This chapter provides an overview of what can be done in the future to address the prevention and control of mental and behavioral disorders. It begins with a description of what has come before, examining progress and pitfalls. This is followed by a discussion of the evolution needed to bring about Winslow's vision of mental health care as an integral part of the public health. It examines the growing role of such factors as the social determinants of health; attention to the full spectrum of mental health and illness from prevention through recovery across the life span; the importance of resilience in preventing behavioral problems; the still evolving key role of consumers in treatment and recovery; and the policy changes needed to embrace mental health as an intrinsic part of the public health.
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This pre-post study examined mental health service utilization and cost before and after participating in self-direction. Findings from this modest pre-post examination of self-direction suggest that mental health self-direction can result in more person-driven, individualized services without increasing costs.
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This Open Forum describes the National Survey of Peer-Run Organizations, which was conducted in 2012 to gather information about peer-run organizations and programs, organizational operations, policy perspectives, and service systems. A total of 895 entities were identified and contacted as potential peer-run organizations. Information was obtained for 715 (80%) entities, and 380 of the 715 responding entities met the criteria for a peer-run organization.
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This study sought to identify risk factors for child protective services (CPS) involvement among parents with serious mental illnesses. Compared with parents without CPS contact, parents with a CPS contact were more likely to be nonwhite and to be less educated. They were also more likely to have less attachment-related social support, more parenting-related needs in numerous areas, and more substance use–related issues and to have experienced adverse childhood and traumatic events. One-quarter of the parents with CPS contact reported not having a mental disorder diagnosis at the time of the first contact, and those in the CPS group were less likely to have taken medications at the time of the first contact than were parents who did not have a CPS contact.
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Every two years beginning in 2010, Live & Learn staff and partners have conducted a Peer Respites Essential Features (PREF) survey. All peer respites in the U.S. are invited to participate. Since the first survey in 2010, the number has grown substantially, as reflected in our Peer Respite Directory. This effort creates nationwide, longitudinal data that documents trends in organizational development and program policy so that communities and states can learn from each other as the number of peer respites grows nationwide. Results from the 2018 PREF Survey examine changes in peer respite operations, funding, staffing, and guest experience between 2014-2018. In 2018, the results are reported in two separate reports.
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The first peer respites arose around 2000, said Laysha Ostrow, CEO of Live & Learn, which conducts behavioral health research. The approach seems to be expanding. Live & Learn counts 33 peer respites today in the U.S., up from 19 six years ago. All are overseen and staffed by people with histories of psychiatric disorders.
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2014 panel discussion about peer respites at the California Institute for Behavioral Health Solutions
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A 2016 presentation to the Milwaukee Mental Health Task Force about peer-run respites.
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In partnership with the California Association of Mental Health Peer-Run Organizations (CAMHPRO), Live & Learn, Inc. conducted a survey on the impact of stakeholder advocacy on decisions affecting public mental health systems in California. The California Mental Health Stakeholder Advocacy Survey was designed by people with personal experience of the mental health system and related advocacy work from CAMHPRO, Live & Learn, Inc., and Shifa Consulting.
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