16 research outputs found
Patterns of Recovery from Severe Mental Illness: A Pilot Study of Outcomes
We performed a pilot study examining the patterns of recovery from severe mental illness in a model integrated service delivery system using measures from the Milestones of Recovery Scale (MORS), a valid and reliable measure of recovery outcomes which ranges from 1 to 8 (8 levels). For purposes of presentation, we constructed an aggregate MORS (6 levels) where the levels are described as follows: (1) extreme risk; (2) unengaged, poorly self-coordinating; (3) engaged, poorly self-coordinating; (4) coping and rehabilitating; (5) early recovery, and (6) self reliant. We analyzed MORS data on individuals followed over time from The Village in Long Beach, California (658 observations). Using Markov Chains, we estimated origin-destination transition probabilities, simulating recovery outcomes for 100Â months. Our models suggest that after 12Â months only 8% of âextreme riskâ clients remain such. Over 40% have moved to âengaged, poorly self-coordinating.â After 2Â years, almost half of the initial âextreme Riskâ clients are âcoping/rehabilitatingâ, âearly recoveryâ or âSelf reliant.â Most gains occur within 2Â years
Risk Adjustment of Florida Mental Health Outcomes Data: Concepts, Methods, and Results
This article discusses outcome evaluation systems for mental health programs. It reviews and critically evaluates design and analysis methods for strengthening the validity of such uncontrolled comparisons. The article examines methods for statistically adjusting preexisting groups, now referred to as risk adjustment or case-mix adjustment, and offers guidelines for determining when this procedure is appropriate. Then, analyses on two dependent variablesâa global rating of functioning and a consumer satisfaction measureâavailable from an outcomes evaluation system currently underway in Florida are used to demonstrate the proposed method of risk adjustment. Results for 24 providers of mental health services showed that while risk adjustment only made a small difference in the overall provider rankings, the ranking of some specific providers changed considerably. The article concludes with a discussion of the implications of this research