Early Experiences of Employing Consumer-Providers in the VA

from Psychiatric Services:

OBJECTIVES: Following guidelines in the mental health strategic plan of the Department of Veterans Affairs (VA), VA began in 2005 to fund a number of new positions for consumer-providers (CPs)—that is, individuals with personal experience of serious mental illness who provide support services to others with serious mental illness, typically as clinical team members. This study explored the challenges of CP implementation in its early stages within the VA. METHODS: Four focus groups were conducted with a total of 59 VA CPs and 34 VA supervisors from across the United States. Group notes were coded by using a modified grounded theory approach to generate themes. RESULTS: Data from the groups suggest that hiring and employing CPs within VA has been feasible, beneficial, and acceptable to a majority of teammates. CPs reported experiencing some role confusion and resistance and fears among professional staff about how CPs would fit in. The authors make three recommendations on the basis of the focus group findings. First, CPs, traditional staff, and administrators need to be adequately prepared so that CPs can be effectively incorporated into clinical teams. Second, training for CPs varies widely, and efforts should be made to determine the best training package. Third, systems that are considering using CPs should establish a continuous quality improvement system to help evaluate CPs' performance and patient outcomes and to gather data to improve the knowledge base about CPs and their functions. CONCLUSIONS: CPs provide a wide range of recovery-oriented services and are valued by staff and consumers.

Beyond Generic Support: Incidence and Impact of Invalidation in Peer Services for Clients With Severe Mental Illness

from Psychiatric Services:

OBJECTIVE: This study explored experiences of validation and invalidation among clients with severe mental illness in treatment with either peer providers or traditional providers.

RESULTS: Mixed analysis of variance showed that communications from and interactions with providers were perceived to be more validating than invalidating by clients in treatment with peer providers than by those in treatment with traditional providers.

CONCLUSIONS: Peer providers, who reveal their experiences of mental illness to their clients, were perceived to be more validating, and their invalidating communications were linked with favorable short-term outcomes. Both peer and traditional providers sometimes express disapproval of clients' attitudes, values, or behaviors—a form of invalidation. This study found that early in the course of treatment peer providers may be effective in fostering progress by challenging clients' attitudes, values, or behaviors.

This story of mental illness -- and recovery -- is still being told

from seattlepi.com:

OLYMPIA -- Stephanie Lane saw the man arrive out of the corner of
her eye, and despite the warmth in the room, she felt a fleeting
shiver, the familiar bone chill of recognition.

The man had a sleeping bag tucked under one arm, a couple of hard
days' worth of stubble on his street-ruddy face, a vaguely hunted look.
He appeared in search of something -- a shower, a hot meal and
something else -- something less tangible. Something that resembled a
chance.

Lane, a program director with the state's mental health division,
had arrived a few minutes earlier at the Capital Clubhouse -- a drop-in
center and job-training program for people with mental illness. Chic in
black, with a toss of strawberry blond hair and sea foam-green eyes,
Lane is funny and smart, articulate and engaging. She was perched at a
lunch table in the common area discussing grant proposals when the man
walked in.

She interrupted her meeting to greet the stranger in the room.

"I'm Stephanie," she said, sticking out her hand. "I've been where you are."

They shook on that, a gesture that sealed a pact that is at once
Lane's job responsibility and her personal mission -- to help people
like herself navigate their way out of the morass of mental illness.

Recovery Movement in a Secure Facility

from St. Martin's:

St. martin's in England has residents with forensic involvement as well as a mental illness. The web site poses the possibility of recovery activity in such a facility and has  a public website created by the residents. They are currently planning a film festival, and have some of the parts of the festival on the website.

Fighting Shadows

from Mission Resource Site:

Fighting Shadows: Self-Stigma And Mental Illness:Whawhai Atu te Whakamâ Hihira incorporates the experiences of 76 men and women from around the country; including Pakeha, Maori, Pasifika, Chinese, young people and refugees.
This study, produced by the Mental Health Foundation was launched on 9th July, 2008.It shows that "negative messages about mental illness in society shape and reinforce attitudes people hold toward themselves,” said Judi Clements, Chief Executive of the Mental Health Foundation of New Zealand. “These attitudes hold people back from full participation in society, and create a cycle of internalised stigma, or ‘self-stigma’" 
Participants in the study described experiences of isolation, self-doubt, rejection by family and peers, and pessimism about their prospects of recovery.
However, participants also identified actions or ‘circuit-breakers’ to counter discrimination and negative thought patterns. These included: more visibility of people with mental illness, building peer support networks, affirming human rights, challenging negative attitudes, and encouraging mental health services to focus on recovery.
The full report can be read online. It's also available in book form, from the Mental Health Foundation.

Barriers to Trauma-Informed Mental Health Systems: Beliefs and Medical Necessity

from Trauma Transformation Peer Support:

One of the challenges for implementing a trauma-informed system is an issue of etiology – that is, the etiology of mental illness.

I know: debating cause of mental illness is not very helpful, especially when I just want peer support. Debating cause isn’t helpful when I am trying to learn how to work again, or trying to get up enough courage to go to the gym full of strangers, or stop hating myself. But I’m afraid that we will have to share uneasy proximity to the question because it is the often unspoken decision people have already made about what causes mental illness that has created so many broken state mental health systems. What we believe about the illness informs the services the system provides.

Archived Trainings on Stigma from SAMHSA and other stuff

From Mental Health News You Can Use:

Spotlight: Archived Training Teleconferences

The ADS Center recently conducted two successful training teleconferences: “Mental Health & Women in the Military: Promoting Social Acceptance and Inclusion” and “Addressing the Challenges of Medical Providers in Treating Persons with Mental Health Issues.” These calls were recorded and are available for playback.

Mental Health & Women in the Military: Promoting Social Acceptance and Inclusion

This training:

• Explores research on women in the military, mental health, and feelings of fear and shame that keep women from seeking care
• Provides an overview of strategies that may help promote acceptance and understanding and reduce negative attitudes in the military related to women, mental health and trauma issues

To access the archived recording via telephone:

1. Call the free playback dial-in number: 1-800-262-0844
2. When prompted, enter the reference number: 154837#
3. Click here to access the presentation files.

Addressing the Challenges of Medical Providers in Treating Persons with Mental Health Issues

This training:

• Describes what research shows about  the challenges providers face in providing general and mental health care to persons with mental health problems; and  the challenges, including attitudinal barriers, persons with mental health problems face when attempting to get quality mental and general health care from providers who do not specialize in mental health.
• Offers first-hand accounts from individuals about their health care experiences with health care providers—both of what worked and what didn’t work.
• Provides an overview of strategies that may help providers to develop accepting, recovery-focused attitudes that help to improve the diagnosis and care of persons with mental health problems.

To access the archived recording via telephone:

• Call the free playback dial-in number: 1-800-262-0844
• When prompted, enter the reference number: 155359#
• Click here to access the presentation files.

Online Resources

The 10 by 10 Pledge for Wellness  
The early mortality rates of people with serious mental illness – up to 25 years life lost – have recently received much-needed attention. This disparity in life expectancy is unacceptable.  People with serious mental illnesses deserve to live as long and healthy lives as other Americans.  The 10 by 10 Pledge for Wellness  was the result of a two-day meeting, sponsored by the Center for Mental Health Services (CMHS) of the Substance Abuse and Mental Health Services Administration, to develop a coordinated and strategic action plan to promote wellness and reduce early mortality. Take action to prevent and reduce early mortality by 10 years over the next 10 year time period by joining the 10 by 10 Pledge for Wellness.  

Building Bridges: Mental Health Consumers and Primary Health Care Representatives in Dialogue
In March 2005, CMHS sponsored a dialogue between consumers of mental health services and representatives of various sectors of the primary health system. In an effort to develop improved mutual understanding, respect, and partnerships, the two dozen participants accomplished the following:

• Identified issues involving mental health consumers and their experiences with primary care providers, including those that both hinder and help recovery; and
• Developed recommendations regarding attitudinal shifts and systems transformation that can lead to improved mental and general health care responses to people with mental illnesses by primary care and mental health providers.

The findings and recommendations from the dialogue are summarized in this publication.

Get it Together: How to Integrate Physical and Mental Health Care for People with Serious Mental Disorders
Get it Together examines model programs for improving integration and coordination of behavioral health and primary health services for adults and children with serious mental health problems who rely on the public mental health system for their care. It summarizes findings of a series of studies and offers recommendations for policymakers.

A Guide to Mental Wellness in Older Age: Recognizing and Overcoming Depression
The purpose of this toolkit is to help older adult mental health consumers, in partnership with their health care providers, identify and treat late-life depression. This recovery kit contains a series of fact sheets and resource material to help individuals recover from mental illness and maintain mental wellness.

Institute for Wellness and Recovery Initiatives, Collaborative Support Programs of New Jersey (CSP-NJ)
The Institute for Wellness and Recovery Initiatives of CSP-NJ (Institute) promotes and provides innovative, state-of-the-art services aimed at creating wellness, recovery and economic self-sufficiency for persons living with disabilities. Their online newsletter contains a wealth of information on wellness and mental health.

Wellness Summit

from Center for Psychiatric Rehabilitation:

As many of you know, the early loss of life by people who use mental health services has resulted in a variety of initiatives to improve our health through wellness programs of various kinds. One source of a great deal of information is the archive from the Wellness Summit. Here is a list of the papers and presentations from the Summit:

Papers & Presentations

The following pre-conference briefing documents were commissioned by CMHS/SAMHSA to guide the Summit's deliberations and provide input into the development of a national action plan:

Improving the Health of Mental Health Consumers: 
Effective Policies and Practices
Text Only Version, Rich Text Format 
Anita Everett, Johns Hopkins University School of Medicine; Jay Mahler; Janet Biblin; Rohan Ganguli, University of Pittsburgh; and Barbara Mauer, MCPP Healthcare Consulting, Inc.
Effective Policy and Practice - slides
Text Only Version, Rich Text Format

Data to Manage the Mortality Crisis
Text Only Version, Rich Text Format 
Ron Manderscheid, Constella Group; Benjamin Druss, Emory University; and Elsie Freeman
Data to Manage the Mortality Crisis -slides
Text Only Version, Rich Text Format

The Quest for Optimal Health: Can Education and Training Cure What Ails Us? -slides
Text Only Version, Rich Text Format 
Peggy Swarbrick, Collaborative Support Programs of New Jersey; Dori S. Hutchinson. Boston Center for Psychiatric Rehabilitation; and Kenneth Gill, University of Medicine and Dentistry, New Jersey
The Quest for Optimal Health: Can Education and Training Cure What Ails Us? -paper
Text Only Version, Rich Text Format

The following are presentations delivered at the Summit:

Opening Remarks
Text Only Version, Rich Text Format
A. Kathryn Power, CMHS, SAMHSA

Defining Wellness: Key Elements, Principles and Barriers
Text Only Version, Rich Text Format
Sarah Linde-Feucht, Office of Disease Prevention and Health Promotion

Promoting Wellness on the Individual Level
Text Only Version, Rich Text Format 
Lauren Spiro, National Coalition of Mental Health Consumer/Survivor Organizations

Morbidity and Mortality in People with Serious Mental Illness 
Text Only Version, Rich Text Format 
Joseph Parks, National Association of State Mental Health Program Directors, Medical Director’s Council

Promoting Wellness for Mental Health Consumers: The Role of Primary Care
Text Only Version, Rich Text Format 
Benjamin Druss, Emory University

National Wellness Summit for People with Mental Illness: Federal Initiatives 
Text Only Version, Rich Text Format 
Ken Thompson, CMHS, SAMHSA

Promoting Wellness - Saving Lives
Text Only Version, Rich Text Format 
Linda Rosenberg, National Council for Community Behavioral Health

Health and Wellness in the Future for People with Mental Illness
Text Only Version, Rich Text Format 
Barbara Mauer, MCPP Healthcare Consulting Inc.

Promoting Wellness at Academic and Research Settings
Text Only Version, Rich Text Format 
Rohan Ganguli, University of Pittsburgh

Ernie Reynolds, advocate extraordinaire!

from Northern Lakes:

We are proud to share that Ernie Reynolds was one of the featured speakers at theMichigan Association of Community Mental Health Boards fall conference. Ernie is a Certified Peer Support Specialist at Northern Lakes and has a great deal of experience with public speaking and advocacy.

Ernie has oftentimes been heard to say that if he can help just one person each day, it was a good day.  This presentation, and the many other presentations he has made in his advocacy career, was extremely effective and helped many, many people – so it must have been a tremendous day for Ernie!

Barber: Creativity, spirituality aid recovery

from Nonpareil Online:

He was a high-achieving high school student who became a pre-med student at Harvard University.

Suddenly, he couldn't handle it anymore and dropped out.

Charles
Barber, who was later diagnosed with obsessive-compulsive disorder,
felt overwhelmed by "an endless stream of worries" and fears that he
had committed terrible, violent acts that he hadn't committed.

Barber,
keynote speaker at the 14th annual Spirituality and Mental Health
Conference held Thursday at New Horizon Presbyterian Church, worked
with mentally ill people in New York City homeless shelters for 10
years. Now a senior administrator in social services and lecturer in
psychiatry at Yale University, he has since written about his
experiences in those shelters. The title essay in his first book,
"Songs from the Black Chair," won a 2006 Pushcart Prize.

MDRC Open House and Board Meeting on October 24

Michigan Disability Rights Coalition will hold an Open House from Noon to 3 PM on October 24, 2008, followed by a public Board Meeting at 4 PM on the same day. Our Office location is:

3498 E. Lake Lansing Road, Suite 100
East Lansing, MI 48823

Our phone number is 517-333-2477.

How Does Self-disclosure affect people

from Laurel Isquith:

http://download.ncadi.samhsa.gov/ken/pdf/SMA08-4337/SelfDisclosure_50p.pdf
 (50 pages, attached)

New Report Examines Mental Health Self-Disclosure

The Center for Mental Health Services recently released a new
monograph
entitled "Self-Disclosure and its Impact on People who Receive Mental
Health Services."  The negative public attitudes associated with mental
illnesses are one of the most persistent problems individuals face. The
research on addressing discrimination and prejudice has shown that
individual's attitudes improve when they have direct contact with
persons with mental illnesses, when they can get to know people beyond
labels and myths.  Such approaches rely on individuals disclosing their
past mental health service use.  This report examines the power of
self-disclosure, the benefits and costs associated with revealing one's
mental health problems, and issues of disclosure in employment settings
and by mental health providers.  Recommendations are offered to further
examine this topic and considerations are presented for individuals who
are contemplating self-disclosure.

Staffers At Workforce Training Organization Know Mental Illness

from The Hartford Courant:

Donna Duda might not be the first person who comes to mind when you think of a job coach.

Diagnosed with agoraphobia and three disorders — panic, obsessive compulsive and post-traumatic stress — Duda, of East Hartford,
hadn't held a full-time job since 1988. After working part time for a
couple of years, she only recently went back to work full time at Focus
on Recovery United in Middletown.

"My coping skill was suicide," said Duda, who would tell herself, "If I can't get through it, I can do that any night."

Duda and the other staff members at FOR-U, a nonprofit support
organization, have similar stories. They've been institutionalized or
homeless, battled drug or alcohol addiction. Most never expected to
work again.

But because of the staff's experience with mental illness, FOR-U was
chosen to run a new state program aimed at helping people dealing with
mental illness or other problems get hired. The program, called the
Connecticut Recovery Employment Consultation Service (C-RECS), will
teach those dealing with mental illness or other problems about the
Americans With Disabilities Act, help them with interviewing skills and
resumes, and maintain a website with a list of available jobs in the
behavioral health field.

Evalutating Programs to Improve Social Acceptance of People with Mental health Issues

Evaluating Programs to Improve Social Acceptance
of People with Mental Health Issues

SAMHSA’s Resource Center to Promote Acceptance, Dignity and Social Inclusion Associated with Mental Health invites you to register now for a free teleconference training titled, "Evaluating Programs to Improve Social Acceptance of People with Mental Health Issues."

Date: Tuesday, October 21, 2008
Time: 2:00 PM - 3:30 PM (Eastern Time)

To register for this training teleconference, please click here for our registration page.
Please pass this invitation along to interested friends and colleagues. Please note: Registration for this teleconference will close at 5:00 p.m., Eastern Time, on Friday, October 17, 2008.

We will email the telephone number for the training teleconference to all registered participants on Monday, October 20, 2008.

Training Summary

Most programs to promote social acceptance and address public perceptions of people with mental health problems are not evaluated for two primary reasons; (1) there is a knowledge gap regarding how to develop and conduct evaluation efforts and (2) there are a lack of resources (both human and financial) available to most groups and organizations who run stigma reduction activities and programs.
This training will:

• Demonstrate how to evaluate programs, and provide opportunities for linking with individuals who have conducted evaluations of similar efforts.
• Explain the types of things to be considered when developing, planning, and conducting evaluation activities.
• Explain how you may work with evaluators for little or no cost.
• Provide information on collaborating with various universities for help with evaluation design issues that will help generate better results.

Send in Your Questions

We invite you to send in your questions related to evaluating programs to improve social acceptance of people with mental health issues in advance of the teleconference. Speakers will answer as many questions as possible during the teleconference. Please send your questions by e-mail topromoteacceptance@samhsa.hhs.gov.
Please note that sending a question does not guarantee its inclusion in the teleconference. We will provide the speakers' contact information so that you may pursue your answer after the call. If you provide your name and organization at the time you ask your question, we may use it during the call. Anonymous questions also can be submitted.

Training Sponsor

This teleconference is sponsored by SAMHSA's Resource Center to Promote Acceptance, Dignity and Social Inclusion Associated with Mental Health (ADS Center), a project of the Center for Mental Health Services (CMHS) of the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services. The session is free to all participants.


Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Free Audio-Net Training on Self-Employment

CMHS CONSUMER AFFAIRS E-NEWS 3 OCTOBER 2008
_________________________________________________________________

You are cordially invited to

TOPIC:      Self-Employment: One Road to Recovery, An Avenue for Transformation DATE:        Tuesday, 21 October 2008 TIME:         10:00 AM - 11:30 AM (EDT)

Learn strategies to support self-employment for mental health consumers

and why entrepreneurship makes sense for some people and their recovery

The training will address the following:

• Demonstrating how entrepreneurship is related to recovery and the supports needed for successful consumer entrepreneurship,
• Providing an overview of a successful program for emerging entrepreneurs, and 
• Using Supported Employment to help consumers start their own businesses.

Presenters

• Mary Blake, SAMHSA/CMHS
• Morris Tranen, Reaching Independence Through Self-Employment (RISE, Inc.)
• Jeanne Michelle (entrepreneur), Range of Emotion
• Robert Burns, Division of Rehabilitation Services, Maryland State Department of Education

To register for this event:

• Go to the URL:  https://www.mymeetings.com/emeet/rsvp/index.jsp?customHeader=mymeetings&Conference_ID=1095798&passcode=1673322

• Choose “”Web RSVP” under “Participant Join” and enter the conference number and passcode:

CONFERENCE NUMBER: 1095798
PASSCODE: 1673322

• Provide your information for the event leader and then click submit.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

The Undead

from The Times Online: 


Trapped inside their bodies, apparently switched off to the world, but still alive: they are the undead. Or so we thought. Forty per cent of patients in a ‘vegetative state’ are misdiagnosed. Now British scientists are leading the field in trying to put that right.

Kate Bainbridge is a lively 37-year-old former schoolteacher. We are communicating in the conservatory of her parents’ home in south Cambridge. She has expressive eyes and a broad and ready smile, but she can utter only occasional single words with difficulty. She sits in a wheelchair “speaking” with the aid of a letter-board, using her left forefinger to spell out words individually.

Ten years ago, Kate went into a deep coma and was on a ventilator for several weeks. She had suffered severe brain inflammation after contracting a viral infection. When she came out of the coma, she opened her eyes and could breathe naturally, but she was unresponsive to speech and visual stimuli, and appeared to lack all conscious awareness. She was still in this condition four months after falling ill, and was later diagnosed to be in a persistent vegetative state, or PVS: in other words, persistently unaware. But the diagnosis was wrong.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Peer Support Training Curriculum Now Available!

(from the SAMHSA/CMHS Consumer E-news Listserv)

After the Crisis Initiative: Healing from Trauma after Disasters

Powerpoint | HTML

After the Crisis is a collaborative initiative between the National GAINS Center at Policy Research Associates (PRA) and National Center for Trauma Informed Care (NCTIC). The initiative is supported in part by the Substance Abuse Mental Health Service Administration’s (SAMHSA) Center for Mental Health Services (CMHS), as well as through the tremendous dedication of its members who have volunteered countless time and resources toward achieving the goals of the initiative.

The urgent need for the After the Crisis initiative was most recently highlighted by the impact of Hurricanes Katrina and Rita in communities all along the Gulf Coast. The key activities of the initiative are focused on the development of technical assistance strategies and support networks that are dedicated to addressing the long term mental health and trauma needs of disaster survivors.

The initiative’s network is comprised of a broad array of experts, many of whom are trauma survivors and have had personal experience with disaster in their communities. Collectively, membership of the initiative includes representatives from the community, state and national levels, including:

· Trauma survivors

· Consumers, consumer advocates and family members

· Program directors and administrators

· Local, state and federal government officials

· Advocacy groups

· Criminal justice system professionals

· Mental health system professionals

· Community leaders and stakeholders

· Researchers

The Issue

Many people in communities across the country have histories of trauma, as well as a serious mental illness and/or substance abuse problems. This is especially true for those individuals who are served by the public mental health and correctional systems. For anyone affected by a major disaster, its effects can be emotionally and psychologically devastating. Even for people who have never before experienced a severe trauma; post-traumatic stress disorder (PTSD), anxiety reactions, increased substance abuse, and many other reactions are common. For those individuals who have a history of trauma, the cumulative impact of trauma in their lives leaves them even more susceptible to the psychological impact of a major community disaster, such as Hurricanes Katrina and Rita.

Our Mission

We believe that providers in the behavioral health and criminal justice systems need to know how to identify and respond to the traumatization and retraumatization that can happen after a major disaster. With so many survivors of Hurricanes Katrina and Rita still struggling with the trauma inflicted by the storm, as well as with disconnection and alienation from their neighborhoods and communities, it is our mission to:

1. educate and organize constituents committed to developing national, state, and local readiness and capacity to begin to integrate the principles and practices of emerging, peer-run disaster response programs for people with mental health, criminal justice and/or previous abuse histories into mainstream disaster response efforts;

2. address what we know about how individuals respond to traumatic experiences, setting the stage for planning and organizing a more effective collective response to future disasters;

3. develop practical recommendations, strategies and program concepts for providing technical assistance to states, communities and individuals following disaster; and

4. expand the knowledge base by stimulating state and local partnerships among a variety of both public and private organizations, foundations, and constituent groups.

For more information please choose from the following options:

· After the Crisis initiative goals and key concepts (PDF)

· After the Crisis Community Mobilization Committee

· Peer Support/Response Committee

· Please email After the Crisis for more information or to become an initiative member.

Kathryn Wyeth, MDRC
"With Liberty and Access for All!"
MDRC Website: http://www.copower.org/