Mental Health Statistics Imprvement Plan (MHSIP) Cnsumer Survey Annual Reprt FY2014 This reprt was prepared by: Adrienne Jnes, M.A., Researcher Data and Evaluatin, Cmmunity Prgrams Office f Behaviral Health, CDHS
Table f Cntents Table f Cntents... 2 Abut this Reprt... 3 What is the MHSIP Survey?... 3 Survey Prcedures... 5 Sample... 5 Survey Distributin... 5 Respnse Rate... 6 Respndent Demgraphics... 6 Race and Ethnicity... 6 Criminal Backgrund... 7 Payr Surce... 7 FY2012 and 2013 Demgraphic Cmparisn... 7 MHSIP Respndents Cmpared t the CCAR Ppulatin... 9 Overall Dmain Results... 9 Ppulatin Characteristics and Dmain Agreement... 11 Qualitative Cmments... 11 Discussin and Implicatins... 13 Appendix A: FY2014 MHSIP Survey... 15 Appendix B: Respnse Rate by Agency fr FY2014... 19 Appendix C: Demgraphic Infrmatin f FY2014 MHSIP Respndents... 21 Appendix D: Payr Status fr FY2014 MHSIP... 23 Appendix E: Cmparisn f Demgraphic Infrmatin f FY2014 MHSIP t FY2014 CCAR Respndents... 24 Appendix F: Percent Psitive Endrsement f MHSIP Dmains by Item... 26 2
Abut this Reprt In 2013, the Clrad Office f Behaviral Health (The Office) cnducted its seventeenth annual Mental Health Statistics Imprvement Prgram (MHSIP) Cnsumer Survey with a fcus n services prvided in State Fiscal Year 2014 (July 1, 2013 - June 30, 2014; FY2014). Cnsistent with natinal trends in perfrmance measurement, the Office administers the MHSIP Cnsumer Survey t assess varius cnsumer perceptins f public behaviral health services prvided in Clrad. This reprt describes data cllectin, sample selectin, and results f this year s survey. The Office is cmmitted t the inclusin f cnsumer participatin at multiple levels f behaviral health services and perceives the MHSIP survey as ne way f meeting this nging gal. It is imprtant t nte that the MHSIP survey has been develped at a natinal level in part t prmte data standards that allw fr valid results t better infrm plicy and decisins (fr a full descriptin f MHSIP and the survey s underlying values, please visit: http://www.nri-inc.rg/prjects/sdicc/tech_assist.cfm). MHSIP wrk grups include cnsumers and families with the gal f such grups being the prmtin f cnsumer-riented services thrugh data. Thank yu t all wh assisted in the data cllectin f the MHSIP survey. Agency cllabratin is instrumental t the success f the survey and the Office acknwledges and appreciates the hard wrk f the behaviral health centers and clinics in this prcess. What is the MHSIP Survey? The MHSIP Cnsumer Survey cnsists f 36 items, each answered using a 5-pint Likert scale ranging frm ne (strngly agree) t five (strngly disagree). These questins create seven dmains, which are used t measure different aspects f custmer satisfactin with public behaviral health services. Figure 1 details the specific questins that cmprise each f the seven dmains: Satisfactin, Access, Quality, Participatin, Outcmes, Scial Cnnectedness, and Functining. 3
Figure 1. MHSIP Dmain Items Access The lcatin f services was cnvenient. Staff were willing t see me as ften as I felt it was necessary. Staff returned my calls within 24 hurs. Services were available at times that were gd fr me. I was able t get the services I thught I needed. I was able t see a psychiatrist when I wanted t. Functining I d things that are mre meaningful t me. I am better able t take care f my needs. I am better able t handle things when they g wrng. I am better able t d things I want t d. My symptms are nt bthering me as much. Outcmes I deal mre effectively with daily prblems. I am better able t cntrl my life. I am better able t deal with crises. I am getting alng better with my family. I d better in scial situatins. I d better in schl and/r wrk. My husing situatin has imprved. My symptms are nt bthering me as much. Participatin I felt cmfrtable asking questins abut my treatment and medicatin. I, nt staff, decided my treatment gals. Quality Staff here believe I can grw, change and recver. I felt free t cmplain. Staff tld me what side-effects t watch fr. Staff respected my wishes abut wh is, and is nt, t be given infrmatin abut my treatment. Staff were sensitve t my cultural/ethnic backgrund. Staff helped me btain infrmatin s that I culd take charge f managing my illness. I was encuraged t use cnsumer-run prgrams. Satisfactin I liked the services that I receieved here. If I had ther chices, I wuld still get services frm this agency. I wuld recmmend this agency t a friend r family member. Scial Cnnectedness In a crisis, I wuld have the supprt I need frm family r friends. I am happy with the friendships I have. I have peple with whm I can d enjyable things. I feel I belng in my cmmunity. 4
The Functining and Scial Cnnectedness dmains were added t the MHSIP survey in 2006. While these items have been cllected in Clrad in prir years, FY2014 is the first year these items have been included in this reprt. These dmains were included in an attempt t prvide further insight n cnsumer s perceptins f their behaviral health treatment and its impact n their daily lives. The MHSIP survey als cntains items pertaining t demgraphic infrmatin (e.g., age, gender, race/ethnicity, arrests, and payr surce), as well as tw pen-ended questins are als included in rder t gather pinins abut the mst and least preferred features f services received. Lastly, the MHSIP survey was mdified this year t exclude demgraphic infrmatin that while infrmative, were nt required by federal reprting standards and cnsiderably increased the length f the survey. Such variables included, but are nt limited t: disability infrmatin, sexual rientatin, spken languages, and armed service. Please see Appendix A fr a cpy f the MHSIP survey as it was presented t cnsumers fr FY2014. Survey Prcedures Since 2008, a cnvenience sample has been used where surveys were given directly t cnsumers when they arrived fr their appintment, meaning the MHSIP nly captures thse wh are currently receiving services. Additinally, cnsumers wh chse t cmplete the MHSIP survey were eligible t enter a drawing t win a $10 gift card fr a lcal grcery r cnvenience stre. All cnsumers were included in the survey regardless f payr surce. This was different frm previus years that included nly the cnsumers wh were classified as indigent r receiving Medicaid. Fr FY2014, the ptin f cmpleting the survey nline was ffered via Survey Mnkey with a link t the survey being prvided in the survey cver letter handed ut t cnsumers with the paper survey. The nline survey was designed t mimic the paper survey as clsely as pssible and prvide the cnvenience f nline cmpletin. The nline survey ptin was ffered in bth English and Spanish. Despite Office effrts, nly seven English surveys were cmpleted via Survey Mnkey. Sample The Office used a cnvenience sampling methd whereby each f the 17 cmmunity mental health centers and the tw specialty clinics, Asian Pacific and Servicis de la Raza, were prvided with surveys t hand ut t cnsumers wh were receiving services during a three week perid cnducted between Octber 28 th and Nvember 15 th 2013. Cnsumers wh were attending their first appintment, r intake, were excluded frm the sample. Survey Distributin The Office cntracted with the State f Clrad Central Services, Integrated Dcument Slutins (IDS) t prepare, mail, and receive surveys as well as enter data fr the FY2014 survey perid. IDS mailed a pre-determined number f MHSIP packets 5
(including a cver letter, survey, and a lttery ticket) t each f the 17 cmmunity mental health centers and the tw specialty clinics. During the three-week data cllectin perid, cnsumers were ffered the pprtunity t cmplete the MHSIP survey and lttery ticket t enter the gift card drawing. Cnsumers culd chse t mail the survey directly t IDS in a pstage-paid return envelpe r culd drp (cmpleted and refused) surveys in a secure bx lcated at the center. At the end f the data cllectin perid, centers shipped all surveys t IDS where they were srted and prcessed. Data frm the cmpleted surveys were then entered int Excel and sent t the Office by IDS. Respnse Rate Data were analyzed at the state level. While the Office previusly reprted agency level data, this apprached was discntinued because it undermined the Office s gal t fster a cllabrative envirnment amng Clrad s public behaviral health prviders. The Office prvides raw agency data t each cmmunity mental health center and specialty clinic shuld they want t cnduct their wn analyses. Respnse rate was calculated by taking the number f surveys cmpleted frm each agency divided by the number f cnsumers scheduled fr appintments. When calculating respnse rate in this way, it is assumed that every cnsumer was ffered the survey and either declined r accepted. The Office received a ttal f 3,676 cmpleted r partially cmpleted MHSIP surveys. Sn after the survey administratin, agencies were asked fr the number f cnsumers that were seen during the survey perid. All agencies respnded and 22,248 adult cnsumers were reprtedly seen during the 3-week survey perid, representing a 16.5% return rate (see Appendix B). This percentage is higher than FY2013, which had a respnse rate f 15.7%. This year s survey prcess was nt significantly different frm the three previus years, and the number f surveys cmpleted this year was higher than past years (2,327; 2,642; 3,338 respectively). Respndent Demgraphics The majrity f the MHSIP respndents wh reprted gender were female (64.7%) and 34.4% were male. Respndents were generally middle aged with 36.6% between 31-45 years ld and anther 37.1% between 46-64 years ld. Race and Ethnicity: Fllwing natinal guidelines, race and ethnicity were separated int tw questins n the survey. Hispanic/Latin(a) was the sle chice fr ethnicity and 20.2% f respndents endrsed this item. Hwever, 22.2% f the respnses were missing r marked Prefer nt t Answer. Race had the fllwing chices: American Indian/Alaska Native, White/Caucasian, Black/African American, Native Hawaiian/Pacific Islander, Asian, Other, and Prefer nt t Answer. If a respndent chse mre than ne race, their racial identificatin was cded as Multiracial. Mst respndents identified with nly ne racial grup (83.1%). The majrity f respndents identified as White/Caucasian (65.9%) fllwed by Multiracial (4.4%), Other (6.9%), African American/Black (3.6%) and American Indian/Alaska Native 6
(3.8%). Apprximately 17.3% left this item blank r chse Prefer nt t Answer. Please see Appendix C fr all respnses. Criminal Backgrund: FY2014, the survey asked abut criminal backgrund (i.e., arrests) fr respndents wh had received services fr mre than ne year and fr thse wh had received services fr less than ne year. Fr respndents wh had received services fr mre than ne year, 7.6% f survey respndents reprted having been arrested in the past 12 mnths with a slightly higher prprtin (10.1%) indicating having been arrested in the 12 mnths prir t that time frame. Fr thse wh had received services fr less than ne year, 5.4% reprted having been arrested since beginning behaviral health services. A slightly higher prprtin (18.1%) was arrested in the 12 mnths prir t beginning behaviral health services. Please nte that a significant percentage (77.2% and 78.6% respectively) did nt answer the last tw questins. Payr Surce: On this year s survey, tw survey questins addressed payr surce. There were tw specific items n the survey: D yu currently receive Medicaid? with a yes/n answer and What frm f payment best describes yur payment plan fr services here? with multiple ptins. Fr thse wh respnded t the Medicaid questins, 60.1% were currently receiving Medicaid at the time f survey cmpletin (with nly 2.2% f respndents missing data n this item). The next highest endrsed ptin was Medicaid/Medicare c-pay was the mst frequently chsen, fllwed by n payment (16.2%) and sliding scale (13.7%). Please see Appendix D fr all respnses. FY2012 and 2013 Demgraphic Cmparisn: Each year, the Office cmpares the current respndent demgraphics t prir years. This is dne fr tw reasns t ensure data integrity and t lk at demgraphic trends acrss time. FY2013 data are similar t FY2014 s, demnstrating that the ppulatins are highly cmparable. See Figures 2 and 3 fr FY2013 and FY2014 fr demgraphic cmparisns f age and race/ethnicity data. 7
Figure 2. Age f respndents by percentage, FY2013-FY214 45% 40% 35% 30% MHSIP Age Cmparisn FY2013 and FY2014 25% 20% 15% 10% 5% 0% 18-20 21-30 31-45 46-64 65-74 75+ FY2013 FY2014 Figure 3. Race f respndents by percentage, FY2013-FY2014 MHSIP Race Cmparisn FY2013 and FY2014 80% 70% 60% 50% 40% 30% 20% 10% 0% FY2013 FY2014 8
MHSIP Respndents Cmpared t the CCAR Ppulatin The MHSIP respndents demgraphics were als examined in cmparisn t demgraphics fr the Clrad Client Assessment Recrd (CCAR) ppulatin. Any individual wh receives treatment at a public behaviral health center r specialty clinic has a CCAR cmpleted by a clinician. The CCAR demgraphic measures are mre cmplete and are thus a mre representative sample f peple receiving behaviral health services within the state. As such, the samples were cmpared t explre whether the MHSIP sample is representative f this larger grup. Statistical cmparisns were nt cnducted as the sample sizes vary greatly in size, the instruments measure demgraphics slightly differently, and are cmpleted by different individuals (i.e., the MHSIP is self-reprt and the CCAR is clinician reprt). Furthermre, The Office implemented changes t bth the race and ethnicity variables starting in January 2014. This lead t FY2014 year data cntaining tw different race and ethnicity measures fr half the year. Every attempt was made t recncile the data and present, as accurately as pssible, a prtrait f demgraphic infrmatin frm the CCAR ppulatin. The tw samples were cmpared n gender, age, ethnicity, and race. In general, the tw samples are demgraphically similar: mre wmen receiving services than men, and adults (21-65) as the primary age grup served. Respndents identifying as Hispanic/Latin(a) in bth samples was similar with 20.2% n the MHSIP and 21% n the CCAR. These data shw the CCAR ppulatin cntinues t be cmparable t the MHSIP ppulatin. Please see Appendix E fr a detailed cmparisn f CCAR and MHSIP demgraphic data. Overall Dmain Results The Office cmputes dmain scres fr the seven dmains captured n the MHSIP survey. Using the five pint Likert-scale, agreement is defined as a mean that ranges frm 1 t 2.49, whereas disagreement is defined as a mean that ranges frm 2.50 t 5. Respndents wh did nt answer at least tw-thirds f the dmain items did nt receive a dmain scre and were excluded frm analysis. This methd f cmputatin fllws natinal recmmendatins frm the Substance Abuse Mental Health Service Administratin (SAMHSA). Table 1 presents the ttal mean scre results, in percentages, fr FY2014, as well as fr FY2010/2011, FY2012 and FY2013. Lking at the trends ver time, FY2014 levels f agreement remained relatively stable fr all dmains cmpared t prir years. Please refer t Appendix F where percentages f agreement/disagreement fr the 5- pint Likert scale are presented by item within each dmain. 9
Table 1. Valid Dmain Percent Agreement by Fiscal Year Dmain FY2010/2011 FY2012 FY2013 FY2014 Access (n) 84.9 (1951) 83.1 (1973) 84.8 (3301) 84.9 (3095) Functining (n) N/A N/A N/A 68.8 (2408) Outcmes (n) 66.8 (1467) 66.1 (1506) 64.7 (3180) 65.7 (2216) Participatin (n) 79.8 (1759) 79.6 (1812) 80.8 (3178) 81.4 (2957) Quality (n) 89.6 (2016) 88.7 (2069) 90.7 (3246) 88.1 (2965) Satisfactin (n) Scial Cnnectedness (n) 90.6 (2098) 90.3 (2150) 90.1 (3315) N/A N/A N/A 90.2 (3295) 63.8 (2224) Due t cnsistent methdlgy, it is pssible t examine trends in dmain scres frm year t year. Figure 4 demnstrates that the dmain scres fr these fur years are cnsistent and fllw the same verall trend in percent agreement. Figure 4. MHSIP Dmain Scres, FY2010/11 thrugh FY2014 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% MHSIP Dmain Scres: FY2010/2011 - FY2014 FY2010/2011 FY2012 FY2013 FY2014 10
Ppulatin Characteristics and Dmain Agreement Parametric statistics were used t analyze mean difference fr gender, age, ethnicity, race, and Medicaid grups fr all MHSIP dmains. When apprpriate, certain respnse chices (i.e., Prefer Nt t Answer), with small sample sizes, were remved befre analysis. Gender 1 Independent sample t-tests results fund statistically significant mean differences between men and wmen fr three dmains. Lwer scres were reprted by men than wmen acrss the fllwing dmains: Quality: [t (3393) 3.73, p =.000] Satisfactin: [t (3537) 4.21, p =.000] Participatin: [t (3524) 4.47, p =.000] Fr all ther demgraphic grups there were n statistically significant mean differences. In the past, previus statistical methdlgies were used t analyze these grup differences; hwever, the Office has since adpted a mre cnservative methdlgy leading t the decrease in differences reprted this year. Qualitative Cmments Tw pen-ended survey questins queried cnsumers abut their tw mst and least liked aspects f the services they received. In respnse t these questins, apprximately 76% f respndents prvided written cmments t ne r bth f the questins. What Cnsumers Like Mst The respnses t the pen-ended questin f What tw things d yu like mst abut the services yu receive? were reviewed fr cmmn themes. The fllwing themes were fund frm the respnses: Psitive Experiences with Staff There were numerus cmments regarding the friendliness f staff, including therapists, psychiatrists, and supprt staff. Many individuals mentined specific CMHC emplyees by name. Everyne is helpful and upbeat. 1 Respnses f Transgender and Dn t Knw were remved frm analysis due t small number f respnses. 11
Clinician/Therapist is genuinely interested and cncerned abut my well-being. She encurages me t d what is best fr me. Curteus, prfessinal, and caring service acrss the bard Nn-Judgmental and Feeling Heard Cmments n nt feeling judged r being listened t were als cmmn. I feel I am being listened t and heard. I dn t feel like I m being judged r like a sick persn. The therapist s ability t listen and understand my cncerns when I feel I barely knw what t say. Treatment Gals Anther cmmn theme was cnsumers expressing appreciatin that they were included in the treatment planning prcess. They culd decide what they wanted their gals and utcmes t be and nt have it dictated by their therapist. I am able t participate in my treatment plan and meds. I like the way I can make my wn decisin abut my treatment. I am invlved in my treatment plan and staff are very psitive in believing that I can grw, change and recver. Services/Grups The specific services being ffered were als mentined frequently. Many cnsumers cmmented they appreciated the amunt f services available and many specifically mentined grup therapy r specific therapies by name (i.e., dialectical behaviral therapy). What Cnsumers Like Least The respnses t the pen-ended questin f What tw things d yu like least abut the services yu receive? were als reviewed fr cmmn themes. Many were the ppsite f thse fund in the psitive cmments. Feeling Judged r Nt in Cntrl f Their Treatment The [dctrs] make yu feel bad abut yurself. Difficulty Scheduling Appintments Cmments abut difficulty getting appintments were acrss different types f prviders, such as therapists, case managers, and psychiatrists. Many respndents als stated that prviders did nt return their phne calls r were delayed in returning phne calls. I am nt able t get an appintment in a timely manner when I need ne. It is smetimes difficult t get in t be seen. When I call t make appintments, cannt reach anyne. 12
Cst f Services Sme respndents stated that they didn t have enugh mney fr the services. Other cmments were regarding incnsistent billing and the general cst f services. My mental health can t be imprved n in this incme It is way t expensive at $35! Lcatin and Envirnment Respndents wh cmmented abut lcatin stated that the center was t far frm their hme and difficult t attend n a regular basis. There were als cmplaints abut the verall envirnment. Parking is nt gd The bad smell Nt enugh tea flavrs. Building atmsphere des nt have a warm feeling here. Staff Turnver/Staff Overlad The turnver f staff was anther theme reflected in the respnses. There s been t much turn-ver lately and gd clinicians, psychiatrist have left. Wuld like mre cnsistent availability f dctrs (psychiatrists, etc.); nt s much f peple in and ut f center (jbwise at the center). Outcmes Fewer respndents discussed utcme explicitly in their respnses. Sme were nt satisfied with the lack r rate f prgress. I am having difficulty making meaningful changes smetimes it feels like I can t mve frward. I feel that they need mre treatment ptins. Discussin and Implicatins The MHSIP Cnsumer Survey ffers valuable infrmatin n cnsumer perspectives f Clrad behaviral health services. Althugh the MHSIP survey has limitatins, the use f the survey in cmmunity behaviral health settings allws fr feedback acrss a brad spectrum f behaviral health cnsumers regarding satisfactin. Hwever, it is imprtant t interpret these findings with its limitatins in mind. Limitatins include the fllwing: The cnvenience sampling methd used fr the MHSIP survey nly samples cnsumers wh are currently attending sessins at a public behaviral health agency. These data d nt capture the pinins f cnsumers wh have discntinued services with the agency fr whatever reasn r thse unable t access services. 13
There is n infrmatin n wh declines t cmplete the survey and hw they may differ frm thse wh respnded. The Office is unable t capture thse individuals wh successfully cmpleted treatment/services and hw their respnses might differ. Despite these limitatins, the MHSIP prvides rich infrmatin that may be helpful fr infrming future behaviral health services. Overall, the majrity f respndents indicated that their perceptins f Access, Quality/Apprpriateness, Participatin and General Satisfactin were generally satisfactry. The Outcmes, Functining, and Scial Cnnectedness dmains were nted as having the lwest levels f agreement. Hwever, it is imprtant t nte that despite utcme scres being lwer than ther dmains, tw-thirds f respndent still rate these dmains psitively. One pssible explanatin fr the cnsistent finding f lwer levels f agreement fr these dmains is that cnsumers wh are currently receiving services are nt able t assess utcmes as well as they culd after they have cmpleted treatment. Anther explanatin culd be that mst respndents are able t easily identify their pinins abut cmpnents f treatment, but have a harder time identifying hw thse cmpnents translate int impacting their lives. In summary, the MHSIP Cnsumer Survey fr FY2014 agency data prvides invaluable infrmatin regarding cnsumer perceptins and supprts the ideals f a cnsumerdriven mdel; this infrmatin can infrm change and highlight strengths fr individual behaviral health centers and fr the state as a whle. Fr infrmatin regarding this reprt please cntact Adrienne Jnes, M.A., MHSIP Prject Crdinatr at the Office f Behaviral Health, 3824 W. Princetn Circle, Denver, CO 80236, 303-866-7400/adrienne.jnes@state.c.us. 14
Appendix A: FY2014 MHSIP Survey Adult Cnsumer Satisfactin Survey MHSIP Please help ur agency make services better by answering sme questins abut the services yu received OVER THE LAST 6 MONTHS. Please fill in the circle that best represent hw yu feel abut each statement. If the questin des nt apply t yu, please mark Nt Applicable. Please fill ut the circle cmpletely. Example: Strngly Agree Agree Neutral Disagree Strngly Disagree Nt Applicable 1. I liked the services that I received here. 2. If I had ther chices, I wuld still get services frm this agency. 3. I wuld recmmend this agency t a friend r family member. 4. The lcatin f services was cnvenient (parking, public transprtatin, distance, etc.) 5. Staff were willing t see me as ften as I felt it was necessary. within 24 hurs. fr me. needed. wanted t. recver. 6. Staff returned my calls 7. Services were available at times that were gd 8. I was able t get the services I thught I 9. I was able t see a psychiatrist when I 10. Staff here believe I can grw, change and 11. I felt cmfrtable asking questins abut my treatment and medicatin. 12. I felt free t cmplain. abut my rights. I live my life. effects t watch fr. 13. I was given infrmatin 14. Staff encuraged me t take respnsibility fr hw 15. Staff tld me what side 15
16. Staff respected my wishes abut wh is, and is nt, t be given infrmatin abut my treatment. 17. I, nt staff, decided my treatment gals. 18. Staff were sensitive t my cultural/ethnic backgrund. 19. Staff helped me btain infrmatin s that I culd take charge f managing my illness. 20. I was encuraged t use cnsumer-run prgrams (supprt grups, drp-in centers, crisis phne line, etc.). AS A DIRECT RESULT OF SERVICES I RECEIVED HERE 21. I deal mre effectively with daily prblems. my life. with crises. with my family. situatins. and/r wrk. imprved. bthering me as much. family r friends. friendships I have. I can d enjyable things. cmmunity. meaningful t me. care f my needs. 22. I am better able t cntrl 23. I am better able t deal 24. I am getting alng better 25. I d better in scial 26. I d better in schl 27. My husing situatin has 28. My symptms are nt 29. In a crisis, I wuld have the supprt I need frm 30. I am happy with the 31. I have peple with whm 32. I feel I belng in my 33. I d things that are mre 34. I am better able t take 16
35. I am better able t handle things when they g wrng. things that I want t d. 36. I am better able t d The fllwing tw questins request yur feedback regarding yur experiences with this center. We value yur cmments, but they are ptinal. Shuld yu chse t write cmments, please DO NOT include yur name r any infrmatin that wuld identify yu. Yur cmments will be shared with the center exactly as yu write them. 37. What tw things d yu like the MOST abut the mental health services yu receive? 38. What tw things d yu like the LEAST abut the mental health services yu receive? Please answer the fllwing questins t let us knw a little abut yu. 39. D yu currently receive Medicaid (Please chse ne)? Yes N Dn t knw 40. What frm f payment best describes yur payment plan fr services here (Please chse ne)? Sliding Scale Self-Pay Medicaid/ Medicare C-Pay Third Party Insurance C-Pay N Payment Dn t knw 17
41. Gender Male Female Transgender Dn t Knw Other (Specify): 42. Age 18-20 21-30 31-45 46-64 65-74 75+ 43. Ethnicity I am Hispanic/Latin(a) I am NOT Hispanic/Latin(a) I prefer nt t answer 44. Race-Mark all that apply t yu. Other (Specify): Tribal Affiliatin (Specify): American Indian/Alaskan Native Black/African American White/ Caucasian Asian Native Hawaiian/ Pacific Islander I prefer nt t answer 45. Hw lng have yu been receiving services at this center? Less Than a Year (Skip t Questin 46-48) Mre Than a Year (Skip t Questin 49-51) 46. Were yu arrested since beginning services frm this center? 47. Were yu arrested during the 12 mnths prir t that? Yes Yes N N 48. Since yu began t receive services frm this center, have yur encunters with the plice. Been reduced (nt been arrested r hassled by plice) Stayed the same Increased Des nt apply I have had n plice encunters 49. Were yu arrested during the last 12 mnths? 50. Were yu arrested during the 12 mnths prir t that? Yes Yes 51. Over the last year, have yur encunters with the plice Been reduced (nt been arrested r hassled by plice) Stayed the same Increased Des nt apply I have had n plice encunters N N 18
Appendix B: Respnse Rate by Agency fr FY2014 2 Agency Cmpleted Surveys Number f Adult Cnsumers Seen Respnse Rate Arapahe/Duglas Mental Health Netwrk Asian Pacific Develpment Center 46 712 6% 8 111 7% AspenPinte Health Services 208 2074 10% Aurra Cmprehensive Cmmunity Mental Health Center 209 2876 7% Axis Health Systems 132 473 28% Centennial Mental Health Center 268 526 51% Cmmunity Reach Center 267 2312 12% Jeffersn Center fr Mental Health Mental Health Center f Denver 432 1917 22% 240 938 26% Mental Health Partners 287 1230 23% Ming Springs Inc. (frmerly Clrad West) Nrth Range Behaviral Health San Luis Valley Cmprehensive Cmmunity 204 1492 14% 223 2658 8% 86 364 24% 2 These numbers are based n agency-reprted numbers f adults seen during the survey perid, excluding intake cnsumers. 19
Mental Health Center Servicis de la Raza, Inc. 8 27 30% Sutheast Mental Health Services Spanish Peaks Mental Health Center The Center fr Mental Health (frmerly Midwestern MHC) 105 194 54% 518 1674 31% 115 1040 11% Tuchstne Health Partners 168 1250 13% West Central Mental Health Center, Inc. 149 380 39% Ttal 3 3673 22248 16.5% 3 Three nline respnses did nt include agency affiliatin. 20
Appendix C: Demgraphic Infrmatin f FY2014 MHSIP Respndents 4 MHSIP Respndents Gender % n Female 63.2 2317 Male 33.6 1231 Dn t Knw 0.4 14 Transgender 0.5 19 Missing 2.4 88 Race 5 % n White/Caucasian 65.9 2419 Multi-Racial 4.4 162 Other 5.4 199 Black/African American 3.6 133 American Indian/Alaska Native 3.8 139 Asian 0.4 15 Native Hawaiian/Pacific Islander 0.2 <10 Prefer Nt T Answer 9.1 333 Missing 12.5 459 Ethnicity % n Nn-Hispanic/Latina() 59.5 2184 4 Reprted percents include missing cunts (valid percent). 5 These are nt mutually exclusin categries. 21
Hispanic/Latina() 18.2 668 Prefer Nt T Answer 12.6 463 Missing 9.6 354 Age Grup % n 18-20 years 3.1 113 21-30 years 17.6 644 31-45 years 34.9 1282 46-64 years 35.4 1299 65-74 years 3.9 143 75+ years 0.5 19 Missing 4.6 169 22
Appendix D: Payr Status fr FY2014 MHSIP MHSIP Respndents Self-Reprted Medicaid % n Yes 58.8 2159 N 36.2 1330 Dn t Knw 2.8 101 Missing 2.2 79 Self-Reprted Payment Plan fr Services 6 % n Medicaid/Medicare C-pay 43.5 1596 Self Pay 7.6 280 Sliding scale 13.7 502 Dn t Knw 10.1 371 N Payment 16.2 596 Third-party C-Pay 5.2 189 Missing 3.7 135 6 Respndents were asked t select nly ne chice. 23
Appendix E: Cmparisn f Demgraphic Infrmatin f FY2014 MHSIP t FY2014 CCAR 7 Respndents MHSIP Respndents CCAR Respndents 8 Gender 9 % n % n Female 64.7 2317 59.3 41627 Male 34.4 1231 40.7 28571 Age Grup % n % n 18-20 years 3.2 113 6.4 4491 21-30 years 18.4 644 23.3 16373 31-45 years 36.6 1282 34.7 24357 46-64 years 37.1 1299 30.9 21700 65-74 years 4.1 143 3.7 2565 75+ years 0.5 19 1.0 712 Race 10 % n % n American Indian/Alaska Native 4.8 139 1.8 1195 Asian 0.5 15 1.1 709 Black/African American 4.6 133 6.9 4629 Multi-Racial 5.6 162 19.1 11 12766 Native Hawaiian/Pacific 0.3 <10 0.2 132 7 The CCAR data represent CCARs given during FY2014 (July 1, 2013 June 30, 2014). 8 These numbers represent unduplicated cunts. 9 The MHSIP ptins f Transgender and Dn t knw were remved frm this analysis because the CCAR des nt have analgus ptins. 10 These are nt mutually exclusive categries. 11 The Multiracial respnse is inflated cmpared t FY2013 due t the change in the CCAR demgraphic variables. 24
Islander Other 6.9 199 1.7 1108 White/Caucasian 84.1 2419 69.3 46406 Ethnicity % n % n Nn-Hispanic/Latina/ 76.6 2184 79.0 54390 Hispanic/Latina/ 23.4 668 21.0 14419 25
Appendix F: Percent Psitive Endrsement f MHSIP Dmains by Item 12 Access Items (N) Strngly Agree Agree Neutral Disagree Strngly Disagree The lcatin f services was cnvenient (3628). Staff were willing t see me as ften as necessary (3625). Staff returned my calls within 24 hurs (3406). Services were available at times that were gd fr me (3637). I was able t get all the services I thught I needed (3621). I was able t see a psychiatrist when I wanted t (3393). 49.9 33.3 11.8 3.8 1.2 53.7 33.9 8.1 3.1 1.1 47.1 32.9 12.9 5.6 1.6 51.0 37.8 7.5 2.8 0.9 50.9 37.4 7.9 2.7 1.1 39.2 32.1 17.1 8.1 3.6 Functining Item (N) Strngly Agree Agree Neutral Disagree Strngly Disagree I d things that are mre meaningful t me (3476). I am better able t take care f my needs (3494). I am better able t handle things when they g wrng (3505). I am better able t d things I want t d (3499). 30.6 38.6 22.6 6.5 1.8 30.5 42.7 20.4 4.9 1.5 27.2 41.1 22.2 7.2 2.3 28.8 38.6 22.3 7.7 2.5 12 Nt Applicable was an additinal respnse chice; thse respnses are nt included in the verall percentages prvided in these tables. 26
My symptms are nt bthering me as much (3464). 24.9 35.8 23.2 11.3 4.7 Outcme Items (N) Strngly Agree Agree Neutral Disagree Strngly Disagree I deal mre effectively with daily prblems (3513). I am better able t cntrl my life (3501). I am better able t deal with crisis (3498). I am getting alng better with my family (3398). I d better in scial situatins (3445). I d better in schl and/r wrk (2785). 35.4 41.9 18.1 3.8 0.9 33.8 40.8 20.5 4.0 1.3 31.7 40.0 21.7 5.3 1.3 32.0 36.3 23.7 5.4 2.6 27.4 34.6 27.1 8.3 2.6 26.9 30.7 31.8 8.0 2.6 My husing situatin has imprved (3104). My symptms are nt bthering me as much (3464). 29.2 28.8 28.8 8.9 4.4 24.9 35.8 23.2 11.3 4.7 Participatin Items (N) Strngly Agree Agree Neutral Disagree Strngly Disagree I felt cmfrtable asking questins abut my treatment and medicatin (3584). I, nt staff, decided my treatment gals (3551). 57.5 33.3 6.8 1.7 0.6 44.3 35.0 15.6 3.7 1.4 27
Quality Items (N) Strngly Agree Agree Neutral Disagree Strngly Disagree Staff here believe I can grw, change, and recver (3598). I felt free t cmplain (3534). I was given infrmatin abut my rights (3603). Staff encuraged me t take respnsibility fr hw I live my life (3572). Staff tld me what side effects t watch fr (3343). Staff respected my wishes abut wh is, and is nt able t be given infrmatin abut my treatment (3555). Staff were sensitive t my cultural/ethnic backgrund (3263). Staff helped me btain infrmatin s that I culd take charge f managing my illness (3473). I was encuraged t use cnsumer-run prgrams (3382). 55.8 33.2 9.5 0.9 0.6 46.9 34.2 13.4 3.9 1.6 58.1 34.0 5.3 1.8 0.7 54.4 34.9 8.7 1.4 0.6 43.9 32.5 15.6 5.7 2.2 58.9 31.6 7.5 1.0 1.0 49.5 33.8 14.6 1.3 0.7 47.7 37.2 12.2 2.3 0.5 47.0 33.3 15.6 3.6 0.6 Satisfactin Items (N) Strngly Agree Agree Neutral Disagree Strngly Disagree I liked the services that I received here (3650). If I had ther chices, I wuld still get services frm this agency (3624). I wuld recmmend this agency t a friend r family member (3635). 60.1 32.5 5.9 0.9 0.5 52.1 32.6 10.7 3.3 1.4 58.5 32.0 6.8 1.9 0.9 28
Scial Cnnectedness Items (N) Strngly Agree Agree Neutral Disagree Strngly Disagree In a crisis, I wuld have the supprt I need frm family r friends (3492). I am happy with the friendships I have (3465). I have peple with whm I can d enjyable things (3477). I feel I belng in my cmmunity (3452). 36.0 35.4 17.2 7.2 4.2 33.5 35.1 20.8 7.5 3.1 33.7 38.0 17.9 7.3 3.1 27.2 30.7 27.1 9.7 5.2 29