Reducing Stigma By Focusing On Recovery

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Reducing Stigma By Focusing On Recovery A Systems
Approach
Thomas A. Kirk, Jr., Ph.D., Commissioner Connectic
ut Department of Mental Health and Addiction
Services
State Systems Development Program November 20,
2002
Gerald Croog
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We are a healthcare service agency.
Promote health
through prevention and early intervention
services.
Recover and sustain health
through treatment and recovery support services.
Need to broaden and strengthen our system of
effective prevention, early intervention and
treatment services.
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addicts
a chronic, relapsing disease
severe persistent mental illness
What message are we conveying?
Doesnt anybody ever get better?
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I AM NOT A JUNKIE ANYMORE!
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Recovery
People get better!
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Recovery Defined

• The Department endorses a broad vision of
  recovery that involves a process of restoring or
  developing a positive and meaningful sense of
  identity apart from ones condition and then
  rebuilding a life despite or within the
  limitations imposed by that condition. A recovery
  oriented system of care identifies and builds
  upon each individuals assets, strengths, and
  areas of health and competence to support
  achieving a sense of mastery over his or her
  condition while regaining a meaningful,
  constructive, sense of membership in the broader
  community.

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Recovery is not a stand-alone initiative. It is
an overarching theme for everything we do.
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Anchors for the Recovery System Implementation
Commissioners Policy Statement

• Provides recovery vision for the system
• Establishes recovery and quality as overarching
  system goals
• Emphasizes person centered approach
• Guides policy and planning efforts
• Highlights importance of meaningful community
  membership

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Factors Influencing the New Recovery Movement in
CT

• Addiction self-help movement
• Mental Health consumer/survivor movement
• Family movement - NAMI
• Advances in treatment approaches
• Recovery oriented research
• Mental health and addiction advocates
• Commitment of DMHAS leadership to recovery
  principles

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Strategic Goals

• Establish a statewide quality of care management
  system to achieve defined service outcomes and
  the continued improvement of the integrated DMHAS
  healthcare system.
• Provide culturally competent and integrated
  services to persons whose needs are particularly
  challenging or not being well met in the current
  system.

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Three Essentials for Effective Treatment

• Maybe I have a Problem
• Tools of Recovery
• Examples of Success

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• RECOVERY SPECIALISTS
• RECOVERY HOUSES
• RECOVERY PLANS
• BASIC NEEDS PROGRAM RECOVERY SUPPORT SERVICES
• CCAR FUNDING

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Sample Recovery Dimension in DMHAS Recovery
Model Supportive Others
Direct Service Provider How I can support people
in their recovery
Manager/Administrator How I can lead an
organization that supports recovery
Person In Recovery What recovery means to me

• Staff help people build connections with
  neighborhoods and communities
• Services are provided in natural environments
• Peer support is facilitated and utilized
• Natural supports are relied upon

Recovery Markers We will know that we are
working together toward recovery when
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Current Initiatives
Public Education
Advance Directives
Recovery Institute
Recovery Plan
Housing and Vocational Services
CSAT/CMHS Consultation
Recovery Self Assessment
Commissioners Advisory Council
Recovery Policy Work Group
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Recovery Self Assessment

• Assessment tool developed to measure recovery
  oriented practices of DMHAS providers
• Designed to provide information regarding
  provider recovery readiness
• Surveyed providers, persons being served, and
  family members

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What did we learn?

• Connecticut agencies vary in the provision of
  recovery-oriented practices
• Agencies were rated highest on items related to
  rights and respect i.e., refraining from use of
  coercive measures and access to records
• Agencies were rated lowest on items related to
  consumer involvement in development/ provision of
  services and recovery education
• Providers had more negative appraisals of
  agencies recovery-oriented practices than
  directors, persons being served, and family/sig.
  oth./advocates

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Recovery Policy Work Group

• Established to review DMHAS policies that support
  or impede recovery practice
• Examine key areas of fiscal and administrative
  areas of operation
• Charge is to make recommendations regarding
  policy that supports recovery
• Comprised of state-operated staff

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CMHS and CSAT Consultation

• Consultation through Federal partners re recovery
  system re-design
• Assess DMHAS recovery readiness
• Consult with key stakeholders
• Provide recommendations re implementation of
  recovery system

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Person Centered Recovery Plan

• Promotes self-determination and community
  membership in valued social roles
• Re-orients participants, including providers to
  strengths based or solution oriented models
• Develops skillful use of personal and community
  assets
• Extends beyond medical model

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Components of Connecticuts Recovery Model

• Promotion of recovery vision
• Workforce development initiatives
• Consumer/Recovering Person service initiatives
• Public education and anti-stigma campaign
• Initiatives to increase individual and family
  participation
• Resource reallocation strategies
• Align policies and administrative procedures to
  support recovery

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Recovery Institute

• Assist in development of a recovery oriented
  system of care by providing education and
  training, consultation and technical assistance.
• THREE LEVELS OF OFFERINGS
• Open Trainings To promote widespread knowledge
  of recovery paradigm. 5 regional session. 100
  participants/session.
• Intensives Skill based. Direct service staff,
  administrators/supervisors, persons in recovery.
  25 participants/cohort. 8 weeks, 2 hour/session
  after initial day of training.
• Centers of Excellence Develop agency-based model
  programs. Provide training to staff, technical
  assistance to administrators. Phase 1- Program
  development. Phase 2- Use Centers as
  training/internship sites.

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Strategy for Implementing a Recovery-Oriented
System
Bauers S-shaped Diffusion Curve
From Mark Bauer, in press
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Highlights of Progress to Date

• Developed Commissioners Recovery Policy
• Hosted 2 major recovery conferences
• Developed CT Recovery Model
• Secured funding for Recovery Institute
• Obtained technical assistance grants for
  development of recovery-oriented system
• Completed recovery system assessment
• Completed system wide consumer driven Voice Your
  Opinion satisfaction survey
• Supported continuation and expansion of peer
  operated services

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Areas for Further Development

• Consensus building with persons in recovery,
  family members and providers
• Identification of best practices and model
  programs and distribution to field
• Re-orienting all DMHAS systems and initiatives
  (Behavioral Health Partnership, outcomes,
  monitoring, housing) to support recovery oriented
  system of care
• Development of recoveryoriented outcomes
• Coordination with housing initiatives

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State of Connecticut Department of Mental Health
Addiction Services
Recovery is our business
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THE FISCAL REALITIES OF

• 2003
• 2004
• 2005

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The Ultimate Goals of Recovery

• Decent place to live
• Something worthwhile to do
• A social life

Recovery is a Journey, Not an Event
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THANK YOU FOR THE CASSEROLE
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Public Education

• Marketing strategy for increasing and maintaining
  awareness of recovery activities (consumer,
  provider, and DMHAS staff )
• Anti-stigma campaign aimed at general public
• Build momentum through community education

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Thank You