Determining Appropriate Outcome Measures in a Psychosocial Rehabilitation Model for the Mentally Ill: a Knowledgeable Citizen\u27s Perspective

This dissertation research focused on the determination of appropriate outcome measures for community-based psychosocial rehabilitation programs for the mentally ill from the perspective of knowledgeable citizens. Specifically, this research identified a conflict between the Mississippi Department of Mental Health, as the certifying agency, and the Mississippi Division of Medicaid, as the funding agency, with regard to the transitional employment component of the psychosocial rehabilitation program. In order to ascertain whether transitional employment should be retained in the psychosocial rehabilitation program, survey questionnaires and in-depth interviews were completed with one hundred and sixty-eight consumers and twenty-three staff in six psychosocial rehabilitation Clubhouse programs in north central Mississippi. The survey questionnaires and interviews focused primarily on the effects of demographics, diagnosis, and barriers to employment on the willingness of consumers with mental illness to participate in transitional employment. Eleven independent variables were identified including age, living arrangements, years of attendance in the psychosocial rehabilitation program, diagnosis, stigma/attitudes, external influence, symptoms of mental illness, training/experience/education deficits, social/cognitive/behavior deficits, financial barriers, and total barriers to employment. Mixed methodology found convergence between quantitative and qualitative findings with regard to seven independent variables and differences with regard to four. Mixed methods found age, living arrangements, and years of attendance in the psychosocial rehabilitation program were not predictive of willingness to participate in transitional employment. Mixed methods found that stigma/attitudes, external influence, symptoms of mental illness, and total barriers to employment were predictive of willingness to participate in transitional employment. Symptoms of mental illness were found to have the greatest impact. Mixed methods also differed in the findings with regard to four variables. While no statistical significance was found to support diagnosis, training/experience/education deficits, social/cognitive/behavior deficits, or financial barriers as predictors of willingness to participate in transitional employment, substantively these variables are important. Based on the findings, the study recommends adjustments and considerations by the Mississippi Department of Mental Health, the Mississippi Division of Medicaid, and the psychosocial rehabilitation programs that will reconcile the differences and lead to the development and implementation of appropriate outcome measures