COSP stands for Consumer Operated Service Projects. MHCAN was part of this federally funded multi-site study of the effectiveness of such COSP sites which ran from 1998-2002. For a year and a half we were pooled with four other drop-in programs in California being studied by UC Berkeley and the Center for Self Help Research, but Berkeley pulled out of the study. MHCAN then appealed to our friends at the Florida drop-in called the PEER Center to add MHCAN as a sub contract. They agreed and Washington approved in late February, 2000. The grant money funds the Research Director and Interviewer, but also pays toward MHCAN's expenses such as rent, utilities, office supplies, peer counselors, extra staff, equipment. The grant will last for two more years until August 30, 2002 and possibly 2003.

The research design basically follows an equal number of clients who are receiving traditional services (such as case management, medication, housing supports) and another group also receiving traditional services in addition to attending a COSP such as MHCAN. Clients chosen for the research study are randomly assigned to one group or the other--experimental or control group. They are followed for one year and asked questions about satisfaction with many areas of their life.

This is the first time the federal government has committed to study the effects of consumer-run services on the seriously and persistently mentally ill. There are eight sites throughout the country, ours being the only one on the West Coast. Other collaborating agencies besides Florida Mental Health Institute and Florida International University (our overseer) are Boston University, the University of Chicago, Edmund S. Muskie School of Public Service, Mental Health Association of Southeastern Pennsylvania, Vanderbilt University and the Mount Sinai School of Medicine. MHCAN's history will be part of a book on the Common Ingredients of Consumer-Run Programs.

MHCAN
1051 Cayuga Ave.
Santa Cruz, CA 95062

Date: February 19, 2000
To: Dr. Betsy McDonel Herr, Center for Mental Health Services, SAMHSA
From: Bonnie Schell, Executive Director
Re: Consumer Operated Services Program (COSP)-Multi-Site Research Project

The Mental Health Client Action Network staff and volunteers look forward to being part of SAMHSA-sponsored research into the outcomes and policies of client-run drop-in centers, as well as other types of consumer operated programs. We are willing to be a provider site for the Florida grant #SM52332 under the direction of Dianne Cote as the Principal Investigator, Greg Teague as lead researcher, and Sally Clay as primary consumer representative to the COSP.

We plan to fully participate in the COSP Multi-Site study as initially outlined in the GFA and subsequently implemented by decisions of the Steering Committee. We commit to implementing the multisite study design as agreed upon by the Steering Committee and to abide by and cooperate with all Steering Committee decisions.

We understand our obligations to insure the success of this study to be as follows:

Enhancement of our program at MHCAN: Our program has added more peer counseling groups, volunteer opportunities, computer instruction, and display space for art and writing projects. We have expanded our hours to be open earlier for homeless mental health clients and to staff a drop-in room on Wednesdays and Monday afternoons at the traditional service site. We will endeavor to structure our reception and structured programs to appeal to clients of varied ethnic, cultural, religious, gender orientations. In year 3 we plan to add a Mother’s Group and OCD support group to the two men’s group, one women’s group, dual-recovery group, schizophrenia group, two mood disorder groups, writing and art groups already in place.

While staying on the same corner clients were accustomed to, we have moved the drop in into a newer more spacious site (vacated by a private school), still on two bus lines. We have added 3,042 sq. feet to better serve the additional 100 county mental health clients who will be referred to our site.

Consumer participation in the multi-site project: MHCAN has a Consumer Advisory Panel made up of staff, volunteers, counselors and regulars at the drop in. The Advisory group has meetings once a month on Fridays at 11 a.m. Drop-in Staff also meet monthly on Wednesdays for up to date COSP information. Reports are made to the Board of Directors monthly in writing. Both FL and CA sites have FAX machines for those who are afraid of computers.

As is determined appropriate by the Florida team, our site will commit to participate in the listservs, teleconferences, and face-to-face meetings.

We look forward to Ca. clients being able to share their opinions and experiences with the FL clients through FLiCA, our joint list serv and teleconference group. COSP-CAP and Steering Communications are also posted on FLiCA for easy reading by clients. MHCAN and the PEER Center drop-ins have both developed a web site and we plan to include staff and advisory panel member’s pictures with their permission. FLiCA teleconferences will be held monthly, including site directors and at least four consumers from each site. Minutes will be taken and posted to the COSP CAP. Research staff will be available if FLiCA has questions or concerns. The FLiCA will have one representative to the Multi-Site Steering Committee with a backup person. Our Communications liaison is Greg Warren, both Program Assistant at MHCAN and manager of the computer room.

Annual Site Visits: We look forward to site visits by SAMHSA and Coordinating Center staff and will set up interview groups with Senior staff, line staff and minority consumers, and a consumer focus group as required in the ROW Sciences instructions. Site visits at the traditional service site can be handled by Karolin Schwartz (831) 454-4170, and by Susan Ashworth at MHCAN (831) 469-0462 on Tues. and Thurs.

COST Data from MHCAN: We keep track of daily attendance with separate lists for those who attend groups and classes. On a quarterly basis we will track volunteer hours and donated goods to the drop-in. Our data will go to FL to be put into their form for Brian Yates. Bonnie Schell will go over the attendance lists and make a separate list of participation of those referred to the COSP. We will also turn in data on sq. footage and personnel used for different activities at the COSP. We will submit complete annual personnel and expense FY budgets on the cost of operating our center.

Interviews with clients in the experimental condition: MHCAN will make private space available for baseline and follow-up interviews. We will assist the interviewer with appointments as required. We will provide van transportation or bus passes to clients referred to MHCAN.

Partnership: While CA and FL share a client base of those who try to survive in a costly housing market, who have unnecessary brushes with the police, who suffered early trauma or Vietnam experiences, who migrate to the coastlines on a spiritual quest, we also share a self-help philosophy emanating from the consumer movement, expressed in the Common Ingredients effort of the Multisite Study.. Both of our traditional service sites provide care to those with serious psychiatric disabilities instead of contracting out their care to a managed care company. The Multi-site SAMHSA study has already given MHCAN a chance to grow and expand our services. From January 1999 to January 2000 our drop-in count increased from 491 to 791. Working with the larger and more sophisticated FL Peer Center on the common task of creating and maintaining a safe and engaging drop-in environment will serve as a model for MHCAN’s continued growth. We will inform the Florida team of any problems that we encounter so they may be remedied immediately.

We are grateful for the Peer Center’s friendship and SAMHSA’s and the Coordinating Center’s support of this change in study plans mid second year.

Bonnie Schell - Executive Director

MHCAN-FL letter.doc

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