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Montana Warm Line

Montana Warm Line. Warm Line Responder Training. Training Agenda. Introduction, Policies & Procedures Boundaries and Frequent Callers Values and Feelings Active Listen Crisis Theory and Management Cultural Issues Suicide Mental Health Self Care and Stress Management

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Montana Warm Line

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  1. Montana Warm Line Warm Line Responder Training Mental Health America of Montana

  2. Training Agenda • Introduction, Policies & Procedures • Boundaries and Frequent Callers • Values and Feelings • Active Listen • Crisis Theory and Management • Cultural Issues • Suicide • Mental Health • Self Care and Stress Management • Child and Elder Abuse • Sexual and Relationship Violence • Addictions Mental Health America of Montana

  3. Introductions, Policies and Procedures Mental Health America of Montana

  4. Introductions, Policies, and Procedures • Who is MHA of MT • What is the Montana Warm Line • What is the role of a Warm Line Responder • Training expectations and Activities • Personnel policies, grievance procedures, responsibilities • Scheduling, call log forms, supervision, and team meetings • Code of Ethics Mental Health America of Montana

  5. Who is MHA of MT • Mental Health America of Montana (MHA of MT) is a nonprofit organization whose mission is “educating and advocating for the mental health of all Montanans” • MHA of MT also provide resource referrals and professional education • MHA of MT is the official Montana Outreach Partner for the National Institute of Mental Health (NIMH), and provides informational materials for mental health providers, consumers, family members and the general public. Mental Health America of Montana

  6. MHA of MT: Programs • Montana Warm Line and Virtual Drop-In Center • Annual Children’s Mental Health Conference • Mental Health Caucus and Advocacy • Newsletter and Information Dissemination • Information and Referral • Prevention and Reduction of the Incidence of Suicide in Montana (PRISM) • Stigma Reduction • Consultation Mental Health America of Montana

  7. Montana Warm Line • Consumer run • All responders are mental health consumers who are in recovery (job description) • Responders do the following: • Give back to the mental health community • Are sensitive and re-assuring • Provide supportive active listening • Telephone-based “warm line” • Open 4:00 – 10:00 pm Monday thru Friday • Open 1:00 to 10:00 pm Saturday and Sunday • “Virtual” drop-in center • Blogs • Chat Room Mental Health America of Montana

  8. Training Expectations & Activities • Background into state of Montana mental health facts • Purpose of Montana Warm Line • Responsibilities of Responders • Active Listening • Promote caller self-determination and decision-making • Offer encouragement, hope, and re-assurance • Maintain own wellness and recovery • Respond to emergencies appropriately • Maintain supervision with prevention coordinator • Complete call log sheets • Be available during your responder shift • Participate in trainings • Comply with policies and procedures Mental Health America of Montana

  9. Training Expectations & Activities • Objectives • Safe training environment • Role plays • Group • Triads • Individual • Self Evaluation process • Understand responder role • Confidentiality Policy • Policy and Procedure manual • Complete responder responsibilities • Call log sheets • Supervision Mental Health America of Montana

  10. Personnel Policies, Grievance Procedures, & Responsibilities Mental Health America of Montana

  11. P & P Manual • Volunteer or Employee?? • Employment application • Confidentiality statement signature • Protections • Expenses • Discipline process • MHA of MT Board oversight Mental Health America of Montana

  12. Scheduling & Call Log • Warm Line Responder scheduling process • Warm Line hours • Telephone capacity • Accountability to Prevention Coordinator • Call log sheet • Hard copy/Soft Copy • On-line access • Quantification of log sheet data • Quarterly reporting • Continual learning process Mental Health America of Montana

  13. Code of Ethics • The primary responsibility of a WLR is to help peers achieve their own needs, wants, and goals. • WLRs will maintain high standards of personal and professional conduct. • WLRs will conduct themselves in a manner that fosters their own recovery. • WLRs will openly share with peers, other WLRs and non-peers their recovery stories from mental illness or co-occurring disorders as appropriate for the situation in order to promote recovery and resiliency. • WLRs at all times will respect the rights and dignity of those they serve. • WLRs will never intimidate, threaten, harass, use undue influence, use physical force, use verbal abuse, or make unwarranted promises of benefits to the individuals they serve. • WLRs will not practice, condone, facilitate, or collaborate in any form of discrimination on the basis of ethnicity, race, sex, sexual orientation, age, religion, national origin, marital status, political belief, mental or physical disability, or any other preference or personal characteristic, condition, or state. Mental Health America of Montana

  14. Code of Ethics • WLRs will promote self-direction and decision making for those they serve. • WLRs will respect the privacy and confidentiality of those they serve. • WLRs will promote and support services that foster full integration of individuals into the communities of their choice. • WLRs will be directed by the knowledge that all individuals have the right to live in the least restrictive and least intrusive environment. • WLRs will not enter into dual relationships or commitments that conflict with the interests of those they serve. • WLRs will never engage in sexual or intimate activities with peers they serve. • WLRs will not use illegal substances under any circumstances. • WLRs will keep current with emerging knowledge relevant to recovery and will share this knowledge with other certified peer specialists. • WLRs will not accept gifts from those they serve. Mental Health America of Montana

  15. Boundaries and Frequent Callers Mental Health America of Montana

  16. Know The and Thy Boundaries • What are boundaries • How to recognize • How to set them with self and callers • Supporting callers • What helps • What hinders/hurts • Know your own signals • Physiology • Emotions • Thoughts • Actions Mental Health America of Montana

  17. Know The and Thy Boundaries (cont.) • Outline for calls • How to introduce yourself • How to get to the need(s) of the caller • How to be strength based • Ending a call • Complete the call log • Supervision about calls • Do a follow up call the next day with your supervisor • Have a specific call to discuss • Answer your questions Mental Health America of Montana

  18. Frequent Callers • It’s not necessarily a bad thing (you or we must be doing a good job) • Boundaries you can set: • Time • Scope of the Warm Line • Code of Ethics • What doesn’t feel good to you • Your comfort • Identify what is out of your boundary (anger, trauma, substance use, harmful thinking) • Learn to re-direct Mental Health America of Montana

  19. Frequent Callers • What’s inappropriate for me? • Use supervision and FYI sessions to establish your comfort level • Ask for help • Prevention Coordinator • Warm Line Responders • Executive Director Mental Health America of Montana

  20. Values and Feelings Mental Health America of Montana

  21. Values Your role on the WL is not to change callers’ values, or even to talk about your own values. It is to help callers think through their individual situations and make the best decision for themselves based on their own beliefs, values, and circumstances. • What WLRs value: • Acceptance • Non-judgment • Balance • Realism • Awareness • Self-determination Mental Health America of Montana

  22. Feelings • Feelings are neither good nor bad; they just are. • Everyone has the right to his or her own feelings. • Everyone has the responsibility for his or her own feelings. • Feelings make sense when considered in the context of the individual’s world view • Denying a feeling does not make it go away. Mental Health America of Montana

  23. Feelings • Categories of Feelings: • Desire • Anger • Happiness • Sad • Fear • Depressed • Guilt • Anxiety • Inadequate Mental Health America of Montana

  24. Assumptions • Religious Fanatic • Pregnant Teen • Promiscuous Female • Welfare Recipient • Professionals • Child Abusers • Volunteers • Promiscuous Male • Child Molester • Spouse Abuser • Drug Abuser • Psychotic • Minorities • Alcoholics • Hysterical People • Abortion • GLBT • Extramarital Affairs • Senior Citizen • Pro-wrestling Mental Health America of Montana

  25. Why Do People Do What They Do: Understanding Human Behavior • Basic human needs • Security • Love and belonging • Power • Freedom • Fun • Intrinsic vs. extrinsic psychology • Stimulus response • Choice theory Mental Health America of Montana

  26. Active Listening Mental Health America of Montana

  27. Active Listening Strategies • Be fully present – communicate genuine interest, positive regard • Be fully present – eliminate external distractions • Be fully present – eliminate internal distractions • Be fully present – eliminate internal personal judgments • Be fully present – practice empathy understanding Mental Health America of Montana

  28. Active Listening Strategies • Be fully present – actively listen for understanding • Be fully present – use reflective and empathic responses • Be fully present – facilitate clarification and concreteness • Be fully present – encourage exploration of deeper meaning Mental Health America of Montana

  29. Roadblocks to Active Listening • Evaluating and/or judging • Jumping to conclusions • Assuming (remember the old adage) • Know it all behavior • Short attention span • Hearing what we want • Talking when we ought to listen • Thinking we know better • Fearing change Mental Health America of Montana

  30. Door Openers • I see • I’m not sure I understand – do you mean… • Oh • You hate that • Mm hmm • You’re confused that • Interesting • Let’s discuss it • Seems you’re know… • You’re really clear about that • You feel lonely right now • I’d be interested in your point of view • Go ahead – I’m listening • You’re upset • Tell me the whole story Mental Health America of Montana

  31. Crisis Theory and Management Mental Health America of Montana

  32. Crisis • Definition: A crisis is any situation for which a person does not have adequate coping skills. It is “self-defined”. Mental Health America of Montana

  33. Crisis Intervention • Defined: Crisis intervention is “emergency first aid” for mental health. • Purpose: Assist the person and/or group to return to a pre-crisis level of functioning Mental Health America of Montana

  34. Crisis Counseling or Support • Primarily home or community-based • Focuses on assessment of strengths, adaptation of existing coping skills, and development of new ones • Seeks to restore people to pre-crisis levels of functioning • Accepts content at face value • Validates the appropriateness of reactions to the event and its aftermath and normalizes the experience • Has a psycho-educational focus Mental Health America of Montana

  35. Crisis Process • Recognition • The person realizes she/he is not coping • Attempted Resolution • Person strives to solve problem • Person involves others to help • Emotional Blockage • Emotions become overwhelming • Intensity and duration of frustration impact the physiology of the person • Self-doubt grows • Self-talk is defeating Mental Health America of Montana

  36. Four Steps to Crisis Intervention • Step One: Listen • Step Two: Assess • Step Three: Develop an action plan • Step Four: Close Mental Health America of Montana

  37. Step One: Listen • Elements of listening • Establish rapport and trust • Identify precipitating problems • Help the person deal with, identify, and diffuse feelings • Techniques for listening • Use first names; ask if it OK to use the person’ first name • Use content questions • Ask or use feeling questions or statements Mental Health America of Montana

  38. Step Two • Elements of Assessing • Determine the severity of the crisis • Assess potential lethality or physical harm to the person or others • Identify coping patterns, strengths, and resources • Techniques for Assessing • Find out if the person is suicidal, homicidal, or both • Find out to what extent the crisis has disrupted the person’s normal life pattern • Daily routines with family, friends, work, etc. Mental Health America of Montana

  39. Step Two (cont.) • Techniques for Assessing • Find out if the level of tension has distorted the perception of reality • Find out how the person deals with anxiety, tension, or depression – have they been proactive • Find out what coping methods were used in the past – do they have a variety • Find out if family and social resources are potential resources – positive or negative • Find out what the person used as support systems in the past – WRAP or traditional system Mental Health America of Montana

  40. Step Three: Develop An Action Plan • Elements of Developing an Action Plan • Selectively choose and use appropriate approaches to action planning • Assist in modifying previous inadequate coping skills • Negotiate a contract or action plan • Select appropriate referral resources • Plan for immediate action and implementation • Techniques for Developing an Action Plan • Use three basic approaches: • Start by being non-directive • Be collaborative by working together on a joint plan • Be directive if the person does not or will not make a plan Mental Health America of Montana

  41. Step Three: Develop An Action Plan (cont.) • Techniques for Developing an Action Plan • When making an action plan, keep it simple and manageable • Keep the action plan short-term – 24 hours to three (3) days • Keep the action plan achievable and focused • Plan for follow-up provisions • KISS method • Keep it simple stupid Mental Health America of Montana

  42. Resolution Of A Crisis In order to successfully assist a person to resolve the crisis, a helper must begin, not at the start of the situation, but at the end, with the overwhelming emotions. • Deal with the person’s feelings • Develop coping skills and alternatives • People in crisis are easily influenced • Personalize the solutions • Empathize your understanding of what the situation means to the person • Encourage the person to identify the problem Mental Health America of Montana

  43. Cultural Issues Mental Health America of Montana

  44. Culture • To describe culture is to describe the values, beliefs, behavioral norms, and social structures common to a group of people. • Culture is learned from the following: • Children’s caretakers • Religious ceremonies • Community celebrations • Art • Literature • Stories passed down from generation to generation Mental Health America of Montana

  45. Essential Elements to Cultural Competence • Value Diversity • Have the capacity for cultural self-assessment • Be conscious of the “dynamics” inherent when cultures interact • Institutionalize cultural knowledge • Develop adaptations to service delivery reflecting an understanding of diversity between and within cultures Mental Health America of Montana

  46. Steps To Becoming Culturally Competent • Develop Awareness • Admit personal biases and prejudices • Value diversity • Acquiring Knowledge • Attend classes • Read about other cultures • Developing and maintaining Cross-Cultural Skills • Develop diverse friends • Learn another language • Overcome fears Mental Health America of Montana

  47. Suicide Mental Health America of Montana

  48. Suicide Facts • Over 32,000 people in the U.S. die by suicide each year • A person dies by suicide every 16 minutes in the U.S. • 90% of all people who die by suicide have a diagnosable psychiatric disorder • There are four male suicides for every female suicide, but twice as many females as males attempt suicide • Suicide is the fifth leading cause of de3ath among those 5 -14 years old • Suicide is the third leading cause of death among those 15 – 24 years old • The suicide rate for men rise with age, most significantly after age 64 • More than 30% of persons suffering from major depression report suicidal ideation Mental Health America of Montana

  49. Risk Factors For Suicide • Psychiatric disorders • Past history of attempted suicides • Genetic predisposition • Neurotransmitters • Impulsivity • Demographics Mental Health America of Montana

  50. Suicide Crisis A suicide crisis is a time-limited occurrence signaling immediate danger of suicide. The signs of crisis are: • Precipitating event • Intense affective state in addition to depression • Changes in behavior • Changes in speech • Changes in actions • Deteriorating in functioning Mental Health America of Montana

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