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COSP Multi-Site Research Design Overview
Chapter 3: COSP Program Models

3.1.           Services Provided by Consumer-Operated Services
3.2.           Consumer Run Drop-In Centers
3.3.           Peer Support Programs
3.4.           Education and Advocacy Programs
3.5.           Common Ingredients of COSPs   

3.1 Services Provided by Consumer Operated Services

The programs included in the COSP Multisite Research Initiative cluster into three broad categories: consumer-run drop-in centers, peer support programs, and education and advocacy programs. Because COSPs have different points of origin, there is much variety in the ways in which these programs are organized, the services that they provide and the philosophies underpinning these services.

During the first months of the initiative, sites were surveyed to begin the process of understanding what was actually being provided at the COSPs and the TMHS in each site. Sites were asked about 52 different services that a review of proposals and initial discussions suggested were important. Additionally, 50 other services were reported during this survey. A matrix was developed to provide information about what services were provided by each COSP and TMHS included in this study. Exhibit 3-1 provides a comparison of the distinctive services that were reported in TMHS and COS. By this, we mean that the services in each column were reported for more than half of the group and less than half of the other group.

Exhibit 3-1 Comparing Traditional Mental Health System and Consumer Operated Services: Distinctive Services Provided in Traditional and COS Settings

In terms of the services actually provided within settings, they appeared to vary according to the three broad categories mentioned at the outset.

 

3.2 Consumer-run Drop-In Centers

Four drop-in centers are included among the participating study sites (FL/CA, MO, and ME). Consumer-run drop-in centers offer a wide range of potential services and activities to their participants, who typically participate on a voluntary, at will, and non-coercive basis. Drop-in centers are typically open during set hours, and are generally available to whichever members choose to participate. The programs participating in the COSP Multisite Research Initiative offered a number of services in common. These include: providing a physical space for dropping in, individual peer support, group peer support, volunteer activities, computer training, and art activities. Virtually all of the participating programs provided: assistance with entitlement, medication education, clothing, bus or transportation passes, and assistance with moving. Most provided: linkage with services, employment assistance, outreach, phone peer support, and field trips. In addition to these activities, individual drop-in programs reported an extremely wide range of potential services.

 

3.3 Peer Support Programs

Currently, the COSP Multisite Research Initiative includes two peer support programs: One is organized to provide peer support primarily in a group context (IL), with regularly scheduled meetings, while the other provides peer support primarily on a one-on-one basis (PA). Both programs provide: some individual peer support opportunities, some group peer support opportunities, linkage with other services, volunteer opportunities and outreach. In addition, the programs provide opportunities for phone peer support, natural supports, and advocacy.

 

3.4 Education and Advocacy Programs

Two of the programs provide education and advocacy (TN and CT). Utilizing a classroom format, with courses scheduled to last 14-16 weeks, these provide shorter, but intense experiences for program participants. Both of these programs provide: advocacy education, individual peer support, group support, and volunteer opportunities. Both have well-defined syllabi that provide guidance for instructors about issues dealt with during the course.

3.5 Common Ingredients of COSPs

While the survey of services provided important information about the kinds of activities that take place within the participating consumer operated services, it did not include other equally important elements of program structure and program philosophy. In addition, there was a sense that while the list of services provided may capture some of what was going on, that there were a number of dimensions that were not captured.

To more clearly articulate commonalities across all of the participating consumer-operated programs, a process was initiated to begin to identify program elements that were found in many, if not all, consumer-operated programs. There was considerable involvement in this process of both consumer and researcher participants in the COSP Multisite Research Initiative. In addition, after one Subcommittee (the Common Ingredients Subcommittee) drafted a list of common ingredients and definitions, the national Consumer Advisory Panel refined this list through extensive discussion.

As a result of this process, we have developed an understanding both about what the participating COSPs indicate that they provide. In addition, we have developed a mechanism (described in Section 6) for assessing programs on the basis of these common ingredients. The common ingredients are found in the attached Exhibit. Considerable work has gone into operationalizing these constructs, and this information is provided in Section 7.