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Our Position. Seclusion and restraints were part of the institutional design of the pastWe know that seclusion and restraints have no place in recovery-oriented environmentsThe Copeland Center wants to partner with others across the nation to move by design toward a culture of wellness and recover
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1. Creating A Culture of Wellness A Path To Eliminating Seclusion and Restraints
February 29, 2012
2. Our Position Seclusion and restraints were part of the institutional design of the past
We know that seclusion and restraints have no place in recovery-oriented environments
The Copeland Center wants to partner with others across the nation to move by design toward a culture of wellness and recovery
3. Our Hope Our position paper on eliminating seclusion and restraints aspires to stimulate an active, ongoing dialogue about alternatives to any use of seclusion and restraints in any part of our mental health system
Through dialogue, relationships, leadership, policy changes, peer support and staff training, together with others we can create a foundation upon which to build a person-centered, wellness and recovery-oriented mental health system free of seclusion and restraints
4. Our Committee Many thanks to the members of our committee for their time, talents and conviction
Mary Ellen Copeland Katie Wilson
Matthew Federici Carol Bailey Floyd
Cheryl Sharp Gina Calhoun
Erica Buffington Ed Anthes
Sarah Bourne Audrey Garfield
Ellie Goldfarb Christine Allers
5.
Cheryl S. Sharp, MSW, ALWF, CPSST
Special Advisor for Trauma-Informed Services
The National Council for Community Behavioral Healthcare
1701 K Street, Suite 400
Washington, D.C. 20006-1526
Ph. 202/684-7457, ext. #254
6. Joan Gillece, PhD
Director, SAMHSA Promoting Alternatives to Seclusion and Restraint through Trauma-Informed Care and Director, SAMHSA’s National Center for Trauma-Informed Care
7. Tonier Cain
Coordinator of Consumer Affairs, SAMHSA Promoting Alternatives to Seclusion and Restraint through Trauma-Informed Care and Coordinator, SAMHSA’s National Center for Trauma-Informed Care
8. Seclusion-Restraint Reduction: Pennsylvania’s History Robbie and Aidan Altenor
9. Pennsylvania’s Guiding Principles Seclusion and restraint are NOT treatment interventions
Seclusion and restraint represent power and control
Very traumatizing to individuals receiving services and their caregivers
Often these interventions are implemented in arbitrary, abusive and violent ways
10. Major Factors To Consider Leadership
Dedicated, supportive administrative and clinical leadership
Policy changes
Debriefing
Values-driven approach
Seclusion and restraint use = Treatment failure
Training
For all staff
Psychiatric Emergency Response Teams
Treatment
Recovery-supporting approach
Measurement and data sharing
Transparency
11. Progress Summary: December, 2011
12. Progress Summary: December, 2011
13. Outcome Hospital environments safer for individuals receiving services and their support staff
Much more respectful and supportive
Much less use of invasive procedures
PRN medications and seclusion and restraint
Focus is on treatment in support of recovery
Much more hopeful
Since the initiative started, 5 Pennsylvania state hospitals have closed
14. Alternatives to seclusion and restraint in Pennsylvania’s state hospitals Increased attention to special needs and individual strengths of each person
Increased attention to closing/downsizing institutions
Development of the Community Support Planning initiative
Supports recovery-focused treatment while hospitalized and identifies supports needed upon discharge
Increased attention to environment/milieu
Increased transparency
Invite community partners into institution; view hospital as part of, not apart from, the community
Increased role of Certified Peer Specialists
15. Individuals involved in Pennsylvania’s criminal justice system State hospital data for S/R includes individuals confined in the hospitals’ forensic centers
Important distinction between restraint for a psychiatric emergency vs. restraint for detention/security purposes
Individuals convicted and sentenced to a State Correctional Institution are under jurisdiction of Department of Corrections
Collaboration between Office of Mental Health and Department of Corrections
16. WRAP Expansion at Oregon State Hospital Michael Hlebechuk
Outreach Specialist
Oregon State Hospital
17. WRAP Training at Oregon State Hospital (OSH) 74 patients, staff and community stakeholders received Seminar I training in September and November of 2011
48 graduates of Seminar I will receive Seminar II training beginning in March 2012 and will be certified WRAP Facilitators
18 graduates of Seminar II will receive Advanced WRAP Facilitator Training
The 18 Advanced WRAP Facilitators will train and certify other OSH staff, patients and community members as WRAP Facilitators
18. OSH Treatment Malls Patients at OSH attend groups and activities for up to 20 hours a week at treatment malls
WRAP Facilitators certified through the WRAP Expansion Project will facilitate WRAP training on OSH treatment malls and in local communities where most patients are discharged
Every patient who elects to have a WRAP will be provided WRAP training
Participation in WRAP will be self-directed
19. Projected Outcomes The expansion of WRAP at OSH is likely to increase patient recovery and decrease patient-to-patient and patient-to-staff conflict and altercations
With improved recovery and decreased conflicts and altercations, seclusion and restraint is likely to decrease markedly
20. For More Information For more information e-mail Michael Hlebechuk at
Michael.Hlebechuk@state.or.us
21. Question & Answers
22. WRAP Retreat May 6-10, 2012
Genesis Spiritual Life and Conference Center
Westfield, MA
• Join experienced recovery educators for
a week of activities, workshops, and
fun while expanding your wellness
toolbox, trying new things, and
focusing on your personal wellness.
Recovery educators will be on hand to
support participants in writing and
expanding their WRAPs.
23. SAVE THE DATE WRAP AROUND THE WORLD CONFERENCE
Oakland, CA
January 26-28, 2013
24. WRAP Facilitator Training • April 9-13, 2012 in Chicago, IL - partnership with
National Council for Community Behavioral
Healthcare
• Oct 1-5, 2012 in Brattleboro, VT
• More being added to calendar!
• check http://copelandcenter.com for most up to
date information