This proposed study addresses the problem of service disengagement within the mental health system. No matter how effective mental health practices are now or become in the future, they are of little value should persons with mental illnesses continue to choose not to receive them. Consumers have attributed their disengagement from care to having poor alliances with care providers, including experiences of not being listened to and not being offered the opportunity to make decisions and collaborate in their own treatment. Person-centered care planning is a field-tested intervention designed to maximize consumer choice and ownership of the treatment process. Providers collaborate with consumers to develop customized plans that identify life goals and potential barriers to achieving them. The proposed study tests the effectiveness of Person-Centered Care Planning (PCCP) together with two implementation strategies designed to target barriers and efficiently implement PCCP throughout an agency. One strategy involves clinical supervisor training in PCCP, while a second involves consultation and technical assistance for agency leaders to create organizational readiness for PCCP. By conducting a randomized controlled trial with 15 community mental health clinics from two states, the study will assess whether PCCP improves service engagement and consumer outcomes and whether implementing PCCP with both provider training and organizational readiness is more effective than implementing PCCP with provider training alone. The study will also utilize qualitative methods to understand how care planning impacts service engagement and how implementation processes influence organizational and provider level behavior. Designed to bridge the science to services gap, this study focuses on two priorities identified by the NIMH Division of Services and Intervention Research: developing models and methods to implement effective mental health services in the community and the study of personalized mental health care.
The study will generate evidence to support person-centered care planning, a promising practice that seeks to improve the quality of care for people with severe mental illnesses. By maximizing choice and individualizing care, person-centered care planning has the potential to engage more people in services and improve their outcomes. The study also addresses how to implement person-centered care planning in diverse and complex real world settings that are further complicated by limited financial resources.