OBJECTIVE: This study examined the characteristics of long-term members
of self-help agencies managed and staffed by mental health clients, why
they sought help from the agencies, and how they differed from clients of
community mental health agencies. METHODS: A survey and assessment
instruments were used to obtain information on the service utilization of
310 long-term agency members as well as on their resources, history of
disability, functional status, psychological disability, health problems,
and DSM-III-R diagnosis. Data from management information systems of the
self-help and community mental health agencies were used to compare service
populations. RESULTS: The self-help agencies served a primarily
African-American population (64 percent), many of whom were homeless (46
percent). Eighty-seven percent had confirmed DSM-III-R diagnoses, and 50
percent had dual diagnoses with moderate to severe substance or alcohol
abuse or dependence. They had sought help from the self-help agencies
primarily for resources such as food or clothing, for "a place to be," or
because they were homeless. Obtaining counseling or help for substance or
alcohol abuse was a less important reason for coming to the self-help
agencies. CONCLUSIONS: A high proportion of the persons served by the
self-help agencies in the study were homeless and had a dual diagnosis of
mental disorder and substance abuse. The self-help agencies provided their
clients with material resources while community mental health agencies
provided psychotherapeutic and medical care.
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