Center on Integrated Health Care and Self-Directed Recovery
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  • About Us
    • Our Team
  • Practice, Policy, & Science Exchange
  • Solutions Suite
  • Policy Academy
  • Science Showcase
  • Current Research & Evaluation
  • Completed Research
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Implementing Evidence-baseD Mental Health Self-Directed care

History and models of self-direction

An overview of self-directed care, also called SDC, from the Centers for Medicare and Medicaid and from a Center for Independent Living (CIL) 
The Deficit Reduction Act (DRA) in 2005 authorized two avenues for states to offer the self-direction option. These are described under section 1915(i) and section 1915(j)  of the DRA. In 2010, the Affordable Care Act, passed by Congress and signed by the President on March 23, 2010, authorized section 1915(k)  of the DRA to offer self-directed services.
Learn more about "Cash and Counseling," now called participant direction, which is an approach to long-term care whereby people receive cash allowances to pay for services and goods they feel would best meet their personal care needs, along with counseling about managing these services. 
Types of mental health SDC that have been offered in the U.S. 

Research on mental health self-directed care 

Mental health self-directed care financing: Efficacy in improving outcomes and controlling costs for adults with serious mental illness
Participatory action research to establish self-directed care for mental health recovery in Texas
Evaluation of a mental health self-directed care program in Florida
Participants’ assessment of the impact of behavioral health self-direction on recovery
Repository of SDC evaluation and research studies

SDC reports and policy scans 

Mental Health America Position Statement 36: In Support of Self-Determination Initiatives 
Environmental Scan of the Behavioral Health Field to Determine Interest in a Self-Direction Model
Cash-Out Funding Sources for SDC 
Free to Choose: Transforming Behavioral Health Care to Self-Direction 
Feasibility of Expanding Self-Directed Services to People with Serious Mental Illness 

Podcasts on the evidence for mental health SDC

Learn about the outcomes of a rigorous study on mental health self-directed care, presented by Psychiatric Services Pages to Practice Podcast 
Hear Dr. Judith Cook reflect on the randomized controlled trial study of mental health self-directed care conducted with various collaborators in Texas.

Lessons learned from state demonstrations

Strategies and resources from Florida in Jacksonville and in Ft. Myers
Strategies and resources from New York State
Strategies and resources from Pennsylvania
Strategies and resources from Texas

Mental health SDC implementation tools

Self-Directed Care Implementation Manual: A Comprehensive Mental Health Program Guide
(free implementation manual, podcast introducing the manual, and a how-to webinar)
UIC Center's Self-Directed Care Fidelity Assessment Tool 
A Guide to Creating Self-Directed Care Programming: The Delaware County CRIF SDC Model
In the Driver’s Seat: A Guide to Self-Directed Mental Health Care
Booklet on self-direction in mental health 
CMS offers key messages and tips for SDC beneficiaries
Texas SDC program participants share their success stories
Videos of mental health SDC participants sharing their experiences and the impact of self-direction
Understanding barriers to mental health self-directed care 

Global mental health SDC

Self-directed support: A national strategy for Scotland
Individualized funding in Canada
​Personal budgets in the Netherlands

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Views expressed on the Academy for Policymakers web site do not necessarily represent those of our Center or any federal agency. Our mission is to share the latest policy information and the perspectives of a variety of stakeholders without endorsement.  

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