Feasibility of Expanding Self-Directed Services to People with Serious Mental Illness. 5. Research on the Benefits and Costs of Mental Health Self-directed CARE


At the present time, few firm conclusions can be drawn about either the benefits or the costs of mental health SDC approaches. Research on SDC programs for persons with SMI is at an early stage of development. Only a few research and evaluation studies have been completed to date. All of these studies have substantial methodological limitations. However, the strongest evidence available relates to the effects of SDC on program process outcomes (e.g., whether or not service planning is person-centered) and in relation to participants' level of satisfaction with SDC programs. In independently conducted evaluations of SDC programs in Florida and Oregon, SDC participants reported a generally high level of satisfaction with SDC programs, generally agreed that SDC programs have a strong recovery orientation, and endorsed various process indicators of person-centered planning.67, 68 In contrast, currently available research lacks any reliable information regarding the effects of SDC on participants' outcomes in several domains considered critical by state and federal policymakers, such as functional and residential independence, participation in competitive employment, use of inpatient mental health care, and physical health and health-related quality of life. Information on these outcomes is either completely unavailable or has limited reliability. Reliable information regarding the effects of SDC participation on participants' mental health care utilization and the overall public costs of care is similarly scarce.

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