Transcript Slide 1

Building Recovery Oriented
Services
Chacku Mathai
Associate Executive Director, NYAPRS
Why Focus on Recovery?
Expectations of consumers and
people in recovery
Expanding research base on
recovery and showing improved
effectiveness of recovery supports
Federal initiatives and
expectations
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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
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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
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SAMHSA’s Strategic Initiatives
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1.
Prevention
2. Trauma
and Justice
3. Military
Families
4. Recovery
Support
5. Health
Reform
6. Health
Information
Technology
7. Data,
Outcomes,
& Quality
8. Public
Awareness
& Support
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
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Recovery Construct
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HOME
↑ Permanent
Housing
HEALTH
↑ Recovery
Individuals
and
Families
PURPOSE
↑ Employment/
Education
COMMUNITY
↑ Peer/Family/
Recovery
Network
Supports
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
SAMHSA Guiding Principles of Recovery
• Hope
• Person-Driven
• Many
Pathways
• Holistic
• Peer Support
• Relational
• Culture
• Addresses
Trauma
• Strengths/Resp
onsibility
• Respect
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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
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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
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Program Design and Culture
THE JOURNEY THROUGH SERVICES
FIRST
CONTACT &
INTAKE
DISCHARGE
PROVIDING &
MONITORING
SERVICE
ASSESSMENT
SETTING
GOALS &
TREATMENT
PLANNING
Screening and Assessment
Person-Centered, RecoveryOriented and Culturally
Competent Treatment Planning
Recovery – Oriented
Clinical Supervision
Continuous Quality Improvement
Program Evaluation
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.”
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
Observable Correlates of Recovery
1. Level of Risk
2. Level of Engagement
3. Level of Skills and Supports
MILESTONES OF RECOVERY
1. Extreme Risk
2. High Risk / Not Engaged
3. High Risk / Engaged
4. Poorly Coping / Not Engaged
5. Poorly Coping / Engaged
6. Coping / Rehabilitating
7. Early Recovery
8. Advanced Recovery
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
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?
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Person-Centered Planning
• is a collaborative process
resulting in a recoveryoriented treatment plan
• is directed by consumers and
produced in partnership with
care providers and natural
supporters
• supports consumer
preferences and a recovery
orientation
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Adams/Grieder
Literature References
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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 RecoveryOriented 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.
Literature References
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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: Great Lakes Addiction
Technology Transfer Center and Philadelphia Department of Behavioral
Health and Mental Retardation Services.
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/practiceguideli
nes.pdf
• Getting in the Driver’s Seat of Your Plan
– http://www.ct.gov/dmhas/lib/dmhas/publications/PCRPtoolkit.p
df
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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-economicdevelopment/toolkit/
• Bringing Recovery Supports to Scale Technical Assistance Center
– http://beta.samhsa.gov/brss-tacs/
• Recovery to Practice
– http://www.samhsa.gov/recoverytopractice/
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Contact Information
Chacku Mathai
Associate Executive Director
New York Association of Psychiatric Rehabilitation Services, Inc.
[email protected]
www.nyaprs.org
Joe Lunievicz, BA, RYT
Director Training Institute
[email protected]
Northeast & Caribbean Addiction Technology Transfer Center
National Development & Research Institutes, Inc.
71 W 23rd Street, 8th Floor
New York, NY 10010
www.ndri.org, www.training.ndri.org
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