Tuesday, April 13, 2010

New Feature in the Blog

Starting this week, every second week of the month, Dr. P. Antonio Olmos-Gallo, director of Evaluation and Research will be presenting some research-related topic. It will be either about a project conducted at the Mental Health center of Denver (MHCD) or some research project that may be of interest to readers of this blog.
Development of Instruments to measure recovery
I would like to start by describing how we got where we are now. About 8 years ago, MHCD decided that they wanted to do something about recovery. Back then, our center, like many others, wanted to become more recovery oriented. Every year MHCD sponsors a Recovery Conference that will feature well known speakers (in past events we have invited Priscilla Ridgway, Ed Knight, and more recently, Fred Freese) and always felt energized after the conference. We had critical mass, and the commitment, but we had little direction about to what to do next. At that time, it was decided to create a “Recovery Committee” that was formed by consumers, clinical people, psychiatrists, and administrators. The directive for this committee was to help MHCD become more recovery oriented. After some initial meetings, it became obvious that one thing we needed to do was to define what recovery meant for our center, and try to find a way to measure it. The plan was not only to be able to track changes over time in order to know if we were moving in the right direction, but also, to be able to know what of the multiple things we were doing, will help us or hinder our efforts, and be able to correct our trajectory as we moved forward.
Initially our objective was to meet with several groups of stakeholders, and try to create a definition of recovery that will fulfill our requirements. Our definition of recovery is: “a non-linear process of growth by which people move from lower to higher levels of fulfillment in the areas of sense of safety, hope, symptom management, satisfaction with social networks and active/growth orientation”
Some members of the committee were asked to do a literature review and try to find if there were instruments already developed that would help us measure Recovery. We found multiple instruments, but we were never fully satisfied because the instruments always seemed to fall short in one area or the other. Finally, after much debate, we decided to create our own set of instruments.
The decision was then made to create our own instruments. But we also felt we needed specific requirements: 1) Recovery is different for different people, and is affected by many variables, therefore, we needed to have more than one instrument, to be able to capture those multiple facets. 2) The instruments should be developed using state-of-the-art techniques.
With those two directives, and the total support of our center, we started the development of our instruments. We have:
1. The Recovery Markers Inventory (RMI), measures the factors associated with recovery. This is not an instrument that will measure recovery per-se, but factors like housing, employment, education, participation in services, that are usually associated with recovery. This instrument is completed every three months by the clinician/case manager who is helping the consumer
2. The Consumer Recovery Measure (CRM) which measures the consumer’s perception of their own recovery. Although there are many areas that are related to recovery, our stakeholders decided that we will concentrate in 5 areas: 1) safety, 2) hope, 3) symptom management, 4) satisfaction with social networks and 5) active/growth orientation. This instrument is also completed every 3 months by the consumer either by him/herself or with the help of a clinician/case manager.
3. The Promoting Recovery in Mental Health Organizations (PRO) which measures the perception of the consumer about the ability of the staff at our center (clinical, nurses, psychiatrists, even front-desk people) to help them or hinder their recovery. We complete this instrument once a year on a random sample of adult consumers (about 10-12%).
If you are interested in learning more about our instruments, please visit our Evaluation and Research website (http://www.outcomesmhcd.com//) we have presented in multiple forums, and we have several manuscripts under review at several peer-reviewed journals

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