Participation Outcome
Through their participation in the Friends Connection, program participants are likely to experience the following benefits:
- decrease in substance use,
- decrease in hospital and crisis service utilization, and
- satisfaction with services provided.
It is estimated that between 40 and 60 percent of persons with severe mental illness will develop a substance use disorder (SUD) at some time in their lives. These co-occurring disorders are consistently found to adversely impact the course of mental illness and response to treatment, psychosocial functioning, and cost of care.
The literature on co-occurring disorders documents a number of common consequences of SUD in persons with severe mental illness. Among those documented include: housing instability, symptom relapse, treatment noncompliance, violent behavior or threats of violence, suicidal ideation or attempts, cognitive impairments, difficulty budgeting funds, prostitution, social isolation and social difficulties, employment difficulties, hygiene and health problems, and legal problems.
The Friends Connection believes that addressing the substance abuse of those individuals with co-occurring disorders is likely to lead to improvement in psychiatric and social functioning. Through the process of engaging consumers in community based recovery, social, cultural, education, and recreational activities, consumers are introduced to new people, places and things, and are empowered to design their own recovery and rehabilitation plans.
As substance use is reduced, as new behaviors, cognitions, social networks and sober interests are developed; the negative impact of the SUD will also be reduced leading to improved mental health (psychosocial functioning).
As psychosocial functioning increases and community support networks (both social and recovery oriented) are developed and enhanced, program participants will be better equipped to deal with crisis and psychosocial stressors, thereby decreasing the likelihood of reliance on hospitalization and crisis contacts to deal with these stressors.
Finally, a high level of consumer satisfaction is predicted secondary to the program's philosophy, stage-wise treatment process, non-punitive approach, and most of all the provision of services by peer support counselors. Peer counseling provided by others successfully recovering from similar problems with substance abuse and mental illness plays a major role in facilitating the recovery process for others who are in need of treatment and support.
Again, the literature documents that consensus on the basic principles underlying the provision of services for persons with severe mental illness and SUD has been developing. As program development progresses, a range of promising treatment orientations and components have been identified. They include such strategies as harm reduction, stage-wise treatment, motivational interviewing, cognitive-behavioral interventions, and modified 12-step self-help groups. The Friends Connection continues to incorporate these interventions into the framework of services delivered.
In cooperation with the Philadelphia County Office of Mental Health and the University of Pennsylvania, Center for Mental Health Policy and Services Research, the Friends Connection is currently involved in a national multi-site research initiative evaluating Consumer Operated Service Programs (COSP).
Outcome measures for this research initiative include other areas of psychosocial functioning that Friends Connection services are likely to impact. These include quality of life, community integration, social inclusion, and consumer empowerment. The measures utilized in this initiative are considered to be the best available in the field today.