Wednesday March 27
Senate Health Committee Room 4203
Mental Health Self-Directed Care Financing: Efficacy in Improving Outcomes and Controlling Costs for Adults With Serious Mental Illness by Judith A. Cook, Ph.D., Samuel Shore, L.M.S.W., Jane K. Burke-Miller, Ph.D., Jessica A. Jonikas, M.A., Marie Hamilton, L.C.S.W., M.P.H., Brandy Ruckdeschel, M.Ed., L.P.C., Walter Norris, M.A., Anna Frost Markowitz, M.P.H., Matthew Ferrara, B.A., Dulal Bhaumik, Ph.D.
Over the past two decades, the federal Centers for Medicare and Medicaid Services (CMS) has promoted use of a consumer-directed, “money follows the person,” health care financing approach for use by individuals with a broad range of disabilities. Called self-directed care, this model gives individuals direct control over public funds to purchase health care services, supports, and material goods necessary for them to reside in the community rather than in inpatient or nursing facilities.
Although use of this model to promote the recovery of people with serious mental illness is less common, multiple states are now developing mental health self-directed care initiatives, and interest in this approach is growing. Recently, consumer, advocacy, and service provider communities have called for greater use of self-directed care in mental health, as have federal agencies, including CMS (1), the Substance Abuse and Mental Health Services Administration (2), and the U.S. Department of Health and Human Services’ Office of Disability, Aging and Long-TermCare Policy (3). The purpose of this study was to conduct a randomized controlled trial of a mental health self-directed care program, assessing its effects on participant outcomes, service satisfaction, and service costs.
Self-directed care allows individuals with disabilities and elderly persons to control public funds to purchase goods and services that help them remain outside institutional settings. This study examined effects on outcomes, service costs, and user satisfaction among adults with serious mental illness.
Public mental health system clients were randomly assigned to self-directed care (N=114) versus services as usual (N=102) and assessed at baseline and 12 and 24 months. The primary outcome was self-perceived recovery. Secondary outcomes included psychosocial status, psychiatric symptom severity, and behavioral rehabilitation indicators.
- Compared with the control group, self-directed care participants had significantly greater improvement over time in recovery, self-esteem, coping mastery, autonomy support, somatic symptoms, employment, and education. No between group differences were found in total per-person service costs in years 1 and 2 or both years combined.
- However, self-directed care participants were more likely than control group participants to have zero costs for six of 12 individual services and to have lower costs for four.
- The most frequent nontraditional purchases were for transportation (21%), communication (17%), medical care (15%), residential (14%), and health and wellness needs (11%).
- Client satisfaction with mental health services was significantly higher among intervention participants, compared with control participants, at both follow-ups.
The budget-neutral self-directed care model achieved superior client outcomes and greater satisfaction with mental health care, compared with services as usual.
Psychiatric Services in Advance (doi: 10.1176/appi.ps.201800337)
The National Coalition for Mental Health Recovery (NCMHR)
The Catholic University of America (CUA)
July 7 – 11, 2019
Last year we returned to our roots: We held Alternatives 2018 at a university for the first time in decades, without relying on federal funding, the way our movement for social justice first began. The freedom of truly being “On Our Own Again” was felt as a palpable energy. The opportunity to do advocacy training and host a “Hill Day” was exciting and rewarding. We are eager to repeat this Pre-conference Action at Alternatives 2019.
The Alternatives conference is the oldest and largest conference of its kind, organized and hosted for more than three decades by peers for peers (people with lived experience of the behavioral health system, emotional distress/crisis, trauma, substance use, and/or addiction). The Alternatives conference is renowned for offering the latest and best information in the peer recovery movement, and provides an invaluable opportunity for peers to network with and learn from one another. This conference is funded entirely through registration fees and donations.
Alternatives 2019 will include a two-day pre-conference, July 8 and 9, with advocacy training on Monday and a “Hill Day” on Tuesday, when peer advocates will meet, by appointment, with the staff of their U.S. senators and congressional representatives. Now more than ever, it is important for us to participate in the national debate.
The conference will officially open with dinner and keynote presentations on Tuesday evening, July 9, followed by workshops and caucuses on Wednesday and Thursday. A call for workshop proposals will be announced soon.
Newer college dorm rooms with single beds and private or shared bathrooms will be available for an affordable price, and three buffet-style meals a day will be provided in the dining hall. All meeting rooms are ADA-accessible; some accessible dorm rooms can be reserved. There is a newly renovated Metro stop on campus; parking is also available. There are many hotels a few Metro stops away for those who wish to stay off campus.
NCMHR appreciates CUA’s mission statement for Alternatives 2019: Catholic University encourages “serious and sustained discourse among people of different faiths, cultures, and beliefs, and promotes intellectual, ethical and spiritual understanding. We embody this principle in the diversity of our students, faculty and staff, our commitment to justice and the common good, our intellectual openness, and our international character.”The Alternatives conference strives to be a welcoming environment for all people, and we have been assured that all of our attendees will be treated with respect.
Alternatives 2019 is a great opportunity to learn new skills and share your passion for recovery, advocacy, the arts, multicultural and diversity awareness, youth involvement, and more! Come, find and raise your voice, share your expertise, meet old friends and make new ones!
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Webinar A: Advocacy Basics
Thurs., Feb. 21, 2019 at 10:00 AM
- What is advocacy, who are stakeholders and why advocate.
- Consumer roots of the law, the Mental Health Service Act (MHSA) and regulations for Stakeholder involvement in planning mental health services.
- A bird’s eye view of who the County decision-makers are and how you can participate.
- Access to basic terms and acronyms used in Behavioral Health and where you can go to find county contacts.
Webinar B: Best Community Planning Practices
Thurs., Mar. 7, 2019 at 10:00 AM
- Types of County meetings and various stakeholder participation or roles
- Meeting mechanics, culture and etiquette
- MHSA stakeholder community planning best principles & practices applied to different stakeholder roles.
- What to look for in county budgets and plans.
- More resources to become a meaningful stakeholder
Webinar C: Community Planning; How to Work It
Thurs., Mar. 21, 2019 at 10:00 AM
- More on applying the MHSA community planning best principles & practices
- How you compose and give public comment.
- How you get on decision-making boards/councils.
- Next steps to being a meaningful stakeholder.
Volume 15, Number 7 The National Mental Health Consumers’ Self-Help Clearinghouse
now affiliated with the
Temple University Collaborative on Community Inclusion
- “Psychiatric Hospitals with Safety Violations Still Get Accreditation,” WSJ Reports
- FDA Reclassifies ECT Equipment into Lower-Risk Category Despite Controversy about ECT’s Risks
- National Center on Advancing Person-Centered Practices and Systems Is Launched
- Parents with Mental Health Conditions Are 8 Times as Likely as Parents without Mental Health Conditions to Have Contact with Child Protective Services, National Survey Shows
- Mental Health First Aid Australia Seeks Research Participants to Update MHFA Guidelines
- “‘Circles’ Could Offer Promising Outcomes After Incarceration for People with Serious Mental [Health Conditions]”
- “Psychosis 365” Video Podcast Is Available for Free!
- And much more updates HERE
Thursday, February 14, 2019 at Noon
- Misa Miele Mandigo Kelly Peer Support, ArtBark, Multidisciplinary Artist in Santa Barbara
- Meli Harmon, Peer Specialist, HOPE Project, Abode Services, Alameda County
What you learn:
- Prevalence of trauma
- What is the ACE Study
- The Trauma Informed Approach–Principles & Guidelines
- Trauma Informed Resources
CAMHPRO disclaimer: The deadlines of these webinars are from January, so they may not be available, but please look at the material for updates and resources. Thank you.
Welcome to the January 2019 Monthly Update from SAMHSA’s Bringing Recovery Supports to Scale Technical Assistance Center Strategy (BRSS TACS). BRSS TACS monthly updates highlight upcoming events and resources that promote recovery.
In This Issue:
Recovery LIVE! Virtual Event
What Does the Data Say? Effective Use of Recovery Supports in Various Treatment and Healthcare Settings
Thursday, January 24, 2:00–3:00 p.m. EST
BRSS TACS invites you to join national experts in a conversation about using research and program data to communicate the effectiveness of recovery supports.
Presenters will discuss real-life examples and strategies for measuring and using program data to communicate effectiveness and reinforce the value of recovery supports in treatment and healthcare settings. They will share data from several research studies on the effectiveness of recovery supports and recent data from the Association of Recovery Community Organizations.
This event supports critical SAMHSA strategic priorities as described in the SAMHSA FY2019–FY2023 Strategic Plan, including activities related to the Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) to improve the lives of individuals living with serious mental illness or serious emotional disturbances and their families. For example, included in the 45 recommendations in the ISMICC’s seminal report, issued in December 2017, is a focus on developing standards that include a full spectrum of integrated, complementary services known to be effective and to improve outcomes. These standards include team-based models of care delivery that are interdisciplinary and incorporate peer and family support specialists as a matter of routine practice.
Presenters include Phil Rutherford, Director of Operations, Faces and Voices of Recovery; Annette Crisanti, Associate Professor, Department of Psychiatry and Behavioral Sciences, University of New Mexico; and Jennifer Chadukiewicz, Recovery Coach Program Manager, Connecticut Community for Addiction Recovery (CCAR).
Join us for this free, interactive virtual event, moderated by BRSS TACS Deputy Director Steven Samra.
About BRSS TACS
BRSS TACS helps programs, systems, states, territories, and tribes as they implement effective recovery supports and services for individuals of all ages and diverse populations with mental or substance use disorders or co-occurring mental and substance use disorders.
SAMHSA’s mission is to reduce the impact of substance use and mental illness on America’s communities.
Questions or comments about this e-mail? Let us know!
Joining BRSS TACS Listserv
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Disclaimer: This newsletter was supported by contract number HHSS2832012000351/HHSS28342002T from the Substance Abuse and Mental Health Services Administration (SAMHSA). The views, opinions, and content of the newsletter are those of the writers and do not necessarily reflect the views, opinions, or policies of SAMHSA or the U.S. Department of Health and Human Services (HHS).