WELCOME!

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 Peter.Ashenden@optumhealth.com

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. RECOVERY 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.”

4. RECOVERY 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 Bell • 1940’s Psychosocial Rehabilitation programs • 1950’s Medication, shock therapy • 1960’s Anti Psychiatry Movement • 1970’s Organized groups fighting for patients' rights • 1980’s Consumers self-help/advocacy groups & peer-run services • 1990’s Surgeon General’s report – peer services /support mainstream • 2000’s President's New Freedom Commission validates the concept of recovery • 2000’s IOMQuality Chasm mental health is key to overall health

6. FORCED SERVICES 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.”

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

8. Bella the Wonder Dog/Service Dog

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

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

11. SURVEY FINDINGS • 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%)

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

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. Defining Recovery As a process of discovery…

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” • The bipolar in room six vs. Joe who lives with bipolar disorder • Compliance vs. Adherence • Mary failed the treatment vs. the treatment failed Mary • The treatment team vs. member-centered treatment • The front lines vs. partner in care • Decompensate vs. having a bad day • 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 Peter.Ashenden@optum.com