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Visit with ...........................

Visit with . Scotch Plains, NJ, January 24, 2014. Outline. PsyR : What? Where? Who? NJPRA World: Sector Analysis NJPRA Stand: Issues and Positions. Psychiatric Rehabilitation: What? Where? Who?. What is PsyR ?. Psychiatric Rehabilitation...

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  1. Visit with ........................... Scotch Plains, NJ, January 24, 2014

  2. Outline • PsyR: What? Where? Who? • NJPRA World: Sector Analysis • NJPRA Stand: Issues and Positions

  3. Psychiatric Rehabilitation: What? Where? Who?

  4. What is PsyR? Psychiatric Rehabilitation... helps those with psychiatric disabilities... get emotional, social and intellectual skills and supports... to live, love, learn and work... as and where and how they wish... as independently of professional supports as possible... thus to engage, pursue and achieve recovery... as they determine it for themselves.

  5. What is PsyR? Psychiatric Rehabilitation... helps those with psychiatric disabilities... get emotional, social and intellectual skills and supports... to live, love, learn and work... as and where and how they wish... as independently of professional supports as possible... thus to engage, pursue and achieve recovery... as they determine it for themselves. Psychosocial

  6. What is PsyR? Psychiatric Rehabilitation... helps those with psychiatric disabilities... get emotional, social and intellectual skills and supports... to live, love, learn and work... as and where and how they wish... as independently of professional supports as possible... thus to engage, pursue and achieve recovery... as they determine it for themselves. Schizophrenia Bipolar Schizoaffective Borderline Depression

  7. What is PsyR? Psychiatric Rehabilitation... helps those with psychiatric disabilities... get emotional, social and intellectual skills and supports... to live, love, learn and work... as and where and how they wish... as independently of professional supports as possible... thus to engage, pursue and achieve recovery... as they determine it for themselves. Coping Relaxation Living Financial Social Employment Education Housing

  8. What is PsyR? Friends Lover Spouse Psychiatric Rehabilitation... helps those with psychiatric disabilities... get emotional, social and intellectual skills and supports... to live, love, learn and work... as and where and how they wish... as independently of professional supports as possible... thus to engage, pursue and achieve recovery... as they determine it for themselves. College Grad School Tech School Social life Clubs Church Worker Manager Volunteer

  9. What is PsyR? Psychiatric Rehabilitation... helps those with psychiatric disabilities... get emotional, social and intellectual skills and supports... to live, love, learn and work... as and where and how they wish... as independently of professional supports as possible... thus to engage, pursue and achieve recovery... as they determine it for themselves. Choice Community

  10. What is PsyR? Programs Doctors Hospitals “Interventions” Psychiatric Rehabilitation... helps those with psychiatric disabilities... get emotional, social and intellectual skills and supports... to live, love, learn and work... as and where and how they wish... as independently of professional supports as possible... thus to engage, pursue and achieve recovery... as they determine it for themselves. “Disability” supports SSI / SSD

  11. What is PsyR? ... helps those with psychiatric disabilities... get emotional, social and intellectual skills and supports... to live, love, learn and work... as and where and how they wish... as independently of professional supports as possible... thus to engage, pursue and achieve recovery... as they determine it for themselves. “Stabilization” Remission “Normal” Adjustment Actualization Autonomy

  12. Recovery Principles...

  13. What Is PsyR? • A goal • A role • A specialty • A discipline

  14. Who Provides PsyR? Consumer

  15. Where is PsyR? • Day services • Residential abodes • Case management • PACT (Programs of Assertive Community Treatment) • Vocational programs • Educational programs • Hospitals • Families • Peer initiatives

  16. Why PsyR? • Severe and persistent mental illness is... • Long term • Recurrent • Difficult • Disruptive (of life) • Interruptive (of development) • Debilitating (of capacity) • PsyR thus advances... • Long-term recovery • Community integration • Quality of life

  17. PsyR Values • Self determination • Individual dignity and worth • Individual potential • Cultural sensitivity • Hope

  18. PsyR Principles • Individual services • Maximum individual choice • Normalized community basis • Strengths-based • Situational assessments • Holistic, integrated supports and skills training • Accessible, coordinated services • Environmental modifications • Partner with families • Practical outcomes

  19. Challenges to PsyR • Institutional pessimism • Organizational barriers • Training demands • Funding shortages • Quick-fix thinking • “Courtesy” stigma

  20. The National Organization Since 1975 Formerly IASPRS Formerly USPRA 8000 members

  21. What Is A CPRP? • “Certified Psychiatric Rehabilitation Practitioner” • Supervised by the Commission • Partly “founded” in NJ • Transdisciplinary

  22. Who Are CPRPs • Professors Melissa Roberts, PhD, CPRP • Doctors • Psychologists • Social Workers Nora Barrett, MSW, CPRP • Occ. Therapists • Managers Tom Pyle, MBA, CPRP • Peer Specialists Harry Coe, CPRP • Nurses • Direct Care

  23. 1000 individual members • A leading state chapter • (along with NY, CA, MA, IL, GA...) • 501c4  501c3 • A 2 day annual conference > 250 people • Various trainings • Advocacy work

  24. Organizational Members • Advance Housing • Atlanticare • Bridgeway • CareLink • Collaborative Support Programs of NJ • Consumer Provider Association of NJ • Greater Trenton Behavioral Healthcare • Northwest Essex • Project Live, Inc. • Prospect House (MHA of Essex County) • SERV Behavioral Health Triple C Housing • Rutgers PsyR Dept. • Volunteers of America (Greater New York)

  25. Sector Analysis Government, Industry, Market, Customer, Product...

  26. Government: New Jersey

  27. Government of New Jersey

  28. Government of New Jersey

  29. Government

  30. Government • Increasing regulations • Electronic Medical Records • “RAC” Audits • Capricious and arbitrary administration

  31. Industry: An Optimal Tx Plan?

  32. Industry: An Optimal Tx Plan? 1. Hospital 2. Treatment Residential 3. Supported Residential Need (IDDT) 4. Independent Residential 4. IOP

  33. Industry: Treatment vs. Need Hospital Gap Current Tx

  34. Industry: Tx vs. Need: Choices Clinical Residential Hospital Hospital Therapeutic Communities Hospital State Hospital Group Homes Local PHP PACT Supported Housing Need (IDDT) Local IOP 4. Independent Residential 4. IOP

  35. Industry: Tx vs. Need: Choices Clinical Residential Hospital Hospital Therapeutic Communities Hospital Assertive Community Treatment State Hospital Group Homes Family Psychoeducation Local PHP PACT Illness Management & Recovery Supported Housing Need (IDDT) Local IOP Supp Housing 4. Independent Residential Supp Education 4. IOP Supp Employ

  36. Industry: 120 Agencies Of which... • Bridgeway • Catholic Charities • Drenk • Easter Seals • Family Services • Greater Trenton • Mental Health Assn Essex • Twin Oaks • ...others...

  37. Industry: Specialty Providers • Supported Housing: 46 agencies • Supported Employment: 22 agencies • Consumer-operated: 33 centers • State Hospital patients: ~1500 per year

  38. Market: Medicaid Enrollments(Centers for Medicare and Medicaid, 2012)

  39. Market: NJ Medicaid Enrollment

  40. Customer: Consumers DMHAS BG appl. says... Governor’s budget says.. • 285,000 “unduplicated consumers in community settings”, of which... • 123,000 with SMI

  41. Product: PsyR Evidence-Based Practices • Illness Management and Recovery • Integrated Dual Disorder Treatment • Assertive Community Treatment • Family Psychoeducation • Supported Employment • Supported Education* • Supported Housing* • Other “promising” practices PsyR  Recovery

  42. Recovery: As Outcome RECOVERY time

  43. Recovery: As Process RECOVERY time

  44. Recovery: 3 Models of Care Psychiatric Rehabilitation Medical RECOVERY Individual Empowerment time

  45. Models of Care Psychotherapy Psychiatric Rehabilitation Medical RECOVERY Individual Empowerment time

  46. Models of Care Psychotherapy Psychiatric Rehabilitation Illness Management & Recovery Medical RECOVERY Individual Empowerment time

  47. Models of Care Psychotherapy Psychiatric Rehabilitation Illness Management & Recovery Supported Housing Medical RECOVERY Individual Empowerment time

  48. Models of Care Psychotherapy Psychiatric Rehabilitation Illness Management & Recovery Supported Housing Supported Education Medical RECOVERY Supported Employment Individual Empowerment time

  49. Models of Care Psychotherapy Psychiatric Rehabilitation Illness Management & Recovery Supported Housing Supported Education Medical RECOVERY Supported Employment Assertive Community Treatment Family Psychoeducation Individual Empowerment time

  50. Finance: Rate Ratio (Zuckerman et al., 2009) US 0.72 WY 1.43 AK 1.40 DE 1.00 PA 0.73 CA 0.56 NY 0.43 NJ 0.37

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