2022. A Consumer-Led Intervention Improves Clinical Competencies of Providers
Alexander S Young, MD, MSHS, VA Greater Los Angeles Healthcare System, M Chinman, VA Greater Los Angeles Healthcare System, EL Knight,
ValueOptions, Colorado Springs, H Vogel,
Mental Health Empowerment Project, Albany, AN Cohen,
VA Greater Los Angeles Healthcare System, A Miller,
ValueOptions, Colorado Springs, SL Forquer,
Comprehensive Neuroscience, Colorado Springs
Objectives: Although new treatment and rehabilitation approaches can improve outcomes for many people with severe and persistent mental illness, they are not widely used. Many current providers lack core clinical competencies, especially in the areas of recovery and empowerment at the heart of rehabilitation. We evaluated an innovative consumer-led intervention designed to improve provider quality through intensive education, structured clinician-consumer dialogues, ongoing consultation, and technical assistance regarding self-help.
Methods: One-year controlled trial of the effect of the intervention on provider competencies (knowledge, skills, attitudes), care processes, and the formation of mutual support groups. The setting was five large community mental health organizations with 16 sites in two western states. Participants included 269 providers. Outcomes were assessed using previously validated instruments (the Competency Assessment Instrument and Recovery Attitudes Questionnaire), and semi-structured interviews with clinic staff and consumers. Change over time was compared between the intervention and control groups using covariance analyses.
Results: Compared to controls, clinicians at intervention sites improved significantly (P<.05) in holistic approach (F=4.0), rehabilitation methods (F=5.6), natural supports (F=4.5), team-work (F=5.1), education about care (F=8.4), overall competency (F=6.5), and recovery orientation (F=4.4). Magnitude of exposure to the intervention was correlated with improvement for each of these competencies (P<.05, r=0.17 to r=0.28). Rehabilitation techniques were incorporated into practice at intervention clinics. Eleven mutual support groups formed.
Conclusions: A feasible consumer-led intervention improves self-help and clinical competencies necessary for the provision of high quality care.
Impact: This intervention could help VA organizations move to consumer-centered care models that support recovery.