This three year project will study the interorganizational development of community systems for persons with severe and persistent mental illnesses in six (6) cities. Five (5) of these cities are Robert Wood Johnson (RWJ) demonstration sites; the sixth will serve as a comparison city. The study will analyze the changes in the delivery of services to chronically mentally ill persons during the operational phase of the RWJ demonstration, particularly the relationship between formal structures informal case manager networks, and client outcomes. The study has three distinct components, each of which will be conducted at two points in time to coincide with the collection of outcome data from the RWJ Evaluation Project. The first component is a network analysis of the formal community support system using the key informant most knowledgeable about the orginization's interaction with the rest of the community support system. The second component consists of a study of the case managers' view of the formal system which should give an indication of the extent to which the RWJ initiatives have been implemented at the line worker level. Lastly, the informal networks which case managers actually use to deliver services will be studied to see if differences in these networks affect client outcomes. The data from each of the levels will be compared across sites to illuminate the differences in structural arrangements and network characteristics, the degree of implementation, and informal networks. The relationship between each component will be used to construct site profiles. These will all then be related to client outcomes. Finally, the changes at all these levels will be looked at over time to trace their evolution and to evaluate their impact on client outcomes.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Epidemiologic and Services Research Review Committee (EPS)
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University of Cincinnati
Other Domestic Higher Education
United States
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Ridgely, M S; Morrissey, J P; Paulson, R I et al. (1996) Characteristics and activities of case managers in the RWJ Foundation Program on chronic mental illness. Psychiatr Serv 47:737-43
Morrissey, J P; Ridgely, M S; Goldman, H H et al. (1994) Assessments of community mental health support systems: a key informant approach. Community Ment Health J 30:565-79
Morrissey, J P; Calloway, M; Bartko, W T et al. (1994) Local mental health authorities and service system change: evidence from the Robert Wood Johnson program on chronic mental illness. Milbank Q 72:49-80