Become An M-POWER Friend

Thomas Gagnon Interviews Jonathan Delman

Editor's note: In this article Journalist Thomas Gagnon interviews Jonathan Delman the Director of the Massachusetts Consumer Satisfaction Team. MCST is a growing organization committed to including users of the mental health system in the decision making process about the type and quality of care we receive. The surveys the Team collects from consumers at various treatment settings around the state become the basis for program evaluation and improvement. The Team is largely comprised of consumer/survivors in addition to those employees whose loved ones have been impacted by psychiatric disabilities.

I met with Jonathan Delmain in his comfortable yet professional office at the headquarters of the Consumer Satisfaction Team in Dorchester, MA.

 Thomas Gagnon: The Consumer Satisfaction Team (CST from now on) has a nice ring to it, but how does it really work and what does it accomplish?

Jonathan Delman: The CST is interested in the ideas and opinions of mental health consumers about the quality of care that they receive. Our mission is to promote the consumer voice in the mental health system. The way we do it currrently is primarily by conducting interviews, based on structured surveys, survey instruments that we develop—Let me take a step back. We first develop the survey instruments for particular levels of service, based on both focus groups, and secondly, through a work group that has consumers on it and helps us shape the survey. So the survey is really consumer developed to ask people about what is important to them. We are all pretty much consumers in the CST,and people who do the interviewing are also mental health consumers. During the interview we sit down with people for ten minutes and ask them questions using a structured survey. We ask them to rate things about the mental health service they receive. We also ask them a series of open-ended questions, to really get them thinking about what they like about something, how a service helps them, how else the service, like a day treatment program, could be helping them. So we do it by sitting down and giving a person a chance to talk about things and encouraging them to talk. Then we write reports based on these interviews for providers, managed care companies, and for the consumers themselves. We also have focus groups now, to try to identify what some of the issues are in the community. We’re looking for the voice of the consumers and family members, too.

TG: Based on that, I’m wondering: when you ask consumers questions, are you going to particular environments—are you going to outpatient environments, clubhouses, inpatient environments? Where are you going?

JD: Currently we have two contracts. One is with the Mass. Behavioral Health Partnership and their network of day treatment programs, inpatient facilities, and outpatient clinics. We’re developing a survey for child/adolescent services, and soon we’re going to be looking at child/adolescent day treatment services and youth outpatient clinics. We are also getting into chemical dependency services, so we’re currently interviewing at structured outpatient addiction programs. We’d like to go to crisis services, and those are much harder, more difficult, because it’s hard to get people to interview in there, in crisis, and then following up is also difficult. So we’re starting off at places where it’s easier to find people to interview. In our work with DMH, we’re going to be interviewing people about their vocational needs and what helps get them back to work. Interviews also look at community rehabilitation services, which are services that help people who have basic needs in the community. And we’re also interested in finding out what people’s needs are with regard to the public system overall. So those are the services we’re looking at now.

TG: Another question based on the first question: these focus groups—are these M-POWER based groups, or where are they coming from?

 JD: They’re not M-POWER-based. The CST is a separate organization. We do have people from M- POWER who are sometimes in these focus groups, but they’re not necessarily M-POWER-based. The focus groups are sometimes held at M-POWER but we hold them wherever there are consumers. It could be a provider center, it could be at a hospital, so consumers can talk about what’s important to them. Or it could be at a residence, so we just go wherever there are consumers.

 TG: Where did the idea for the CST come from?

 JD: My wife, Deborah Delman, actually was the one who scoured the country looking at different programs. She went down to Philadelphia and saw a project called the Consumer Satisfaction Team there. This consumer based program was interviewing people about the quality of their care. Deborah really liked the consumer based idea, so she brought it back to Massachusetts. There was not necessarily a lot of interest here at first we had to overcome several challenges. I think there were people who didn’t feel that consumers could offer much value, or that it would cost too much money to interview people, or consumers really couldn’t start a business. Then Deborah got the attention of Laurie Ansorge Ball at the Division of Medical Assistance—Laurie needed to fulfill a requirement essentially, for the managed care company, the partnership, to help a consumer group start a project like this. So, yeah, it’s sort of grown from there.

TG: How did you get involved, and who else is involved.

JD: Well, at the time that Deborah was promoting this, I was working with her to advocate with the Division of Medical Assistance, amd the Department of Mental Health, for greater involvement of consumers in the partnership, in quality management, in just developing the mental health system. We’re both very invested in this as well as other people, and she thought I would be goof for this role. I’ve had an interest in promoting the consumer voice for a long time, I have a Master’s in Public Health, and I have a general interest in better health care for people. Who else is involved? Nan Donald, who’s a member of M-POWER, is our director of operations. Laura Cinq Mars is our coordinator in Western Mass., and she is a member of the planning team, the M- POWER sponsored planning team. Other M-POWER people include John DePaulo, who’s a team leader and interviewer. Howard Trachtman has also interviewed for us, and we have a new family coordinator— our staff is really Her name is Cathy Pineau. Brian Ryter, is the young man coordinating our examination of adolescent services. So those are our main regular people. We have a series of important part-time people, including June Mendelsohn, who is with the Alliance for the Mentally Ill, and John Frasier, and other people.

 TG: What other endeavors like this have you been involved in?

JD: I’ve never been involved in an endeavor like this. It is such an innovative idea which we are trying to develop: a better system largely based on the opinions of the people it’s serving—consumers. This is generally done in businesses. When Staples goes out and develops products, it’s not because they love the products, it’s because they think people will buy them. And I think this needs to be a better way of thinking in the health care system. How are we going to service the clients? How are we going to keep them involved in their care? Because if they don’t like the care, they’re not going to take advantage of it, unless they’re forced to, and we don’t want people forced to be involved in their treatment. So this is a new endeavor for me. It’s starting a business. In the past, I was director of the Consumer Legal Education Network, which advocated for greater consumer knowledge about legal issues and mental health issues generally, and that’s consistent with what I’m doing now. But this is for me something new, and I think it’s a new kind of project.

 TG: In general what draws you to advocacy for people with mental illness?

 JD: I am mentally ill, been a bit in the system, have at times been served very well and other times haven’t. I’ve faced some abuse in the system. I am fortunate that I am better now. I have some advantages that other people don’t: I’m a lawyer, and have a family backing me up, this has allowed me to gain access to really good health care. Yet there are a lot of people in this system who are still not getting good care.