 National Consensus Statement (2004): Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.

 SAMHSA Definition of Recovery Forum May-August 2011  Current SAMHSA working definition: “A process of change through which individuals work to improve their own health and wellbeing, live a self-directed life, and strive to achieve their full potential.”

 Maryland was one of nine states to receive a Mental Health Transformation State Incentive Grant.  Cross-site evaluation included measures of individual consumer recovery and recovery- orientation of practices in programs.  Cultural and Linguistic Competence Training and Consultation Project implemented in Adult Psychiatric Rehabilitation Programs (PRPs).  Trainers and evaluators collaborated to design evaluation protocol and disseminate results.

 To what extent do our programs foster and promote recovery?  Are there differences in the way in which program staff and consumers view the recovery-orientation of programs?

 Data was collected from 13 programs. › N=149 staff members (self-administered surveys). › N=120 consumers (telephone interviews).  Data collected prior to didactic training  Measure used was the Recovery Self- Assessment (RSA-R; O’Connell, Tondora, Croog, Evans, & Davison, 2005)

 The majority of both groups were female (62% of consumers and 77% of staff).  The largest group of consumer respondents were between years old (40%); the largest group of staff were younger (35% between 25-34).  The majority of both groups were Caucasian (64% for each); approximately one-third of both groups were African American (38% of consumers and 33% of staff).

 Developed by at the Program for Recovery and Community Health at Yale University  ssessment.html  32-items designed to gauge the degree to which programs implement recovery-oriented practices  Respondents rated items on 1-5 Likert Scale.  Scoring: Total Mean Score and 6 Empirically Derived Factors

1. Life Goals – do staff help with the development and pursuit of individually defined life goals such as employment and education? 2. Involvement – are persons in recovery involved in the development and provision of programs/services, staff training, and advisory board/management meetings, and community education activities? 3. Diversity of Treatment – does the agency provide linkages to peer mentors and support, a variety of treatment options, and assistance with becoming involved in non-mental health/addiction activities?

4. Consumer Choice – do staff members refrain from using coercive measures, provide consumers with access to treatment records, and facilitate outside referrals? 5. Individually-tailored Services – are the services tailored to individual needs, cultures, and interests, provided in a natural environment, and focus on building community connections? 6. Inviting Space – do persons in recovery feel welcomed by staff and feels the physical environment/ space is inviting?

RSA-RRespondent Mean (SD)T-Test Means Score and 6 FactorsConsumerStaff Sig. (2 tailed) MSDM tdf Overall Mean Score Life Goals Involvement Treatment Diversity Choice Individually Tailored Services Inviting Space

 Staff may think they are doing a better job creating a recovery-oriented culture than they actually are.  It is important to have other measures of fidelity to determine whether subjective perceptions of recovery-oriented practices are consistent with actual program practices (O’Connell, Tondora, Croog, Evans, & Davidson, 2005).  Consumers may be unaware of specific policies, treatment options if not related to their goals, consumer participation on boards, etc. that reflect recovery-orientation.

 Activities around the State have been promoting and targeting enhancement for Consumer Recovery as well as Recovery-Oriented Practices at Programs.  Program Enhancing Initiatives: › Recovery-oriented regulations › Trainings/Recovery Centers of Excellence Project  Consumer (Individual) Recovery Initiatives: › Expansion of Wellness and Recovery Centers, with an increased emphasis on personal recovery, less on program characteristics.  Several areas overlap with key issues identified in promoting cultural competence (Life Goals, Inviting Space, Involvement).

 Agency-specific reports containing descriptive data only was provided to Leadership Teams.  “Data for dialogue”

 Analyses were not conducted at the program level due to the small sample sizes; differences between programs may have obscured the findings.  Not clear how representative the consumer sample was for the program or across the state.  May not be applicable to other PRPs or other types of mental health services.

Diana C. Seybolt, PhD University of Maryland Systems Evaluation Center