Building Recovery Oriented Services

1. Building Recovery Oriented Services ChackuMathai Associate Executive Director, NYAPRS

2. Why Focus on Recovery?

3. Recent Federal Legislation • The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (Public Law 110-343, Section 511) • Eliminates certain forms of discrimination in insurance coverage of mental health and addiction treatment benefits • Expands access to treatment for people with mental illness and/or addiction

4. Recent Federal Legislation • Patient Protection and Affordable Care Act (PPACA, 2010) • Requires that all health plans include treatment for substance use disorders among their basic benefits • Greatly expands coverage to people for whom treatment is unavailable • Hallmarks of the Act (access, quality, efficiency, effectiveness) may be able to be leveraged to provide services and supports to create the best opportunity for long-term recovery

5. 5 SAMHSA’s Strategic Initiatives

6. Federal Strategy - SAMHSA SAMHSA’s Strategic Initiatives (2011-2014) #4 Recovery Support—Partnering with people in recovery from mental and substance use disorders and family members to guide the behavioral health system and promote individual-, program-, and system-level approaches that foster health and resilience; increase permanent housing, employment, education, and other necessary supports; and reduce discriminatory barriers. • BRSS TACS (Bringing Recovery Support Services to Scale Technical Assistance Center) • Recovery Month

7. Recovery Construct • 7

8. Working Definition of Recovery Recovery is a process of change through which individuals improve their health and wellbeing, live a self-directed life, and strive to achieve their full potential. – SAMHSA, 2011

9. SAMHSA Guiding Principles of Recovery • Hope • Person-Driven • Many Pathways • Holistic • Peer Support • Relational • Culture • Addresses Trauma • Strengths/Responsibility • Respect

10. Vision for Recovery Across Communities Recovery can be expected despite barriers and obstacles Recovery can flourish when barriers and obstacles are lifted We uncover abandoned and/or develop new hopes and dreams We discover our personhood through our culture, strengths, values, and skills

11. Vision for Recovery (continued) We recover together and engage communities as life-sustaining forces We re-author the way we see ourselves We (re)claim a meaningful life and roles We give back to others what we have gained

12. Program Design and Culture

13. THE JOURNEY THROUGH SERVICES

14. Screening and Assessment

15. Person-Centered, Recovery-Oriented and Culturally Competent Treatment Planning

16. Recovery – Oriented Clinical Supervision

17. Continuous Quality Improvement

18. Program Evaluation

19. Program Evaluation A traveler to a new land came across a peacock. Having never seen this kind of bird before, he took it for a genetic freak. Taking pity on the poor bird, which he was sure could not survive in such deviant form, he set about to correct nature’s error. He trimmed the long, colorful feathers, cut back the beak, and dyed the bird black. “There now,” he said, with pride in a job well done, “you look more like a standard guinea hen.”

20. Quality of Life Outcome Domains • Housing/Home • Work/Career • Relational: Family/Friends/Romantic • Educational • Legal • Financial (Payee Status, e.g.) • Conservatorship • Incarceration • Hospitalization • Recreation/Leisure • Community/Citizenship • Health/Physical Wellbeing • Spiritual/Religion

21. Observable Correlates of Recovery

22. MILESTONES OF RECOVERY

23. SAMHSA-Funded Initiatives and Opportunities http://www.samhsa.gov/recovery/ Recovery to Practice Resource Center: http://www.dsgonline.com/rtp/resources.html Bringing Recovery Supports to Scale Technical Assistance Center Strategy (BRSS TACS)http://beta.samhsa.gov/brss-tacs Resources for People with Co-Occurring Disorders

24. Engagement vs. Compliance What are the differences between engagement and compliance? What can we look for to determine if a person or family is engaged? What are they engaged with/to?

25. What is PCP? Taking a Closer Look Person-Centered Planning • is a collaborative process resulting in a recovery-oriented treatment plan • is directed by consumers and produced in partnership with care providers and natural supporters • supports consumer preferences and a recovery orientation Adams/Grieder

26. Literature References Adams, Grieder, (2005) Treatment Planning for Person-Centered Care Anthony, W.A. (2000). A recovery-oriented service system: setting some system level standards. Psychiatric Rehabilitation Journal, 24(2), 159–168. Davidson, L & White, W. (2007). The concept of recovery as an organizing principle for integrating mental health and addiction services. Journal of Behavioral Health Services and Research, Journal of Behavioral Health Services and Research, 34(2), 1094-3412. Drake, Mueser, Brunette, (2007) Management of persons with co-occurring severe mental illness and substance use disorder: program implications, World Psychiatry 2007; 6:131-136 Gagne, C., White, W., & Anthony, W.A. (2007). Recovery: A common vision for the fields of mental health and addictions. Psychiatric Rehabilitation Journal, 31(1): 32–37. Hill, T. (2010). Addiction Recovery Peer Service Roles: Recovery Management in Health Care Reform. Faces and Voices of Recovery. Ragins, (2007) Concrete Approaches to Recovery Based Transformation Sheedy C. K., and Whitter M. (2009). Guiding Principles and Elements of Recovery-Oriented Systems of Care: What Do We Know From the Research? HHS Publication No. (SMA) 09-4439. Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration.

27. Literature References Substance Abuse and Mental Health Services Administration. (2011). Leading Change: A Plan for SAMHSA’s Roles and Actions 2011–2014. HHS Publication No. (SMA) 11–4629. Rockville, MD: Substance Abuse and Mental Health Services Administration. Substance Abuse and Mental Health Services Administration, and Center for Mental Health Services (2007).Systems Integration. COCE Overview Paper 7. DHHS Publication No. (SMA) 07-4295. Rockville, MD: White, W. (2008) Recovery Management and Recovery-Oriented Systems of Care: Scientific Rationale and Promising Practices. Pittsburgh, PA: Institute of Research, Education & Training in Addiction. White, W. (2009). Peer-based addiction recovery support: History, theory, practice, and scientific evaluation. Chicago, IL: GreatLakes Addiction Technology Transfer Center and Philadelphia Department ofBehavioral Health and Mental Retardation Services.

28. Resources • Selected Papers of William White • http://www.williamwhitepapers.com • Outreach and Engagement in Homeless Services: A Review of the Literature • http://homeless.samhsa.gov/ResourceFiles/m1tifkgu.pdf • Treatment Planning for Person-Centered Care (Adams, Grieder) • Practice Guidelines for Recovery-Oriented Behavioral Health Care • http://www.ct.gov/dmhas/lib/dmhas/publications/practiceguidelines.pdf • Getting in the Driver’s Seat of Your Plan • http://www.ct.gov/dmhas/lib/dmhas/publications/PCRPtoolkit.pdf

29. Resources • Faces and Voices of Recovery • http://www.facesandvoicesofrecovery.org • Young People in Recovery • http://youngpeopleinrecovery.org • NYAPRS Economic Self-Sufficiency Curriculum and Workbook • http://www.nyaprs.org/community-economic-development/toolkit/ • Bringing Recovery Supports to Scale Technical Assistance Center • http://beta.samhsa.gov/brss-tacs/ • Recovery to Practice • http://www.samhsa.gov/recoverytopractice/

30. Contact Information Chacku MathaiAssociate Executive DirectorNew York Association of Psychiatric Rehabilitation Services, Inc.chackum@nyaprs.orgwww.nyaprs.orgJoe Lunievicz, BA, RYTDirector Training Institutelunievicz@ndri.orgNortheast & Caribbean Addiction Technology Transfer CenterNational Development & Research Institutes, Inc.71 W 23rd Street, 8th FloorNew York, NY 10010www.ndri.org, www.training.ndri.org