WRAP®

1. WRAP® Wellness Recovery Action Plan Presented at the conference Rediscovering PSR in a New Decade September 21st 2010 By Danielle Perron-Roach Registered Social Worker at Montfort Hospital (Ottawa) and Certified Advanced Level WRAP Facilitator

2. Today Will discuss: Current social and political context outlining the need the establish a recovery approach; The Copeland Center and its founders; Ottawa’s own WRAP ® culture; The key concepts of recovery; Review the components of a Wellness Recovery Action Plan; Present the findings of empirical studies supporting this framework; The future of WRAP ®?

3. Mental Health Recovery in Canada • TOWARD RECOVERY & WELL-BEING: A Framework for a Mental Health Strategy for Canada published by the Canadian Commission on Mental Health in November 2009. • Canada was the only G8 country who had not defined mental health strategies until this report was published. • This document is meant to stimulate profound transformations to our existing mental health system. • This rapport insists that recovery be placed at the heart of our mental health reform. (p.8)

4. Mental Health RecoveryA global phenomenon • Recovery is recognized by the United States, Australia, England, Italy, New Zealand, Scotland and Canada as being fundamentally neccessary to the reform of their mental health system. A. Kathryn Power (Director of the Center for Mental Health Services (SAMHSA) U.S. Department of Health and Human Services) at the Mental Health Commission of Canada’s Annual Conference on May 29, 2009 in Toronto, Canada. The speech was entitled Recovery in DEPTH: Transforming Mental Health Care in the United States and Canada.

5. REFORM • The medical model establishes mental health issues as being the result of a neurological disorder which can primarily be treated with medication. • This traditional model promotes the alienation and exclusion of people who receive a psychiatric diagnostic by portraying them as being unable to manage their own difficulties and as being dependant on the system.

6. Recovery is… « …, we consider mental health recovery to be a journey, not necessarily a destination. The process of recovery builds on the strengths of each individual. It is nonlinear and self-directed. Recovery is holistic and person-centered and it involves personal and community respect and responsibility. It empowers consumers to make decisions that impact their lives and to support and encourage one another. Perhaps, most important, recovery involvesHOPE. » • Kathryn Power (speech given May 29th 2009)

7. What is WRAP ®? Wellness Recovery Action Plan ® Have you every had to deal with a difficult situation that affected your physical, mental, social, professional and personal functioning? YES/NO What did you do to help you cope with the situation? WRAP ® is about identifying what works for YOU!

8. History: • After eight (8) years of living within a mental • health institution and her family having been • told that she would never be discharged home, Kate developed the first peer-support group within that establishment. Kate recognized her own need to obtain the support from others who shared common experiences. Follow this initiative, Kate started to feel much better and was shortly thereafter discharged home at the age of 45.  She went on from there to get a highly coveted job as nutritionist in an inner city high school. The Copeland Center for Wellness and Recovery is named in  honor of, and dedicated to, the memory of Kathryn Strouse Copeland (1912-1994)

9. WRAP ® • WRAP® is a structured series of workshops (8 to 12 sessions lasting each between 120 to 150 minutes); • WRAP® is facilitated by people who have developed their own WRAP ® and who are trained by Advanced Level Facilitators who are certified exclusively by the Copeland Center;

10. WRAP ® (continued…) • The purpose of the WRAP® workshops is to provide a mutually supportive environment in which you can define your own personalized plan that will help you to cope with life’s challenges; • WRAP ® can be applied to any situation (i.e. weight loss, addictions, veterans, youth, trauma, loss, loneliness, chronic pain…).

11. WRAP ® (continued…) WRAP ® works because… • It breaks the social stigma associated with the “invalidity ” perception; • Its self-directed; • It puts YOU in charge of your well-being; • Its ALL about choices; • Everyone is treated equally;

12. WRAP ® works because… (cont…) • WRAP ® provides HOPE: • Workshops facilitated by peers (not a teaching format); • Through mutual support; • Validation of shared experiences; • Non-judgemental; • Reinforces the use of personal strengths.

13. VALUES & ETHICS HOPE Personal Responsibility Education Support Self-Advocacy

14. Parts of the WRAP ® Wellness Toolbox Daily Maintenance Plan Triggers and Action Plan Early Warning Signs and Action Plan When Things are Breaking Down and Action Plan Crisis Plan or Advanced Directives

15. Parts of the WRAP ® (cont…) Post Crisis Planning

16. WRAP in Champlain District 2002 to 2007 • Psychiatric Rehabilitation Team introduces WRAP to clients of the ROMHC • September 2004 two members of the Psychiatric Rehabilitation Team attend the WRAP five day facilitator training at the Copeland Center • WRAP Groups are offered to clients and orientation sessions are offered to clinicians in the Ottawa area

17. WRAP in Champlain District (cont…) 2006 to 2007 • Increase the number of trained WRAP Facilitators • Train people in recovery as facilitators • A partnership is formed between CMHA, the Eastern Regional Network and the Royal Ottawa Mental Health Centre

18. WRAP in Champlain District (cont…) June 2007 • Communication is made with the Copeland Center • Organize WRAP Facilitator training in Ottawa for people in recovery across the Champlain District

19. WRAP in Champlain District (cont…) • 2008 Stephen Pocklington, CEO of the Copeland Center comes to Ottawa • Trains and certifies 20 people from the Champlain District as WRAP Facilitators • Emphasis is on training people in recovery

20. WRAP in Champlain District (cont…) • WRAP Groups: Community settings and hospital settings • Facilitation: partnership between peers and clinicians • WRAP groups are now being offered in a number of Consumer Survivor Initiatives in the Champlain District, at CMHA, Carlington Community Centre, at the Royal Ottawa Mental Health Centre and by Peer Support Workers on ACT Teams in the Champlain District

21. WRAP in Champlain District (cont…) 2008 and 2010 • Additional persons are trained and certified by the Copeland Center • Translation of the material into French • First WRAP workshop at Montfort Hospital in French

22. Evidence Based:“promising early results suggest” Initial Outcome of a Mental Illness Self-Management Program Based on Wellness Recovery Action planning (at the University of Illinois at Chicago) Cook, J., Copeland, M.E., Hamilton, M., Jonidas, J., Razzano, L., Floyd, D., Hudson, W., MacFaland, R, an Gray,D. Published in Psychiatric Services: A Journal of the American Psychiatric Association, February, 2009 pp.246-249. • Demonstrated significant improvement in self-reported symptoms, recovery, hopefulness, self- advocacy, and physical health.

23. Local studies: • Royal Ottawa Hospital’s study « Change Foundation » demonstrated significant improvements among the participants of the WRAP workshops offered at the Outpatient Mood Clinic in regards to their perceived: • quality of life; • self-confidence; • Recovery; • Hope Scale; • Ability to make decisions for themselves.

24. Montfort Hospital • Pilot Project from February to May 2010 (general out-patient services) • First WRAP workshop offered in French. • 10 out of 13 people completed the workshop. FINDINGS • Significant improvements: • Overall level of functioning • Perception of Hope • Recovery Process • Less negative emotions • More positive emotions • Better life satisfaction

25. Montfort Hospital (cont…) • Significant tendencies: • More confident in their ability to manage their health • Tendency to appropriate more their own decision making abilities • No changes: • Level of social support A second WRAP workshop will be offered January 2011. Further studies will be conducted to prove its efficacy.

26. Contact Us • Jacquie Cooligan, (PSO) WRAP Coordinator 613-567-4379 ext. 25 • Danielle Perron-Roach 613-822-0084 or 613-746-4621 ext 3967 • Copeland Center (802) 254-5335 • WRAP Around the World: http://wrapworld.accountsupport.com