Mental health self-directed care (SDC) is a service delivery model that allows people with mental health conditions to have more control and choice over their care. Participants work with an advisor to develop a person-centered recovery plan and budget.
The SDC model offers greater flexibility in choosing providers and services. Services can be traditional (such as counseling) or non-traditional (such as computer classes to train for reentry into the workforce).
The association of serious mental illness with poor health and social outcomes makes innovative service models, such as mental health SDC, of critical interest to state and national policymakers.
My Voice, My Choice
The My Voice, My Choice project was a two-year randomized controlled trial overseen by HHSC in the Travis Service Delivery Area. It assessed the impact of mental health self-directed services in the Medicaid managed care system for adults with disabilities (known as STAR+PLUS).
HHSC tested mental health self-direction as a performance improvement project in partnership with Medicaid managed care organizations, state universities, stakeholders and people with lived experience of mental illness. Federal partners were also involved, including the Centers for Medicare & Medicaid Services and the Substance Abuse and Mental Health Services Administration.
Participants were allowed to self-direct a portion of their outpatient mental health budget with the assistance of a trained advisor. They purchased goods and services related to their recovery plan goals. An independent evaluation showed participants experienced better outcomes at no greater cost than traditional service delivery models.
HHSC is using learnings from My Voice, My Choice, as well as other state and national projects, to develop more effective, person-centered systems of care. My Voice, My Choice could also help other states improve their systems of care.
To learn more, contact Innovation Strategy.
- Applied Self-Direction
- Mental Health Self-Direction
- Mental Health Self-Directed Care Financing: Efficacy in Improving Outcomes and Controlling Costs for Adults with Serious Mental Illness (Psychiatric Services Journal)
- My Voice, My Choice Study Executive Summary (PDF)
- My Voice My, Choice Presentation (PDF)
- Mental Health Self-Directed Care Presentation (PDF)
- Participatory Action Research to Establish Self-directed Care for Mental Health Recovery in Texas (Psychiatric Rehabilitation Journal)