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01-10-2016 | Original Paper

Participants’ Assessment of the Impact of Behavioral Health Self-Direction on Recovery

Authors: Bevin Croft, Susan Parish

Published in: Community Mental Health Journal | Issue 7/2016

Abstract

Self-direction involves managing a flexible budget, selecting and purchasing services and supports to meet individual needs and preferences. An emerging practice in the behavioral health field, self-direction is part of a systemic shift toward person-centered approaches to service provision. To understand the relationship between recovery and self-direction, the authors conducted a content analysis of 30 in-depth interviews with individuals from two self-direction programs in one state. A positive relationship between self-direction and recovery was established. Meeting basic needs for food, clothing, and shelter are important first steps in the recovery process for self-directing participants. Recovery domains were dynamic and interrelated, with gains in independence, self-esteem, and self-confidence facilitating achievement of goals in other domains. To maximize the benefits of self-direction, program administrators may need to develop clearer program implementation standards and address poverty and limited access to appropriate behavioral health services and supports.

Alakeson, V. (2008). Self-directed care for adults with serious mental illness: The barriers to progress. Psychiatric Services (Washington, DC), 59(7), 792–794. doi:10.1176/appi.ps.59.7.792.CrossRef

Anthony, W. A. (1993). Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal, 16(4), 11.CrossRef

Berwick, D. M. (2009). What ‘patient-centered’ should mean: Confessions of an extremist. Health Affairs, 28(4), w555–w565. doi:10.1377/hlthaff.28.4.w555.CrossRefPubMed

Caplan, M. A. (2014). Financial coping strategies of mental health consumers: Managing social benefits. Community Mental Health Journal, 50(4), 409–414. doi:10.1007/s10597-013-9674-7.CrossRefPubMed

Carlson, B. L., Foster, L., Dale, S. B., & Brown, R. (2007). Effects of cash and counseling on personal care and well-being. Health Services Research, 42(1–2), 467–487.CrossRefPubMedPubMedCentral

Chamberlin, J. (1990). The ex-patient’ movement: Where we’ve been and where we’re going. The Journal of Mind and Behavior, 11(3), 323–336.

Charmaz, K. (1983). The grounded theory method: An explication and interpretation. In R. M. Emerson (Ed.), Contemporary field research: A collection of readings (pp. 109–126). Prospect Heights, IL: Waveland Press.

Cook, J. A., Russell, C., Grey, D. D., & Jonikas, J. A. (2008). Economic grand rounds: A self-directed care model for mental health recovery. Psychiatric Services (Washington, DC), 59(6), 600–602. doi:10.1176/appi.ps.59.6.600.CrossRef

Croft, B., & Parish, S. (2013). Care integration in the patient protection and affordable care act: Implications for behavioral health. Administration and Policy in Mental Health and Mental Health Services Research, 40(4), 258–263. doi:10.1007/s10488-012-0405-0.CrossRefPubMed

Croft, B., Simon-Rusinowitz, L., Loughlin, D., & Mahoney, K. (2013). An environmental scan of self-direction in behavioral health: Summary of major findings. Chestnut Hill, MA: Boston College National Resource Center for Participant-Directed Services.

Doty, P., Mahoney, K. J., & Sciegaj, M. (2010). New state strategies to meet long-term care needs. Health Affairs, 29(1), 49–56. doi:10.1377/hlthaff.2009.0521.CrossRefPubMed

Doty, P., Mahoney, K., & Simon-Rusinowitz, L. (2007). Designing the cash and counseling demonstration and evaluation. Health Services Research, 42(1), 378–396.CrossRefPubMedPubMedCentral

Emerson, R. M., Fretz, R. I., & Shaw, L. L. (1995). Processing fieldnotes: Coding and memoing writing ethnographic fieldnotes. Chicago, IL: University of Chicago Press.CrossRef

Epstein, R. M., Fiscella, K., Lesser, C. S., & Stange, K. C. (2010). Why the nation needs a policy-push on patient-centered health care. Health Affairs, 29(8), 1489–1495.CrossRefPubMed

Flick, U. (2007). Managing quality in qualitative research. Thousand Oaks, CA: Sage.CrossRef

Hsieh, H.-F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9), 1277–1288. doi:10.1177/1049732305276687.CrossRefPubMed

Hutchings, G. P., & King, K. (2009). Ensuring U.S. health reform includes prevention and treatment of mental and substance use disorders—A framework for discussion: Core consensus principles for reform from the mental health and substance abuse community. Rockville, MD: Substance Abuse and Mental Health Services Administration.

Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century (N. A Press ed.). Washington, DC: National Academy Press.

Kessler, R. C., Heeringa, S., Lakoma, M. D., Petukhova, M., Rupp, A. E., Schoenbaum, M., et al. (2008). Individual and societal effects of mental disorders on earnings in the United States: Results from the national comorbidity survey replication. The American Journal of Psychiatry, 165(6), 703–711. doi:10.1176/appi.ajp.2008.08010126.CrossRefPubMedPubMedCentral

Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. London, England: Sage.

Mechanic, D. (2012). Seizing opportunities under the affordable care act for transforming the mental and behavioral health system. Health Affairs, 31(2), 376–382. doi:10.1377/hlthaff.2011.0623.CrossRefPubMed

New Freedom Commission on Mental Health. (2003). Achieving the promise: Transforming mental health care in America. Final report. Rockville, MD: Department of Health and Human Services.

Palinkas, L. A., Horwitz, S. M., Green, C. A., Wisdom, J. P., Duan, N., & Hoagwood, K. (2013). Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Administration and Policy in Mental Health. doi:10.1007/s10488-013-0528-y.

Pope, C., Ziebland, S., & Mays, N. (2000). Analysing qualitative data. BMJ, 320(7227), 114–116. doi:10.1136/bmj.320.7227.114.CrossRefPubMedPubMedCentral

SAMHSA. (2011). Description of a good and modern addictions and mental health service system. Rockville, MD: Substance Abuse and Mental Health Services Administration.

Sciegaj, M., Mahoney, K. J., Schwartz, A. J., Simon-Rusinowitz, L., Selkow, I., & Loughlin, D. M. (2014). An inventory of publicly funded participant-directed long-term services and supports programs in the United States. Journal of Disability Policy Studies. doi:10.1177/1044207314555810.PubMed

Shen, C., Smyer, M. A., Mahoney, K. J., Loughlin, D. M., Simon-Rusinowitz, L., & Mahoney, E. K. (2008a). Does mental illness affect consumer direction of community-based care? Lessons from the Arkansas Cash and Counseling Program. The Gerontologist, 48(1), 93–104. doi:10.1093/geront/48.1.93.CrossRefPubMed

Shen, C., Smyer, M., Mahoney, K. J., Simon-Rusinowitz, L., Shinogle, J., Norstrand, J., et al. (2008b). Consumer-directed care for beneficiaries with mental illness: Lessons from New Jersey’s Cash and Counseling Program. Psychiatric Services (Washington, DC), 59(11), 1299–1306. doi:10.1176/appi.ps.59.11.1299.CrossRef

Smith, J. A. (2007). Qualitative psychology: A practical guide to research methods. Thousand Oaks, CA: Sage.

Spaulding-Givens, J. C., & Lacasse, J. R. (2015). Self-directed care: Participants’ service utilization and outcomes. Psychiatric Rehabilitation Journal, 38(1), 74–80. doi:10.1037/prj0000103.CrossRefPubMed

Tondora, J., & Pocklington, S. (2007). Implementation of person-centered care and planning: How philosophy can inform practice: Yale Program for Recovery and Community Health. New Haven, CT: Department of Psychiatry, Yale University School of Medicine.

Webber, M., Treacy, S., Carr, S., Clark, M., & Parker, G. (2014). The effectiveness of personal budgets for people with mental health problems: A systematic review. Journal of Mental Health, 23(3), 146–155. doi:10.3109/09638237.2014.910642.CrossRefPubMed

Weiss, R. S. (1994). Learning from strangers: The art and method of qualitative interview studies. New York, NY: First Free Press.

Whitley, R., & Drake, R. E. (2010). Recovery: A dimensional approach. Psychiatric Services (Washington, DC), 61(12), 1248–1250. doi:10.1176/appi.ps.61.12.1248.CrossRef

Wilton, R. D. (2003). Poverty and mental health: A qualitative study of residential care facility tenants. Community Mental Health Journal, 39(2), 139–156. doi:10.1023/A:1022662704461.CrossRefPubMed

Title: Participants’ Assessment of the Impact of Behavioral Health Self-Direction on Recovery
Authors: Bevin Croft
Susan Parish
Publication date: 01-10-2016
Publisher: Springer US
Published in: Community Mental Health Journal / Issue 7/2016
Print ISSN: 0010-3853
Electronic ISSN: 1573-2789
DOI: https://doi.org/10.1007/s10597-016-9999-0

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