A new initiative to gather in-depth feedback from Connecticut Mental Health Center (CMHC) consumers has begun.
Findings of the first peer-led focus groups at CMHC show general approval of the quality of care while pointing out key areas for improvement. For the full report, click here (PDF).
The focus groups were launched at the request of CEO Michael J. Sernyak, MD. "Peer-led focus groups are a wonderful way for us to find out what our consumers really want, and then to determine whether we are meeting those needs," notes Dr. Sernyak.
How & Why of Peer-Led Focus Groups
The focus groups involved 101 outpatient consumers, four peer researchers, and—behind the scenes—Joy Kaufman, PhD and Cindy Huang, PhD. Kaufman, Director of Program & Service System Evaluation at The Consultation Center and Director of Quality Improvement for the Community Services Network, trained the peers in qualitative research and evaluation methods along with Huang, a psychology fellow.
Kaufman says it is essential for service recipients to be part of the data collection process. Responses obtained in the peer-led focus group setting are "more meaningful," she explains, and "data that is more meaningful can be more useful in making changes."
In all, the peer researchers led thirteen focus groups over a period of several months. Dr. Sernyak plans to continue using peer-led focus groups at CMHC in the future—including those now underway on the inpatient units. This year's successful pilot project was funded in part by the CMHC Foundation.
The Department of Mental Health and Addiction Services conducts an annual Consumer Satisfaction Survey of ambulatory services at all sites statewide including CMHC. In 2011, 92% of CMHC respondents expressed overall satisfaction with CMHC services (2012 results have not yet been released). Peer-led focus groups aimed to learn more about what’s happening with the remaining 8% and what can be done to improve satisfaction levels across the board.
The Peer Leaders
Three dedicated, enthusiastic peer leaders, Ronald Byrd, Eddrena Claggett, and Reno Perkins led the focus groups with one serving as note-taker, the other as facilitator. Byrd, Claggett, and Perkins were joined by peer researcher Sandra DeVeaux in designing the questions, analyzing the data, and reporting the results.
Their questions assessed quality of care, access to care, comfort within the building, and recovery.
"We were able to provide a unique interview," says Byrd, "because we’re also consumers. We have shared experiences and can identify with them." Byrd notes that consumers often feel less pressure when talking with peers, suggesting that they were more likely to have natural, open conversations.
After the interviews were completed, the data was coded and analyzed by peer leaders working with Consultation Center staff. Five themes emerged: (1) satisfaction with CMHC and its services, (2) comfort, rights, and respect at CMHC, (3) the recovery process, (4) barriers to services and recovery, and (5) suggestions for additional services.
Responses & Recommendations
"Most of the responses were very positive," Claggett says. "The consumers were pleased with the friendly and caring staff, and with the sense of safety they feel at CMHC. They were also happy to get the opportunity to speak about how they truly felt."
Consumers also suggested areas of improvement. Some felt unsure of their rights; others wanted more education about their psychiatric medication and its side effects. Some prefer evening and weekend hours to accommodate their work schedules. Others were unclear as to whether they were making progress toward recovery.
The report issued several recommendations including "that CMHC consider continuing or newly offering trainings for clients regarding the recovery model and ways clients can be active participants in the treatment planning process."
A Positive Process
Byrd and Claggett say they learned a lot from the project and felt rewarded because it gave them an opportunity to help others. Claggett, who describes herself as a "people-person," adds that she enjoyed meeting people with different personalities. As a focus group leader, she encouraged the quieter participants to add to the conversation, because "I wanted to make sure everyone had a chance to say something."
Peer leaders also enjoyed working with their trainers Joy Kaufman and Cindy Huang. "It was enlightening," Claggett explains. "Joy and Cindy were good coaches. They were patient, and we had lots of laughter." The peer leaders are currently collaborating with Kaufman’s colleagues Cindy Crusto, PhD and Jessica Costeines, MSW on the inpatient focus groups, where they face new challenges and continue to enjoy the work.
Going forward, peer-led focus group findings will serve as the basis for discussion about how to make positive, consumer-oriented changes at CMHC.
This article was written by Hannah-Rose Mitchell, Yale MPH Candidate 2013, for Center Focus, the newsletter of Connecticut Mental Health Center.