six percent of the participants attended one or more meetings and only attended with a peer advocate. Problems related to health, life resources, and the scheduled time of meetings were the primary reasons given for lack of participation.
SIGNIFICANCE OF FINDINGS/POLICY IMPLICATIONS
This self-help project was designed within a self-directed recovery framework.
Results indicate that in a five year period participants in self-help groups were less likely to have been hospitalized
than non-participants. This finding suggests that self-help
programs aid the
recovery process and help reduce the use of mental health services. Integration of
self-help into traditional approaches may further act to reduce overall service
use. Combined use of self-help and traditional approaches are possible, rather than
requiring selection of any one method over the other.
Project completed.
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