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Early Experiences of Employing Consumer-Providers in the VA

Dr. Chinman is with the Mental Illness Research, Education, and Clinical Center, Veterans Integrated Service Network (VISN) 4, Department of Veterans Affairs, Pittsburgh, and with the RAND Corporation, 4570 5th Ave., Pittsburgh, PA 15213 (e-mail: chinman{at}rand.org). Dr. Lucksted is with the Mental Illness Research, Education, and Clinical Center, VISN 5, Department of Veterans Affairs, Baltimore, and with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore. Dr. Gresen is with the Office of Mental Health Services, Veterans Health Administration (VHA), Washington, D.C., and the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Ms. Davis is with the Mental Health Care Line, VISN 3, Bronx, New York. Dr. Losonczy and Dr. Sussner are with the Veterans Affairs New Jersey Health Care System, Lyons, New Jersey. Ms. Martone is with the Central Arkansas Veterans Healthcare System, Little Rock.

OBJECTIVES: Following guidelines in the mental health strategic plan of the Department of Veterans Affairs (VA), VA began in 2005 to fund a number of new positions for consumer-providers (CPs)—that is, individuals with personal experience of serious mental illness who provide support services to others with serious mental illness, typically as clinical team members. This study explored the challenges of CP implementation in its early stages within the VA. METHODS: Four focus groups were conducted with a total of 59 VA CPs and 34 VA supervisors from across the United States. Group notes were coded by using a modified grounded theory approach to generate themes. RESULTS: Data from the groups suggest that hiring and employing CPs within VA has been feasible, beneficial, and acceptable to a majority of teammates. CPs reported experiencing some role confusion and resistance and fears among professional staff about how CPs would fit in. The authors make three recommendations on the basis of the focus group findings. First, CPs, traditional staff, and administrators need to be adequately prepared so that CPs can be effectively incorporated into clinical teams. Second, training for CPs varies widely, and efforts should be made to determine the best training package. Third, systems that are considering using CPs should establish a continuous quality improvement system to help evaluate CPs' performance and patient outcomes and to gather data to improve the knowledge base about CPs and their functions. CONCLUSIONS: CPs provide a wide range of recovery-oriented services and are valued by staff and consumers.

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