Interviewee

Dr Margaret Swarbrick, Post-Doctoral Fellow, University of Medicine and Dentistry New Jersey, USA

Article

Swarbrick M. (2006) Consumer-operated self-help services. Journal of Psychosocial Nursing and Mental Health Services, 44(12): 26-35.

Summary

Michael Bouwman spoke with Dr Margaret Swarbrick, who has been involved in a study of consumer operated self help centres in New Jersey, USA. Michael's podcast discussion with Dr Swarbrick focussed on the success of these self help centres in aiding people's recovery from mental illness, some of the obstacles faced in the data collection and relevant feedback received from the study.

Transcript

Michael Bouwman: Introducing Dr. Peggy Swarbrick, a Post-Doctoral Fellow, University of Medicine and Dentistry New Jersey, Department of Psychiatric Rehabilitation, National Institute on Disability and Rehabilitation and Training Institute Coordinator; Collaborative Support Programs of New Jersey. We're here to discuss Peggy's research and her article 'Consumer Operated Self-Help Services.' Peggy, could you please give us a summary of your article?
Peggy Swarbrick: The article pretty much provided, really a snapshot of the background on this consumer operated service model that has started in the United States pretty much back in the eighties to nineties. And here in New Jersey, we've been very fortunate to have really developed a very strong network of these centers. So in New Jersey, we just had a really large cohort of people to pull from and just to start to look at what was really some of the elements of what makes this service different and how people feel it's benefiting them and their recovery.
Michael Bouwman: You've got a connection with the Collaborative Support Programs of New Jersey, they developed eleven consumer operated self-help centers initially, did they?
Peggy Swarbrick: Around the country, there was a push for more consumer involvement in the planning and design and the delivery of services and we were fortunate in New Jersey to get this small project going which eventually became Collaborative Support Programs. At the time of the study there was twenty-seven centers around the state of New Jersey and they're pretty much providing a service for people to meet long term social, emotional support. And we're really in the last four or five years on, our training institute is really working with these centers to try to help people look at wellness and lifestyle factors to help people really work on their recovery and address so many of the comorbid health problems many people with serious mental illness are facing and they're all consumer run. People with serious mental illness basically running them, in terms of opening and closing, deciding on what happens, driving the vans, deciding on what the money in the budget is allocated. They really use this empowerment model and that was one of the things I wanted to look at in the study; how well are they really promoting empowerment. It seems as though they were but really, there was no study of this model that was clearly starting to look at how empowering this was for people as well as satisfaction. Because this service model evolved from the notion that people were quite dissatisfied with the coercive nature of the service delivery that was available to them, which still does exist to some degree but maybe back in the seventies, eighties and prior to that, the services were very coercive, very much [based] on a medical model.
Michael Bouwman: And these are basically modeled on a self-help, drop-in center style?
Peggy Swarbrick: Yeah, they initially started as this drop-in center but we found over time that the drop-in center started to create a little bit of a complacency with people, it still does a little bit. And people sort of then just come there and then think that's the rest of their life instead of trying to help see themselves into other aspects of the community.
Michael Bouwman: Okay, so there'd be some aspects of these centers that both encourages reliance on them but also independence from them?
Peggy Swarbrick: Well, kind of come back but don't make it your focal point of all your social support. Try to help people to expand, into more of their natural support, getting back to work, getting back to school. We're really trying to help people see their way back into school, so many people's dreams of completing an education are shattered when the illness happens.
Michael Bouwman: And there's no professional services provided at these centers, correct?
Peggy Swarbrick: Not formally, but the centers can then decide for example, we're working with very heavily on the mortality and morbidity issue that exists here where people are dying very young as well as living with very chronic health conditions; diabetes, cardiovascular issues, respiratory which are believed to be a result of some lifestyle factors. So for example, they may decide in their budget to bring in nurses to come and check people out on a regular basis or nutritionists.
Michael Bouwman: And as this was part of your doctoral study, what was the broader context of your study?
Peggy Swarbrick: The idea was that people felt that there was something different about this environment, it's suppose to be really different than traditional services that were available. How much the center environment promotes relationships, provides social support, how much the center provides opportunity for personal growth as well as how much the environment has a structure and order to it that people feel involved in creating. So when I look at those three factors and how much any of those factors help the sense of empowerment of the participants as well as the sense of satisfaction of the members. The consumer operated self-help article was really just a snapshot from the qualitative data. There were three questions, what's helpful? How can the center be improved? What's the best aspect of this center? What's the worst aspect of this center?
Michael Bouwman: Could you talk about the aspects of your findings that provided specific insights into their recovery from mental illness?
Peggy Swarbrick: Some of the feedback was like, 'this is like my family or my surrogate family'. And the importance of social support in many of the people's lives I think was a big factor in why people find this center to be appealing because so many people have had many strained relationships as a result of whatever went on in their life, especially with their families. I also think the big thing for many people, was that people get a different role, the idea that there is all these different roles people can participate in and their participating as a member or a driver or they're a leader in the center. It helps them to transcend that patient role.
Michael Bouwman: And of the 144 self-help participants, could you provide some further detail on these participants, such as the types of mental illness and socio-economic groups they were drawn from?
Peggy Swarbrick: The diagnosis and things like that are always suspect, the people have been given about twenty different diagnoses over the course of their illness. The mean age was forty-five years old with the range of eighteen to seventy-five years old. So there's a broad range of ages but seems at that time, there seems to be more of this thirty, forty year old group that seems to be attracted to this model.
Michael Bouwman: Peggy went on to explain how the self-help centers also address the isolation experienced by consumers.
Peggy Swarbrick: Yeah, a lot of people talked about this really helps with their loneliness. I know that loneliness myself, one of the reasons I did this work was [that] I experienced the mental health system on all ends so I deal with this illness and there is this profound sense of loneliness. I have to work on it myself a lot and I found school, that's why I'm at a post-doc, you know I can't get enough of school and that's where I found my loneliness has been really still myself so this provides; you know it's free, it doesn't cost anything to join and it's available to people.
Michael Bouwman: Thank-you so much for giving us the time to talk about your research.
Peggy Swarbrick: Well thanks, I appreciate the opportunity. I hope people understand my New Jersey accent.
Michael Bouwman: Okay, well thanks very much Peggy, it's been a pleasure.

Podcast Keywords

self help centres, recovery, mental health, ipp-shr, health, psycho social research, cquniversity