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This article was downloaded by: [Dalhousie University]On: 06 October 2014, At: 21:06Publisher: RoutledgeInforma Ltd Registered in England and Wales Registered Number: 1072954 Registeredoffice: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
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Collaborative Support Programs of NewJerseyMargaret Swarbrick a ba Institute for Wellness and Recovery Initiatives CollaborativeSupport Programs of New Jersey , Freehold, New Jerseyb University of Medicine and Dentistry of New Jersey, Schoolof Health Related Professionals, Department of PsychiatricRehabilitation and Counseling , Scotch Plains, New JerseyPublished online: 21 Aug 2009.
To cite this article: Margaret Swarbrick (2009) Collaborative Support Programs of New Jersey,Occupational Therapy in Mental Health, 25:3-4, 224-238, DOI: 10.1080/01642120903083952
To link to this article: http://dx.doi.org/10.1080/01642120903083952
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Collaborative Support Programsof New Jersey
MARGARET SWARBRICKInstitute for Wellness and Recovery Initiatives Collaborative Support Programs
of New Jersey, Freehold, New Jersey
University of Medicine and Dentistry of New Jersey, School of Health Related Professionals,
Department of Psychiatric Rehabilitation and Counseling, Scotch Plains, New Jersey
INTRODUCTION
This manuscript has revealed the vast array of practical services andresources that have been designed and delivered by persons living withmental illness. This article will present a unique service organization, Colla-borative Support Programs of New Jersey (CSP-NJ). This agency isconsidered a leader in creating a vast range of these resources designed tomeet the needs of people living with mental illness. The history of CSP-NJparallels the mental health consumer-survivor self-help movement describedin the article ‘‘Historical Perspective—From Institution to Community’’(this issue). Many of the services portrayed in this issue (self-help centers,wellness, and recovery programs and the peer employment support project)were conceived by leaders and innovators at CSP-NJ. This section will offer asnapshot of some of the other CSP-NJ innovations in order to further demon-strate how peer-operated services can be an instrumental resource for mentalhealth systems transformation.
CSP-NJ HISTORY
CSP-NJ is a not-for-profit, peer-operated statewide mental health agency that wasincorporated in 1984. Since the mid 1980s, CSP-NJ has established itself as arespected innovator of housing, self-help centers, employment, and economicdevelopment services that promote the wellness and recovery of people livingwith disabilities. The agency grew from a small grassroots group running three
Address correspondence to Margaret Swarbrick, Institute for Wellness and RecoveryInitiatives Collaborative Support Programs of New Jersey, 8 Spring St., Freehold, NJ 07728.E-mail: [email protected]
Occupational Therapy in Mental Health, 25:224–238, 2009Copyright # Taylor & Francis Group, LLCISSN: 0164-212X print=1541-3101 onlineDOI: 10.1080/01642120903083952
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drop-in centers to a statewide organization that is now a nationally recognizedleader in the design and delivery of wellness- and recovery-oriented services thatoffer opportunities for people to live, learn, and work in the community of theirchoice. Their motto is: ‘‘The greatest resource is the life experiences of personsworking through their own recovery.’’
Collaborative Support Programs of New Jersey, Inc. (CSP-NJ) is a privatenot-for-profit organization. The agency is directed, managed, andstaffed through collaborative efforts of mental health consumers andnon-consumers. CSP-NJ strives to provide individualized, flexible,community-based services that promote responsibility, recovery, andwellness. This is done through the creation and administration ofself-help centers, supportive housing, advocacy, and entrepreneurialprograms for adults with mental health issues and other special needs.CSP-NJ shares a vision of healing and hope, which is promoted bychoice, freedom, inclusion, and destigmatization. Our greatest resourceis the life experiences of persons working through their own recovery.
Throughout its history CSP-NJ has created services in response to theneeds of people living with a psychiatric disability and who also have extre-mely low incomes. Initially, the agency attempted to address isolation andtranscend the ‘‘patient role’’ by developing and operating drop-in centers(now named self-help centers) as well as creating statewide advocacy initia-tives. They organized educational forums and participated in the nationalAlternatives Conference (sponsored by the Center for Mental HealthServices) to network and learn about other innovative, recovery-fosteringalternatives from peers throughout the country. Through active participationin these forums, they were able to organize, seek funds, and pilot aninnovative housing and support model to address poverty and inadequateliving conditions that impede recovery. By 1989 they had opened the firstpeer-run house in Asbury Park. The organization now provides safe, decent,affordable housing for more than 600 persons in New Jersey. Realizingthe effects of poverty, CSP-NJ created an array of financial services to helppeople transcend the poverty trap.
The notion of recovery has always been central to the agency missionsince the very beginning. In 1997, CSP-NJ consciously added the notion ofwellness into the agency mission, services, and administrative policies. Ofparticular concern were the issues of mortality and morbidity facing personsliving with mental illness (Parks et al., 2006). The agency started promoting awellness approach to mental health recovery (Swarbrick, 2006a) within theagency structure and throughout the system. CSP-NJ has become an effectivechange agent in terms of promoting a system based on wellness and recoverythrough the efforts of the Institute for Wellness and Recovery Initiatives.
The agency embraces (and values) innovation and has continuedto challenge the status quo both internally and externally for persons with
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mental illness, as perceived not only by themselves, but also the generalpopulation. As they have expanded and diversified, they have continuallychallenged themselves to keep abreast of new and effective means ofdelivering services. A quality improvement (QI) initiative started in 1998,and in 2003 the agency adopted a Participatory Action Research (PAR)approach to QI, out of which was created the Consumer-Operated MissionPerformance: Assessing Services Strategically (COMPASS), an agency-wideoutcomes-based measurement system designed to evaluate the effectivenessof the CSP-NJ and CEC programs and services.
CSP-NJ believes strongly in work, and the expansion of the agencyservices created employment opportunities for many people living withmental illness. Within all of the services they attempt to help peopletranscend the patient role so people who are diagnosed with a mental illnesscan realize and have opportunities to further develop talents, skills, andabilities so they can participate in as many roles as they define (familymember, worker, community member, citizen of the world, hobbyist, etc.).The agency’s success and services also impact stigma and discrimination,as they are evidence that people living with mental illness can accomplishgoals, dreams, and provide a positive contribution to society. The followingsection will describe some information regarding services not previouslyoutlined in this issue.
CSP-NJ SERVICES
Support Services
The support services division of CSP-NJ offers flexible, strength-basedservices designed to promote wellness and recovery. As of 2009, the agencyoffers statewide support services to about 400 persons living with mentalillness. They offer a menu of support services that help people live success-fully in safe, decent, accessible, and affordable housing. The support servicesdivision has been placing a lot of focus on offering opportunities for indivi-duals who may be unnecessarily hospitalized in state facilities for extendedperiods of time.
The agency believes that psychiatric rehabilitation values, principles,and goals (Pratt, Gill, Barrett, & Roberts, 2007) best promote wellness andrecovery, and they have committed themselves to maintain and provideservices that are guided by the psychiatric rehabilitation framework. Staffhas been trained extensively on psychiatric rehabilitation goals, values, andprinciples, so that they are able to empower persons served to achievevalued life roles. The agency supports people’s efforts to return to workand=or school. Sixty-eight percent of the support service staff has obtainedthe Certified Psychiatric Rehabilitation Practitioner (CPRP) certification. Thisskill set and knowledge base prepares staff to empower the people they
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serve to strengthen their natural support systems and help them create apersonal Wellness and Recovery Action Plan (WRAP) as a means of avertingand=or managing personal crises.
Support services will continue to evolve to improve ways of promotingcommunity integration and offering access to further opportunities for com-munity participation. CSP-NJ believes that work, in particular, is an importantcomponent of recovery, and they are committed to helping individuals returnto the workforce. In light of the alarmingly high rates of co-morbidity andearly mortality among people living with mental illnesses, they have consid-erable work to do toward promoting healthy lifestyles for both the staff andthe people they serve.
Supportive Housing Model
Table 1 outlines the CSP-NJ supportive housing model. The supportivehousing model evolved as an outgrowth of efforts to link permanent housingoptions (e.g., apartments, single room occupancy, condominiums, single-family homes, etc.) with supports needed and desired by residents(O’Hara & Day, 2001). The model combines access to permanent housingwith services and supports such as case management services, employment
TABLE 1 Supportive Housing Key Elements
Element Description
Personal preference(provision of options andchoices and the respectfor choices made by theindividual)
When someone is given options and their personal preferenceis respected, they feel a greater sense of control,responsibility, and ownership, which leads to more positiveoutcomes. Providing options in the form of livingarrangements and supports offers an empoweringexperience, which can maximize opportunities for success.
Mainstream housing (accessto community housingthat is decent, attractive,safe, affordable,accessible, andpermanent)
Persons served are assisted with locating mainstream housingsites that maximize community integration and promoteindependence. The security of knowing that one’s home willnot be taken away in the event of hospitalization promotesemotional stability. Homes are located in neighborhoodsthat are close to shopping, public transportation, andrecreational opportunities.
Flexible support services(linkages to flexiblesupports that areindividualized, accessible,and consistentlyavailable)
Availability of flexible support services based on individualneed rather than on program protocol empowers theprovider to work collaboratively with the individualholistically, which avoids prescriptive services that engenderdependency. Services are available at various levels of needand respond to the consumers’ changing needs. Supportappears to be a critical factor in determining whether peoplecan integrate into the community—accessible and consistentsupport can mean the difference between remaining in one’shome and developing symptoms that force the personserved to be hospitalized.
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assistance, substance abuse treatment, and daily living supports (Carling,1993, 1995). Permanent housing may include single-room occupancy hotels,scattered sites, or apartments with no predetermined conditions. This type ofhousing generally includes access to services in the community—supportsare considered crucial for peers to live independently. The tenant (personin recovery receiving services) signs a lease and may remain in the housingas long as they adhere to the requirements of the lease.
Supportive housing services includes but is not limited to medicationmanagement, money management, 24-hr=7-day-a-week crisis intervention,wellness promotion, transportation, linkage to educational and employmentopportunities, and housing assistance. The combination of affordablehousing and support services is believed to be effective in providing personsserved with opportunities to achieve and maintain stability, facilitate recov-ery, and move toward higher levels of well-being. The combination of per-manent housing with independent service does not require that the personmove as they get ‘‘better’’ or as they experience stressors that exacerbatesymptoms.
Key Element: Personal Preference
Personal preference is the provision of options and choices and the respectfor choices made by the individual (tenant). The rationale is based on prefer-ence surveys CSP-NJ conducted in 1991, which indicated that preferencesidentified by persons living with mental illness differed significantly fromthe housing and mental health service options available to them at the time(CSP-NJ, 1991, 1996; Minsky, Reisser, & Duffy, 1995). The greatest desire waspermanent housing in the community and localized support servicesdesigned to meet individual needs. They expressed a preference to have agreater role in deciding where they live and what services they receive.When someone is given options and their personal preference is respected,they feel a greater sense of control, responsibility, and ownership, whichleads to more positive outcomes. Providing them these options in the formof living arrangements and supports offers an empowering experience,which can maximize their opportunities for success.
Key Element: Mainstream Housing
Mainstream housing is housing in the community that is decent, safe,affordable, attractive, and permanent. Persons served are assisted withlocating mainstream housing in sites that maximize community integrationand promote independence. The security of knowing that one’s home willnot be taken away in the event of hospitalization promotes emotional stability.Homes are located in neighborhoods that are close to shopping, publictransportation, and recreational opportunities of easy access.
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Key Element: Flexible Support Services
Flexible supports are services that are individualized, accessible, andconsistently available. The availability of flexible support services based onindividual need rather than on a program protocol empowers the providerto work collaboratively with the individual holistically, which avoids pre-scriptive services that engender dependency. Services are available at variouslevels of need and respond to the peer’s changing needs. Support appearsto be a critical factor in determining whether people can integrate intothe community—accessible and consistent support can mean the differencebetween remaining in one’s home and developing systems that force theindividual to be hospitalized.
Self-Help Centers
For more than 20 years, CSP-NJ has recognized the power of self-help andwhat it can do in the lives of mental health peers. CSP-NJ self-help centersare freestanding, community-located sites that are designed to offer a safe,comfortable environment where mental health peers can socialize withpeers, meet new people, learn new skills, join self-help and advocacygroups, and enjoy recreational activities (Swarbrick & Duffy, 2000; Swarbrick,2005). The idea of ‘‘not being alone,’’ the value of knowing the experience‘‘from the inside out,’’ and the opportunity to provide and receive help offera unique perspective that helps people improve the quality of their lives andtheir sense of well-being (self-help centers are described in further detail in‘‘Collaborative Support Programs of New Jersey’’ and ‘‘Peer-OperatedSelf-help Centers’’ [this issue]).
In 1985, CSP-NJ was able to take the ideas of self-help and mutual aidand put them into practice with the initial establishment of threepeer-operated drop-in centers: Social Connections in Clifton, The CARECenter in Asbury Park, and New Horizons in Vineland. With the formationof just those three drop-in centers, no one could have predicted theexpansion of and changes in peer-operated services to meet the needfor services run by and for peers statewide that would follow. In 1997,the number of drop-in centers increased significantly with 12 new centersand had a new name: ‘‘drop-in’’ was changed to ‘‘self-help’’ to reflect thegrowing recognition of the idea of self-help as being a valuable tool forpromoting recovery and wellness. In 2005, the NJ Division of MentalHealth Services further recognized the importance of self-help centersas part of the continuum of services for mental health peers. Additionalfunding allowed CSP-NJ to provide over 20 full-time positions for peersas self-help center managers to improve conditions for members bymoving and renovating centers and expanding services to reach morepeers and meet changing needs.
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CSP-NJ has taken the lead in developing a self-help center data-reporting system (SHOUT, described in ‘‘Collaborative Support Programsof New Jersey’’ [this issue]) that has been adopted statewide. Developed bypersons in recovery, this is part of a comprehensive plan to track outcomesand establish quality-improvement measures to further expand self-helpcenter services.
INSTITUTE FOR WELLNESS AND RECOVERYINITIATIVES (THE INSTITUTE)
The Institute is an agency venture designed to provide innovative, state-of-the-art services aimed at creating wellness, recovery, and self-sufficiency forpersons living with disabilities. Since the agency was viewed as aninnovative leader as providers of housing, support services, self-help, andeconomic development, we desired to become a trend-setting trainingand consultation facility in the state of New Jersey, as well as nationally,through research and dissemination efforts. Over the years, the Institutehas expanded and continues to offer interactive and uniquely tailored train-ings, conferences, and consultations. Institute staff, upon request, offer con-sultation and technical support on how social services and mental healthservice organizations can incorporate wellness, recovery, peer-operatedservices, and empowerment philosophy, principles, and practices intoexisting services.
Wellness Model
The agency embraced the wellness model in 1998. We observed that adultsliving with mental illnesses are becoming seriously ill and dying, evenwhile under the care of the mental health system. They were developingchronic medical diseases that significantly shorten their lives. At that time,people living with psychiatric disabilities died about 15 years earlier thanthe general population, and, as of 2006, statistics indicate that people die25 years earlier. Sixty percent of premature deaths are due to medical con-ditions such as cardiovascular, pulmonary, and infectious diseases (NationalAssociation of State Mental Health Program Directors Council [NASMHPD],2006).
These serious health problems are frequently caused or worsened bycontrollable lifestyle factors (physical activity, smoking, access to adequatehealthcare and prevention services, diet and nutrition, and substance abuse,as well as others).
Since mortality and morbidity are linked to high rates of modifiablerisk factors, including smoking, alcohol consumption, poor nutrition=obesity, lack of exercise, unsafe sexual behavior, IV drug use, residence in
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group-living situations creating exposure to TB and other infectious diseases,we saw this as an opportunity to embrace a wellness and health promotionapproach. Psychotropic medications may mask symptoms of medicalillness and contribute to symptoms of medical illness and causemetabolic syndrome. The lack of physical wellness is a serious barrier toparticipation in recovery and leads to premature death and poorer qualityof life.
Since there is a clear indication that general physical health is anobvious problem among the psychiatric population, we mobilized a seriesof activities to specifically assist persons living with mental illnesses toaddress wellness concerns. We viewed a clear need and opportunities forthe agency to collaborate and find ways to address this unacceptablephenomenon. Recently, we developed a campaign to screen for metabolicsyndrome.
In 2007, the Center for Mental Health Services (CMHS) launched theNational Wellness Summit for People with Mental Illness. The heart of thissummit is the ‘‘10 in 10’’ campaign, which strives to improve the lifeexpectancy of individuals with serious mental illness (SMI) by 10 years,and to achieve this goal within 10 years. Currently, individuals with SMIhave a lifespan that averages 25 years less than the general population,due not only to SMI but also various comorbidities, such as diabetesand heart disease. At its summit, CMHS also introduced ‘‘The Pledge forWellness,’’ which includes the goal of the ‘‘10 in 10’’ campaign. All healthand mental health provider organizations, individuals, and governmententities are strongly encouraged to make the pledge. CSP-NJ staff wasinvolved in this event and are making great efforts to help address thisunacceptable healthcare disparity impacting persons living with mentalillness. We have made a commitment to help persons in recovery, theirsupporters and families, and the system to embrace wellness. Words ofWellness is one such vehicle.
Words of Wellness
As part of its broad array of services to foster wellness, recovery, andeconomic self-sufficiency for individuals with disabilities, the Institute forWellness and Recovery Initiatives and Collaborative Support Programs ofNew Jersey (CSP-NJ) offers a monthly newsletter, Words of Wellness. TheInstitute also regularly disseminates practical wellness information throughthis venue. This publication features valuable information and resources,including details about educational events to help people achieve andmaintain wellness. The purpose of this newsletter is to bring useful informa-tion to all of our readers, whether pursuing recovery themselves, supportingrecovery in clients or family members, helping to administer and change ourmental health and related services system, or researching the field and
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educating future practitioners. This newsletter can be accessed through theCSP-NJ website www.cspnj.org. A full range of Words of Wellness reprintswill appear in ‘‘Peer Employment Support’’ (this issue). Words of Wellnessco-editors are Jay Yudof and Peggy Swarbrick.
INSTITUTE ACTIVITIES
The agency hosts an Annual Wellness Conference, which has become knownas the premier education and networking event in the area of wellness andrecovery for the mental health community throughout New Jersey. Thetwo-day event has featured workshops and institutes that combine topicsof interest with practical and experiential elements. The conference has beenable to attract persons living with mental illness, peer providers, familymembers, and policy-makers who are able to network and learn more aboutroles and responsibilities for moving the system toward one that is fullywellness and recovery oriented.
Recovery Network
The Recovery Network Project, a peer-delivered wellness and recoveryeducation program that started in 2004 (described in ‘‘Designing a Studyto Examine Self Help Centers’’ [this issue]), is based on the renewed hopeand optimism that people diagnosed with a mental illness can growbeyond the preconceived limits of their diagnoses and live a full life(Swarbrick & Brice, 2006). Peer educators (persons living with mental ill-ness who identify themselves as in recovery) share resources and personalexperiences that can help others begin their own recovery journey(Swarbrick & Brice, 2006). The content of the presentations provides aclear message of hope and exposes participants to the array of self-help,wellness, and recovery resources available (Swarbrick & Brice, 2006). Peereducators facilitate groups one day per week with patients and staff at statepsychiatric hospitals in New Jersey. The project also offers wellness andrecovery training for the state hospital’s new employee orientationprogram.
Research and Development
In addition to the annual conference, training, and consultation services,the Institute partners on grant applications and research projects withthe Department of Psychiatric Rehabilitation and Counseling, Universityof Medicine and Dentistry of New Jersey (UMDNJ), and School of HealthRelated Professions (SHRP). An exciting collaboration between the
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Institute and UMDNJ-SHRP is the development of a peer wellness coachspecialist certificate program. The peer specialist acts as a coach, helpingto guide the person toward successful and durable behavioral change.Peers learn to apply principles and processes of professional lifecoaching to the goal of lifestyle improvement (Swarbrick, Hutchinson, &Gill, 2008).
Community Enterprise Corporation
In 1990, Community Enterprises Corporation (CEC), formerly ButterflyProperty Management (incorporated in 1992), was established by CSP-NJas a partner entity to assist with the development and management ofaffordable housing. CEC is a statewide not-for-profit, peer-operated organi-zation and is a Housing and Urban Development (HUD)-certified propertymanagement entity. The mission of CEC is to provide services to indivi-duals and organizations by providing economic opportunities and safe,decent, affordable, and permanent supportive housing to low income per-sons with special needs. CEC also provides comprehensive property man-agement and maintenance service for all housing units sponsored orowned by CSP-NJ. Property management services include marketing,rent-up, leasing, rent collection, payment of housing site utilities, andrelated landlord fiscal obligations, as well as regulatory and governmentagency compliance monitoring. The management entity also is responsiblefor financial oversight of operating budgets and collection of rents andpayments. All tenants pay up to 40% of their income for rent and utilitiesin accordance with established U.S. Department of Housing and UrbanDevelopment rent guidelines. The agency administers three MainstreamHousing Choice Vouchers programs providing rental subsidies to over200 special needs residents who reside in private apartments. In addition,there is a Housing Quality Standards (HQS) department to regularly assurethat housing is decent and safe.
The CEC Economic Development Department, established in 2001,was designed to help people develop the skills, attitudes, and knowledgeneeded and have access to opportunities to attain economic self-sufficiency. Recognizing that poverty is one of the most pervasive,significant, and debilitating barriers to achieving recovery and full partici-pation in the community for persons with mental illness (Swarbrick,2006b), the agency developed an innovative array of services to help peo-ple address financial wellness. They crafted services to help peopledevelop skills and the capacity to budget their monthly income, repairbad credit, and save for assets that they feel will enhance personal well-ness such as purchasing a computer, bicycle, or car, and also home own-ership. Table 2 lists the array of financial services they offer to promotefinancial wellness.
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COMPASS
Consumer Operated Mission Performance: Assessing ServicesStrategically: Agency-wide Quality Improvement Initiative
CSP-NJ, Inc. is strongly committed to providing high quality servicesfor mental health consumers in New Jersey that promote responsibility,recovery, and wellness. CSP-NJ demonstrates this commitment through con-tinually assessing the quality and efficacy of the services it provides andsponsors. As a leader in peer-operated services, CSP-NJ recognizes the needto implement new technologies and continually assess its methods of evalu-ating its activities to effectively realize its mission and goals. In keeping withCSP-NJ’s mission, we gauge the success of our services based on self-reportsof people in services and evaluate service outcomes on significant quality-of-life indicators—such as physical health, wellness, housing, employment andeducation opportunities, social networks, and availability of resources tosupport individuals in leading fulfilling lives in their community of choice.
TABLE 2 Financial Services Program Description
Financial Management BillPay (FMBP)
FMBP (formerly known as CTA) is an individualized, flexible,community-based service. This service includes financialliteracy training and money management services designedto promote financial stability.
Rainy Day Savings Program A matched savings program designed to help people planahead and save for any emergency that might arise in thefuture and=or to acquire a productive asset.
Simple Purchase SavingsProgram
A matched savings program designed to help save for aproductive asset over the period of three months.
Small Purchase SavingsProgram
A matched savings program designed to help people save for aproductive asset over the period of six months.
Savings Club A one-year matched savings program designed to save for andacquire a productive asset. Participants are required tocomplete financial literacy training.
Individual DevelopmentAccount (IDA)
A matched savings program designed to help people save forand acquire a productive asset, such as a home or business,or to pursue education (including post-secondaryeducation) over the period of five years.
Emergency Loan Program Offered to CSP-NJ=CEC residents—assists with short-termfinancial emergencies and=or unanticipated expenses. Theloan terms are usually no more than nine months.
Financial Fitness Self-HelpCenter (FFSHC)
A service offered for answering questions; providing trainingand support for financial issues, product, or services;budgeting and savings; assisting with credit repair; investing;home-buying; starting a business; and paying taxes; amongothers.
Volunteer Income TaxAssistance (VITA)
A seasonal income tax preparation service provided to thecommunity, sponsored by Community Enterprise Corporationin collaboration with the Internal Revenue Service. The VITAsite offers free income tax preparation to anyone who hasearned income of $40,000 or less during the tax year.
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In order to identify, operationalize, and track quality improvementtargets, we understand the need to involve our stakeholders in definingwhat comprises desired services and their intended outcomes. To thisend, CSP-NJ leadership created an innovative approach aligning perfor-mance monitoring across CSP-NJ services to assess the benefits or outcomesfor peers participating in CSP-NJ sponsored services. Although there are avariety of quality improvement=quality assurance approaches, CSP-NJ selec-ted a Community-Based Participatory Action Research (CPAR) model withfocus on creating active, introspective learning communities, with thecentral tenet that the best approach to improving social practice is bychanging it as most closely aligned with its organizational mission. TheCOMPASS initiative was implemented to address these organizationalinformation needs.
As noted above, the COMPASS agency-wide continuing qualityimprovement (CQI) effort is grounded in community-based participatoryaction research principles (CPAR) (Delman, 2006; McTaggart, 1997;Wallerstein & Duran, 2003). As such, this ongoing initiative brings togetherCSP-NJ stakeholders into an intentional community of co-learners in definingdesired service outcomes and identifying methods of evaluating performancein meeting these goals. The CPAR method is especially suited to ourpeer-operated service philosophy in that it engages everyone affected byagency actions in implementing a continual cycle of planning, acting,observing, reflecting, and re-planning in honing our services to betteraddress the community’s needs. To meet these objectives, the COMPASSproject is continuously implemented in a series of three stages:
. Research-to-action with CSP-NJ=CEC unit staff,
. Research-to-action with end users of CSP-NJ=CEC services,
. Evaluating the effectiveness of CSP-NJ programs and services.
The COMPASS project is facilitated through CSP-NJ’s QI Department andguided by a steering committee comprised of peer leaders, researchers,CSP-NJ executive board and at-large board members, community advocates,and family members tasked with implementing the QI work plan adopted bythe CSP-NJ governing board. The work plan sets forth a structure to guide theimplementation of recovery-oriented evaluation systems in collaborationwith peer leadership and funders. As facilitator of the process, the QI Coor-dinator provides technical assistance in creating logic models to operationa-lize annualized QI goals and coordinates quarterly reporting of indicatoroutcomes to the CSP-NJ community.
COMPASS work plan goals and objectives include:
1. Gathering data to assist CSP-NJ stakeholders in assessing overall perfor-mance in accomplishing CSP-NJ’s mission and vision, and provide needed
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information to evaluate and realign activities and methods of servicedelivery to optimize service outcomes.
2. Seeking opportunities to contribute to the growing body of peer-operatedservices efficacy research.
3. Through stakeholder consensus and COSP literature review, developingservice and peer outcome measures to assist in assessing the impact ofservices for participants, and help inform future services planning andadvocacy efforts.
4. Identifying internal and external reporting systems and requirements forall services and opportunities for data sharing=combining of data systems.
5. Reviewing services and peer outcome data quarterly across CSP-NJ-sponsored services, troubleshoot reporting challenges, and identifyopportunities to enhance services and services delivery.
LESSONS LEARNED
CSP-NJ is evidence that the peer-operated service model is a feasible andviable resource that can offer services that foster wellness and recovery. Thisagency is evidence that peer-operated services are an important componentof mental health system transformation. The agency history demonstrates thatpeople in recovery best know the needs of peers, and peers are in the bestposition to design and deliver an array of innovative services based on prin-ciples of wellness and recovery. Agency growth was slow and steady andalways focused on needs, customers, and collaborative efforts to embraceideas and make things happen. The agency is often called upon to share les-sons learned to help guide and inspire other peer-operated organizations andgroups nationwide. The following are some key factors believed to contributeto the continued growth and evolution of the organization.
Customer Service Approach and Collaboration
The leadership has set up methods of accountability and works in partner-ship with all customers (persons served, funders, community, and staff).They are mission driven at all levels and place a lot of attention on communitybuilding. The agency is named Collaborative Support Programs for a goodreason. CSP-NJ believes in collaboration at all levels, with all customers, per-sons served, funders, staff, and the community. The agency constantly exam-ines how to operationalize collaboration in terms of services, policies, andpractices. The agency believes relationships are at the heart of collaborationand place a lot of value on creating and sustaining positive reciprocalrelationships with persons served, staff, funders, and the community.
Collaboration is important is terms of sharing leadership. From thebeginning, attempts to share leadership were made so the burden did not fallon one person. Innovations came from involving people with diverse skills
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who were given opportunities to be creative and work together. Whenpeople come with new ideas to the agency, the leadership has attemptedto strategically plan to test out the ideas on a small scale first. The leadershipfeels it is important to listen to what all customers want and also be open towhat customers and collaborators offer.
Good Relationships with Funders
CSP-NJ has been fortunate to have established and maintained a trustingworking collaborative relationship with funders. This is through transparencyand being ready to respond to needs and requests. The board and leadershipview funders as partners and know nothing can be done alone. They makean effort to show what people living with mental illness have worthwhile tobring to the table and make every effort to be as transparent and accountableas possible.
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