Demonstration and Evaluation of Self-Direction in Mental Health

Exploring the impact of self-directed care on mental health recovery

Working with Applied Self Direction and funded by the Robert Wood Johnson Foundation and the New York State Health Foundation with support from SAMHSA, we are leading an evaluation of mental health self-direction in six states, charting best practices and exploring its impacts at the individual and system level.


According to our own preliminary findings and those of other researchers, self-direction has the potential to produce better outcomes that facilitate mental health recovery, including employment and housing stability, self-sufficiency, and engagement in mutual support and self-advocacy.

As part of the project, we developed, a resource that features participant stories and serves as a clearinghouse for all things mental health self-direction.

  • Evaluation
  • Data Collection and Analysis
  • Dissemination

Charting Best Practice for an Emerging Approach

The self-direction model first took root as a way to help people with physical and intellectual and developmental disabilities live more independently. Many states have experience with it in this regard, but self-direction in mental health service delivery is relatively newer.

With research partners from Applied Self Direction, we’re conducting a formative process evaluation, underway in six states, to document implementation of the mental health self-direction model and develop guidelines for replication and sustainability. We’re using the RE-AIM framework to understand the Reach, Efficacy, Adoption, Implementation, and Maintenance of this model over time in different state contexts.

Understanding Impact

Current research on self-direction has demonstrated that it holds promise for improving lives, but more evidence is needed, particularly evidence that helps us to understand the system-level impacts of self-direction. We hope to add to the conversation by:

  • Analyzing administrative data for self-directing individuals and a comparison group of people with similar characteristics who are not self-directing
  • Coordinating with local evaluation teams in some states to take a closer look at impacts at the individual-level
  • Synthesizing findings across states to identify common themes and chart a course for future research

For More Information

Our recently developed website – established through work with project partners – contains the following resources:

Featured projects image

Fundamentally, self-direction recognizes that effective supports are not one-size-fits-all. Every person’s journey of recovery is unique.

Related Articles and Publications

Press Coverage

"I found a passion and a purpose. That was a large part—and is still a large part—of my recovery.”


Self-directed care program participant


Robert Wood Johnson Foundation

Project Partner(s):

Applied Self Direction/National Resource Center for Participant-Directed Services

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