MENTAL HEALTH PEER-RUN ORGANIZATIONS NATIONWIDE: CHARACTERISTICS AND ATTITUDES TOWARD THE AFFORDABLE CARE ACT
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Background: Mental health peer-run organizations are operated by people who have received mental health services. This dissertation conducted the first nationally representative survey of peer-run organizations in a decade. It explored variations in activities and resources of peer-run organizations, and attitudes towards policy changes associated with the Affordable Care Act (ACA) of 2010. Aims: The aims of this study, following data collection, were: 1) Describe organizational characteristics and operations; 2) Examine the willingness of peer-run organizations to participate in Medicaid reimbursement and explore concerns; 3) Examine the willingness of peer-run organizations to participate in health homes and explore concerns. Methods: The dissertation obtained data by conducting a nationwide web-based survey of peer-run organizations designed and implemented by the author, in collaboration with mentors and stakeholders. Almost 900 organizations/programs were identified through contacting statewide consumer networks and state offices of consumer affairs. Final inclusion criteria were related to management structure. Following exclusions, there were 380 organizations in the analyses. Analyses are primarily descriptive; multinomial logistic regression is used for the second two aims. Results: The survey achieved a response rate of 80%. The study found that peer-run organizations are providing a range of community-based supports and activities, and that they vary in their resources. Analyses related to willingness to accept Medicaid show that many directors have concerns about how Medicaid reimbursement may affect the values-orientation of the organization and staffing capacity to bill Medicaid. Analyses on health home participation demonstrate that existing patterns of encouraging members to use physical health services is associated with willingness to collaborate on these newer healthcare delivery designs—but that some peer-run organizations have concerns about working with medical professionals. Conclusion: This study increases our understanding of the current operations of peer-run organizations nationwide, and provides baseline data for monitoring the impact of policy changes on these organizations. Results related to the ACA can inform system design and reimbursement changes. The study’s design, data collection, and interpretation were directly informed by key stakeholders in order to ensure that the results would have immediate value to those invested in improving the lives of people with psychiatric disabilities.