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Increasing the Use of Self-Help Programs and Mental Health Empowerment Competencies Under Medicaid Managed Care
Key aims: Patients with severe mental illness frequently receive poor quality care, and the clinicians caring for them often lack competencies necessary to provide appropriate treatment. Interventions are needed that improve clinicians' competencies and treatment quality. In this project we test the effectiveness of Staff Supporting Skills for Self-Help (SSSSH), a consumer-led intervention designed to (a) improve rehabilitation and empowerment competencies in clinicians, and (b) increase client use of peer support and self-help. The intervention focuses on 15 core clinical competencies previously identified as necessary to provide high quality care to this population (Young, et al, 2000)
Methods: This is a twelve month controlled trial in two western states. SSSSH consists of (a) a 7-component intensive educational intervention that includes trainings, structured group dialogues with staff and clients, and consultation that focuses on self-help, mutual support, rehabilitation, and empowerment; and (b) support and technical assistance to facilitate the formation of self-help services. Two provider organizations were assigned to the intervention and 3 to usual care. Clinicians' competencies were measured using scales from the CAI and RAQ, both validated self-report instruments with very good psychometric properties. Organizational changes were characterized. Results: The intervention was successfully implemented at most sites. Participation in the intervention varied, but was, overall, quite good. At 1 year, preliminary analyses indicate that provider competency improved more in the intervention group than the control group for the following domains: Holistic Approach, Family Education, Rehabilitation, Natural Supports, Medication Management, and Team Value. The intervention improved overall competency and recovery orientation. Eleven self-help groups formed. Significance: Patients often do not have access to effective medical and rehabilitative services. This intervention improved provider competencies in domains that support rehabilitation, empowerment and recovery. This is one of a small number of projects to improve care for SPMI, and the first to focus on provider competencies. Impact: The intervention used in this project should be broadly applicable at public mental health clinics. By improving providers' competencies, this intervention can improve services and outcomes for individuals with SPMI. Current status: The intervention and data collection are complete. Data analyses are ongoing & publications are being prepared. Young AS, Forquer SL, Tran A, Starzynski M, Shatkin J: Identifying clinical competencies that support rehabilitation and empowerment in individuals with severe mental illness. Journal of Behavioral Health Services & Research. 2000; 27: 321-333.
Chinman M, Young AS, Rowe M, Forquer S, Knight E, Miller A: An instrument to assess competencies of providers treating severe mental illness. Mental Health Services Research. 2003; 5: 97-108. Young AS, Chinman M, Forquer SL, Knight EL, Vogel H, Miller A, Rowe M, Mintz J: A consumer-led intervention that improves provider competencies as evaluated by research survey. Psychiatric Services. 2005 (in press). |
Principal Investigator: Sponsored by: |
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Last updated on 4/11/2007 |