Measuring the Outcomes of Peer Support Provided by the Empowerment Exchange

November 2012

Cheryl MacNeil, PhD, Principal Investigator.
Associate Professor, The Sage Colleges, Troy, NY 12180

This is Year One of a two-year study measuring the outcomes of peer support at the Empowerment Exchange, a program of the Mental Health Empowerment Project. The study is being conducted by Dr. Cheryl MacNeil at the Sage Colleges and four peer investigators from the Empowerment Exchange. The purpose of the two year study is to describe how participating in the peer support activities offered by the Empowerment Exchange impact peoples’ lives by measuring outcomes across six domains: 1) service use, 2) employment, 3) community engagement, 4) quality of life, 5) well-being, and 6) program satisfaction. These outcomes were measured in Year One (2012) and will be measured again in Year Two (2013) using the Peer Outcomes Protocol Questionnaire (Campbell, J., Einspahr, K., Evenson, R. & Adkins, R., 2004).

In Year One of the study, people who received intentional peer support from the Empowerment Exchange during the year 2011 and had at least three contacts with the program where invited to participate. We were able to identify 82 people using the sign in sheets at the multiple events offered by the program during that year (if a person’s name appeared three times or more throughout the year on sign in sheets), 34 agreed to participate in the study. All participants who completed the survey received a $20 Visa gift card. All individuals who completed the survey in Year One (2012) will be contacted again in 2013 and will receive a $20 gift card if they complete the survey a second time.

Thirty-four people chose to participate in the survey. The majority of the participants where female (74%) and all participants reported having some level of education including: 18% with a four year college degree, 21% with a two year associate degree and 26% with some post-high school training. Participants reported their ethnicity as white (79%) or African American (21%). Over half of the participants (60%) reported having been married at some time. Fifty percent of the participants reported having a sensory or physical disability. The primary financial supports they received included Social Security Disability Income (56%), food stamps (44%), rental supplements (29%), and Social Security benefits (21%).

Participants had been involved with peer support of some kind between 1-14 years throughout their lives. They varied on how frequently they accessed the supports at the Empowerment Exchange, from almost every day (29%), to about once a month (23%).  Of the 34 participants in the study, 74% reported having been hospitalized at some point in their lives. The frequency of hospitalizations ranged from 0- 73 times over their lifetime, beginning as early as 8 years old. Over the past six months, 73% of the participants reported having experienced emotional difficulties. However, 75% of participants claimed the peer support program prevented these difficulties turning into a psychiatric crisis and 70% of the participants reported the program helped them to stay out of the hospital. The program helped these participants to avoid hospitalization by providing support whenever needed (91%), giving them someone to talk to (91%), helping them to cope with their symptoms (81%) and helping them to involve other people in their life (86%).

Of the 34 participants in the study, 21% were employed, their average hourly wage being $7.18. Most of their jobs did not offer health insurance (86%).  Participants were asked to agree or disagree with statements on the survey pertaining to how the program helped them approach employment. The majority of participants (91%) agreed with the statements, ‘I am comfortable discussing work issues with my peers in this program,’ and ‘this program inspires me to believe that meaningful work is possible for me’ (85%). Participants also agreed that they felt comfortable talking with the program about losing their Medicaid benefits (73%) or SSI/SSDI (70%) as result of returning to work.

The majority of participants (85%) lived in their own apartment or house, and did not receive any help with cooking, managing money or housekeeping. When asked if they were satisfied with the neighborhood in which they lived, 71% agreed that they were satisfied. Seventy-five percent of participants agreed that ‘the social relationships they have with their friends are what they want them to be,’ and 85% agreed that ‘the social relationships they have with the peers in this program are what I want them to be.’ When asked if they have experienced discrimination from this program, 94% reported they had not. If participant where to experience discrimination, the majority claimed they knew what to do if it were to happen with the staff at the program (82%), their workplaces (88%) or their landlords (71%).

Responses to the items on the survey asking participants to agree or disagree with statements of how the program has impacted their well-being demonstrated the powerful impacts the Empowerment Exchange has had in enhancing the overall well-being of participants. Participants agreed that the ‘program enables me to make contributions in my life’ (97%), ‘the program helps me to believe that personal growth in my life is possible’ (97%), and that ‘the program helps me get respect from important people in my life’ (79%).

The majority of participants also agreed with the following:

• ‘Being a member at this program helps me to have personal power’ (94%).
• ‘This program helps me to have more choices in my life’ (94%).
• ‘This program helps me have an active role in decisions about my mental health  services’ (88%).
• ‘This program helps me have control over my daily routine’ (74%)
• ‘This program helps me make needed changes in the things that are important to me’ (85%)
• ‘This program helps me become self-sufficient in my life’ (82%)

Eighty-two percent of the participants agreed that they have hope they will recover from a mental illness, and 88% credited the program with giving them hope that they would recover from a mental illness. The program also was credited with helping participants to cope with their psychiatric problems (94%) and helping participants to ‘understand what recovery involves for me’ (94%).

The final series of statements asked the participants to agree or disagree with statements measuring their satisfaction with the program. When asked to rate the item ‘Overall, I am satisfied with this peer support program,’ 94% of the participants agreed with the statement. Participants indicated they felt physically safe at the program (100%) and that the services were useful to them (100%).

Other survey items indicating the participants were satisfied with the program included: ‘At this program I get the kind of information I need’ (100%), ‘At this program I get the information when I need it’ (100%), and ‘This program helps me be knowledgeable about mental health issues’ (94%).

Participants also demonstrated their appreciation of the skilled staff at the Empowerment Exchange in agreeing with the following statements:

I feel the program staff:

• actively promote my human rights (94%),
• are respectful of my racial or ethnic background (94%),
• are respectful of my sexual orientation (100%),
• are respectful of my gender (100%),
• respect my wishes regarding confidentiality of personal information (94%),
• are competent (92%),
• are safe to talk to about personal matters (85%), and
• are able to see me as a person who has strengths (88%).

There was also agreement among all participants that the program ‘helps me become knowledgeable about mental health issues’ (100%), ‘ is making a positive difference in how I feel about myself as a person’ (100%), and ‘helps me cope if I have an emotional crisis’ (100%). Finally, 100% of the participants in this survey agreed that, ‘I would recommend this program to other mental health consumers.’

The Year One evaluation of the Empowerment Exchange included using the entire Peer Outcomes Protocol Questionnaire in an attempt to pilot the instrument. While the questionnaire was useful in providing a large range of information, there were a lot of items that the research team did not feel applicable given what the Empowerment Exchange addresses on a day-to-day basis. This Executive Summary highlights the major survey items that the program has some direct influence in shaping. The comprehensive report provides summary tables of all the survey items rated by participants. In Year Two of the evaluation, the research team will narrow down the questionnaire to focus on items specifically relevant to the purview of the program.