Environments that Promote Recovery

Environments that Promote Recovery

Principal Investigator: Ed Knight, Ph.D. Co-Investigators: Mary Jane Alexander, Ph.D., Kim Hopper, Ph.D.

PROJECT GOALS

Project goals are to develop an understanding of the factors in service environments that provide Medicaid managed mental health services that promote attainment of the goals of recovery of symptom management and adoption of valued social roles. We will examine the relationship between site factors and quantitative indices of:

consumers’ ability to cope with mental health symptoms and substance abuse problems;

their levels of functioning (self and clinician rated);

their development of social networks and social roles beyond the mental health system (work, school, volunteer activities);

their ability to effectively manage psychiatric symptoms and 5)their use of traditional and non-traditional services.

RESEARCH ACTIVITIES AND RESULTS

Method: This project is a collaborative effort between consumer and non-consumer researchers. It uses quantitative and qualitative methods to characterize recovery opportunities and client progress in four Medicaid managed care settings that provide services to PSMD in rural Colorado. All settings have received uniform training in recovery approaches, including the Boston University (BU) Rehabilitation Model. But anecdotally, they have been appraised as having had variable amounts of success in establishing environments that promote recovery. A quasi ethnographic study was carried out to describe the recovery opportunities available in each of the communities where mental health services are located using field observational methods, interviews with key community and provider informants, intensive interviews and focus groups with PSMD. Independently, research staff collected quantitative measures of clinician competencies across the dimensions of recovery specified in the BU model, as well as measures that reflect recovery goals (consumers’ level of functioning, their abilities to cope with psychiatric and substance abuse symptoms, and their development of social networks and roles outside of the mental health system).

Results: Data collection is complete; data analysis is not. The project used tools to measure successful coping with psychiatric symptoms, consumer confidence, and clinician competencies, that were developed by Dr. Knight in conjunction with the NIMH funded Rutgers Center for Research on the Organization and Financing of Care for the Severely Mentally Ill, the NY Center for the Study of Issues in Public Mental Health and the RAND Center.

SIGNIFICANCE OF FINDINGS/ POLICY IMPLICATIONS

Relationships with primary clinicians in service settings are a focal point for consumers as they move toward recovery’s goals: achieving a meaningful life through valued social roles and reducing psychiatric symptoms. The results of this study will provide data on the relationships between local contextual factors, clinician competencies and consumers’ attainment of the basic goals of recovery for PSMD.

PLANS

Consumer and non-consumer researchers will collaborate to complete analyses of qualitative and quantitative data. Environmental descriptors, including clinician competencies in the techniques of psychiatric rehabilitation will be linked with consumers’ recovery measures.

INCLUSION OF GENDER/ MINORITY GROUPS

	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				21	31		52
Male				32	46		78
Unknown
TOTAL				53	77		130

Presentations and Papers:

Alexander MJ, Knight E, Robins C, Bush B, Onken S and Hopper K (discussant). Factors that promote recovery: A holistic approach to service systems change. 13^thAnnual Conference on State Mental Health Agency Services Research, Program Evaluation and Policy, sponsored by the National Association of State Mental Health Program Directors, Baltimore MD, Feb. 11, 2003

Knight E. Recovery. Presented at above conference, available on-line.
Robins CS. Culture and recovery: The importance of local context. Presented at above conference.

Updated: July 1, 2003