Aspect of Recovery Approach

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Aspect of Recovery Approach
Presented at the Schizophrenia Society of Nova
Scotia Conference May 25, 2006

• Presented by
• Dorothy Edem
• Sandra Hennigar

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Presentation Overview

• What is Recovery?
• Concepts Values that Support Recovery
• Recovery Outcomes
• Recovery-Oriented System
• The Healthy Minds Initiative

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Anthony 1993
What is Recovery?

• Described as a deeply personal, unique process of
  changing ones attitude, values, feelings, goals,
  skills, and /or roles
• Development of new meanings and purpose in ones
  life as one grows beyond the catastrophic effects
  of psychiatric disability
• A way of living a satisfying, hopeful, and
  contributing life even with limitations caused by
  illness

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Patricia Deegans Perspective

• Being in recovery means I know I have certain
  limitations and things I cant do. Rather than
  letting these limitations be an occasion for
  despair and giving up, I have learned that in
  knowing what I cant do, I also open up the
  possibilities of all I can do.
• Recovery is a process, a way of life, an
  attitude and a way of approaching the days
  challenges. It is not a perfectly linear process.

Deegan 1988
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Recovery is

• The reawakening of hope after despair
• Breaking through denial
• Achieving understanding and acceptance
• Moving from withdrawal to engagement
• Active participation in life

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Assumptions about Recovery

• Recovery can occur even though symptoms re-occur
• Recovery is a unique process
• Recovery demands that a person has choices
• Recovery from the consequences of the illness is
  sometimes more difficult than recovering from the
  illness itself

Anthony, 1993
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Anthony 1993
Assumptions about Recovery

• A recovery vision is not related to ones theory
  about the causes of mental illness
• A common denominator of recovery is the presence
  of people who believe in and stand by the person
  in need of recovery
• Recovery can occur without professional
  intervention

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Spaniol, 2001
Values that Support Recovery

• Hope
• Empowerment
• Personal Choice
• Personal Involvement
• Community Focus
• Focus on Strengths
• Connectedness

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Recovery Outcomes

• Self-Confidence
• Self-Efficacy
• Hope and Optimism
• Sense of well being
• Established Roles and Positive Identity
  (Citizenship)
• Relief from Symptoms of Illness

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Essential Services of a Recovery-Oriented System

• Treatment
• Crisis intervention
• Case management
• Rehabilitation
• Enrichment

• Rights protection
• Basic Support
• Self-help
• Wellness/prevention

Anthony, 1993
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CMHA, 2001
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Patricia Deegan

• Our role is not to judge who will and will not
  recover. Our job is to create environments in
  which opportunities for recovery and empowerment
  exist. Our job is to establish strong, supportive
  relationships with those we work with.

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The Healthy Minds Initiatives

• Presented at the
• Schizophrenia Society of Nova Scotia Conference
• May 25, 2006
• _______________________
• Presented by
• Sandra Hennigar

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Healthy Minds Initiative

• Was the outcome of strategic planning from the
  fall of 2004-spring of 2005, to create a mental
  health community of excellence
• Joint venture between the CH MHP and the
  Dalhousie University Department of Psychiatry
• Involved many, including individuals and their
  families, consumer groups, government and
  community organizations

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Healthy Minds Initiative

• Aimed to develop and implement a five year plan
  that is person-centered, based on population
  health approach and aligned with provincial
  mandate
• Accomplished by using previous planning documents
  and CMHA's Framework for Support

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Healthy Minds Initiative

• The Healthy Minds Initiative defines a mental
  health community of excellence as a community
  that puts people who are living with mental
  illness or experiencing mental health issues at
  the centre, and encompasses excellence in
  clinical care, advocacy, research and education

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12 Criteria For Success

• We see the person as the sum of his/her mind,
  body, spirit and relationships.
• We view the person as central to this work. We
  see him/her as a citizen first with capacities,
  skills and talents and who is able to live ones
  life as a member in ones community.

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12 Criteria fro Success

• 3. We base our understanding of the person in the
  context of the determinants of his/her health.
  This includes
• Ones health status (well-being, health
  conditions, human functions) and
• Non-medical factors such as housing, education,
  income

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12 Criteria for Success

• 4. We view mental health and mental illness as
  two distinct dimensions.
• 5. In the same manner as the physical body was
  instrumental to our societys success in the
  Industrial economy so is the human mind in its
  holistic sense to what we are calling the
  Knowledge society

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12 Criteria for Success

• 6. We operate universally with an attitude of
  wealth
• 7. We support the integral development of
  collaborative community-based networks that are
  aligned around our shared interest of healthy
  minds, healthy people, and healthy communities

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12 Criteria for Success

• 8. We operate within an academic district- and as
  such are integrally involved with the sponsorship
  of the functions of care, research, education,
  and advocacy.
• 9. We base our strategic action on mobilizing a
  broader Vision in which
• Healthy minds are alive in
• Healthy people who foster
• Healthy communities

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12 Criteria for Success

• 10. We espouse a core set of values Principles
  that guide everything we do
• 11. Those of us living with mental illnesses and
  those of us, who have not, have much in common.
  Those of us who are working in the current mental
  health program and those operating in the
  community have much in common. It is the state of
  mutual respect

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12 Criteria for Success

• Contd
• Each of us is an integral member in the new
  reality we are working to develop.
• I am you and you are me
• became a statement that demonstrates
  that this illness can affect anyone
• 12.This initiative involves one person at a time.

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Strategic DirectionsAcademic Mandate

• First time that the MHP and the Department of
  Psychiatry have developed a plan where members of
  both groups will come together to collaborate
• Design is completed, member chosen and terms of
  reference done

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Strategic DirectionsCitizens Support

• Represents a variety of tools to help support,
  educate, research and advocate for people who are
  living with mental illness or mental health
  issues
• Website
• Toll-free phone support
• Navigational support help-line

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Strategic DirectionsCommunity of Excellence

• Community of Excellence is working to bring
  together groups that support people with mental
  illnesses and mental health issues to
• Advance an understanding of mental health and
  mental health policy
• Reduce stigma
• Foster integration, empowerment and recovery

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Strategic DirectionsCrisis Support

• Crisis Support
• Involves the integration of all the services that
  provide crisis/emergency support (mobile crisis
  team EPAS SSU)
• Currently will be launching the expanded mobile
  crisis service to an integrated service with 20/7
  with integrated staffing partnerships and
  services to cross the age span

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Strategic DirectionsCrisis Support

• Actively involved in planning the Mental Health
  Suite in the plans for renovating HI ED
• Recently asked to partner with a community based
  agency to begin talking about crisis housing
  support

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Strategic DirectionsDay/Night Support

• Services designed to provide assessment,
  diagnosis and treatment for acute episodes of
  mental illnesses, delivered through inpatient or
  alternative overnight care
• IPR committee findings, resulting in
• Changes to the four acute care units into 2 acute
  care and 2 community focused living units (CFL)
• Plans to address a number of issues re the focus
  of acute care

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Strategic DirectionsDay/Night Support

• Look at client centered approaches that better
  support both our strategic plan, the principles
  of both the framework of support and of recovery
• Educating staff about patient choice in treatment
  decisions
• Integrating family care with care of the
  individual, whenever feasible

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Strategic DirectionsDay/Night Support

• Need to give credit to the individuals
  experience and allow them to own their own
  knowledge ( Knowledge Resource Base)
• One way that is being done is through the
  implementation of the Tidal Model of Nursing
• Complements the work of recovery of patient
  focused care, and documents like the Framework
  for Support which puts the patient first/at the
  centre

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Strategic DirectionsDay/Night Support

• Housing
• Committee called Two Hundred Fifty Homes
• Proposal for rent supplements for 150 individuals
  gone to Cabinet
• Currently working in partnership with Connections
  Clubhouse to expand their housing component to
  offer the supports that will allow a number of
  patients currently on the CFLs options to live
  in community. Will begin to see individuals being
  supported by this project by mid summer

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Strategic DirectionsDay/ Night Options

• Other plans for future care delivery that will
  even further promote concepts of allowing care to
  be delivered as close to an individuals community
  as possible

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Strategic DirectionsConcurrent Disorders

• Best practice plus many previous documents tell
  us that creating service's that treat both the
  illness and the addiction concurrently is the
  best
• Leads are
• Tom Payettte and Trevor Briggs

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Strategic DirectionsDiverse Populations

• More culturally diverse mental health services
  and supports that value and respond to the
  cultural, racial and spiritual experiences of
  people who are living with mental illnesses or
  mental health issues
• Focus is on shared learning and understanding

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Strategic DirectionHealthy Minds Co-op

• Created to provide meaningful consumer
  participation
• Independent, not-for-profit
• Mandates includes things like
• Improving access
• Providing education to support early intervention
  and to address stigma

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Strategic DirectionICARE

• This direction fits with the academic mandate of
  integrating research and education with clinical
  care
• E.G Early Psychosis Program provides an
  integrated service approach

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Strategic DirectionCommunity Resource Centres

• Being designed to assess, diagnose, treat and
  support recovery in centers that include mental
  health services as well as other services such
  as
• Primary care services
• Recreational services
• Employment services

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Strategic DirectionEvaluation

• Committee has been working to develop a variety
  of indicators for the overall program as well as
  at each level of each direction
• Will allow us to evaluate our current directions
  and determine additional directions

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Framework for Support
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References

• Anthony, W. A., (1993). Recovery from mental
  illness The guiding vision of the mental health
  service system in the 1990s. Psychosocial
  Rehabilitation Journal, 16(4), 11-23.
• Anthony, W. A., Cohen, M., Farkas, M. Gayne, C.
  (2002). Psychiatric Rehabilitation. Boston, MA
  Center for Psychiatric Rehabilitation.
• Deegan, P. E. (1988). Recovery The lived
  experience of rehabilitation. Psychosocial
  Rehabilitation Journal, 11 (4), 11-19.
• Spaniol, L. (2001).Recovery from Psychiatric
  Disability Implications for Rehabilitation
  Counseling Education. Rehabilitation Education,
  15(2), 167-175.
• Trainor, J., Pomeroy, E., Pape, B. (2004). A
  Framework for support. Ottawa, ON Canadian
  Mental Health Association