Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Purpose The paper presents results of a survey of consumer perceptions of care in mental health programs for individuals with severe and persistent mental illness in New York City. The study was designed to collect data about consumer perceptions regarding the impending implementation of the Personalized Recovery Oriented Services (PROS) program by the New York State Office of Mental Health (NYSOMH). Three primary goals guided the research: (1) To measure dimensions of services (including type and perceived access) provided to consumers in current program configurations, (2) To measure levels of consumer satisfaction with current services that will be affected by the upcoming PROS conversion, and (3) To measure consumer knowledge of and perceptions about the upcoming PROS conversion.

Methods A cross-sectional survey design was used, with consumers of mental health services in New York City as participants. Individuals were recruited from a stratified sample of those mental health programs scheduled to participate in the upcoming PROS conversion. Programs were stratified using linear integer programming software, with three stratifying variables (size, location/borough, and program type) in order to achieve a weighted representative sample of programs. The instrument was a 66-item paper-and pencil questionnaire comprising both original items and some taken from the NYSOMH Mental Health Services Survey (MHSS), and Lehman's Quality of Life scale. A collaborative research team comprising the investigator, key mental health staff, and consumer research assistants, were responsible for survey development and all data collection. Descriptive and bivariate analyses were used to obtain a characteristic picture of consumer satisfaction with services and knowledge about the impending PROS conversion.

Results Data were collected from 362 participants in 20 programs throughout the 5 New York City boroughs. Programs were classified as clubhouse/psychosocial clubs, employment, or outpatient treatment sites. Participants were 57% male, 35% White, and 48% African American, with a median age of 44 years. Satisfaction with services and staff was reported at high levels. Areas of lesser satisfaction centered around the availability of services during off hours, housing, educational, and vocational services. Significant differences in satisfaction were found by program type and size. Less than half the sample had heard of PROS, and of those that had, less than 60% understood what it meant, despite extensive education efforts.

Implications for practice The findings present an overall description of perceptions of and satisfaction with mental health services in this sample of 362 consumers of mental health programs which are scheduled to convert to PROS in the near future. The findings also describe key perceptions among consumers the impending conversion and what it might mean for their services. As such, they have implications for other states considering broad policy changes in mental health service arena. The findings represent an effort to incorporate consumer perspectives into the policy implementation process. Consumers were included not just as research participants, but also as research collaborators and co-designers. Implications for social workers in mental health systems are addressed.