OBJECTIVE: The goal of this pilot project is to manualize a process for recruiting and managing consumer providers within the context of community-based mental health organizations.

METHODS: This is a multi-phase, participatory research project. In Phase 1 of the project, information is gathered about LAMP Community, its current structure and peer support activities as well as potential approaches to implementing structured peer support through qualitative analysis of semi-structured interviews with its administrators, staff, consumer providers and members and 4 experts in the field around Los Angeles County. Data from Phase 1 will be used to tailor a peer support management intervention to LAMP's service delivery system. In Phase 2, this intervention will be implemented, evaluated at LAMP, modified as needed and documented in detail. We hope to begin Phase 2 by the end of the Center's third year (July 2006).

FINDINGS/RESULTS: Preliminary analysis of semi-structured interviews indicates that LAMP is in a period of substantial leadership transition and that the consumer services program is at reduced strength. There was little consistency across interviews as to the current number of peer advocates (consumer providers), the way in which peer advocates are identified, solicited, or selected, the ways in which they are trained and supervised, the duties they perform, and the extent to which they are integrated as staff members. There was consensus, however, that peer advocates could serve a pivotal role in the structure and organization of the LAMP Community, and that more peer advocates were sorely needed. Several participants expressed concern that, without adequate supervision, peer advocates could have difficulty in their roles, and they suggested that strengthening the peer advocacy program would entail providing for supervision and support. Several expressed that peer advocates would need specific support around money management and relapse prevention. Participants were, on the whole, open to contributing feedback to a manual that would aid in the implementation of a more formal peer advocacy management structure. They expressed that this manual should be very practically oriented and user-friendly.

STATUS: In addition to the completed interviews, the project team has been meeting by phone on a weekly basis to discuss progress and to develop ideas for the manual. We recently hired a Research Assistant for LAMP Community who will assist the team by coordinating with LAMP Administration and contributing to the development and organization of the manual. We have most recently developed a draft of the manual and plan to flesh it out during the upcoming months.

IMPACT: Qualitative process evaluations from this pilot will provide a basis for designing longer term experimental studies of the utility and effectiveness of using structured peer support systems, particularly those that focus on consumer providers, nationally with respect to services quality improvement and consumer outcomes.

PUBLICATIONS:
Chinman M, Young AS, Hassell J, Davidson L: Toward the implementation of mental health consumer provider services. Journal of Behavioral Health Services & Research. 2006; 33: 176-195.

Principal Investigator:
Alexander Young, MD, MSHS; Matthew Chinman, PhD; Brittany Butler, BA; Alison Hamilton, PhD; Ed Knight, PhD, CPRP.

Partners: This is a collaboration with LAMP Community, an integrated services agency on Los Angeles' Skid Row with a strong tradition of serving homeless individuals with mental illnesses. The project includes extensive consumer involvement and leadership throughout intervention design and implementation.