Janian Medical Care, CUCS’s signature health care program, is the largest provider of psychiatric care to homeless and formerly homeless individuals in NYC. One of our top priorities is ensuring that we are providing excellent services to the people with whom we work. An important part of our approach is involving patients in their own care and responding to their feedback. This year, we surveyed 211 Janian consumers about their psychiatric care, and we are enormously proud of the results.
As you can see from the graphs below, 94% of consumers surveyed responded that they would recommend their psychiatric provider. In addition, the results indicated that our providers are responsive to patients’ needs, listen carefully to symptoms, help reduce symptoms, and encourage their patients to ask questions, among other key metrics. We view these qualities as being fundamental to providing quality psychiatric care, and we are thrilled to see them reflected in our patients’ experiences.
For a deeper look at the survey results, we talked with our Director of Psychiatry, Dr. Tony Carino who gave us some insight into the methodology and impact of the data that we collected.
Why is it important that we conducted this survey?
We really care about the quality of treatment that we are providing to the people that we serve. A big aspect of that is that people are satisfied with the services, that they come back to see us, and that they feel empowered by their psychiatric care. I think that is really important in psychiatry, because many people have had suboptimal experiences with mental health care. We work really hard to make sure that the services that we provide are empowering and help people achieve their goals, and that those services are very much trauma-informed.
Is the population that we serve particularly vulnerable to having had suboptimal experiences with mental health care?
Absolutely. Often, the people that we serve have previously come to psychiatric care through criminal justice pathways, or their care began with a coercive or mandated treatment. So, our team’s approach is to work hard so that people have a different experience of mental health care—mental health care that is accessible, that allows the consumer to have agency in their own treatment and medical decision-making, and treatment that allows them to work towards their long-term goals and is consistent with their own values.
How were these questions sourced and created?
The questions were derived from the American Board of Psychiatry and Neurology‘s assessment tool, which is a national standard that assesses psychiatric care. We also reviewed the assessment tool with the Consumer Advisory Board, and they provided their input into the process. We used items and questions that CUCS uses in other programs as well.
How are the surveys administered?
The surveys are administered to people that are involved in ongoing treatment with us. The psychiatric practitioners provide the surveys. The consumer is able to anonymously mail in the results. They also have the option to give the results directly to us—many of our Consumer Advisory Board members actually recommended this option. Their sense was that providing the feedback immediately to the psychiatric provider directly would have the most impact on the clinician. So, some of our consumers actually sit down and complete the survey out loud with their psychiatric provider and give immediate feedback to our team. We decided to have that as an option for people, because we take feedback very seriously and we want to be really responsive to the needs of the people that we serve.
What was significant about the methodology of this survey?
We really focused on trying to get the survey out to all of our different program types There was a concerted effort to provide the survey to people that are experiencing housing instability and disruption in their lives. We worked to provide it to people that are currently street homeless, served by outreach teams, in transitional housing and permanent housing, and on ACT and IMT teams. We surveyed people no matter where they were in their housing situation in order to access feedback from all programs.
How will this data help our psychiatric providers better serve their patients?
On the ground, our psychiatric providers use this data as one of the indicators of communication and the therapeutic alliance. The therapeutic relationship is essential to the work we do, and this survey is a way to understand an aspect of the relationship. What we found is that this process often allows us to reflect on what is happening in the interaction, and then make adjustments and improvements.
It helps us in supervision as well. Each of our psychiatric practitioners has one to two supervisors, and so we review the feedback with them. We can look over time for trends and improvements, and reflect on how our care is being experienced.
What are your biggest takeaways from this data?
Our team is a group of dedicated , compassionate and talented psychiatrists and psychiatric nurse practitioners who strive to provide great care to those who are most in need. I think it is really clear that our team works hard to provide excellent psychiatric care and our services are experienced as positive. We are very proud of our team.
This data is also helpful for us to review because we work in a variety of different settings with a variety of community partners. It provides a window to what is happening in those different settings. So, for example, comparing satisfaction rates across multiple programs helps us to provide great care that may look different in different program sites.
Why are we so proud of the data that was collected in this survey?
Our team of practitioners is very motivated to work with people who have barriers to care and who have had suboptimal experiences with psychiatric care. This data shows success in actually providing care that is really effective, and that people experience as positive. Some folks who have housing instability, challenges in their community connections , and social disruption are reporting high quality care and high satisfaction with their psychiatric care, which I think is really important. At the end of the day, so much of what we do in psychiatric practice is dependent on the alliance and the relationship, and this data speaks to a group of people who feel that their psychiatric provider understands them, connects with them, and that they would keep coming back to. That is something which makes us proud.
Ultimately, if you look at all the data, consumer satisfaction is not the be-all-and-end-all of quality of care. However, what I do think and what I am really proud about, is that people want our services and report that our services are something that they really value. They often come back to work with us despite the challenges they face. This is a real testament to the work that is being done by this team of psychiatric providers and our partners.
|Q1 My psychiatric provider is responsive to my needs.
|Q2 My psychiatric provider listens carefully to my symptoms.
|Q3 My psychiatric provider helps reduce my symptoms.
|Q4 My psychiatric provider asks questions regarding my health history.
|Q5 My psychiatric provider explains tests that he/she ordered.
|Q6 My psychiatric provider discusses treatment options with me.
|Q7 My psychiatric provider explains drugs and other treatments.
|Q8 My psychiatric provider encourages me to ask questions about my treatment.
|Q9 My psychiatric provider answers questions to my satisfaction.
|Q10 My psychiatric provider gives me advice on what to do if symptoms persist.
|Q11 My psychiatric provider refers me to medical and mental health providers.
|Q12 My psychiatric provider tells me when to schedule a return visit.
|Q13 My psychiatric provider treats me in a professional manner.
|Q14 If I had several other choices, I would still choose my psychiatric provider.
|Q15 I would recommend my psychiatric provider to someone seeking treatment.