2006 Statewide Survey of Drop-In Centers in Pennsylvania

LaKeetra McClaineUPENN Collaborative on Community Integration

Jim McCormack, PhD.MHASP

John FarmerI CAN in Pennsylvania

Mark Salzer, PhD.UPENN Collaborative on Community Integration

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

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

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%

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

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

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)

Consumer Involvement in Decision-Making

** Missing >20% of responses. Suggests an overestimate.

Members primarily decide: %

Selecting activities to offer at center 96%

Managing conflict 84%

Setting policy on how the center is governed 84%

Responding to consumer complaints 78%

Making rules about who can attend the Center 78%

Organizing fundraising 76%**

Increasing consumer responsibility for the budget 50%**

Hiring/firing of staff 41%**

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”

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.

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 boards 43%

DIC Activities: Career - OrientedActivity %

“Yes”

Provide information re: Social Security Benefits 77%

Connect members with post-secondary educational opportunities

37%

Have OVR reps answer questions about work-related issues

36%

Provide vocational training: 25%

Conduct GED classes 10%

Conduct consumer-run businesses 7%

DIC Activities: Housing Supports & Transportation

Activity %

“Yes”

Provide transportation to attend CSP meetings 65%

Assist members to locate and maintain housing 55%

Provide transportation to DIC 54%

Operate a residential housing program 9%

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 positions 21%

DIC Activities: Civic Engagement

Activity %

“Yes”

Coordinate letter writing efforts 48%

Conduct voter registration 47%

Visit state legislature to make concerns known 37%

Host candidates to educate members on candidate qualifications and positions

23%

DIC Activities: Advocacy

Activity %

“Yes”

Attend regional DIC coalition meetings 61%

Teach members to serve on provider advisory boards 47%

Distribute “Call for Change” OMHSAS paper 47%

Participate in County annual Needs-Based plans 47%

Provide public testimony on County MH plan 45%

Have consumer reps on County MH/MR board 45%

DIC Activities: Advocacy, continued

Activity %

“Yes”

Distribute & discuss minutes from State Advisory planning meeting

39%

Attend State Advisory planning meetings 37%

Ensure consumers serve on managed-care advisory committees

28%

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%

DIC Activities: Misc.

Activity %

“Yes”

Educate members on medical plan options and benefits

61%

Conduct warm-lines 24%

NOTE: Further analysis will include open-ended responses.

DIC Challenges: Consumer Involvement

Challenge % Moderate or Serious Problem

Consumers who want others to do things for them 49%

Consumer participation in Center activities 38%

Motivating consumers to attend the DIC 32%

Leadership among members of the Center 28%

Consumer participation at Center staff meetings 27%

Consumers feeling free to make their own decisions about the Center

17%

Maintaining consumer support of DIC Director 11%

DIC Challenges: Consumer Behavior

Challenge % Moderate or Serious Problem

Managing conflict among membership 22%

Coping with unruly members at the Center 17%

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%

DIC Challenges: Operations

Challenge % Moderate or Serious

Problem

Transportation for Center activities 36%

Fiduciary concerns over liability issues 15%

The location of the Center 11%

Assuring Center remains open during scheduled hours

9%

DIC Challenges: MH System Support

Challenge % Moderate or Serious

Problem

Winning support from local provider agencies 24%

Support from Regional OMH Office 19%

Support from the County MH/MR Office 18%

Interference from professional staff in the way the Center operates

11%

What does all this mean to you?

What are some implications of these survey results?

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.

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.

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.

For More Information

• Contact Katy Kaplan at:– 215-746-6713 or katykap@mail.med.upenn.edu

• Visit our website @ www.upennrrtc.org– More information about Community

Integration (CI)

– CI Tools (fact sheets)