Holding the Hope in Healthcare

Prevention and Recovery Conference 2014

Oklahoma City, OK

Why are we here?

To want or wish for with a feeling of confident expectation

A wish or desire accompanied by expectation of it’s fulfillment

Webster's II New Riverside Dictionary

The realistic expectation that things can get better

Somebody way smarter than me

Hope Webster's II New Riverside Dictionary

People with mental illness Recover

All over the world

Possibilities for Recovery:Vermont & Maine Three Decade StudyCourtney Harding 1981

269 patients from back wards of Vermont State Hospital in the 1950’s

97% of the Vermont group was located and assessed during the follow-up study in the early 1980’s

Vermont subjects were matched by age, gender, diagnosis, and chronicity to those from the back wards of the Augusta State Hospital in Maine

94% of the Maine group was located

Recovery Parameters for Maine/Vermont study

The definition for Recovery used was quite narrow—

They no longer experienced symptoms of mental illness

They were no longer taking medication They were working Carrying on multiple social relationships;

and Taking sole responsibility for their self-care

ConclusionVermont results are attributed to:

Model Psychiatric Rehabilitation Program

Policy allowing earlier release to community life

Outcome of All Studies

Multiple analyses have looked for a variable that predicts who will and who will not recover.

To date, none has been found.

Outcome of All Studies Indicates

Since we cannot predict who will and who will not recover…

We must approach every person as if they are the one who will recover.

New Freedom Commission

Self Directed Individualized &

Person Centered Empowerment Holistic Non-linear

Strengths Based Peer Support Respect Responsibility Hope

SAMHSA components of Recovery

It’s the same thing only different

As a process of discovery…

Defining Recovery

What We Know About Recovery Recovery is a common human

experience Recovery is a process not a model Recovery is a process of self-discovery,

transformation, and renewal Recovery happens in the context of a

relationship Recovery is NOT a linear process

Holistic

The health of an individual and, ultimately, of society mirrors a complex relationships of mental, physical, spiritual, family, community and environmental factors.

When peers talk about recovery, we typically take into consideration all aspects of an individuals life.

One picture of “Holistic”Physical

Mental

Social

Spiritual

Cultural

Environmental

And another picture of “ Holistic”

Mental Health

AddictionsPhysical Health

Individualized & Person Centered

Self-Direction

SELF – According to Webster’s II New Riverside Dictionary:

1. The essential being of 1 person as distinct from another

2. A particular aspect of a person

The essential being of 1 person as distinct from another What are the assumptions here?

There are other people around you. You are unique.There is a part of your “being” that is

essentially different than anyone else.Anyone who ever was or ever will be.

Direct: Webster’s II

1. To regulate the affairs of: Manage2. To take authoritative charge of: Control3. To Order: command4 a) To guide (someone) toward a goal

b) To show the way to

WRAP: A Brief Overview

Wellness Planning Learning Triggers Learning Early Warning Signs Forming a pre-crisis self-care plan Forming a crisis plan

Handout 6

The Wellness Recovery Action Plan (WRAP) includes:

Empowerment

Encourage problem-solving techniques

Utilize psycho-education tools such as medication logs and mood charts

Build a lending library of self-help & mutual support aids

Non-Linear

The path to recovery is not

direct

Hope & Health

The health of every human body is enormously influenced by the state of its mind. ◦ This means that people with an optimistic outlook

are less likely to be ill, both mentally and physically.

◦ Once people are ill the course of their disorder can be strongly influenced by the way they think about it.

Hope & Health

Because each of US play a key role in giving ourselves and our friends or clients the information they have to go on…

Each one of you can help inoculate each other with optimism and help us all avoid defeatism and learned helplessness simply by changing the words we use .

We must think differently and talk differently about our abilities.

RESPECT

Be aware of The Spread Effect

PromotingPerson First Language

Respect & partner

Ensure the inclusion and full participation of consumers in all aspects of their lives

Consider staff boundaries

physical

•Diagnosis, Medicine, Therapies, Health Coaches & Navigators•Surgery, Hospitalization

Mental

• Diagnosis, Medicine, Counseling, Case Management, Peer Support [Housing & Employment]

• Hospitalization;

Addiction

s

•Treatment services, counseling•Inpatient treatment

Things with Billing Codes

Strengths Based

Recovery focuses on valuing and building on the multiple capacities, resiliencies, talents, coping abilities, and inherent worth of individuals.

Responsibility

It's up to each individual to take responsibility for their own wellness

We know that ALL PEOPLE GROW THROUGH TAKING POSITIVE RISKS

This, however, does not mean that we abandon folks when they err...

Peer SupportPeer support provides… Practical resources Reciprocal & experience based support Less formal & rigid relationships Altruism Alternative interpretations

Handout 11

“Behavioral Health”◦ Substance abuse

treatment, mental health care, problem gambling treatment

Health Care Reform◦ Medicaid expansions◦ Health Benefit

Exchanges Integrated Health

Care ◦ Health homes◦ Health Care Authorities

So, what’s new now?

You may be thinking: Why me?

In this environment: we are all

advocates. We are the

experts We can dispel

myths and anticipate assumptions.

We are there.

No one else can tell your story the way you do.

Teach people not to equate the person with the illness. Encourage person first language.

People are not an illness. So if someone refers to a patient by your illness say “They have bipolar disorder, I’m not bipolar." Or “They’re not a schizophrenic, they are a person with schizophrenia."

People with Mental Illness and Addiction are capable of managing their treatment◦ Include strengths as part

of any treatment◦ Make sure to discuss the

impact treatment may have on employment, if a change is being considered .

◦ Build on prior successes.◦ Share the WRAP plan

Seize the opportunity to realign attitudes and perceptions

Recovery is a reality. It can, will, and does happen – ◦ Make a believer out of

Every Dr., policy maker, janitor, landlord, employer

Help them see their part◦ Prescribing peer support,

alternative approaches, language changes;

◦ Messages of HOPE in every conversation

Examining barriers – External

Discussion groups what are the external barriers to bring

recovery practices into an integrated care setting?

Solutions?System wide?Personal?

External Barriers

Empowerment is the process of increasing the capacity of individuals or groups to make choices and to transform those choices into desired actions and outcomes. – The World Bank

Hope Leads to Empowerment

Same skill different office – peer support abides!

We still have a voice, but now we’re part of the choir.◦ Advisory Councils consist of representatives from

all health issues That doesn’t mean we can’t get a solo now

and again.◦ Mental health delivery systems still need your

voice.

Do what we do, with a twist

Skills & Techniques What happens when difficult thoughts or

emotions come from your participation◦ Rely on your preparation skills, both emotionally

and for issues Using critical thinking as well as your

instinct to determine your position Articulating your interest rather than a

specific solution Listening in order to understand

Critical thinking Critical thinkers: distinguish between fact and opinion; ask

questions; make detailed observations; uncover assumptions and define their terms; and make assertions based on sound logic and solid evidence.

Ellis, D. Becoming a Master Student, 1997

Critical thinking is best understood as the ability of thinkers to take charge of their own thinking. This requires that they develop sound criteria and standards for analyzing and assessing their own thinking and routinely use those criteria and standards to improve its quality.

Elder , L. and Paul, R. "Critical thinking: why we must transform our teaching." Journal of Developmental Education, Fall 1994.

What Does Articulating Require? Listening Thinking

◦ Understanding the information being presented and how it fits with your interest

◦ Being clear on your interest Then make your interest known to others

Be who you are, where you are and know that everyone

else is doing the same

During Skills & Techniques What happens when difficult thoughts or

emotions come from your participation◦ Rely on your preparation skills, both emotionally

and for issues Using critical thinking as well as your

instinct to determine your position Articulating your interest rather than a

specific solution Listening in order to understand

This is what Recovery looks like

ACTION• I have many tools to manage my wellness and my participation.

HOPE•Things will get better and better and better - for me and for the system I’m involved with

EMPOWERMENTI have a voice & I use it. I teach others how to do the same

You really do know what you’re talking about.You really can change the world - individually & CollectivelyPeople depend on your authenticityBe afraid together

Examining the barriers - Internal

To find out more about Mary Jadwisiak’s workshops on Recovery, Hope, and Suicide Prevention/Intervention contact her:

Mary JadwisiakHolding the HopePO Box 1314Battle Ground, WA 98604(360) 687-7954mjadwisiak@msn.comwww.holdingthehope.com

Let me know if I can help