New Research on Self-Direction in Behavioral Health

January 24, 2019

Two new research articles on self-direction and behavioral health were recently published.

Mental Health Self-Directed Care Financing: Efficacy in Improving Outcomes and Controlling Costs for Adults With Serious Mental Illness
By Judith Cook, Samuel Shore, Jane Burke-Miller, Jessica Jonikas, Marie Hamilton, Brandy Ruckdeschel, Walter Norris, Anna Frost Markowitz, Matthew Ferrara & Dulal Bhaumik
Published online in Psychiatric Services, January 2019

This study examined the effects of self-direction on outcomes, service costs, and user satisfaction among adults with serious mental illness. Researchers compared 114 public mental health system clients who were self-directing with 102 clients who were receiving services as usual. Self-directed care participants had significantly greater improvement over time in recovery, self-esteem, coping mastery, autonomy support, somatic symptoms, employment, and education.      

Money matters: participants’ purchasing experiences in a budget authority model of self-directed care

By Jennifer Spaulding-Givens, Shannon Hughes & Jeffrey R. Lacasse
Published online in Social Work in Mental Health, December 2018

This qualitative study reports findings from interviews with 18 SDC participants on the factors that influence their purchasing decisions, the benefits derived from SDC purchases, and perceived barriers experienced in making desired purchases. Findings reveal the extent to which money matters in mental health recovery and suggest that individualized budgeting and purchasing contribute to SDC participants’ mental wellness and stability, enhance their control over service choices, and, most notably, provide some material relief in ongoing struggles with chronic poverty. Findings also highlight the importance of flexible spending guidelines and streamlined approval processes; overly proscriptive policies may undermine participants’ self-determination.