Pathways to program entry: Factors promoting entry and participation in veteran peer-support programs.

Given the documented underutilization of community-based services by veterans, this study aims to identify factors promoting engagement in programs. Qualitative data from interviews with 154 veterans in peer support programs were analyzed to identify factors promoting program entry and participation. Findings confirm the importance of both internal and external factors for program engagement. Internal factors included feeling a sense of disconnection, dissatisfaction with other programs, emotional needs, concrete needs, and a desire to serve others. External factors included encouragement from others, program culture, and program climate. Implications for program development and evaluation are discussed. While much of the current literature on veterans focuses on individual characteristics promoting or impeding service use, this study provides insight into programmatic features such as culture and climate which foster participation and meaningful engagement. Ultimately, programs serving veterans need input and influence by veterans, and should emphasize peer support and other opportunities for social connection.

Neighborhood Perceptions of Gun Violence and Safety: Findings from a Public Health-Social Work Intervention.

Efforts to reduce gun violence have moved away from models that rely solely on law enforcement approaches, toward public health-focused models of intervention. This paper discusses urban gun violence from a public health and social work perspective, examining a method to interrupt, reduce and prevent gun violence at the community level. A qualitative research design was utilized to evaluate perceptions held by thirty-seven community members regarding the impact of a gun and related violence prevention program, Albany SNUG. Five key findings emerged from the data analysis: 1) Violence was viewed as significant, widespread and a source of despair and hopelessness; 2) Residents perceived a lack of resources and opportunities within the community; 3) There was general consensus regarding the program's importance to the community; 4) There were several obstacles and challenges to program implementation as identified by participants; and 5) Community involvement and shared responsibility were viewed as central to the reduction of gun and related violence. Recommendations for practice and policy changes and the potential role for social work in future collective efficacy and social change initiatives are also discussed.

Outreach and peer-delivered mental health services in New York City following September 11, 2001.

OBJECTIVE: Following the tragedy of September 11, 2001, the Federal Emergency Management Agency (FEMA) funded Project Liberty, an umbrella program operating from multiple sites throughout New York City to provide free crisis counseling and other assistance. One particular Project Liberty site provided peer support services for individuals with pre-existing psychiatric disabilities. This article reports on the outreach efforts undertaken by Project Liberty's Peer Initiative. METHODS: As part of a broader qualitative study, face to face interviews were conducted with Project Liberty Peer Initiative staff and service recipients. CONCLUSIONS: Outreach was found to be a key strategy used to identify and connect with psychiatrically disabled individuals in need after disasters. Implications for the use of similar outreach strategies in future disaster planning and service delivery are described.

Referral to consumer-run programs by mental health providers: a national survey.

This study describes mental health providers' awareness of, attitudes toward, and likelihood to refer to consumer-run programs. A mail survey method was used with a total of 301 questionnaires returned (33.5% response rate) from a national random sample. Findings suggest that providers believe consumers are able to provide effective mental health services, yet have less confidence in consumer-run programs. Slightly over half of the providers were aware of consumer-run programs and fewer had made referrals. Providers in non-public settings, agencies that hire consumers as providers, and agencies that collaborate with consumer-run programs were more likely to have made referrals. To maximize available community supports for service recipients, providers should consider newer, consumer-run service technologies.

Promoting healthy organizational partnerships and collaboration between consumer-run and community mental health agencies.

Community mental health agencies (CMHAs) and consumer-run agencies (CRAs) both provide critically important services to persons with severe psychiatric disabilities. Emerging research has begun to support the effectiveness of the CRA approach, a newer service delivery mechanism. However, collaboration between the two service systems, when it occurs, is often problematic. This article briefly identifies the core features of CRAs, discusses their potential for collaboration with CMHAs, and suggests ways to promote healthy organizational partnerships between the two based upon the model proposed by Gidron and Hasenfeld [(1994) Nonprofit Management & Leadership, 5(2), 159-172]. Salient collaboration theories are reviewed and barriers to collaboration are discussed. Finally, implications for mental health practice and future research directions are identified.

Making sense of it all: consumer providers' theories about factors facilitating and impeding recovery from psychiatric disabilities.

This qualitative study examined the accounts of fifteen adults regarding how they recovered from serious psychiatric disability. Interviews were analyzed using a grounded theory approach within a framework of Symbolic Interactionism. Recovery was identified as a dynamic process of personal growth and transformation. Barriers to recovery included paternalistic and coercive treatment systems, indifferent professionals, side effects from medication, and psychiatric symptoms. The existence of supportive relationships, meaningful activities and effective traditional and alternative treatments were identified as influential in facilitating recovery. The consumer providers who participated in this study provided important findings and fresh understanding about the recovery process.

Community membership and social networks in mental health self-help agencies.

This article explores community membership among self-help agency (SHA) participants. It is suggested that SHAs foster the enhancement of peer-oriented social networks, leading to the experience of shared community. Social network analysis was used to examine the structure of support mechanisms, and to assess levels of community membership through peer inclusion. Results indicate that both individual and organizational characteristics play roles in predicting peer presence in social networks. Organizational empowerment is a key factor, with the SHA emerging as a promising locus for peer support development through enhanced social networks. Implications for the organization of consumer-based services are discussed.

Predictors of Hope Among Members of Mental Health Self-Help Agencies.

Hope is a key construct for successful community adjustment among those with severe mental illnesses, particularly given the strengths-based recovery model increasingly prevalent in mental health services and in social work. Consumer-run mental health self-help agencies (SHAs) are well suited to fostering hope via their supportive program environments. This study examines factors associated with hope among members of four self-help agencies via a two-stage least squares regression model (N = 310). Findings provide evidence of both individual and program-level associations with hope. These findings mirror social work ethical values of focusing on consumer strengths and self-determination, which are primary goals of SHAs.

Characteristics of new clients at self-help and community mental health agencies in geographic proximity.

OBJECTIVE: Self-help agencies are funded as adjuncts of, referral sources for, or alternatives to community mental health agencies. Little is known about how these two types of organization in geographic proximity interact, whom they attract as prospective clients, and what their clients bring to the service situation. The authors compared the characteristics and past service use of new enrollees of self-help agencies and community mental health agencies serving the same geographic area. METHODS: Interview assessments were conducted with 673 new users at ten pairs of self-help and community mental health agencies serving the same geographic areas. Client characteristics were evaluated with multivariate analysis of variance and chi square tests. RESULTS: Clients of community mental health agencies had more acute symptoms, lower levels of social functioning, and more life stressors in the previous 30 days than clients of self-help agencies. The self-help agency cohort evidenced greater self-esteem, locus of control, and hope about the future. Clients of self-help agencies had received more services from facilities other than self-help or community mental health agencies in the previous six months, and clients of self-help agencies who were not African American had more long-term mental health service histories. CONCLUSIONS: Although self-help and community mental health agencies both provide services to people with major mental disorders, community mental health agencies deliver primarily acute treatment-focused services, whereas self-help agencies provide services aimed at fostering socialization, mutual support, empowerment, and autonomy.

Factors in decisions to seek help from self-help and co-located community mental health agencies.

This study examined 673 new users of co-located mental health self-help agencies run by consumers and community mental health agencies to evaluate the relative importance of predisposing, enabling, and need factors in site selection. Although need dominated help site choice, clients' attitudes toward the helpfulness of mental health treatment and their fears of coerced or inadequate care played an important role in setting choice, a choice indicative of a more complex motivational dynamic in help seeking.