System Level Performance Measures of Recovery

Principal Investigators: Jeanne Dumont, Ph.D., Steven Onken, Ph.D. Co-investigators: Priscilla Ridgeway, MSW, Doug Dornan, MSW, Ruth Ralph, Ph.D.

PROJECT GOALS

Project goals are to:

Describe system factors that mental health consumers identify as either helping or hindering the process of recovery, and

Determine whether this information can be used to establish performance indicators to provide service accountability and help shape policies and systems fostering recovery.

RESEARCH ACTIVITIES AND RESULTS

Methods: Ten focus groups involving 115 consumers were held in which personal, provider and system factors that participants felt had either helped of hindered them in the recovery process were discussed. The goal was to develop performance measures for recovery for state and local service systems.

This Center provided supplemental funding to analyze qualitative data collected from these focus groups discussions. Transcripts of meetings were coded to identify unique concepts and critical themes. Transcript reports were then developed and focus group participants re-contacted to confirm findings and rate the importance of each identified theme. A common codebook based on the unique concepts from each transcript was developed and organized according to critical themes.

Results: Consumers identified systems that promote self-determination, positive attitudes, a sense of personal meaning, meaningful activities, peer support, and positive social and personal relationships as most helpful in the process toward recovery. They thought that programs should provide for ready access, individualize services, should offer treatment choices and accommodate diversity. Conversely, consumers viewed programs that do not address poverty, apathy, isolation, stigma, discrimination, or trauma, deny personal choices and do not allow for control over one’s life as obstacles toward recovery. The view of recovery as a product of complex, dynamic, synergistic, and linked interaction among characteristics of the individual and environment should be embedded in program and system design.

POLICY IMPLICATIONS

Mental health services may not always be helpful to consumers seeking to manage and overcome their disabilities, and striving for recovery. Performance indicators derived have the potential to bolster consumer self-determination and promote well-being, provide resources and supports to meet basic needs, support choice and personal decision-making, individualize services and accommodate diversity, counter stigma and mis-information; and support collaboration and partnership among professionals, administrators, and consumers.

PLANS

The findings from this study are being utilized to comprise a set of prototype performance indicators. The resulting measure will be pilot tested across sites in multiple states.

INCLUSION OF GENDER AND MINORITY SUBJECTS

	American Indian or Alaskan Native	Asian or Pacific Islander	Black, not of Hispanic Origin	Hispanic	White, not of Hispanic Origin	Other of Unknown Origin	TOTAL
Female							67 (59%)
Male							44 (39%)
Unknown							4
TOTAL	8 (7%)	2 (2%)	14 (12%)	5 (4%)	79 (70%)	4	115

SUMMARY OF CONSUMER FINDINGS:

What Helps:

Basic resources such as a livable income, affordable and safe housing and reliable transportation;
Positive attitudes, self-care and self advocacy where persons believe that recovery is possible for everyone;
A sense of meaning and purpose, for many hope or spiritual faith;
Choice in whether and what treatment to use and life options in general;
Relationships such as family and friends that sustain regular activities including fun;
Meaningful activities involving employment, education and/or volunteer and advocacy work;
Peer support in the form of groups, programs and role models;
Access to formal mental health services oriented toward the whole person where respectful staff partner with each person in achieving agreed upon goals.

What Hinders:

The lack of helping factors and the resulting conditions e.g., poverty, apathy, isolation and hopelessness;
Stigma (internalized and external);
Discrimination;
Situations and structures which deny persons� choices and control over their life;
Tenaciousness of the disorder itself;
Abuse and trauma.

REPORT

Onken, S. J., Dumont, JM, Ridgway, P., Dornan, D. H., & Ralph, RO (2002). Phase One Research Report: A National Study of Consumer Perspectives on What Helps and Hinders Mental Health Recovery. National Association of State Mental Health Program Directors (NASMHPD) National Technical Assistance Center (NTAC), Alexandria, VA.

On line at: <http://www.nasmhpd.org/ntac/reports/index.html> in PDF format under the October 2002 listing.

To obtain up to 10 free copies of the Phase One Report, contact:

AIeshia Haynie
National Technical Assistance Center for State Mental Health Planning
66 Canal Center Plaza, Suite 302, Alexandria, VA 22314
Phone: (703) 739-9333; Fax: (703) 548-9517
General inquiries: ntac@nasmhpd.org

Bulk copies of 11 or more are available at $10/copy.

PRESENTATIONS

Onken, S. J. Mental Health Recovery: What Helps and What Hinders? A National Research Project for the Development of Recovery Facilitating System Performance Indicators. Fifth Annual International Inter-Centre Network for Evaluation of Social Work Practice Workshop, Columbia University, New York, NY, October 3-4, 2002.

Dumont, J. M. & Ridgway, P. Mental Health Recovery: What Helps and What Hinders? Breakout Session, 44^th Annual Southern Regional Conference on Mental Health Statistics, New Orleans, LA, September 22-25, 2002.

Dornan, D. H., & Ridgway, P. Mental Health Recovery: What Helps and What Hinders? Institute, ALTERNATIVES 2002 Conference, Atlanta, Georgia, September 18-22, 2002.

Ridgway. P. What Helps and What Hinders Recovery? The Adult Systems of Care Partnership Conference "Thinking Outside the Box," San Mateo, CA, September 5, 2002.

*Onken, S. J., Dumont, J. M. & Ridgway, P. Mental Health Recovery: What Helps and What Hinders? A National Research Project for the Development of Recovery Facilitating System Performance Indicators. Concurrent Session, 51^st Annual National Conference on Mental Health Statistics, Washington, D.C., May 2002.

Onken, S. J. Mental Health Recovery: What Helps and What Hinders? A National Research Project for the Development of Recovery Facilitating System Performance Indicators. Invited Speaker, National Association of State Mental Health Program Directors, Alexandria, VA, April 2002.

Onken, S. J. Recovery and Consumer involvement. Plenary, Colorado Mental Health Services Conference on Evaluating Mental Health Performance, Denver, CO, April 2002.

Onken, S. J. New Developments in MHSIP: The National Research Project for the Development of Recovery Facilitating System Performance Indicators. Plenary Panel, 50th Annual National Conference on Mental Health Statistics, Washington, D.C., May 2001.

Entered: 6/17/02
Updated: 7/1/03