Mental Health Treatment Outcomes in Rhode Island

Transcription

1 MENTAL HEALTH ASSOCIATION of Rhode Island An Affiliate of Mental Health America O Mental Health Treatment Outcomes in Rhode Island Mental Health Associa7on of Rhode Island September

2 MENTAL HEALTH ASSOCIATION OF RHODE ISLAND The mission of the Mental Health Associa2on of Rhode Island is to promote mental health, prevent mental illness, and improve mental health services through advocacy, educa2on, and research. Board President Richard Antonelli, MSW Execu7ve Director Vivian G. Weisman Sta7s7cal Research & Analysis Jana Hesser Ph.D. William Waters Ph.D. 2

3 Dedica7on This report is dedicated to Edward V. LeDoux, Secretary, Board of Directors, Mental Health Associa7on of Rhode Island (MHARI) who was the inspira7on for this work. Ed is a persistent and persuasive advocate for the measurement and prac7cal use of mental health treatment outcomes. In fact, Ed has even designed and copyrighted a system for measuring and tracking client treatment outcomes called Recovery: The Whole Story! 3

4 Mental Health Treatment OUTCOMES This is the third sta7s7cal report from the Mental Health Associa7on of Rhode Island in three years. The first report, Mental Health Performance Measurement & Public Repor7ng CHART BOOK (2010) deals mainly with service u7liza7on. The second report, The Impact of Mental Illness on Rhode Islanders, Sta7s7cal Measurement addresses life status. This third report links the first two reports by focusing on treatment outcomes. Ideally for this report we would all have access to aggregated mental health treatment outcome data based on the experience of individual clients. Statewide data of this type is not currently available. However, there are some posi7ve examples of the collec7on and use of prospec7ve treatment outcome data. For example: The Mental Health Center of Denver (MHCD) created instruments to gather informa2on from different vantage points: (a) the Consumer Recovery Measures (CRM) captures the consumer s percep2on of his/her own recovery; (b) The Recovery Markers Inventory (RMI) measures the clinician s point of view regarding factors associated with recovery; and (c) Promo2ng Recovery in mental health Organiza2ons (PRO) where consumers evaluate how the mental health center staff helps/hinders their recovery efforts. 1 Locally, Riverwood has used an adapta7on of the Arizona Self Sufficiency Matrix 2 which has 18 domains: 1. Income 2. Employment 3. Shelter 4. Food 5. Childcare 6. Children s Educa?on 7. Adult Educa?on 4

5 8. Legal 9. Health Care 10. Life Skills 11. Mental Health 12. Substance Abuse 13. Family Rela?ons 14. Mobility 15. Community Involvement 16. Safety 17. Paren?ng Skills 18. Credit History The client s status in each domain is measured by a 5- point scale: a. In Crisis b. Vulnerable c. Safe e. Building Capacity f. Empowered Obviously, if we had this type of informa7on on longitudinal basis for each mental health client in Rhode Island we would know how the clients were fairing and to what extent our services were effec7ve. This is exactly where we need to go! In the mean7me, in order to focus more afen7on on treatment outcomes, we will present herein outcome data on a cross- sec7onal basis. This data can serve as a type of base line for our efforts to measure and improve mental health treatment outcomes in Rhode Island, on an individual pa7ent, program, organiza7on, and 5

6 statewide popula7on basis. The data contained in this report come from 1) the Rhode Island 2010 Mental Health Na2onal Outcome Measures (NOMS): Community Mental Health Services (CMHS) Uniform Repor2ng System, 2) the Outcome Evalua2on Instrument Consumer Survey (OEI), and 3) the Behavioral Health On- Line Data System (BHOLD). Our sincere thanks to Noelle Wood, Ph.D. (Project Manager/ Research Associate, Division of Behavioral Healthcare, Rhode Island Department of BHDDH) for her expert data assistance with this project. 1 P. Antonio Olmos- Gallo et.al. Seven Key Strategies that Work Together to Create Recovery Based Transforma7on Community Mental Health Journal, Sringer, Published online: 20 October Arizona Self Sufficiency Matrix, hfp:// MatrixDiagramsColor pdf 6

7 Clients Served by SMHA System by Sex, All Ages, 2010 Male 50.7% 49.3% Female About half of the 29,592 clients served by RI s Statewide Mental Health Agencies (SMHA) System are female and half male. 7

8 Clients Served by SMHA System by Race, All Ages, 2010 White 11.8% 25.0% 7.9% 63.4% Black/African American Other race Unavailable About 63% of the 29,592 clients served by RI s Statewide Mental Health Agencies (SMHA) System are white, 8 % are black, and 12% are of other races; race was unavailable for 25%. About 16% of clients are Hispanic or La7no 8

9 Clients Served by SMHA System by Age, % 31.1% Ages 20 or younger Ages Ages 65 and older 63.4% About 63% of the 29,592 clients served by RI s Statewide Mental Health Agencies (SMHA) System are between the ages of 21 64; 31% are ages 20 or younger and 5% are 65 or older. 9

10 Clients Served by SMHA System by Living Situa7on, All Ages, % 7% 3% Percent 1% Private Residence Foster Home Residen7al Care 88% Ins7tu7onal/ Correc7onal Homeless Of the 24,084 SMHA System clients with a known living situa7on, 88% are in private residences, less than 1% in foster homes; 7% in residen7al care, less than 1% are in ins7tu7onal or correc7onal sepngs, and 3% are homeless, 10

11 Clients Served by SMHA System by Employment Status, Ages 18+, % 19.3% 32.6% Employed (n=3,658) Unemployed (n = 6,187) Not in Labor Force (n= 9121) Of 18,963 clients 18 and older served by RI s SMHA with known employment status, 19% are employed, 33% are unemployed, and 48% are not in the labor force (re7red, homemaker, student, disabled, etc.) 11

12 Clients Served by SMHA System Receiving Evidence- Based Prac7ce (EBP) Services, Ages 18 and older, 2010 Percent receiving services 3% 4% 18% 17% Supported Housing Supported Employment Medica7ons Management Integrated Dual Diagnosis Treatment. Of adult SMHA clients, 3% are in supported housing, 4% in supported employment, 18% receive medica7ons management, and 17 % receive integrated dual diagnosis treatment. 12

13 Clients Served by SMHA System, Percep7on of Service Results, 2010, Ages 18 and Older Percent repor7ng posi7ve percep7ons 70% 80% 89% 90% 92%. Posi7ve Outcomes Treatmnt Plan Par7cipa7on Access Measures of Service Overall Sa7sfac7on w care Of adult SMHA System clients surveyed, 70% to 92% report posi7ve percep7ons about services they are receiving. Quality/ appropriateness 13

14 Clients Served by SMHA System, Percep7on of Social Connectedness and Func7oning from Services, Ages and Older, 2010 Percent repor7ng improvement 71% 73% Improved Social Connectedness Improved Func7oning. Of adult SMHA System clients surveyed, slightly more than 70% reported improved social connectedness and improved social func7oning as a result of services received. 14

15 Readmissions within 180 days to State Psychiatric Hospitals (non- forensic pa7ents) by Age and Gender, 2010 Percent readmifed 19% 25% 19% 16% 21% TOTAL Ages Ages Females Males. Of pa7ents admifed to psychiatric hospitals, 19% were readmifed within 180 days; readmission rates were higher for the youngest adults (25%) and for males (21%). 15

16 Homeless Clients by Age and Gender (N = 732), % Percent 38% 62% 7% Ages 0-17 Ages Females Males. Of the 3% of SMHA System clients who are homeless, 93% are adults ages 18 and older, and 62% are males. 16

17 Homeless Clients by Race and Ethnicity (N = 732), % Percent 63% 13% 5% 19% 15%. White Black/ African American Other race Race unknown Hispanic/ La7no Not Hispanic/ La7no Of the 3% of SMHA System clients who are homeless, 63% are white, 13% are Black and 5% are of other races, while 19% are of unknown race. 15% are Hispanic/La7no. 17

18 Clients in Correc7onal Sepngs by Age and Gender (N = 44), % Percent 36% 64% 18% Ages 0-17 Ages Females Males Although less than 1% of SMHA System clients are in correc7onal sepngs, 82% are adults 18 and older and 64% are males. 18

19 Clients in Correc7onal Sepngs by Race and Ethnicity (N = 44), % Percent 60% 23% 23% 7% 10% White Black/ African American Other race Race unknown Hispanic/ La7no Not Hispanic/ La7no. Although less than 1% of SMHA System clients are in correc7onal sepngs, 60% are white, 7% are black, 10% of other races, while race is unknown for 23%; 23% are Hispanic/La7no. 19

20 Criminal Jus7ce Arrests Among New and Con7nuing Adult Clients by Gender, 2010 Arrested more than 1 yr ago Percent Arrested more than 1 yr ago and rearrested in current year 3% 10% 8% 14% Females Males. 3% of SMHA System female clients, and 8% of male clients were arrested more than 1 year ago; 10% of females and 14% of males arrested more than a year ago, were rearrested in the current year. 20

21 Consumer Survey Results for Adult Clients Served by SMHA System, 2011 Percent Agreeing 59% 66% 67% 69% 69% 72% Do Befer in school and/or work Symptoms not bothering as much Do befer in social situa7ons Befer able handle problems Housing situa7on has improved Gepng along befer with family. 59% to 72% of adult SMHA System clients report various posi7ve results on six selected assessment measures as a result of receiving services. 21

22 Consumer Survey Results, % 73% 73% 76% 78% Percent Agreeing. In a crisis, I Feel I belong in would have the my community support I need from family or friends. Befer able to deal w crisis Do things that are meaningful to me Have people with whom I can do enjoyable things 72% to 78% of adult SMHA System clients report various posi7ve results on a five selected assessment measures as a result of receiving services. 22

23 Consumer Survey Results, % 78% 80% 80% 80% Percent Agreeing Befer able to take care of my need Befer able to control my life Happy with the friendships I have Medica7on I am taking help me control symptoms Deal more effec7vely w daily problems. 78% to 80% of adult SMHA clients report posi7ve outcomes on five assessment measures as a result of receiving services. 23

24 Technical Notes Data displayed in this report is for the most part the result of data gathered by the Rhode island Department of Behavioral Health, Developmental Disabili7es & Hospitals (BHDDH) and forwarded to U.S Substance Abuse & Mental Health Services Administra7on (SAMHSA) subcontractor, NRI, as part of the Federal block grant and data infrastructure grant requirements. In its en7rety this data also includes informa7on re: RI over 7me, as well as comparing RI to other states/regions of the country. 24