1. 2006 Statewide Survey of Drop-In Centers in Pennsylvania LaKeetra McClaine UPENN Collaborative on Community Integration Jim McCormack, PhD. MHASP John Farmer I CAN in Pennsylvania Mark Salzer, PhD. UPENN Collaborative on Community Integration

2. Statewide DIC Survey Purpose Gather information about: –Basic Drop-In Center (DIC) operations and staffing –Assess level of consumer involvement –Understand provider knowledge about DICs, recovery, and empowerment, and its relationship to their support of DICs –Describe common (and uncommon) DIC activities –DIC Operational Challenges Use data for: –Informing others about DICs –DIC program improvement Compare results to those obtained from survey conducted by McCormack in 1996

3. Survey Methods Surveys were administered at the annual Drop-In Center Conference (May 2006) Raffle incentive for completing the survey I CAN provided a complete list of known DICs in PA Surveys were mailed directly to the DICs that did not complete a survey at the conference in Summer 2006 Follow up phone calls were placed to the centers to remind them to complete the survey

4. Sample Our final sample was 58 DICs out 93 known DICs (62% response rate) –We received a total of 62 surveys out of the 93 (67% response rate –Four surveys had to be discarded because they were incomplete Surveys from 34 service systems All PA regions represented Area –Urban: 38% –Suburban: 16% –Rural: 45%

5. Attendance Average Daily Attendance: 22 people –Range: 5 – 65 people 1-20 people: 31 (59%) of DICs 21-40 people: 19 (36%) of DICs 41+ people: 2 (4%) of DICs 6 DICs did not respond

6. Hours of Operation Average hours of operation: 35 hours/week –Range: 3 – 77 hours 1-20 hours/week: 11 (21%) of DICs 21-40 hours/week: 28 (52%) of DICs 41+ hours/week: 15 (28%) of DICs 4 DICs did not respond

7. Staffing Levels Average Paid Non-consumer staff: 2 people –Range: 0 – 12 people Paid Consumer staff: 3 people –Range: 0 – 20 people Average Total Paid staff members: 5 people –Range 0 – 22 people –7 sites completely volunteer (no paid staff)

8. Consumer Involvement in Decision-Making ** Missing >20% of responses. Suggests an overestimate. Members primarily decide:% Selecting activities to offer at center96% Managing conflict84% Setting policy on how the center is governed84% Responding to consumer complaints78% Making rules about who can attend the Center78% Organizing fundraising76%** Increasing consumer responsibility for the budget50%** Hiring/firing of staff41%**

9. Provider Knowledge about Recovery and Empowerment and Their Support How well informed about empowerment and recovery? –34% felt that local mental health providers are “very well informed” and 36% said “moderately informed” –59% felt that County OMH is “very well informed” and 20% said “moderately informed” How cooperative in supporting DIC activities? –39% felt that providers are “very cooperative” and 27% said “moderately cooperative” –54% felt that the County OMH is “very cooperative” and said 29% “moderately cooperative”

10. Provider Knowledge about Recovery and Empowerment and Their Support Correlation between knowledge and support: –Provider knowledge about recovery and empowerment and their support correlated 0.41 (p = 0.002) –County knowledge about recovery and empowerment and their support correlated 0.74 (p < 0.001) County OMH’s and providers that were thought to be more knowledgeable about recovery empowerment were thought to be more supportive of DIC activities.

11. DIC Activities: Collaboration with Other Providers Activity% “Yes” Provide training to providers on consumer empowerment and recovery 58% Participate in crisis intervention services to avoid hospitalizations 53% DIC reps serve on provider advisory boards43%

12. DIC Activities: Career - Oriented Activity% “Yes” Provide information re: Social Security Benefits77% Connect members with post-secondary educational opportunities 37% Have OVR reps answer questions about work-related issues 36% Provide vocational training:25% Conduct GED classes10% Conduct consumer-run businesses7%

13. DIC Activities: Housing Supports & Transportation Activity% “Yes” Provide transportation to attend CSP meetings65% Assist members to locate and maintain housing55% Provide transportation to DIC54% Operate a residential housing program9%

14. DIC Activities: Self-Determination & Peer Support Activity% “Yes” Help members complete Psychiatric Advanced Directives 54% Conduct groups for members to work on Wellness Recovery Action Plans (WRAP) 52% Utilize Certified Peer Specialists (CPS)29% Have CPS’s in paid positions21%

15. DIC Activities: Civic Engagement Activity% “Yes” Coordinate letter writing efforts48% Conduct voter registration47% Visit state legislature to make concerns known37% Host candidates to educate members on candidate qualifications and positions 23%

16. DIC Activities: Advocacy Activity% “Yes” Attend regional DIC coalition meetings61% Teach members to serve on provider advisory boards47% Distribute “Call for Change” OMHSAS paper47% Participate in County annual Needs-Based plans47% Provide public testimony on County MH plan45% Have consumer reps on County MH/MR board45%

17. DIC Activities: Advocacy, continued Activity% “Yes” Distribute & discuss minutes from State Advisory planning meeting 39% Attend State Advisory planning meetings37% Ensure consumers serve on managed-care advisory committees 28%

18. DIC Activities: Institution-to-Community Transitions Activity% “Yes” Visit state hospitals to facilitate integration upon discharge 32% Visit community hospitals to facilitate integration upon discharge 27% Visit prisons, county jails, and state prisons to facilitate integration upon release 11%

19. DIC Activities: Misc. Activity% “Yes” Educate members on medical plan options and benefits 61% Conduct warm-lines24% NOTE: Further analysis will include open-ended responses.

20. DIC Challenges: Consumer Involvement Challenge% Moderate or Serious Problem Consumers who want others to do things for them49% Consumer participation in Center activities38% Motivating consumers to attend the DIC32% Leadership among members of the Center28% Consumer participation at Center staff meetings27% Consumers feeling free to make their own decisions about the Center 17% Maintaining consumer support of DIC Director11%

21. DIC Challenges: Consumer Behavior Challenge% Moderate or Serious Problem Managing conflict among membership22% Coping with unruly members at the Center17%

22. DIC Challenges: Community Engagement Challenge% Moderate or Serious Problem Involving family members in Center activities 43% Collaborating with non-consumers on advocacy issues 30% Community acceptance of the Center’s activities 24%

23. DIC Challenges: Operations Challenge% Moderate or Serious Problem Transportation for Center activities36% Fiduciary concerns over liability issues15% The location of the Center11% Assuring Center remains open during scheduled hours 9%

24. DIC Challenges: MH System Support Challenge% Moderate or Serious Problem Winning support from local provider agencies24% Support from Regional OMH Office19% Support from the County MH/MR Office18% Interference from professional staff in the way the Center operates 11%

25. What does all this mean to you? What are some implications of these survey results?

26. Implications Consider adding more activities to promote community integration In the “DIC challenges” section there were identified problems (i.e., >20%) in many areas – this suggest a need to share ideas for addressing these challenges –For example, workgroups to address increasing consumer involvement.

27. Implications Possible ways to increase support for DICs: –Important to educate providers about Drop-In Center activities. –Increase training to providers about recovery and consumer empowerment.

28. To Be Continued… 1996 -- Jim McCormack and I CAN conducted a survey of the Drop-In Centers (DICs) in Pennsylvania. We will be conducting further analysis of the data from this survey in comparison with the survey data from 1995 to assess for changes that have occurred over time.

29. For More Information Contact Katy Kaplan at: –215-746-6713 or katykap@mail.med.upenn.edukatykap@mail.med.upenn.edu Visit our website @ www.upennrrtc.org www.upennrrtc.org –More information about Community Integration (CI) –CI Tools (fact sheets)