Consumer-Run Programs and Drop-In Centers: Providing a Rationale and Research Base for Implementation of Recovery Oriented Services in Fairfax County Empowered for a Change: Working Conference to Create Consumer-Run Drop-In Centers in Fairfax Counties March 5, 2005

What Makes Drop-In Centers Unique? Consumers being served by consumers gain from being served by staff who are more empathic and more capable of engaging them in mental health services (Mowbray, et al, 1996 as cited in the Surgeon General’s Report on Mental Health, 1999) Provides persons with mental illness with a way to change the service delivery system (either individually or systematically) “Ph.D. in the school of hard knocks”

Data on consumer-delivered services Decreased symptoms, increased coping skills, increased life satisfaction and lessen feelings of isolation (Salzar, 2002; Davidson et al., 1999; Chamberlin et al., 1996). Improvements in psychiatric symptoms and decreased hospitalizations (Galanter, 1988; & Kurtz, 1988) Enhanced self-esteem and social functioning (Markowitz, DeMassi, Knight & Solka, 1996). Peer programs empower people because their practice facilitates a grass-roots process of self- efficacy, self-esteem, and the belief that positive personal change can come about through one’s own efforts (Campbell & Leaver, 2003).

What is the Role of a Drop-In Center? As a full and legitimate partner in a mental health system that provides a continuum of recovery-oriented services and supports for persons with mental illness. Not as a substitute for clinical services More than just “filling in the gaps”

What (and Who) is In a Drop-In Center? – People with shared experiences of a mental illness – A comfortable environment – Support groups – Educational groups – Laundry facilities – Computers – Assistance with finding housing/employment

Consumer Operated Service Programs Consumer-Operated Services Programs that are administratively controlled and operated by consumers and emphasize self-help and their operational approach Multi-site study of 1827 participants who were randomly assigned to either traditional MH services or traditional MH services and peer run services From: The Consumer-Operated Service Program Multisite Research Initiative: Overview and Preliminary Findings. Presentation made by Jean Campbell at the Alternatives Conference

Qualities of Consumer-Operated Service Programs (COSP) Qualities of Consumer-Operated Service Programs (COSP) Participant responsive Offers linkage to other supports Accessible Safe Informal setting Reasonable accommodation (no timeline or “strings” attached to participation) Reciprocity and Mutuality Empowerment

Qualities of COSP Programs Creativity and Humor Choice Recovery Acceptance and Respect for Diversity Respect for Spiritual Growth From “Common Ingredients of COSPS” by Jean Campbell (2000).

COSP Results Participants randomly assigned to consumer-operated services programs of the drop-in type in addition to their traditional MH services showed greater improvement in well-being over the course of the study than participants randomly assigned to only traditional mental health services at those sites” From: The Consumer-Operated Service Program Multisite Research Initiative: Overview and Preliminary Findings. Presentation made by Jean Campbell at the Alternatives Conference

Examples of Consumer-Run Programs and Drop-In Centers On Our Own of Maryland/Soul Haven Drop-in Center: This drop-in center serves over 200 individuals. The center offers crafts, computers, socialization, holiday parties and recreational activities in the community. The center is open Fridays 5pm-8pm and Saturday and Sundays 1pm–5pm. A hot meal is served each day that they operate.

Examples… Project Return: The Next Step (PR:TNS): is a consumer operated peer support program for people with mental illnesses For over two decades, PR:TNS has provided social support community integration, employment, training and advocacy activities throughout Los Angeles County.

Examples… Laurie Mitchell Employment Center (LMEC) -LMEC offers computer training, computer access and employment services with no referral, residence or income requirements. LMEC serves over 400 individuals in two Fairfax County locations.

Funding of Drop-In Centers State General funds Block Grant dollars Foundations/Corporations

Criteria for Reimbursement of Peer Support Through Medicaid Components of state rules on peer services: Definition of covered activities (social and daily living skills training, services to support residential or employment placements and case management, services furnished through consumer-run businesses) Definitions of who is eligible to furnish rehabilitation or case management services so as to include individuals who have experienced mental illness. (can be very broad or restrictive depending on the state) Services must be designed to meet specific goals in the individuals service plan and documentation of services in the individuals service plan Usually must be supervised by a qualified licensed professional ( From “Recovery In The Community: Funding Mental Health Rehabilitative Approaches Under Medicaid – Bazelon Center for Mental Health Law. 2001)

Developing a Drop-In Center Incorporate adequate time for planning – Developing mission, philosophy, organizational structure takes time in the beginning, but is time well spent Collaboration/Cooperation: Make sure there is agreement from stakeholders on the concept of Drop-In Centers Sustainability - Don’t wait until the last minute to seek long-term funding Cultural Competence–Fairfax County is a diverse community – bring on board people of color in the planning and implementation phase Outcomes/Research – Build in ways to track success and look for ways to partner with Universities to research effectiveness of Drop-In Center * Based on Consumer/Survivor-Operated Self-Help Programs: A Technical Report. USDHHS/SAMHSA/CMHS

Developing a Drop-In Center (cont’d) Use the Final Report of the Presidents New Freedom Commission on Mental Health as an advocacy tool! State Infrastructure Grants - $20 Million in state grants Talk or write to your legislator, planning council members, CSB members regarding your plan and potential sources of funding Call NMHA’s National Consumer Supporter Technical Assistance Center ( or Web: