Participatory action research to establish self-directed care for mental health recovery in Texas.

OBJECTIVE: This article describes a public-academic collaboration between a university research center and the Texas state mental health authority to design and evaluate a unique "money follows the person" model called self-directed care (SDC). SDC programs give participants control over public funds to purchase services and supports for their own recovery. METHODS: Through a participatory action research process, the project combined use of evidence-based practice and community consensus as a tool for system change. RESULTS: The story of this effort and the program that resulted are described, along with quantitative and qualitative data from the project's start-up phase. CONCLUSIONS: Lessons learned about the importance of community collaboration are discussed in light of the current emphasis on public mental health system transformation through alternative financing mechanisms.

Combining evidence-based practice with stakeholder consensus to enhance psychosocial rehabilitation services in the Texas benefit design initiative.

This article describes the use of evidence-based practice along with a multi-stakeholder consensus process to design the psychosocial rehabilitation components in a benefit package of publicly funded mental health services in Texas. The Texas Benefit Design initiative demonstrates how the combination of science and consensus can be used as a powerful tool for change. It applies the findings of rigorous research regarding psychosocial rehabilitation service delivery approaches that achieve positive outcomes in real world, community settings. At the same time, it makes use of the unique knowledge and experience that mental health service consumers, providers and other advocates can bring to service system design and planning.