Consumer-Providers Improve Care for Veterans with Serious Mental Illness
To operationalize the President’s New Freedom Commission for the care of people with serious mental illness (2003), VA created a mental health strategic plan that calls for the use of peer support. In 2005, VA began to fund a number of new positions for consumer-providers (CPs) – veterans with personal experience of serious mental illness who provide support services to other veterans suffering from the same condition, typically as clinical team members. Currently, peer support services range from orienting new patients entering programs, to providing support for emotional and social needs, to teaching skills that are necessary to manage symptoms in order to work and live within the community. This study explored the challenges of CP implementation in its early stages within VA. Investigators assessed data from four focus groups that included 59 VA consumer-providers and 34 VA supervisors from across the United States.
Findings suggest that hiring and employing CPs within VA has been feasible, beneficial, and acceptable to a majority of teammates. For example, many focus group participants stated that CPs helped the entire team become more patient-centered, and that most patients trusted and related to CPs more readily than traditional staff. However, CPs reported experiencing some role confusion and resistance and fears among professional staff about how CPs would fit in. The authors make three recommendations: 1) CPs, traditional staff, and administrators need to be adequately prepared so that CPs can be effectively incorporated into clinical teams; 2) training for CPs varies widely, and efforts should be made to determine the best training package; and 3) systems that are considering using CPs should establish a continuous quality improvement system to help evaluate CPs' performance and patient outcomes.
Chinman M, Lucksted A, Gresen R, Davis M, Losonczy M, Sussner B, and Martone L. Early experiences of employing consumer-providers in the VA. Psychiatric Services November 2008;59(11):1315-1321.
This study was partly funded by HSR&D. Dr. Chinman is with the Mental Illness Research, Education, and Clinical Center (MIRECC, VISN 4), and Dr. Luckstead is with the MIRECC, VISN 5.