2015 APHA Annual Meeting & Expo

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Recorded Annual Meeting Presentations (RAMP) are now available for purchase.
Only $90 for presenters, $140 for registered attendees and $200 for non-attendees.

Online Program

334976
Crisis as Opportunity: The Parachute NYC - Approach and Participant Outcomes


Tuesday, November 3, 2015 : 8:50 a.m. - 9:10 a.m.

Mary Jane Alexander, PhD, Center to Study Recovery in Social Contexts, Nathan Kline Institute, Orangeburg, NY
Audio (mp3) recording Recorded Presentation (mp4)
Background Solely biomedical approaches to psychosis related crises are structurally and individually inadequate.  Involuntary hospitalization experiences compound distress by disconnecting people from their lives and alienating natural support networks. Without access to the recovery oriented supports that Mental Health Peers embody, individuals and families are left to construct hopeless narratives for their futures. Through a Medicaid innovation grant, Parachute NYC re-oriented mobile crisis teams to home-based engagement and treatment, and created peer staffed crisis respites.  This presentation will share outcomes demonstrating how Parachute’s explicit embrace of human rights based, peer inclusive, humanistic approaches support people-in-crisis to “stay in their lives.”

Methods:  Standard measures were used to query a volunteer sample (n=164) using Mobile team (74) and Respite (90) services about mental health, quality of life, choice and service use in quarterly interviews over 1 year. We use general population norms and data from mental health samples for comparison

Outcomes At enrollment, Mental Health (MH) symptoms were significantly higher and Social Functioning significantly lower for Parachute survey participants compared to general population norms. Hierarchical Linear Models including Time, Age, Gender and Hospitalization Alternative as covariates showed improvement in overall MH and symptoms by 3 months, increased Empowerment at 6, 9 and 12 months, and no change in Social Functioning. Probability of ER use and hospital decreased at 3 and 6 months. Shared Decision and Agency scores were high throughout.

Implications: MH crises resolve safely and recovery prospects improve using home based hospitalization alternatives that include peers and social networks to support recovery.

Learning Areas:

Public health or related research
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Identify differences between bio medical and recovery oriented outcome measures Explain how alternative approaches to psychosis related crisis support recovery Identify factors that impact recovery from crisis

Keyword(s): Evaluation, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal evaluator for Parachute NYC and have over two decades of experience in mental health services research. I have bee principal investigator on numerous contracts related to public policy and on a federal grant that used Community Based Participatory Research approaches to Study Recovery in Social Contexts.
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.

Back to: 4056.0: Crisis as Opportunity: Creating System Change From Within While Implementing a Soft Landing For People In Crisis