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Mayview Discharge Study

Mayview Discharge Study. University of Pittsburgh. The Pitt Study. Goals of this presentation Recap findings Identify and focus on potential areas for improvement. Methods. 65 people (75% of a random sample) participated in a two-year follow up study of:

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Mayview Discharge Study

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  1. Mayview Discharge Study University of Pittsburgh

  2. The Pitt Study • Goals of this presentation • Recap findings • Identify and focus on potential areas for improvement

  3. Methods • 65 people (75% of a random sample) participated in a two-year follow up study of: • Standardized assessments of major indicators of quality of life and recovery • Qualitative observations and interviews • We met with people every three months • 45-50 participants at each time point • 225 standardized assessments and 138 “check-ins” over two years

  4. Major qualitative findings • Participants like their new residences and were comfortable with the discharge process • With new-found freedom, a few people get in trouble • Many people have staff as their primary contacts, and some find their lives rather monotonous • Housing is an on-going concern

  5. People are satisfied with theirnew residences • New residences are preferred to the hospital • No comparison. It’s better. It’s the freedom factor • I’m free. I go more places. I do what I want to do. • People feel safe and comfortable • Here, I am much more relaxed • I am much more comfortable • There are less people. If residents don’t get along, it gets taken care of by staff

  6. Potential perils of freedom • A small number of people became re-involved with criminal activity, usually illegal substance use, and experienced negative consequences

  7. Progress needed on community integration • Many participants would welcome more varied activities • Q: What do you do? A: Sleep. Get up and watch TV. Come out here and smoke. • Q: What is there to do? A: Sleeping. Groups. That’s about all. • I don’t go anywhere. I don’t have any money. • Some participants are very active • I am in the process of getting prepared to get a job. I’ll see what kinds of things I want to do.

  8. Staff are often the primary social contacts • Many people report that they depend mostly on staff • No one has visited me besides my peer mentor and CTT • My case manager is my best friend, guardian, big sister. I have 24-hour access to her. • I can talk to CTT any time if there’s something going on or I need them to advocate for me

  9. Housing is a continuing concern • Some people adjust well to supervised housing situations designed for short stays (e.g., CRRs), and find the need to relocate again problematic • Most participants are poor, and will rely on public housing as they become more independent • Public housing is not always available • When available, the quality and safety of public housing is variable

  10. Major quantitative findings • Psychiatric symptoms go down over time • 50% of people meet a recently published criterion for symptom remission at the 2-year time point • Contact with friends and social adjustment go up over time • No quantitative indicator deteriorated over time

  11. Average BPRS score over time

  12. Percent with at least moderate illness(BPRS >41)

  13. Criteria for remission • Remission of BRPS-rated psychotic symptoms • Seven symptoms related to psychosis • Grandiosity, suspiciousness, unusual thought content, hallucinations, conceptual disorganization, blunted affect • Rated 3 (mild) or less for six months • Additional criterion: • Overall BPRS < 31 for six months • 50 participants had at least two standardized assessments in Year 2 of the study • We examined their last two observations

  14. Remission • 30 of 50 (60%) were in remission from psychotic symptoms • 24 of 50 (48%) were in remission and also had low overall BPRS scores

  15. See friends regularly (percent)

  16. How do participants compare to other groups? • Quality of life and Progress towards Recovery • Did not change over time • Compared favorably to other populations for whom data have been published • Perceptions of Care • Did not change over time • Were somewhat lower than the major published benchmark

  17. Quality of Life – all scales (by scale)

  18. WHOQOL: Mayview contrasted with other samples (by sample)

  19. WHOQol compared to other samples

  20. WHOQol compared to other samples

  21. Recovery Assessment Scale– all subscales (by subscale)

  22. RAS: Mayview contrasted to Australian sample of MH consumers

  23. RAS: Mayview in contrast to Australian MH consumers

  24. Perceptions of Care– all scales (by scale)

  25. POC: Mayview contrasted with JCHO sample

  26. Would you recommend this facility?

  27. Rate services from 1-10 (percent)

  28. Omitting the 25-30% who choose ‘10’

  29. Rate services from 1 to 10 (percent)

  30. Conclusions • The closing was successful • Possible areas for continued discussion are: • How to bring variety and community integration into people’s lives • Housing • Is there enough • Can it be stable, supportive, and recovery-oriented • Perceptions are care • Can satisfaction with providers be improved

  31. “The best experience has been knowing that I can make it in the real world. Not as hard as I projected it to be.”

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