1 WELCOME! Tennessee Certified Peer Recovery Specialist Conference October 14, 2013 Montgomery Bell State Park Burns, TN “The Personal Journey to Recovery ” By: Peter Ashenden Director of Consumer Affairs Optum Health

2 THIS PRESENTATION  Discuss recovery perspectives and my personal recovery story  The skills I have acquired while in recovery  Surveys and Information that is helpful in demonstrating that peer support is powerful  Things you can do to help you and your community

3 The President’s New Freedom Commission: “We envision a future when everyone with a mental illness will recover… and at any stage of life has access to effective treatment and supports – essentials for living, working, learning, and participating fully in the community.” RECOVERY

4 The Consumer Perspective: “Recovery is having a meaningful life in the community of your choice.” --- consumers “Hope is to recovery as Oxygen is to the human body.” --- Larry Fricks

5 Origins of Recovery: It ’ s mainstream now 1900’s MHA, The Bell1900’s MHA, The Bell 1940’s Psychosocial Rehabilitation programs1940’s Psychosocial Rehabilitation programs 1950’s Medication, shock therapy1950’s Medication, shock therapy 1960’s Anti Psychiatry Movement1960’s Anti Psychiatry Movement 1970’s Organized groups1970’s Organized groups fighting for patients' rights 1980’s Consumers1980’s Consumers self-help/advocacy groups & peer-run services 1990’s Surgeon General’s report1990’s Surgeon General’s report – peer services /support mainstream 2000’s President's New Freedom Commission2000’s President's New Freedom Commission validates the concept of recovery 2000’IOMQuality Chasm2000’s IOM Quality Chasm mental health is key to overall health

6 A Powerful Statement: On August 11, 2008 in Bethesda, Maryland at the “Returning Vets Conference” Kathryn Power, Director of the Center for Mental Health Services (former), a division of SAMHSA said: “Restraint and Seclusion as well as any type of FORCED SERVICES must be seen as treatment FAILURE not treatment protocol.” FORCED SERVICES

7 Bottom Line People with mental illnesses and chronic medical conditions can and do get WELL

8 Bella the Wonder Dog/Service Dog

9 My Story:  My Past  My Own Self-Destructive Behaviors  The Turning Point  Finding Support Groups  How I Maintain Wellness Today PETER’S RECOVERY JOURNEY

10 I am going to cover several surveys that let us know what people are looking for from their mental health service system Important information from Surveys

11  I wish my provider would:  Provide tangible things to do between appointments (63%)  Help me create a plan for my life with specific goals (60%)  Talk about my whole life, not just medication (54%)  Give me information about my illness (51%)  Provide choices instead of telling me what to do (49%)  Treat me like an individual, not a case (48%) SURVEY FINDINGS

12  I want my provider to: 1.Give me hope for recovery 2.Listen deeply for what is important to me 3.Treat me like a person 4.Look at my whole life and build on my strengths, instead of focusing on my deficiencies 5.Give me information I can use 6.Empower me to take more responsibility for my wellness CONSUMERS TELL US

13 But I know all this already: Keep an open mind Survey results of over 500 providers and 2,000 of their patients reveal the most basic of recovery/resilience practices are not occurring: Explain your Illness to your satisfaction? No: Psychiatrist 47%, PCP 63% Explain your treatment to your satisfaction? No: Psychiatrist 48%, PCP 57% 71% of Providers say they make joint decisions, but only 39% of their patients say they were even asked their preferences 69% of Providers say they tell side effects, but only 16% of their patients say they were told What we think and how we are acting may not be in synch or we may know less about how to incorporate recovery into practice than we think we do

14 NEW TOOLS Tools that help us to take better care of ourselves

15 NEW: FacingUs.org

16 NEW: DBSA Wellness Tracker

17 Copeland Center on Wellness WRAP – the Wellness Recovery Action Plan WRAP is a structured system to monitor uncomfortable and distressing symptoms that can help you reduce, modify or eliminate those symptoms by using planned responses. This includes plans for how you want others to respond when symptoms have made it impossible for you to continue to make decisions, take care of yourself or keep yourself safe. WRAP is designed to: Decrease and prevent intrusive or troubling feelings and behaviors Increase personal empowerment Improve quality of life Assist people in achieving their own life goals and dreams. copelandcenter.com

18 As a process of discovery… Defining Recovery

19 The Five Stages in the Recovery Process (Fricks, 2011) The Role of Peer Support is Promoting Hope and Fostering Strengths - The role of Peer Support is to: 1. Being overwhelmed by the disabling power of the illness. Decrease the emotional distress by reducing symptoms. 2. Feeling like life is limited and will never be the same again. Instill hope, a sense of possibility, and rebuild a positive self-image. 3. Recognizing that change is possible and believing life can be different. Empower the person to participate in their own recovery by beginning to take small steps. 4. Making a commitment to change and exploring the challenging and disabling power of the illness. Help identify a person’s strengths and needs in terms of skills, resources and supports. 5. Moving beyond the disabling power of the illness and adopting actions for change. Help a person to use their strengths and get the necessary skills, resources, and supports.

20 Characteristics of a Recovered Person: Full Life in the Community  Make their own decisions  Fulfilling network of friends  Major social role other than consumer  Uses emotional distress as an opportunity for growth  “Most untrained persons would not consider him/her sick”  Primary supports outside mental health system Dan Fisher, MD, PhD

21 “Seven Dirty Words” 1.The bipolar in room six vs. Joe who lives with bipolar disorder 2.Compliance vs. Adherence 3.Mary failed the treatment vs. the treatment failed Mary 4.The treatment team vs. member-centered treatment 5.The front lines vs. partner in care 6.Decompensate vs. having a bad day 7.Unmotivated vs. someone who we have not engaged in strengths based recovery goal setting

22 Strengths Based Recovery focuses on valuing and building on the multiple capacities, resiliencies, talents, coping abilities, and inherent worth of individuals.

23 Responsibility We can promote self-responsibility by supporting people in:  Making life and treatment choices for themselves, no matter how different they look from traditional treatment  Building their own crisis and treatment plans  Having the ability to obtain all their records  Accessing information about medication side effects  Determining the potential outcomes of decisions  Choosing their own relationships and spiritual practices  Creating the life of their choice

24 Peer Support Peer support provides …  Practical help  Reciprocal support  Friendship-based relationships  Experiential Knowledge  Alternative interpretations  Consensual validation

25 Recovery… … does not refer to an end product or result. It does not mean that one is "cured" nor does it mean that one is simply stabilized or maintained in the community. Recovery often involves a transformation of the self wherein one both accepts ones limitation and discovers a new world of possibility. -Pat Deegan

26 The Cycle: based on a real person in our system  Man presents with depression  Is given an antidepressant  His symptoms worsen  His prescription is strengthened  His symptoms worsen  He is sent to talk therapy – and refuses  A second medication is added to the first  He ends up in the hospital after a suicide attempt  He is set up with talk therapy day treatment and a new psychiatrist upon discharge  He does not show up for any appointments

27 The Cycle: same person, different look  Man presents with depression – he has chronic back pain and can no longer work or have intimacy with his wife. She is the most important thing to him in his life. He fears she will leave him.  No one asks about his back pain, employment or what he wants from treatment. He is given an antidepressant that further impairs his ability for intimacy.  His symptoms worsen as he blames himself and fears his wife will leave him.  His prescription is strengthened which further worsens his issue  In despair he attempts suicide.  Still not asking him his goals or wishes, he is set up with a talk therapist, day treatment and new doctor – how does this help him achieve intimacy and get a job? The intervention makes no sense to him. He does not show up at the appointments.  Did we make him better or worse?

28 The Cycle: a different look  Man presents with depression  He is asked what he cares most about and what he hopes will occur from the visit.  He and the provider talk through a strategies for communicating with his wife about his worries.  He and his wife are encouraged to go to no more than 2-3 sessions with a talk therapist to make it easier to communicate.  In the meantime he is set up with a new specialist to look at his back issues.  He is set up in a job retraining program to discover things he can do with his experience, mind, and skills even with back pain.  If still needed after a month, prescription for a mild anti-anxiety or antidepressants with no intimacy side effects will be offered.

29 TAKING ACTION  Ways to motivate individuals to take action:  Focus Groups  Listening Sessions  Educational Sessions  Determining a Common Cause  Voter Registration  Peer Networking Groups  Support Groups  Drop-In Centers

30 TAKING ACTION  Ways to motivate individuals to take action:  Prepare Questions before our Visits with Health Care Providers  Encourage Active Discussions with Health Care Providers  Ask for Information about any Treatment or Medication  Seek Support from Others  Attend Online Support Groups

31 Watch your thoughts; They become your words. Watch your words; They become your actions. Watch your actions; They become your habits. Watch your habits; They become your character. Watch your character for it will Become your Destiny.

32 THANK YOU! Peter Ashenden Director of Consumer Affairs Optum Health