Many public mental health systems are implementing recommendations from the President's New Freedom Commission17 regarding care for serious mental illness (SMI). That Commission set goals for a system of care that is recovery-oriented, high quality, and maximizes the delivery of evidenced-based practices. One transformative recommendation is to involve consumers in service delivery. One way to realize that goal is the hiring of """"""""Consumer Providers"""""""" (CPs). Like consumer addiction treatment counselors, CPs are individuals with SMI who draw upon their lived experiences to provide services to others with SMI. CPs are not meant to replace traditional treatment, but to augment it. A unique contribution of CPs is their ability to share personal recovery experiences and serve as role models to facilitate the learning of self-management skills, provide hope, engage patients into treatment, help patients connect with others in their communities, and serve as a liaison between patients and providers.80 Randomized controlled trials and quasi-experimental trials have shown that professional teams with CPs can provide services that yield at least equivalent patient outcomes, including improved social functioning and better self-care.81'82 Particular benefits have been noted when CPs work on intensive case management teams.81'82 However, dissemination of CPs has been modest, in part because past efforts have not addressed the barriers of hiring and managing CPs. Barriers include poorly defined CP roles and resistance from traditional providers. A recent study of staff perceptions of hiring CPs found strong concerns that CPs might harm patients, not serve a useful purpose, or relapse themselves due to the stress of their new role, although these concerns have not been borne out by research.82 This proposed study will address such barriers by establishing a 3-year partnership between consumer leaders, mental health patients, providers, managers, and researchers to tailor and evaluate a novel strategy for implementing and managing CPs in a local provider organization.
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