142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Promoting Self-Determination through Behavioral Health Self-Direction: Recent Developments and Future Directions

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 2:30 PM - 2:50 PM

Bevin Croft, MPP, PhD (cand.) , Human Services Research Institute, Cambridge, MA
Lori Simon-Rusinowitz, PhD, MPH
Dawn Loughlin, PhD
Kevin Mahoney, PhD
Self-direction is a model for financing services and supports in which the individual manages, with support from a specially trained peer,  a flexible behavioral health service dollar budget. Self-direction has been clearly linked with positive outcomes for older adults and individuals with disabilities. Under this strategy, participants control how funds are spent. Purchases are linked to goals identified in an ongoing assessment and planning process.

Self-Direction is less commonly implemented in the behavioral health arena. However, a small but growing body of evidence suggests that self-direction can improve recovery outcomes while keeping costs similar to traditional arrangements. The principles of self-direction are in harmony with the Affordable Care Act’s emphasis on integrated, person-centered care, and recent changes to Medicaid financing options support an expansion of self-direction in behavioral health.This presentation will offer an overview of self-direction, including existing national initiatives and evidence of their effectiveness. 

The presentation will provide the results of a Robert Wood Johnson Foundation-funded study of Self-Direction. This "environmental scan" (descriptive study) was designed to understand the barriers and facilitators to self-direction in behavioral health from the perspective of multiple stakeholders. The method used was a survey of state and county behavioral health program directors; focus groups and in-depth interviews with administrators, providers, and behavioral health service users.

The environmental scan identified key barriers and bridges to the adoption and implementation of behavioral health self-direction. Findings will address: trends in interest in and enthusiasm for self-direction; demand for further research;  and the need for  technical assistance to assist with implementation.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Program planning
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Define the self-direction model, including basic program elements and current evidence of effectiveness Discuss stakeholder views on behavioral health self-direction, including barriers and bridges to adoption and implementation Describe how behavioral health self-direction fits within the priorities of the Affordable Care Act

Keyword(s): Self-sufficiency and Empowerment, Patient-Centered Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have ten years experience with behavioral health services provision, management, quality assurance, and workforce development, and I have been conducting research in the area of behavioral health self-direction for five years, including as a key contributor to two Robert Wood Johnson Foundation projects. I am pursuing a PhD in behavioral health policy at Brandeis University, and my dissertation is a mixed methods study of a behavioral health self-direction program.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.