Authors: Steven P. Segal & Carol Silverman
Event: 2000 TheMHS Conference
Subject: book of proceedings, Mental health outcomes, consumers, self-help, self-help agencies, SHAs, mental health services, consumer operated service programs, COSP, empowerment.
Type of resource: Conference Presentations and Papers
While managed care has increased the emphasis on outcome driven treatment, empirical investigation of the determinants of outcomes in mental health self-help agencies (SHAs) has received little attention. This study assesses the impact of SHA attendance, satisfaction with the SHA experience, organizationally mediated empowerment, i.e. involvement of clients in decisions about their own services and the services of their peers and psychological disability on three member outcomes: independent and assisted social functioning and personal empowerment.
Long-term users of four client-run mental health SHAs provided information at baseline (N = 310) and at a six month follow-up interview (N = 283). Univariate descriptive analyses as well as At@ tests describing changes in sample outcomes were conducted across time. Three multiple regression models, one for each of the selected outcomes, were used to assess the impact of each of the four determinants on outcome change after controlling for baseline status on the given outcome variable.
Personal empowerment for the average SHA member increased, independent social functioning remained the same, and assisted social functioning decreased over the six month follow-up period. Multivariate analyses indicate that organizationally mediated empowerment positively influenced all three outcomes. Psychological disability negatively influenced two of the three. SHA attendance and satisfaction with the SHA experience were not significant outcome determinants.
Central to the operation of SHAs is the active involvement of clients in the helping process. It would appear that the significant ingredient for promoting positive outcomes in mental health SHAs is the effort by the SHA to use its structure to provide opportunities for members to meaningfully participate in decisions about their care and the care of others in their organization.