Key Informa Pereeptlons Of R al Community Mental Health Program By

FLOYD R. SMITH, M.A., AND LEONARD STEPHENS, B.S.

The Iosco-Ogemaw Community Mental Health Board serves three counties in Northern Michigan, with a combined population of under 50,000. Mental health services have been provided directly in this community for the past six years. For the past eighteen months, service has been provided by a locally based Board. Prior to that, service was provided by a seven county board with offices approximately 80 miles away.

The new locally based Board wished to assess the community's perception of mental health needs, and also the community's perception of the mental health agency as such. Using CETA funding, a needs assess- ment surveyor was employed. The individual has a B.S. in Business Administration, with training in market surveying.

Given the type of information which was being sought, the key informant method of surveying seemed appropriate. An eleven point questionnaire was developed to assess awareness of the agency and its services, perception of mental health needs in the community remaining unmet, specific individuals needing mental health services, and suggestions for improvement of mental health in the area. A twelfth question relating to incidence of suicide attempts was added part way through the survey. The questionnaire was based on a survey developed by Neigher and Baker(I) . The questionnaire is shown in Figure 1.

A total of 573 informants were contacted during the survey. Of these, 318 individuals responded, for a response rate of 55.5~'o. Approximately half of the informants were contacted at least once directly. In the case of informants such as teachers, sheriff's deputies, and hospital personnel, these informants were contacted through their employers. Approxi- mately 15~o of the informants were contacted only by mail.

Initiation of the survey followed a year of operation of the locally based Board. During this time there was significant periodic Positive coverage of the operations of the agency by local news media.

As a result of this coverage, agency administration anticipated that most respondents would be somewhat aware of the services of the agency, and that the primary needs expressed would be specific solutions to gaps in services, such as the lack of a local psychiatrist or psychiatric inpatient facility.

Such specific needs were addressed by the respon- dents. However, in spite of the amount of media

coverage which had been given, the question "How would you improve mental health care in this area?" was answered "more community awareness of services, including more publicity" four times as often as the answers given next most frequently, "set up a hot-line service" and "more local services." The situation is underlined by the fact that the hot-line service requested as the number two item is already met by a professionally staffed 24-hour emergency on-call service, which has been publicized i n local news media . . . .

Of individuals responding to the question "do you think the mentally ill in your area are receiving poor care, average care, or above average care?" 23.9~'o of the respondents said "poor care." There was a direct correlation between the "poor care" answers and the answers indicating that the respondents were not aware of the services provided by the mental health agency.

In summary, the one highly significant fact that we learned from the needs assessment survey was that far less people in the area are aware of the services which are available to them then we had believed. We learned further that they are concerned about this fact and would like us to remedy it. And we also learned that when people don't know what you are doing, they assume you are doing a poor job.

As a result, we are in the process of extending our service awareness program through audiovisuals, mailings, and news media efforts.

We were told many of the things that we expected to be told, such as the need for the psychiatrist, the need for additional work programs for mentally retarded individuals, and the need for marriage counseling services. It was the one thing that we were told that we did not expect which will make us more responsive to the community and to the needs expressed within it.

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REFERENCES

Neigher, lt'illiam D. and Baker, David P. Approaches to Community Mental Health Needs Assessment: The Community Residents Survey, In IV. Neigher, R. Hamnler, G. Landsberg (Eds.), EblERGING DEVELOP- /,tENTS IN MENTAL HEALTtt PROGRAM EVALUATION. New York: Argold Press, 1977.

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