Harkness Project Title: Is Self-Direction a Way of Creating a More Patient-Centered Healthcare System? Lessons from Self-Direction in the U.S. Public Mental Health System
Mentor: Pamela Doty, Ph.D.
Placement: Office of Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Washington, D.C.
Biography at time of Harkness Fellowship: Vidhya Alakeson, a 2006–07 Commonwealth Fund Harkness Fellow in Health Care Policy, is lead analyst, mental health, at the Office of the Assistant Secretary for Planning and Evaluation in the U.S. Department of Health and Human Services. Prior to her Harkness Fellowship, she was a research associate at the Social Market Foundation, one of the UK's leading public policy think tanks. She was previously policy advisor at HM Treasury, leading a cross-government review of policy for children, young people and families and has also worked on an international study of youth policy at the Prime Ministers' Strategy Unit. Before working in government, she spent several years working in public policy think tanks, including Forum for the Future and Policy Network. She graduated with a first class degree from Oxford University in 1994 and a M.Sc. with distinction in European studies from the London School of Economics and Political Science in 1999.
Project: Alakeson’s project analyzed three pilot programs for “self-directed care,” in which individuals have direct control of a budget with which to purchase services to meet their needs. She explored why consumers choose to self-direct, what they purchase to meet their mental health needs with an individual budget, and how program design influences the ability of consumers to make informed decisions. She conducted site visits to self-directed pilots for adults with serious and persistent mental illness in Florida, Michigan and Oregon, where she conducted interviews with consumers, staff, and state officials. Analysis of service use data was also conducted for the pilots in Oregon and Florida.
Career Activity Since Fellowship
- Chief Executive, The Power to Change, 2015
- Deputy Chief Executive, Resolution Foundation, 2013
- Director of Research and Strategy, Resolution Foundation, 2011
- Senior Fellow in Health Policy, The Nuffield Trust, 2010
- Lead Analyst, Mental Health, Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, 2007
Current Position: (updated 10/2017)
- Chief Executive, The Power to Change
E-mail: [email protected]
Selected Publications:
Alakeson V., Frank R. G., Katz R. E. “Specialty Care Medical Homes for People With Severe, Persistent Mental Disorders.” Health Affairs 2010; 29 (5).
Alakeson V. International Developments in Self-Directed Care, Commonwealth Fund, Feb. 2010.
Alakeson V. “Nothing about me, without me: Participant involvement in self-direction,” In: Self-direction Handbook for States (Princeton, NJ: Robert Wood Johnson Foundation).
Alakeson V. “Why Oregon went wrong.” BMJ. 2008 Oct 14;337:a2044. doi: 10.1136/bmj.a2044.
Alakeson V. “America's health choices.” BMJ. 2008 Sep 23;337:a1563. doi: 10.1136/bmj.a1563.
Alakeson V. ‘Self-direction for adults with serious mental illness: The barriers to progress’, Psychiatric Services, 2008: Vol. 59, No. 7: 792-794
Alakeson V. “Let Patients Control the Purse Strings,” BMJ 2008 Apr 12; 336(7648):807-9.
Alakeson V. ‘My body, my budget’, Public Finance, August 2007.
Alakeson V. ‘Let patients control the purse strings’, The Guardian, 4th July 2007.
Alakeson V. “Direct Dollars,” Mental Health Today, March 2007, 16-18.
Alakeson V. Putting Patients in Control: The Case for Extending Self-Direction into the NHS (London: Social Market Foundation, 2007).
Alakeson V. The Contribution of Self-Direction to Improving the Quality of Mental Health Services (Washington DC: Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, 2007).