Service Use Outcomes Among Peer Support, Wellness, and Respite Center Users

Background and Purpose: The Peer Support, Wellness, and Respite Centers (PSWRC) are peer-run alternatives to traditional mental health day programs and psychiatric hospitalization. PSWRCs are voluntary in nature and seek to de-escalate mental health crises by providing home-like environments to guests and strengthen community connections. Prevalence of PSWRCs have expanded consistent with the shift in mental health care to recovery-oriented approaches. While prior research has developed evaluation criteria and conceptual frameworks to understand PSWRCs, little is known concerning PSWRC outcomes among guests. In this study, we examine the types and quantities of mental health services used before and after an overnight stay at a PSWRC.

Methods: Medicaid reimbursement data was obtained from the state of Georgia, including a statewide sample of participants who had their first overnight stay at a PSWRC within a 3-month study window (July -September 2019) (N =157). For each participant, all mental health-related service use was examined for the three months before and after their first stay at a PSWRC. Differences in services used before and after an overnight stay at a PSWRC were examined using negative binomial regression models, to control for total number of services used across the entire study period.

Results: When examining the differences in services used before and after an overnight stay at a PSWRC, there was a significant increase in recovery-oriented services including psychosocial rehabilitation (pre-M = 1.96, post-M = 1.98, IRR = 1.24, p < .01), individual outpatient (pre-M = 0.71, post-M = 0.79, IRR = 1.93, p < .01), supported employment (pre-M = 0.11, post-M = 0.15, IRR = 2.28, p < .01), and family outpatient services (pre-M = 0.02, post-M = 0.15, IRR = 5.62, p < .01). Last, there was a significant reduction in case management (pre-M = 1.51, post-M = 1.17, IRR = 1.25, p < .01) and psychiatric hospitalization (pre-M = 0.47, post-M = 0.41, IRR = 2.19, p < .01).

Conclusion and Implications: PSWRCs are an important component in the spectrum of mental health services intended to de-escalate mental health crises with a recovery-oriented practice approach. While the results presented from this study support this claim, more research is needed to extend outcomes to additional dimensions of recovery beyond the types and frequencies services used. Social work practitioners can benefit from this research, especially among those providing mental health services. Through understanding the range of services available and the evidence associated with them, social workers can further ensure the effective services are available to individuals in need of mental health care that will prevent the likelihood of crisis or more intensive forms of mental health treatment.