2016 Adult Consumer Satisfaction Survey Report

Transcription

1 Overview 2016 Adult Consumer Satisfaction Survey Report In September 2016, the Quality Systems Department of the Saginaw County Community Mental Health Authority (SCCMHA) administered its annual adult consumer satisfaction survey to adult consumers to measure their satisfaction with care and treatment outcomes. The Mental Health Statistics Improvement Program (MHSIP) Survey was sent to adult consumers who received services during the previous six months from SCCMHA, Disability Network of Mid-Michigan, Hope Network, Saginaw Valley Rehabilitation Center, Saginaw Psychological Services, and Training and Treatment Innovations. Methodology All adult consumers with Mental Illness and/or Intellectual and Developmental Disabilities who received services during the six months prior to survey implementation were included in the survey sample. A total of 2,319 surveys were distributed in this year s survey. The primary method of distribution was by mail with a postage-paid return envelope. As part of a regional survey initiative, 36 were hand delivered to consumers receiving Assertive Community Treatment services. Four hundred and forty-nine (449) completed surveys were received resulting in a 19% return rate. The table below shows each team s return rate as well at the total return rate Team Distributed Received Return Rate Distributed Received Return Rate DNMM Supports Coordination % % HNNP Adult Case Management * * * % SCCMHA Community Support Services % % SCCMHA Community Support Services % % SCCMHA Supports Coordination Services 1** % % SCCMHA Supports Coordination Services 2** % % SPS Adult Case Management % % SVRC Supports Coordination * * * % TTI Adult Case Management % % TTI Assertive Community Treatment*** % % Total 2, % 2, % *new survey team in 2016 **SCCMHA SCS children received the Youth survey in 2016 ***hand delivered 3/7/2017JMcCulloch Page 1

2 Survey Instrument The MHSIP survey s 41-items assess seven different domains of consumer satisfaction. The first four domains reflect attributes of the provider and the last three reflect the consumer s status in clinical improvement, daily functioning, and relationships. Domain General Satisfaction Description Would the consumer recommend this provider to a friend or family member and does the consumer like the services provided? Access to Services Are services available when and where they are needed? Quality/Appropriateness Were the staff helpful in providing information about presenting conditions and did they show respect for the consumers race, ethnicity and culture? Participation in Treatment Planning Did the consumer feel involved in treatment decisions? Outcomes As a result of services, has the consumer's social functioning, familiy relations, ability to deal with crises and daily problems, and symptoms improved? Functioning Has the consumer's overall well-being improved? Social Connectedness Does the consumer feel connected to friends, family and the community? Results Calculation Respondents were asked to rate their level of agreement with statements along a five-point Likert scale from 1 to 5: 1 = Strongly Agree 2 = Agree 3 = Neutral 4 = Disagree 5 = Strongly Disagree 9 = Not Applicable Those in agreement represent consumer satisfaction. Scores for the seven domains were calculated in two ways. First, the mean score of each item was calculated. Those scores less than or equal to 2.5 were classified as being in agreement. Second, the number of respondents in agreement was divided by the number of respondents to arrive at a percentage. Items with more than two-thirds missing data and responses of not applicable were omitted from the calculations. 3/7/2017JMcCulloch Page 2

3 Survey Results by Domain Satisfaction was evident across all seven domains indicating that respondents were pleased with the services received. The Outcomes and Functioning domains were noted as having the lowest levels of satisfaction. The overall level of satisfaction was 83%. The percentages of satisfaction for each team are shown in the following table. Also provided are the regional and statewide results from this year s ACT survey. Team # Received General Satisfaction Access to Services Quality / Appropriateness Participation in Treatment Planning Outcomes Functioning Social Connectedness Overall DNMM SC % 88% 84% 84% 77% 91% 89% 90% 74% 67% 69% 64% 93% 96% 82% 83% HNNP ACM * 7 * 71% * 57% * 57% * 86% * 57% * 43% * 57% * 61% SCCMHA CSS % 89% 86% 89% 78% 70% 83% 74% 61% 63% 64% 70% 66% 67% 75% 75% SCCMHA CSS % 93% 71% 79% 86% 86% 71% 86% 87% 64% 79% 57% 85% 64% 80% 76% SCCMHA SCS % 93% 92% 92% 91% 94% 88% 92% 84% 85% 85% 81% 95% 93% 90% 90% SCCMHA SCS % 94% 87% 94% 88% 93% 82% 95% 81% 73% 81% 78% 91% 96% 85% 89% SPS ACM % 83% 81% 81% 86% 81% 85% 86% 59% 59% 73% 66% 73% 74% 77% 76% SVRC SC * 20 * 90% * 82% * 89% * 88% * 80% * 69% * 84% * 84% TTI ACM % 91% 82% 90% 87% 84% 88% 83% 65% 64% 64% 66% 71% 69% 77% 78% TTI ACT % 89% 93% 100% 96% 91% 93% 100% 86% 76% 85% 79% 89% 91% 91% 89% Overall % 90% 86% 89% 87% 87% 86% 89% 74% 72% 76% 72% 84% 83% 83% 83% MSHN ACT % 85% 92% 86% 97% 85% 94% 84% 84% 74% 73% 75% 82% 77% ** ** Statewide ACT ** ** 90% 89% 87% 89% 92% 91% 84% 84% 78% 78% 76% 75% 75% 75% ** ** *new survey team in 2016 **unknown Confidence Level Survey results depict the scores with a 95% confidence level and a 4% confidence interval. Statistically this means we can be 95% certain that the true scores for the entire population of individuals surveyed are the scores reported by the respondents plus or minus 4%. For example, if 80% of the respondents indicated satisfaction, we can be sure that between 76% and 84% of the entire population would indicate satisfaction. The larger the sample size, the more we can be sure that the responses reflect those of the entire population. 3/7/2017JMcCulloch Page 3

4 Results by Survey Item The table below is a two-year comparison of the overall level of satisfaction for each survey item sorted by domain. General Satisfaction 2014 n=442 1 I liked the services that I received. 90% 92% 2 If I had other choices, I would still choose to get services from this provider. 85% 88% 3 I would recommend this agency to a friend or family member. 85% 89% Access to Services 4 The location of services was convenient (parking, public transportation, distance, etc.). 87% 88% 5 Staff were willing to see me as often as I felt it was necessary. 86% 88% 6 Staff returned my calls within 24 hours. 80% 81% 7 Services were available at times that were good for me. 89% 89% 8 I was able to get all the services I thought I needed. 82% 84% 9 I was able to see a psychiatrist when I wanted to. 76% 79% Quality/Appropriateness 10 Staff believed that I could grow, change and recover. 78% 83% 12 I felt free to complain. 79% 82% 13 I was given information about my rights. 93% 95% 14 Staff encouraged me to take responsibility for how I live my life. 85% 86% 15 Staff told me what side effects to watch for. 76% 79% 16 Staff respected my wishes about who is and who is not to be given information about my treatment services. 90% 89% 18 Staff were sensitive to my cultural/ethnic background (e.g., race, religion, language, etc.). 84% 88% 19 Staff helped me obtain the information I needed so that I could take charge of managing my illness or disability. 83% 82% 20 I was encouraged to use consumer-run programs (support groups, drop-in centers, crisis phone line, etc.). 78% 75% Participation in Treatment Planning 11 I felt comfortable asking questions about my treatment, services, and medication. 85% 87% 17 I, not staff, decided my treatment goals. 78% 79% Outcomes 21 I deal more effectively with daily problems. 79% 73% 22 I am better able to control my life. 75% 72% 23 I am better able to deal with crisis. 66% 68% 24 I am getting along better with my family. 73% 69% 25 I do better in social situations. 69% 69% 26 I do better in school and/or work. 66% 62% 27 My housing situation has improved. 70% 68% 28 My symptoms are not bothering me as much. 64% 64% Functioning 29 I do things that are more meaningful to me. 72% 76% 30 I am better able to take care of my needs. 73% 69% 31 I am better able to handle things when they go wrong. 65% 63% 32 I am better able to do things that I want to do. 73% 71% Social Connectedness Survey Item Two-Year Comparison 33 I am happy with the friendships I have. 78% 81% 34 I have people with whom I can do enjoyable things. 82% 83% 35 I feel I belong in my community. 72% 76% 36 In a crisis, I would have the support I need from family or friends. 83% 80% 2016 n=449 3/7/2017JMcCulloch Page 4

5 The following table details the percentage of satisfaction for each team by survey item. General Satisfaction DNMM SC n=25 HNNP ACM n=7 1 I liked the services that I received. 92% 67% 93% 86% 96% 98% 81% 100% 89% 92% 92% 2 If I had other choices, I would still choose to get services from this provider. SCCMHA CSS 1 n=27 SCCMHA CSS 2 n=14 SCCMHA SCS 1 n=137 SCCMHA SCS 2 n=48 SPS ACM n=70 SVRC SC n=20 TTI ACM n=65 TTI ACT n=36 TOTAL n=449 84% 71% 88% 93% 92% 92% 77% 95% 89% 92% 88% 3 I would recommend this agency to a friend or family member. 92% 71% 93% 86% 92% 98% 84% 90% 86% 86% 89% Access to Services The location of services was convenient (parking, public 4 transportation, distance, etc.). Staff were willing to see me as often as I felt it was 5 necessary. 90% 71% 89% 71% 91% 87% 87% 88% 89% 86% 88% 80% 57% 89% 79% 90% 96% 76% 88% 91% 100% 88% 6 Staff returned my calls within 24 hours. 84% 71% 65% 64% 90% 84% 68% 84% 81% 94% 81% 7 Services were available at times that were good for me. 91% 86% 85% 71% 90% 92% 87% 94% 88% 91% 89% 8 I was able to get all the services I thought I needed. 75% 57% 81% 57% 87% 94% 78% 89% 83% 94% 84% 9 I was able to see a psychiatrist when I wanted to. 79% 71% 81% 57% 82% 91% 63% 86% 84% 88% 79% Quality/Appropriateness 10 Staff believed that I could grow, change and recover. 68% 83% 81% 71% 90% 89% 79% 67% 80% 89% 83% 12 I felt free to complain. 92% 86% 67% 64% 89% 85% 69% 94% 79% 83% 82% 13 I was given information about my rights. 96% 100% 85% 93% 96% 98% 91% 90% 97% 94% 95% 14 Staff encouraged me to take responsibility for how I live my life. 100% 86% 81% 77% 85% 91% 84% 71% 83% 97% 86% 15 Staff told me what side effects to watch for. 60% 57% 70% 64% 90% 82% 67% 43% 79% 89% 79% Staff respected my wishes about who is and who is not to be 16 given information about my treatment services. Staff were sensitive to my cultural/ethnic background (e.g., 18 race, religion, language, etc.). Staff helped me obtain the information I needed so that I 19 could take charge of managing my illness or disability. I was encouraged to use consumer-run programs (support 20 groups, drop-in centers, crisis phone line, etc.). Participation in Treatment Planning 11 I felt comfortable asking questions about my treatment, services, and medication. 90% 86% 78% 71% 94% 95% 88% 87% 87% 89% 89% 80% 83% 78% 79% 92% 93% 90% 94% 82% 83% 88% 82% 57% 74% 79% 84% 97% 77% 82% 77% 94% 82% 70% 57% 62% 86% 79% 72% 75% 73% 72% 86% 75% 100% 86% 78% 71% 87% 93% 81% 77% 87% 97% 87% 17 I, not staff, decided my treatment goals. 85% 57% 65% 62% 87% 82% 75% 93% 70% 77% 79% Outcomes 21 I deal more effectively with daily problems. 62% 57% 67% 71% 77% 71% 71% 86% 66% 86% 73% 22 I am better able to control my life. 62% 71% 74% 64% 83% 64% 57% 73% 68% 80% 72% 23 I am better able to deal with crisis. 60% 57% 70% 64% 72% 67% 56% 46% 73% 77% 68% 24 I am getting along better with my family. 67% 29% 61% 71% 77% 76% 59% 79% 63% 74% 69% 25 I do better in social situations. 73% 29% 54% 54% 83% 78% 52% 64% 61% 77% 69% 26 I do better in school and/or work. 59% 0% 68% 25% 80% 72% 37% 75% 46% 53% 62% 27 My housing situation has improved. 65% 17% 76% 36% 80% 77% 57% 60% 54% 79% 68% 28 My symptoms are not bothering me as much. 61% 43% 48% 36% 74% 78% 56% 36% 62% 80% 64% Functioning 29 I do things that are more meaningful to me. 73% 57% 52% 69% 85% 90% 75% 79% 60% 80% 76% 30 I am better able to take care of my needs. 62% 43% 67% 64% 77% 71% 56% 71% 63% 88% 69% 31 I am better able to handle things when they go wrong. 53% 29% 73% 50% 72% 58% 52% 36% 65% 71% 63% 32 I am better able to do things that I want to do. 73% 43% 65% 50% 83% 79% 60% 64% 58% 74% 71% Social Connectedness 33 I am happy with the friendships I have. 79% 100% 59% 57% 92% 86% 74% 83% 69% 88% 81% 34 I have people with whom I can do enjoyable things. 96% 43% 56% 57% 92% 96% 71% 89% 77% 89% 83% 35 I feel I belong in my community. 91% 43% 62% 50% 86% 91% 64% 94% 58% 86% 76% 36 Survey Item In a crisis, I would have the support I need from family or friends. 96% 43% 56% 71% 90% 93% 71% 84% 64% 83% 80% 3/7/2017JMcCulloch Page 5

6 Quality Improvement Opportunities Results of the MHSIP Consumer Satisfaction Survey provide valuable feedback and insight into the perspectives of consumers regarding the care and services they receive. The following are recommendations to assure that the outcomes of this survey are shared with staff, providers, consumers, stakeholders, etc. and that quality improvement opportunities are identified and acted upon as needed: 1) A final draft of this survey report will be reviewed by the SCCMHA Quality Governance Council (QGC) for comment and approval. The QGC will identify any trends that have occurred from year to year and determine possible system-wide improvement efforts. 2) The final survey report will be presented to the SCCMHA Adult Case Management Supervisors. Supervisors will review this information with their staff to identify areas needing improvement and celebrate successes as appropriate. They will be required to provide the SCCMHA Quality Systems Department evidence that this has occurred within 45 days of receiving the report. At least one area of improvement based on survey domain or individual survey item will be identified and a performance improvement plan will be submitted. 3) The final report will be formally presented to the SCCMHA Ends Committee, the SCCMHA Citizen s Advisory Committee, and the SCCMHA Board of Directors. 4) The final survey report will be posted on the SCCMHA website. 5) A one-page summary of results will be completed for distribution to consumers. 6) The survey process will be reviewed by the SCCMHA Quality Systems Department to determine if additional action may be needed to improve the return rates of future surveys. (e.g., address cleanup, prior notice to staff, reminders to consumers). Qualitative Comments Several consumers and guardians provided comments at the end of the survey. They have been typed verbatim except in cases where names were replaced with pronouns to protect anonymity. Comments of concern were addressed with the staff when identifiable information was provided. Disability Network of Mid-Michigan The communication is poor when trying to reach a caseworker. I didn t get the paperwork that needed to be sent. This has been a pain in my fanny to get her reinstated. First time in 13 years that this has happened. I'm not very happy at this time. My caseworker is great. Needs speech services and things to do. I'm doing better, can't complain. Hope Network I am very happy with the services. I feel it s very unfair that our case manager cannot make arrangements for transportation for the consumers. A lot of us get high anxiety and nervous when try to arrange a ride, some of us can t afford to take the bus, I m hoping the Mental Health Authority reconsiders this. We the consumers, depend on our case managers often to set these rides up for transportation to doctors visits, etc. Thank you. 3/7/2017JMcCulloch Page 6

7 SCCMHA Community Support Services 1 Some workers are rude, not polite. I greatly appreciated the assistance and guidance I've received at SCCMHA. Dr. Tadeo is compassionate and truly concerned over my well-being. Brooke Maylee, my case manager, has been going to bat for me and hitting home runs since the beginning, along with her supervisor, John Burages. Nurse Julie has always explained everything in simple terms and takes care in helping me. I'm very thankful. I'm very happy with Saginaw Community Mental Health! They have helped me out so much over the years and years. I have an awesome doctor, he's the greatest. He's been so helpful to me. I have an awesome peer support worker. My caseworker is the greatest to me; she's been so very helpful to me. Will this survey have any effect on my getting discharged from the Caro center? Don t like the building changes feeling more unsafe. Would like better security for guns or knives need less people coming from prisons. CMH does not encourage employment or recognize that it is impossible to live on the money you receive on SSI. Hi, I love my foster home and my own here. I love to garden and keep busy and I like Birch Run! The only staff I enjoyed was Dr. Anne Tadeo and the nurse, Julie. I was comfortable with them and wish I was still there, as most of my problems stem from abandonment. SCCMHA Community Support Services 2 Get on the ball. I wish the services I now have would have been offered at intake. One person at place is not nice to me. With God in Life all things are wonderful! Six people have died within past 2 1/2 years, all acquaintances. Some sadness! Up and down memories. I had great services five months ago. I was arrested for the murder of my step-daughter by a son I never knew until four months prior. I am awaiting trial for this illegal charge as he keeps accusing me, and in a murder case it has to run its course before release. All DNA evidence is in my favor, not linking me to this crime. I need and want to resume my CMH Services at the time of release. Thank you. Caseworker missed a scheduled appointment on August 26th with SSI because she was in a training session. Talked to another caseworker about counseling but he was more interested in being on his cellphone. My caseworker said to come see me after my dentist appointment September 22nd expecting me at 10:00. I wasn t told she had an 11:00, so when I got there, I couldn t see her. Whenever I have an appointment with a caseworker, I want full attention with no interruptions. SCCMHA Supports Coordination Services 1 Wonderful services!! We deal with Robin. She has been a big help and always has time to answer questions, etc. She is a wonderful and caring person. Parking can be a problem some days. I am filling out the form as guardian. I viewed questions using her/she instead of I. I feel she is getting excellent help and her doctor listens to me, as well as watching her behavior/gestures. Excellent support staff is only a phone call away when needed. I got roaches living with me. I don't feel I want to live here anymore. Caseworker never returns calls. Did not get plan on time or other necessary authorizations on time. I would like more work hours. 3/7/2017JMcCulloch Page 7

8 I cannot express in words of how much help our social worker (support coordinator) is to us. She is so caring and is there for us when we have concerns or need help with something. We feel free to call her at any time. She responds quickly and sets up appointments or if we need, she will answer the question on the phone. She will come to our home and help us work through some of the paperwork that we get that we don t understand. She is so patient, understanding, pleasant, and kind and always has a smile. Amazing lady she is like family to us. We feel so free to share things with her. We are so blessed and so fortunate to have her and we feel you are too, to have her on your staff. Best ever. Thank you Robin Heise-Kukulski. Thank you Malinda. Thank you so much for a great health care team- Janet LaLonde, Angie Irish, Dr. Vize, and my staff are wonderful support to me and my family. So much appreciated!!! Thank you. I like living in my home. I enjoy going to CTS and to work. I like it here. I get along with staff that cares for me. I like going to CTS to program. I am happy with the services I get. Coming from the Caro Light House, which I was having about 30 seizures a month and were long. Now in my new home with less stress, I now have 15 or less and do not last as long. Thank for your time. I get along better with the staff. We love our services and caseworker. I wouldn t change a thing. This client s main diagnosis is development disabilities. I like where I live and the services provided for me at mental health. She is not really capable of making any decisions. Doing real good. Thank you. Thank you! SCCMHA Supports Coordination Services 2 He totally enjoys attending SVRC. Lynn White continues to go above and beyond in helping him with all necessary needs that he has. She takes her work and responsibilities very seriously as his case worker. We truly appreciate all her help and concern. Community Ties South is a great program, which I love to go to. The staff is great and I love them. They help me a lot. Thank you to Lynn White for all the help that she is and has been to me and my family, and to Carrie and all the workers at CTS. Saginaw Psychological Services Adult Case Management Thanks for all the coping strategies. I'm glad there are services of this type to help out people like me. Thank you for your support. Good caseworker. Psych doctor questionable. Psych meds needed to be changed five weeks ago. I feel I have a good caseworker T. Winters. I could not take the night time medicine I was given because of a real bad reaction/intolerable five weeks ago. I have been unable to get a change or to converse with my psych Rao. Ms. Winters has gone over and above in trying to make things easier and available. She has been unable to connect with Dr. Rao for some reason. I don't have an appointment with Dr. Rao until end of month. I have not seen my caseworker since June. I would have a lot better services if I did. She does not return my phone calls. I can no longer see Dr. Rao until she shows up. 3/7/2017JMcCulloch Page 8

9 I am totally disabled now. I sincerely thank Tony K. for providing a home for me. I will do landscaping and garbage, etc. to provide housing. (I can't go back to the Eastside). I served one year in jail with a violent criminal inside my cell when I was in jail. Saginaw Psych is definitely helping me deal with my mental health issues better. They are professional as well as compassionate. I am extremely happy with my case manager, Tracy Bellhorn, and my psychiatrist, Dr. Nagarkar. The staff is always very helpful, as well. My treatment at Saginaw Psychological Services is helping me to live a better life, and hope I will continue to receive services from them. I enjoy coming here and the help. My caseworker does not show up or return phone calls. She has not received help from your services that she requires. She is also receiving bills for treatment she has not received!! My caseworker, Tomekia Winters is very helpful. Thank you. I like to be left alone and I love my animals that come in my yard. Thank you for your help and to the managers that don t work there anymore. Things are up with me at this time and I feel that I need to go to mental health, but they keep trying to send me to a treatment center and I don t need no treatment. I keep hearing voices telling me to do things and thinking someone is out to get me and I m afraid to go out at night. I need some help getting into mental health. So do you think you can get me mental health? I feel I can trust my therapist fully. My therapist has helped me in working to feel normal and not depressed. I love Saginaw Psychological very much. They really care about the people that come here and I will always come here. The doctor is very nice and the front desk people are very nice. I have the best case manager. Case management does not return calls and Psychiatrist does not (I feel) take the necessary time to ask about how meds affect you. She also does not listen to med changes or side effects of meds. Very aggressive way of conducting meetings. All I needed was a medication adjustment. I will never need involuntary hospitalization treatment by petition again because I now have a plan. I feel alone most of the time. People are out to make me suffer. I have failed to get hired and I believe it s personal. Previous employers are out to destroy me. She has a vendetta against me to ruin my life. All of my friends have dumped me since I moved away. I have gained weight and have low self-esteem. I feel nobody wants me around. I feel I don t fit in with my community, even though I have volunteered for some events. When I go out, I try and draw attention to myself so people will notice me. I have an online blog and I m known as darkness and my real name. The services are very helpful. SVRC Supports Coordination My son never had any trouble with the law, he is a good child. I have no problem with him, he is a very good kid and he is a big help to me and a big help to his neighbor. Also, he is not a problem child. He is a very good kid, and he is always willing to help with people when they need it. I am very grateful to him, as my son. He never had trouble with the police and he never been arrested by the police. He is a part of the SVRC program for disabled persons. The program has benefited him for a long time. I enjoy Amanda Mathews, our new caseworker. She is very astute, knowledgeable and kind with a winning personality. Thank you. 3/7/2017JMcCulloch Page 9

10 Why do they make us work? Tell them to give me more hours now please. Thank you. I m the boss now of my staff members. I know you have lots of money now somewhere. Count it a blessing to be helped because people don t have to be nice but I love the services that SVRC provides for me and thank you for your help. Training and Treatment Innovations Adult Case Management I need TTI services, but they terminated me. I don't know what to do now. Everything is falling apart. Amber is a liar. Kelley is too. TTI sucks. They don't care. The ladies answering the phone are a$$holes; they talk so mean to you. I need to find better help people. I have been lied to for the last time. Ya ll need some help. Ya'll workers have down syndrome and need a pill. Great Services. I would highly recommend services to anyone in need. Thanks. Keep up the good work. Thanks. Ok, I liked your facilities and the staff and the security, which made me feel safe because of my agoraphobia. Now I was let go because I missed 2 appointments, from being paranoid and my phobia to go out in public. Now if you read this, I would be thank you if you could set me up to get help with you. If you could set me up with an appointment, call me. I ll try to make an appointment on my own, but I would appreciate you giving me feedback. Thank you. I like to get my house fixed. I need help so I get help to fix my mother's house. My mother and father are gone. So I am on my own. I don't have any comments right now to all of these questions, except to say that I am still pregnant. I love my case manager, Judy. She is great and don't know what I would do without her. Jill is great. I just do not like that you cannot talk to her. However, I understand the reasoning why she would have a ton on her plate more than she already does. Thank you and please make sure Judy gets a pat on her back. Love that lady to death. Thanks. I believe these services need to improve. I don t like it at all. Someday, I hope I ll never need it again. I am working on it, because I am an overcomer. The waiting room would be more conducive to various diagnoses if no music with lyrics or TV (some illnesses think they get dire and cryptic and personal messages from various media). I think a practical choice would be to play instrumental music that promotes brain health, such as classical or jazz, etc. (with no lyrics). I don't feel I have the support I need when I'm in crisis. Great job helping us with our son. Grayson, Brian and Lori have done an excellent job in helping me to improve my mental health status. Thanks. If it weren t for my parents and you, I would be worse off. Thank you. I never had a social problem, but I would rather not do group sessions. I absolutely love the staff, especially my caseworker and nurse. But I still have insomnia that I have been working on for years and my depression has not changed. I hate paper work. Prayers to all. My caseworker is doing a fantastic job. Dan Durow is great! They need help on how to get workers to stay. Too hard on workers when they also have to do another case. It is double the work. I d be lost without the help of Robert Miller, Case Manager at TTI. Medication Management, Jill LeBourdais, was very good. Sarah Kennedy, therapy was okay, Case Management was terrible avoided scheduling appts, did not reply or respond to my inquiries, did not help at all. Case Manager, Grayson Hood. 3/7/2017JMcCulloch Page 10

11 I have been dealing with the same problems 2 years later that took me to hospital road to begin with. I m still homeless, penniless, depressed, occasionally suicidal, anti-social and constantly in chronic pain. Nothing helps and nothing has changed. Good service. I am now on medication. I need to maintain and not feel so out of control. The arrests are only due to my not being responsible enough pay fines and my driver s responsibility fees. Your office has been extremely helpful in that situation as well as helping me keep my appointments. Training and Treatment Innovations Assertive Community Treatment The treatment that I've received from TTI has been a great help and encouragement to me with the conditions I have. I believe with their help, I've come a long way in my life. I thank God for all my workers that are in my life. They have been a great help to me since being with me and I with them. My nurse has been a great support to me in my life, along with special caseworkers. I thank God for all of them and my doctors. I thank God for having caring people in my life when help was needed. I thank you and I thank God. God Bless All. Thanks for your positiveness and help as a therapist and your supporters. Thanks for making a difference. God Bless You. I like working with ACT. Some of the best services. I enjoy being in the program and have improved my attitude and have been stable and met new friends at Friends for Recovery. I want to thank the staff for helping me. I just wanted to take this opportunity to thank you and for your encouragement and support. When times are really rough, it's nice to know that you are there to help me through. You are also there to help me achieve positive goals and healthful days. I appreciate all that you do. TTI has been very helpful to me in the past couple of years. I appreciate their services. TTI and ACT have been a God send to me and my family too. Thank God! I am with the ACT team, and I feel I am a person too. I have things that I have to do in the day. It would be nice and considerate if all calls were made by 11 a.m. to all clients so they can plan their day. Cause they are people too. Instead of calling at 12:30 and saying we will be there by 3:00. 3/7/2017JMcCulloch Page 11