The White Paper: Why a White Paper?

- Foreword -
▪ Consumer-Survivor ▪
- Involvement in Evidence-Based Practices -
▪ Why a White Paper
For the State of New York
Mental Health Service Delivery System? ▪

NEW YORK, MAY 1, 2008 --

Nearly 5 years ago, the New York State Office of Mental Health (NYS OMH) began to work, in partnership with people who use or have used mental health services, to infuse their perspective into the OMH evidence-based practices initiative.

At that time, a widespread Evidence-Based Practices (EBPs) awareness-building campaign had gotten underway. This campaign-

● offered education on the national EBPs' trend and

● focused on New York State's priority set of EBPs, which include

Self-Help & Empowerment.

The goal of this campaign was not only to educate people on this issue, but to seek out input and guidance that would answer the question, "How can NYS OMH Infuse Recovery-Based Principles into Evidence-Based Practices?"

As the campaign moved forward, over 6,000 people participated in consensus-building dialogues that would create and refine, The White Paper by Consumers, Survivors, Patients, and Ex-Patients, in New York State.

In addition to these dialogues, an EBPs/ Recovery-Consumer/Survivor Steering Committee was conceived, and the involvement of people who are current and former users of mental health services was infused into many of NYS OMH's internal workgroups.

The debate over the value of EBPs within the consumer-survivor community was well-known to the EBPs/ Consumer-Survivor Steering Committee. It was decided that rather than focusing on that issue, we would use NYS OMH's own focus on EBPs, as an opportunity to improve mental health services as a whole.

As a first step, this Steering Committee discussed a document delivered by the Institute of Medicine (IOM) called,

Crossing the Quality Chasm: A new Health System for the 21st Century, and agreed that-

-the 10 rules which the IOM recommended for a quality health care system would be a good place to start.

The IOM's
'Crossing the Quality Chasm'
report suggests the following rules:

1. Care based on continuous healing relationships

2. Customization based on patient needs and values

3. The patient as a source of control

4. Shared knowledge & free flow of information

5. Evidence-based decision making

6. Safety as a system property

7. The need for transparency

8. Anticipation of needs

9. Continuous decrease in wasted

10 Cooperation among clinicians

These rules were discussed in two inclusive meetings of people who were current or formed users of mental health services

A new set of draft rules was created that would be specific to mental health care in NYS.

These new rules then became the focus for 11 dialogues with participation from over 200 people.

The content of these dialogues was then summarized and brought out to approximately 6,000 additional people for their reactions and input.

After giving input into the creation of the rules, each participant select his or her top three rules, and the results were then tabulated in a ranking order to determine importance. Those of us involved in the dialogues want it stated that all of the rules are equally important; however, there is a level of hierarchical importance that must be considered. Here is the list of rules in prioritized order.

The White Paper
To establish a mental health service system that promotes Recovery:

1. There must be informed choice

2. It must be recovery-focused

3. It must be person-centered

4. Do no harm

5. There must be free access to records

6. It must be a system based on trust

7. It must have a focus on cultural values

8. It must be knowledge-based

9. It must be based on a partnership between consumer & provider

10. There must be access to services regardless of ability to pay

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