Implementation of the strengths recovery model of case management
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IMPLEMENTATION OF THE STRENGTHS RECOVERY MODEL OF CASE MANAGEMENT. Lee Cordell-Smith Paul Liddy . Total Population SCDHB Population 52,785 Under age 15 3222 Over age 65 9078 Adult population 40,485 High Need 212 Overall Percentage of Population seen to be moderate to severe

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Implementation of the strengths recovery model of case management l.jpg

IMPLEMENTATION OF THE STRENGTHS RECOVERY MODEL OF CASE MANAGEMENT

Lee Cordell-Smith

Paul Liddy


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Total Population SCDHB

Population 52,785

Under age 15 3222

Over age 65 9078

Adult population 40,485

High Need 212

Overall Percentage of

Population seen to be

moderate to severe

psychiatric illness 0.5%

Total Maori Population SCDHB

Population 2841

Under age 15 1116

Over age 65 93

Adult population 1,632

High Need 8

Overall Percentage of

Population seen to be

moderate to severe

psychiatric illness 0.5%


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WHAT WERE WE WANTING TO ACHIEVE?

  • Develop MHS demonstrate and sustain recovery approach to case management to produce the best outcomes for those with moderate to severe psychiatric disability.


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OBJECTIVES

  • Introduce the strengths model of case management –inpatient – community.

  • Compare and measure outcomes for clients

  • Compare and measure outcomes for the staff


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WHY?

What were the guides that were encouraging us to do this?


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RECOVERY APPROACH NZ

  • Underpins public policy

  • Blueprint: How things need to be

  • MHC vision is for a recovery approach to become standard practice for MHS at all levels

  • Competencies for mental health workforce

  • MHWD Programme 2002 (training and development, retention and recruitment, organisational development, research and evaluation)

  • Moving Forward: The NMH Plan for More and Better Services

  • NMHS and HDSS


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Recovery Principles

Personhood (hope, respect, individuality)

Basic Needs (housing, income, transport)

Social connectedness

Citizenship (connected to the community)

Empowerment (power and control over lives)

Best practice culture

Resources

Strengths Principles

Focus on strengths not pathology

Community is an oasis of resources

Self determination

Relationship with Key Worker

Assertive outreach

People can learn, grow and change

PRINCIPLES


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Benefits to People using Services

  • Increased opportunities to participate in:

    • Employment

    • Education

    • Leisure

    • Quality housing

  • Increased satisfaction (e.g. client rights)

  • Ease of access to services

  • Stable workforce

  • Reduced no. relying on formal psychiatric services

  • Reduction in use of restrictive practices (e.g. MHA, seclusion and restraint.)



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PROJECT DEVELOPMENT

  • REFERENCE TO GUIDING DOCUMENTS

  • CONSULTATION WITH CONSUMERS AND FAMILIES & MENTAL HEALTH WORKERS

  • BUILDING ON THE FOUNDATIONS OF SERVICE PROVISION FRAMEWORK

  • TRAINING OF MANAGEMENT IN PERSON-CENTRED PRINCIPLES AND PRACTICE


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Risks and Resistances

  • Perception of increased paperwork

  • Succession planning

  • Time and financial costs

  • Inadequate data collection system

  • Client resistances

  • Length of time to change the culture

  • Meeting existing standards


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PROJECT IMPLEMENTATION

  • 2001

    TRAINING OF STRENGTHS MODEL TO ALL SOUTH CANTERBURY MENTAL HEALTH WORKERS

  • 2002

    IMPLEMENTATION OF STRENGTHS MODEL ADULT MENTAL HEALTH SERVICES – INPATIENT AND COMMUNITY

  • 2003

    IMPLEMENTATION OF STRENGTHS MODEL ALCOHOL AND OTHER DRUGS SERVICES

  • 2005

    IMPLEMENTATION OF STRENGTHS MODEL CHILD AND ADOLESCENT SERVICE


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TOOLS IMPLEMENTED

  • STRENGTHS PRINCIPLES

  • STRENGTHS ASSESSMENT

  • GOAL PLAN

  • WELLNESS RECOVERY ACTION PLAN

  • GROUP SUPERVISION

  • FOCUS ON COMMUNITY RESOURCES


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IMPLEMENTATION SUPPORTS

  • STRENGTHS WORKSHOP’S

  • GROUP SUPERVISION

  • PERSON CENTRED MANAGEMENT

  • SERVICE PROVISION FRAMEWORK

  • PERFORMANCE REVIEW PROCESS

  • AUDITING TOOLS

  • KNOWING THE PEOPLE PLANNING

  • ONGOING TRAINING


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Monitoring of the day to day requirements

  • Recruitment and defining of team roles

  • Performance Management

  • Team motivation and Morale

  • Reward/recognition/incentives linked to the goals

  • Training and Support provided


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Review of progress

  • Monitoring of the quality of the Recovery Work.

  • Development of the skills of the management team to promote recovery enhancing environment

  • Maintaining the momentum

  • Involving Families

  • Incorporating within existing cultural practices.



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ACCREDITATION

FINANCIAL

COMPLAINTS

2000 = 48

2003 = 6

1.5 MILLION UNDERSPEND

2000 = 24

2002 = 12

2004 = 16

PRELIMINARY REPORT





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GROUP THREE RESULTS

  • PEOPLE IN THE TIMARU PSYCHIATRIC SERVICE FOR

    5 YEARS OR MORE

  • TOTAL NUMBER = 155







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VOCATIONAL ACTIVITY 2004

  • 119 People considered as High Need

  • 71 of those individuals have been in the service for 5 plus years

  • 34% of those people were in some form of vocational activity

  • 10 individuals in part-time employment

  • 14 individuals in full-time employment



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ACCOMMODATION outcomes

  • TOTAL OF 119 LONG-TERM PEOPLE

  • Living independently = 69 (58%)

  • Living semi independently = 26 (22%)

  • Living semi dependent = 8 (6%)

  • Living dependent = 15 (13%)




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In the past I felt like the tail of the dog now I feel the head.

Feel I’m on the same level as my Key Worker

Its now acceptable to have dreams even if they are dreams

Before strengths professionals were like God now they are like people

I didn’t like it at the beginning cause I felt there was nothing good about me, it made me mad

PEOPLES COMMENTS


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SI REGIONAL PLAN - VISION head.

SIDHB’S support the funding and provision of services for people with serious mental health problems that are delivered by a competent mental health workforce that understands the practices and principles of recovery and supports the destigmatisation of mental illness in South Island communities.


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HIDEAWAY MENTAL HEALTH SERVICE head.

  • Identify the strengths and weaknesses of the service?

  • What are the potential barriers and risks?

  • What are the outcomes you would like to achieve?

  • How are you going to measure them?


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