Recovery in DEPTH: Transforming Mental Health Care in the United States and Canada Mental Health Com

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Recovery in DEPTH Transforming Mental Health
Care in the United States and CanadaMental
Health Commission of Canada Annual
ConferenceMay 29, 2009

• A. Kathryn Power, M.Ed.
• Director, Center for Mental Health Services

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International Transformation Priorities

• Making mental health a public health priority,
  promoting mental wellbeing, and diminishing the
  discrimination associated with mental illness
• Improving access and enhancing the range of
  available services
• Assuring an adequate, competent, and skilled
  mental health workforce
• Making consumer involvement, response to
  individual needs, and recovery and wellness the
  focus of mental health care
• Integrating and linking mental health care with
  general health care and other sectors and
  services
• Promoting evidence-based, measurable, and
  accountable mental health care

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New Freedom Commission Goals

• Goal 1 Americans understand that mental health
  is essential to overall health.
• Goal 2 Mental health care is consumer and family
  driven.
• Goal 3 Disparities in mental health services are
  eliminated.
• Goal 4 Early mental health screening,
  assessment, and referral to services are common
  practice.
• Goal 5 Excellent mental health care is delivered
  and research is accelerated.
• Goal 6 Technology is used to access mental
  health care and information.

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Federal Partners

• Department of Agriculture
• Department of Defense
• Department of Education
• Department of Health and Human Services
• Department of Housing and Urban Development
• Department of Justice
• Department of Labor
• Department of Transportation
• Department of Veterans Affairs
• Social Security Administration
• Equal Employment Opportunity Commission

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Recovery In DEPTH

• Define recovery and all its dimensions.
• Eliminate practices and beliefs that work against
  recovery.
• Promote healthy behaviors that support recovery.
• Train health care providers to understand,
  embrace, and expect recovery.
• Hold ourselves and others accountable for
  transforming systems and services that make
  recovery possible.

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Consensus Definition of Recovery
Mental health recovery is a journey of healing
and transformation enabling a person with a
mental health problem to live a meaningful life
in a community of his or her choice while
striving to achieve his or her full potential.
National Consensus Statement on Mental Health
Recovery
Ten fundamental components of recovery

• Strengths-Based
• Peer Support
• Respect
• Responsibility
• Hope

• Self-Direction
• Individualized and Person-Centered
• Empowerment
• Holistic
• Non-Linear

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Campaign for Mental Health Recovery
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Suicide Prevention Lifeline
Special Feature for US Military Veterans The
National Suicide Prevention Lifeline has a new
feature for veterans. Call for yourself, or
someone you care about 1-800-273-TALK (8255) and
press 1. Your call is free and confidential.
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Mental Health Continuum
Positive Mental Health Mental Health
Problem Mental Disorder High-level capacity of
the Disruption in interactions Medically
diagnosable illness individual, group,
and between individual, group,, that results in
significant environment to interact and
environment, impairment of cognitive, to promote
well-being, producing a diminished affective, or
relational abilities optimal development,
and state of positive mental health use of mental
abilities
Mental Health Status Continuum Mental Health
Care Continuum
Enhancing Health Primary Prevention Early
Recognition Treatment and Promoting
optimum Addressing risk factors and
Intervention Rehabilitation mental health,
e.g., job vulnerable groups, Detecting a
problem Interventions to satisfaction,
resilience, e.g., coping skills for or illness
at an early reduce symptoms of self-esteem,
people who are stage and increasing an illness,
diminish and social skills, improving unemployed,
home visits access to effective disability, and
improve access to income for families
experiencing treatment quality of
life separation or divorce
Source Scanlon, K., Williams, M., Raphael,
B. (1997). Mental Health Promotion in NSW
Conceptual framework for developing initiatives.
NSW Health Department, Sydney, Australia, p.9
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Mental Health Is Essential to Health

• Roughly half of Americans will have a mental
  health disorder in their lifetime.
• 30 percent of the burden of disease is
  attributable to mental health and substance use
  conditions.
• Individuals with depression and chronic physical
  health conditions cost 1.7 times more to treat.
• There is a 25 to 50 percent increased cost to
  treat physical health conditions when mental
  health and substance use conditions are not
  adequately treated.

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Global Burden of Disease
The top 3 leading causes of disability worldwide
are behavioral disorders.
The World Health Report 2001 Mental Health
New Understanding, New Hope
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Workforce Development Resource Center
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Defining Transformation

• A continuous process, without endmeant to create
  or anticipate the future
• Identifies, leverages, and even creates new
  underlying principles for the way things are done
• Identifies and leverages new sources of power
• Once the process is begun, a profoundly different
  organization emerges, including changes in
  structure, culture, policy, and programs
• The Late Vice Admiral Arthur Cebrowski
• Special Assistant for Transformation
• U.S. Department of Defense

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Principles for Health Reform

• Articulate national health and wellness plan for
  all Americans
• Universal coverage of health insurance
• Coordination and integration of care for physical
  health, mental health, and substance use
  conditions
• Provide full range of prevention, early
  intervention, treatment, and recovery services
• Implement national quality standards and means to
  measure and monitor results as well as ensure
  accountability
• Invest in results align payment to most
  appropriate treatment, use of evidence based
  approaches, and outcomes
• Strengthen and expand the workforce to address
  unmet needs and health disparities

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Evidence-Based Practices

• First generation toolkits
• Assertive Community Treatment
• Co-occurring Disorders
• Supported Employment
• Illness Management and Recovery
• Family Psychoeducation

• Second generation toolkits (in press)
• Older Adults
• Supported Housing
• Consumer-operated Services
• Disruptive Behavior Disorders in Children

Evidence-based practices will be featured on our
Workforce Development Resource Center and Mental
Health Transformation Web Portals
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• It was once said that the moral test of
  government is how government treats those who are
  in the dawn of life, the children those who are
  in the twilight of life, the elderly and those
  who are in the shadows of life, the sick, the
  needy and the handicapped.
• Hubert H. Humphrey, Jr.