Welcome!

Internationally, the two major movements in adult mental health are recovery and evidence-based practice (EBP). Kansas is an emerging leader in both. In terms of EBP, Kansas was one of the eight states in the National Implementation Project with Bert Nash, Comcare and Wyandot implementing supported employment, and Franklin, Wyandot and the Guidance Center doing integrated dual diagnosis treatment. The Kansas sites compared quite favorably to the other 47 sites. Since that time, Kansas has mounted 6 other supported employment sites, five other IDDT sites, and a strengths case management site at Pawnee.

As the level of EPB activity increases, we thought an electronic newsletter would help us all stay informed of the exciting developments that are occurring and to recognize those people and centers who are leading us in this journey. We decided to keep the newsletter short and rather frequent (monthly) with links to other sites for those who want more information. Monika Eichler (785-864-3873) will be the editor. Your feedback and suggestions are critical to the usefulness of the EBP Times, so please let Monika know your thoughts.

Charles A. Rapp, Professor
Director, Office of Mental Health Research & Training
School of Social Welfare
University of Kansas

FIRST EDITION NOTES

We begin the first edition of the EBP Times, by presenting information about Pawnee Mental Health Center's participation in the Strengths Model Case Management Project.  For further information, please email Rick Goscha, Consultant/Trainer at KU's School of Social Welfare, or call at: 785-864-4720.  In subsequent months, we will highlight information from other evidence-based practices, such as Supported Employment and Integrated Dual Diagnosis Treatment.

WHAT ARE THE OUTCOMES?: Strengths Case Management Project Highlights

In March 2004, Pawnee Mental Health Center started as the pilot site for the Strengths Model Case Management Project.  Going into the project, CSS Director Francis Begnoche knew they would score low on strengths model fidelity, but wanted to be considered for the project because of his insistence to improve services for people diagnosed with a severe psychiatric disability. Pawnee has now completed 18 months as a project site and as a result has seen not only improvement in outcomes for people receiving services, but also a renewed enthusiasm by staff for providing recovery-oriented services.

Being a pilot site for the project, Pawnee decided to form one team that would commit to moving towards high fidelity Strengths Model practice. At baseline Pawnee scored low on Strengths Model fidelity (see fidelity scale on Website), but within 18 months has just reached the lower end of the scale for high fidelity (A score of 60 is the highest fidelity score possible)

The above table shows the outcomes over the first 18 months of the project:

With increased fidelity to the Strengths Model of case management, the corresponding outcomes were achieved:

1)  The number of people competitively employed increased from 8% to 24%. In addition to this the numbers of people involved in supported employment have risen dramatically.

2)  A decrease in the numbers of people hospitalized over the previous quarter from 24% to 10% (at the 18-month review only one person went to the state hospital, the rest were all brief local hospitalizations

3)  An increase in the number of people in post-secondary education from 1% to 6%

            Dennis Webb, supervisor of the Strengths Model case management team, reported that staff gave more weight to some fidelity items over others as attributing to the increase in outcomes. Staff reported the following as being significant changes that helped improve outcomes on the team:


               1) having a supported employment worker as part of the team;

               2) using the group supervision model as outlined in the Strengths Model;

               3) having the supervisor of the team spend more in-depth time supporting case managers; and

               4) using the strengths assessment as a tool in daily practice.

This does not mean that there were not any challenges within the project. Like with all programs, staff turnover was an issue. Three staff persons (two case managers and a supported employment worker) had to be replaced during the project. In upcoming issues of EBP times, we’ll discuss how Pawnee dealt with these challenges to minimize the impact on the team. 

FEEDBACK
Now, we'd like to receive your feedback.  At the next CSS Director's Meeting, we'll be passing out a survey to receive feedback about this newsletter.  Pass your thoughts along to your CSS Director so that he or she can incorporate them, or otherwise, you are welcome to email Monika Eichler.