Substantial Recovery Gains Seen by Utilizing Mental Health Court in Treating and Maintaining Recovery in Psychiatric Patients
Introduction: The recovery concept within the mental health field means empowering individuals to assume control over their mental health. , Maintaining recovery is particularly difficult for patients with dual diagnosis. Recovery is a central focus of Kalamazoo’s Mental Health Recovery Court (MHRC). In addition to intensive court supervision and case management, MHRC includes a voluntary peer-support component, Wellness Recovery Action Plan (WRAP). Study Objective: To measure the gains in recovery associated with MHRC and the contribution of WRAP to these gains. Our hypotheses were: i. Post-MHRC Recovery scores would be higher than pre-MHRC scores, ii. WRAP participants would have greater gains than non-WRAP participants. Methods: This quasi-experimental study utilized a pre-post test design. Data was collected retrospectively through secondary analysis of MHRC administrative records. Recovery scores were available for 190 individuals. The Recovery Assessment Scale-Revised is a 24-item scale, with strong internal consistency (α = 0.93), test-retest reliability(r=0.88) and concurrent validity with other recovery-related scales. Recovery scores range from 24 to 120; the higher the score, the greater the recovery. 1. Statistical Analyses: Multivariable analyses (generalized estimating equation (GEE) regression) was conducted with two-tailed significance level set at p<.05. Results: There was no statistically significant difference in Recovery scores between those enrolling in MHRC and those not enrolling in MHRC. Among enrollees, post-MHRC Recovery scores were statistically significantly higher than the pre-MHRC scores, 100.7 and 89.1 respectively (Wald Chi Square 51.618, p <.001). The greatest gains were in the Recovery sub-scale “not dominated by symptoms,” with an average 29% gain. WRAP-participants started out with significantly higher Recovery scores, but stratified analysis illustrated that all MHRC enrollees saw Recovery gains, regardless of WRAP-participation (pre-post WRAP scores averaged 92.6 to 102.9, while pre-post scores of non-WRAP graduates averaged 82.8 to 94.9). Conclusion: Our hypothesis that MHRC was associated with gains in Recovery scores was confirmed, while our hypothesis that WRAP participants would see greater gains was not. In sum, all saw gains, regardless of where they started. WRAP may help those who are further along the recovery path realize even greater gains, while those who chose not to participate in WRAP may not have been ready for this additional challenge.