Sunday, 16 January 2005 - 8:00 AM

This presentation is part of: Beyond Mental Health Treatment: Research on Psychosocial Rehabilitation Services

Consumer-Operated Mental Health Services: Developing and Validating Fidelity Criteria

4. Consumer-Operated Mental Health Services: Developing and Validating Fidelity Criteria

Purpose: While direct involvement of consumers in mental health and psychosocial rehabilitation service delivery has expanded in recent years, research on consumer-operated services remains sparse. Effectiveness studies are of critical importance but before they can be meaningfully conducted more information is needed about the operations, services, and subtypes of consumer-run programs.

Consumer-operated drop-ins are structured according to psychosocial rehabilitation principles and are an increasingly popular adjunct to professionally staffed services. We describe steps used to test and refine critical ingredients (or fidelity criteria) of consumer-operated mental health services using data collected on measures of each criterion from participants, staff and records of consumer-operated programs.

Methods: The NIMH-funded Assessing Consumer-Centered Services (ACCS) Project surveyed 915 mental health consumers attending drop-ins in 31 locations across Michigan. The field research team also collected qualitative data, based on structured observations taken over two-day visits to each site, as well as documents, including mission statements, attendance figures, annual budgets, and funding information. The ACCS project operationalized and validated fidelity criteria for self-help-oriented, consumer-operated mental health services, resulting in the development of a Fidelity Rating Instrument for consumer-operated programs (COS-FRI).

Results: Convergent analyses were used to examine the extent to which program level COS-FRI scores significantly related to relevant consumer report measures. Results indicated that the COS-FRI validly assesses a number of domains including consumer-consumer relationships, group empowerment, consumer involvement-operations, consumers in control, interior physical environment, and safeness of the location.

Implications: Consumer-operated drop-ins are one of the few settings giving consumers a direct voice in structure and operational issues. The COS-FRI is a useful tool for monitoring and improving program quality. It also provides a foundation for future effectiveness research on consumer-operated mental health services. Further implications for practice, policy and further research will be discussed.

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