Presentation on theme: "The Power of Hope Paolo del Vecchio, MSW Acting Director, Center for Mental Health Services Substance Abuse and Mental Health Services Administration."— Presentation transcript:
The Power of Hope Paolo del Vecchio, MSW Acting Director, Center for Mental Health Services Substance Abuse and Mental Health Services Administration SAMHSA Primary and Behavioral Healthcare Integration Program Baltimore, MD ♦ May 18, 2012
Recovery Emerges From Hope “Hope is to the soul what oxygen is to the body.” – Larry Fricks
The Spark of Hope “But one day, something changed in us. A tiny, fragile spark of hope appeared and promised that there would be something more than all of this darkness…This is the mystery. This is grace. This is the birth of hope called forth by the possibility of being loved.” – Patricia Deegan
Defining Hope Recovery begins with hope…Sustained recovery perpetuates and strengthens one’s hope for the future. — E. Sally Rogers, Sc.D., Director of Research at the Center for Psychiatric Rehabilitation
Quest for a Better Life “Without hope, recovery can seem like an elusive goal, a quest that demands too much of our body, our minds, and our spirit. But, hope gives us strength to fight for that better life. Hope helps us overcome hurdles that we otherwise could not scale, and it moves us forward to a place where healing and recovery can begin.” – Jerome Groopman. M.D. The Anatomy of Hope
Comorbid Mental and Physical Conditions Adults experiencing major depressive episodes had higher rates of the following physical illnesses than adults without past-year major depressive episodes: – high blood pressure (24.1% vs. 19.8%) – asthma (17.0% vs. 11.4%) – diabetes (8.9% vs. 7.1%) – heart disease (6.5% vs. 4.6%) – stroke (2.5% vs. 1.1%) Source: SAMHSA National Survey on Drug Use and Health
Social Exclusion “By any measure, it is clear that people with mental illnesses are on the margin, actually not on the page at all. Dying decades earlier than the general population is testament enough about how those with mental illnesses have been marginalized.” – Paolo del Vecchio
SAMHSA Integrated Care Initiative Seeks to better coordinate and integrate primary and behavioral health care resulting in: Improved access to primary care services Improved prevention, early identification, and intervention to reduce the incidence of serious physical illnesses, including chronic disease Increased availability of integrated, holistic care for physical and behavioral disorders Better overall health status of clients
Prescription for a Healthier Life Physicians wish they could write prescriptions for: – Fitness program 75% – Nutritional food 64% – Transportation assistance 47% For those whose patients are mostly urban and low- income, they would write prescriptions for: – Employment assistance 52% – Adult education 49% – Housing assistance 43% Source: Robert Wood Johnson Foundation. (2011, Dec.). Health Care’s Blind Side: The Overlooked Connection between Social Needs and Good Health. 11
Recovery-Promoting Competency (RPC) Study Consumers ranked the RPC ingredients most important to them. They indicated that providers must: Have genuine respect for consumers Help clients develop skills to cope and manage symptoms See clients as persons, apart from their diagnoses and symptoms Trust the authenticity of clients’ experiences and accounts Help clients accept and value themselves Listen to clients without judgment Believe in clients’ potential to recover Care about clients Be accessible to clients when they need help Understand clients Russinova, Z., Rogers, E.S., Ellison, M.L., & Lyass, A. (2011). Recovery-promoting professional competencies: perspectives of mental health consumers, consumer-providers and providers, Psychiatric Rehabilitation Journal, 34(3), 177–185.
Recovery Is Based on Respect Individuals in recovery are: Workers Tenants Participants Members Neighbors Employees They are not cases.
Eight Dimensions of Wellness – Adapted from Swarbrick, M. (2006). A wellness approach. Psychiatric Rehabilitation Journal, 29,(4) 311- 314.
Lack of Healthy Choices More than 42 percent of adults with serious mental illnesses are obese. Fewer than 20 percent of people with schizophrenia engage in regular moderate exercise. People with schizophrenia consume fewer fruits and vegetables and more calories and saturated fats than the general population. Bartels, S., & Desilets, R. (2012). Health promotion programs for people with serious mental illness. Washington, D.C. SAMHSA-HRSA Center for Integrated Health Solutions.
SAMHSA’s Pledge for Wellness “We envision a future in which people with mental health problems pursue optimal health, happiness, recovery, and a full and satisfying life in the community via access to a range of effective services, supports, and resources.”
Shared Decision Making The new SDM site offers a print/video link, online decision aid, workbooks, and cool tools: http://www.samhsa.gov/consumersurvivor/sdm/StartHere.html
Importance of Choice Common Antipsychotic Side Effects: Abnormal movements Diabetes Dry mouth Metabolic syndrome Neuroleptic malignant syndrome (NMS) Sexual side effects Sleep problems Stroke Sudden cardiac death Weight gain
Medication Best Practices Shared Decision-Making: Provide individuals with to up-to-date information about the drugs they take, including potential side effects. Individualized, Person-Centered Care: View medication use as a dynamic process that evolves over each person’s unique recovery journey. Holistic Approach: Adopt a bio-psycho-social-cultural-spiritual model to assess benefits and costs of using medications as a tool for recovery. Relational: Prescribe and monitor medications within the context of a trusting and collaborative relationship. Integrated Treatment: Prescribe and monitor medications within an integrated community-based recovery plan. Need for Protocols: Use medication “if needed, as needed, and as seldom as possible” and in combination with psychological and social supports.
Education + Activity = Better Health Interventions lasting longer than 3 months were 39% more likely to report statistically significant weight loss (89% versus 64%). Programs that combine education and activity are 34% more likely to report statistically significant weight loss than programs that provide education alone (75% versus 56%). 81% of the studies with significant body weight findings incorporated both exercise and nutrition into their interventions. Bartels, S., & Desilets, R. (2012). Health promotion programs for people with serious mental illness. Washington, D.C. SAMHSA-HRSA Center for Integrated Health Solutions.
Choosing Health The My Activity Pyramid for Adults is modeled after the USDA's MyPyramid and is based on the 2008 Physical Activity Guidelines for Americans. http://extension.missouri.edu/p/n388
Peer Support “Peer specialists bring the essential message of hope that acts as a catalyst for people to begin their journey of recovery.” – Paolo del Vecchio – Visions of Hope Arizona
Peer Support = Wellness SAMHSA’s Transformation Transfer Initiative grants are supporting peer specialists in the following ways: Pennsylvania and New Jersey – Wellness and Older Adult Peer Support Services Michigan – Certified Peer Support Specialists at Federally Qualified Health Centers Georgia – Peer Supported Whole Health and Wellness Coaching – Bowl Of Apples Painting – Arline Wagner – Fine Art America, http://arline-wagner.artistwebsites.com/
SAMHSA Peer Support and Consumer-Operated Activities SAMHSA funds and supports the following initiatives, among others: Peer-Run and Recovery Community Organizations Expert Panel Meeting on Peer Specialists and Peer Recovery Coaches Pillars of Peer Support Services Summit Statewide Consumer and Family Network Grants National Consumer and Consumer Supporter Technical Assistance Centers Annual Consumer Conference – Alternatives Conference “Peer recovery coaches go where no other group goes.” – Joe Powell, Executive Director, Association of Persons Affected by Addictions
Defining Recovery A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. – SAMHSA, 2011
Four Dimensions of Recovery Individuals and Families
KSAPs: Knowledge, Skills, Abilities, and Personal Characteristics Elements of Competency: Knowledge – Awareness, information, or understanding about facts, rules, principles, guidelines, concepts, theories, or processes needed to successfully perform a task. Skill – Capacity to perform physical or mental tasks with a specified outcome. Ability – A demonstrated cognitive or physical capability to successfully perform a task with a wide range of possible outcomes. Personal Characteristics – Values, attitudes, traits, etc. – Miller, 1990 Hoge, M.A., Tondora, J., & Marrelli, A.F. (2005). The fundamentals of workforce competency: implications for behavioral health. Administration and Policy in Mental Health, 32(5/6), 509–531.
Recovery to Practice The following organizations have been funded to develop recovery-oriented educational materials and train practitioners: American Psychiatric Association American Psychological Association American Psychiatric Nurses Association Council on Social Work Education National Association of Alcoholism and Drug Abuse Counselors National Association of Peer Specialists.