Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Purpose The purpose of this study was to conduct a multidimensional, mixed method evaluation of consumer-provided services in New York City as a response to the events of Sept. 11, 2001. A primary goal was to understand the role that a consumer-provided disaster relief program played in addressing the mental health needs of service recipients. While mutual support and consumer-provided services have long been utilized with outpatient mental health populations, there is a lack of understanding and agreement about their relevance in the provision of disaster-relief services. The program evaluated in this study provided free non-discriminatory trauma support and relief services to adults in New York with existing psychiatric disabilities experiencing need related to 9/11. Trained staff members that are current or former consumers of mental health services provided all services. Delivered from a preventive public health framework, program features included intensive outreach, individual counseling, group support, and telephone “warm line” services.

Methods Secondary administrative data were quantitatively analyzed to obtain a description and scope of services provided. Primary qualitative data were then collected from service recipients, program staff and administrators. A total of 30 personal interviews and 8 focus groups were completed, using semi-structured interview formats. Interviews were audiotape recorded, transcribed, and analyzed using template analysis techniques.

Results Findings indicate that consumer-provided disaster relief services offer unique mental health benefits and growth opportunities to both service recipients and providers. Both providers and recipients indicated that, while it served the functions traditionally associated with disaster relief services, the program expanded upon existing ideas of trauma, coping and recovery, redefining these concepts with particular sensitivity to the social and economic marginalization often associated with psychiatric disability. Consumer-provided programs are well positioned to provide effective services for vulnerable populations considered at special risk for traumatization and the recurrence of post-traumatic symptomatology in the wake of a large public disaster. Participants reported overwhelmingly positive experiences with consumer-provided support and many utilized the receipt of such services as a pathway into mental health services. Many stated they would not have otherwise received services from a professional and thus found consumer-provided service delivery a meaningful option.

Implications for practice This study highlights the need for innovative and multiple approaches to mental health support following a large-scale public disaster, as well as the need for disaster relief services that take into account the experiences of adults with psychiatric disabilities. Consumer-provided services are one way to begin addressing both these needs. The organization and mobilization of consumer-provided services should be considered in the process of future disaster relief planning. Implications for collaboration between social work agencies and consumer service-providers of services in the wake of disasters are also discussed.