Role of Psychiatrists Role of Psychiatrists in Recovery Oriented in Recovery Oriented

Systems and Systems and Promoting WellnessPromoting Wellness

NASMHPDNASMHPDMedical Directors Council Medical Directors Council

2007 Best Practices Symposium2007 Best Practices SymposiumScottsdale, ArizonaScottsdale, Arizona

"People will forget what you said. "People will forget what you said. People will forget what you did. But People will forget what you did. But people will always remember how people will always remember how

you made them feel."you made them feel."--Margaret Mead--Margaret Mead

Recovery and HopeRecovery and Hope

“If I look into someone’s eyes and all I see is a chronic schizophrenic, then I participate in diminishing that person’s hope.”1

“But if I look into that person’s eyes and I see somebody who can work, who can have friends, who can have a lover, who can have a life that is meaningful in ways that are important to that person, then I will instill that hope in that person, and I will help the recovery process. I cannot fake this. It has to be something I feel in my soul.”1

Hope and RecoveryHope and Recovery

“I often work with people who have lost hope. The most important thing I can do for them is not merely prescribing the right medications or making the right diagnosis, but to hold hope in a crucible and blow the embers to keep hope alive until the person is strong enough to take that crucible back and hold the hope themselves.”1

“Recovery is the personal process of change that people can go through to recapture their own lives, to find meaning in life, and to become more than just a schizophrenic or just a patient.”1

Recovery and Recovery and EmpowermentEmpowerment

“We, as mental health professionals, can promote this process. By our willingness to be part of a real relationship, to support strengths and goals, to accept risks and acknowledge the importance of empowerment, and above all support hope, we can promote the personal journey that is the core of recovery.”1

1. Ronald J. Diamond, MD. (2006) A SPECIAL REPORT Recovery from a psychiatrist’s viewpoint. NEW DIRECTIONS IN SCHIZOPHRENIA • A POSTGRADUATE MEDICINE SPECIAL REPORT

Psychiatrists applaud MI Psychiatrists applaud MI InitiativesInitiatives

Both Carli and Reid mentioned a recommendation for Both Carli and Reid mentioned a recommendation for strengthening the role of the state's medical strengthening the role of the state's medical director for mental health as being particularly director for mental health as being particularly important to psychiatry. important to psychiatry.

The recommendation is to "strengthen the role of the The recommendation is to "strengthen the role of the Department of Community Health Medical director Department of Community Health Medical director so that s/he becomes the leader in the so that s/he becomes the leader in the development of evidence-based practices in the development of evidence-based practices in the mental health system." The recommendation mental health system." The recommendation describes specific actions to implement those describes specific actions to implement those practices. practices.

SOURCE: Mulligan, K. SOURCE: Mulligan, K. Psychiatrists Applaud Plan To Renovate MH SystemPsychiatrists Applaud Plan To Renovate MH System Psychiatric News 2005 40: 1-57. Psychiatric News 2005 40: 1-57.

"Consumer and family members should be involved "Consumer and family members should be involved

in the design and delivery of services," she said. in the design and delivery of services," she said. "It's the only way to go." "It's the only way to go."

She also cited the importance of recommendations She also cited the importance of recommendations about suicide prevention and reducing stigma. about suicide prevention and reducing stigma.

Carli said that psychiatrists reminded the Carli said that psychiatrists reminded the commission that treatment of mental illness often commission that treatment of mental illness often necessitates managing a chronic illness. "We necessitates managing a chronic illness. "We discussed whether or not that concept conflicts discussed whether or not that concept conflicts with a focus on the recovery model and decided with a focus on the recovery model and decided that the two are not incompatible," he added. that the two are not incompatible," he added.

SOURCE: Mulligan, K. SOURCE: Mulligan, K. Psychiatrists Applaud Plan To Renovate MH SystemPsychiatrists Applaud Plan To Renovate MH System Psychiatric News 2005 40: 1-57.Psychiatric News 2005 40: 1-57.

Recovery ThemesRecovery Themes

At the core of recovery is hope!

Another key premise is that of meaning!

Many individuals have derived meaning from advocacy and political action.

A few rhetorical questions …A few rhetorical questions …

1.1. How do you spread hope through the system?How do you spread hope through the system?

2.2. How about sharing meaning with those that we How about sharing meaning with those that we serve and those that we work with?serve and those that we work with?

3.3. Have you joined forces with the local and state Have you joined forces with the local and state advocacy groups?advocacy groups?

Hope and RecoveryHope and Recovery

"Recovery is the experiential shift from despair to hope, alienation to purpose, isolation to relationship, withdrawal to involvement and from passive adjustment to active coping.”

P. Ridgeway. "Restoring psychiatric disability: Learning from first person recovery narratives." Psychiatric Rehabilitation Journal. 24(4). 2001.

The Arizona DialoguesThe Arizona Dialogues

Based on SAMHSA’s Participatory Based on SAMHSA’s Participatory Dialogues modelDialogues model

Unique to Arizona … well maybe not Unique to Arizona … well maybe not anymore!anymore!

– Trained individuals from both groups of people Trained individuals from both groups of people in the dialogue to serve as facilitatorsin the dialogue to serve as facilitators

– Contractor for Maricopa County (ValueOptions) Contractor for Maricopa County (ValueOptions) convened several Arizona Dialogues convened several Arizona Dialogues throughout the countythroughout the county

Voice and ChoiceVoice and Choice

Providing members a voice and a choice in their services:– Child and Family Teams -supporting family

decision-making

– Adult Recovery Teams –empowering individuals that need the most help

– A comprehensive array of covered behavioral health & recovery services

Arizona Fostering HopeArizona Fostering Hope

Creating an environment of hope through the Peer Support workforce:– More than 600 FTE Peer Workers statewide,

including 80 specializing in substance use recovery.

– 14 consumer-operated organizations provide peer services, warm lines, depression and alcoholism screening, employment training and educational services for members & families

– Recovery and Wellness Planning is now a routine component of behavioral health treatment

Arizona’s InclusionArizona’s Inclusion

Involving individuals and families with lived experience in DBHS quality, policy and program operations:– Mystery Shopper– Policy Committee– The Family Committee– Office of Individual and Family Affairs

Source: http://www.cs.brown.edu/courses/cs024/imagesHistoric.html

Thank You