1 / 27

Mental Health Recovery

Mental Health Recovery. James G. McDonagh, Psy.D., Clinical Psychologist, Local Recovery Coordinator, Ralph H. Johnson Veterans Administration Medical Center james.mcdonagh@va.gov. Mental Health Recovery. Topics: What is Recovery? What are the origins of Recovery?

shakti
Download Presentation

Mental Health Recovery

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Mental Health Recovery • James G. McDonagh, Psy.D., Clinical Psychologist, Local Recovery Coordinator, Ralph H. Johnson Veterans Administration Medical Center james.mcdonagh@va.gov

  2. Mental Health Recovery • Topics: • What is Recovery? • What are the origins of Recovery? • How is Recovery different than B.A.U.? • When, where, and how can we change the system? • Why should we try to affect change?

  3. Mental Health Recovery • “…is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.”(emphasis added) • - U.S. Dept. of Health and Human Services

  4. Mental Health Recovery • The 10 Essential Premises of Recovery: • An individual with mental illness… • 1. Self-direction: …can lead, control, and exercise choice over his/her future. • 2. Person-Centered: …is considered to be fully ‘human’– the individual isnot primarily defined by his/her mental illness; rather, his/her mental illness is only component of his/her existence.

  5. Mental Health Recovery • The 10 Essential Premises of Recovery: • An individual with mental illness… • 3. Empowerment: …has capacity to exercise choice; to consider a range of options • 4. Holistic: …has a life marked by mind, body, spiritual, and community dimensions

  6. Mental Health Recovery • The 10 Essential Premises of Recovery: • An individual with mental illness… • 5. Non-linearity: …will have an individualized life course; set-backs and ‘relapses’ are both anticipated and serve as opportunities for future growth • 6. Strengths-based: …will possess strengths; these strengths serve a primary role in self-fulfillment; strengths are the core to effective interventions

  7. Mental Health Recovery • The 10 Essential Premises of Recovery: • An individual with mental illness… • 7. Peer-support: …is part of social system; as such, he/she can give support and receive support from others • 8. Respect: …often confronts the debilitating effects of stigma; often internalizes the shame/guilt of mental illness; needs to be treated like everyone else.

  8. Mental Health Recovery • The 10 Essential Premises of Recovery: • An individual with mental illness… • 9. Responsibility: …is assumed to be accountable for here-in-now decisions and future decisions; has to make the decision to recover. • 10. Hope: …can (and often will) obtain a meaningful life; will always have the capacity to continue to enhance his/her life.

  9. Mental Health Recovery • So, is “Recovery” a … • Process? • Product? • Culture?

  10. Mental Health Recovery • Recovery is…a Philosophy. • It informs processes • It yields distinct outcomes • It is reflected in the totality of socially transmitted behaviors patterns, arts, beliefs, and institutions of human work and thought – i.e., culture.

  11. Mental Health Recovery • The Origins of Recovery: • 1. World Health Organization (1970s) • Longitudinal Studies of Persons with SMI • Heterogeneous outcomes

  12. Mental Health Recovery • Origins of Recovery: • 1. Americans with Disabilities Act (ADA) • 2. Consumer Movement (NAMI, etc.) • 3. Substance use/abuse – AA/NA

  13. Mental Health Recovery • Origins of Recovery: • The “President’s New Freedom Commission on Mental Health (July, 03)” • Commitment to evidenced-based practices • Consumer driven • Expand rehabilitative services

  14. VA & Recovery • The Uniform Mental Health Services in VA Medical Centers and Clinics (9/11/08) • “Delineates the essential components of the mental health program … to be implemented nationally…(page T-1)”

  15. VA & Recovery • “The Uniform Mental Health Services in VA Medical Centers and Clinics (9/11/08)” (43 page document) • “Recovery” mentioned 27 times • “Evidence-Based” mentioned 27 times • “Suicide” mentioned 21 times • Only 2 Positions are directly mentioned/elaborated in the Handbook: Local Recovery Coordinator & Suicide Prevention Coordinator • Reason: Recovery & Suicide Prevention efforts are to cut-across all services

  16. Mental Health Recovery • Recovery vs. Business as Usual (BAU) Partnership vs. Provider-driven Strength-based vs. Sympt. Reduction Treats Person vs. Treats Illness Rewards Progress vs. ‘Rewards’ Illness

  17. Mental Health Recovery: Changing the System • Psychosocial Rehabilitation and Recovery Center (PRRC) • Provide ambulatory (non-residential) services to veterans with serious mental illness • Designed to maximize functioning in all domains. • Intensity of service utilization is expected to decrease over time as veterans develop skills necessary for community reintegration • Individual therapy, social skills training, psycho-ed. groups, illness management, general wellness programming, family ed programs, peer-support services, CWT, etc.

  18. Mental Health Recovery • Measuring Outcomes: • Achieving a meaningful role • Subjective life satisfaction • Perception of control over his/her MI • Number and quality of interpersonal Rel. • Object measures of physical health

  19. Landmark Studies that Support Recovery in People with Schizophrenia LRC Work Group, July 2008

  20. Definitions of Recovery • Most of the researchers in these studies defined recovery as: • being without symptoms • off psychotropic medications • living independently in community • working • relating well to others with no odd/unusual behaviors LRC Work Group, July 2008

  21. SAMHSAEvidenced Based Practices • Assertive Community Treatment • Integrated Dual Disorders Treatment • Wellness Management & Recovery • Supported Employment • Medication Management • Family Psychoeducation LRC Work Group, July 2008

  22. Barrowclough C, Haddock G, Tarrier N, Lewis S ,Moring J, O’Brien, R ,Schofield N Mc Govern J:RandomizedControlled Trial of Motivational Interviewing, Cognitive Behavior Therapy, and Family Intervention for Patients with Co Morbid Schizophrenia and Substance Abuse Disorders. Am J Psychiatry 2001; 158:1706-1713 Kern R, Liberman R, Kopelowicz A, Mintz J, Green M Applications of Errorless Learning for Improving Work Performance in Persons with Schizophrenia. Am J Psychiatry 2002; 159: 1921- 1926 Mc Gurk S, Mueser K, Feldman K, Wolfe R, Pascaris A Cognitive Training for Supported Employment:2-3 Year Outcomes of a Randomized Controlled Trial. Am J Psychiatry 2007; 164: 437-441 McHugo G, Drake R, Teague G, Xie H Fidelity to Assertive Community Treatment and Client Outcomes in the New Hampshire Dual Diagnoses Study. Psychiatric Services 1999 Vol 5 No. 6 Mc Hugo G, Bebot R, Harris M, Cleghorn S, Herring G, Xie H, Becker D, Drake R A Randomized Controlled Trial of Integrated Versus Parallel Housing Services for Homeless Adults With Severe Mental Illness. Schizophrenia Bulletin 2004; 30:949-982 Patterson T, Bucardo J, McKibbin C, Mausbach B, Moore D, Barrio C, Goldman S, Jeste D Development and Piolot Testing of a New Psychological Intervention for Older Latinos with Chronic Psychosis. Schizophrenia Bulletin 2005; 31:922-930 Reeder C, Newton E, Frangou S, Wykes T Which Executive Skills Should We Target to Affect Social Functioning and Symptoms Change? A Study of a Cognitive Remediation Therapy Program Schizophrenia Bulletin 2004; 30: 87-100 Wolff N, Helminiak T, Morse G, Calsyn R, Klinkenberg W. D, Trusty M Cost-Effectiveness Evlauation of Three Approaches to Case Management for Homeless Mentally Ill Clients Am J Psychiatry 1997; 154:341-348 Research to support Evidenced Based Practices LRC Work Group, July 2008

  23. Mental Health Recovery • Why try… • It works, it saves money • The people we serve (and their elected officials who fund us) want it • Beneficence and avoid harm: Ethical Resp.

  24. Mental Health Recovery • The Mantra: • “Nothing about us, without us.”

  25. Mental Health Recovery • Change, as is Recovery, is an on-going journey that takes a lifetime. • It takes time.

  26. Mental Health Recovery • A debt of gratitude: • Direct Supervisor: Dr. Hugh Myrick • VAMC’s Chief of Staff: Dr. Flo Hutchison • VAMC’s Director: Mr. John Goldman • VISN Director: Mr. Lawrence Biro • Most Importantly: The Veterans we serve

More Related