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Medication Crossroads

Medication Crossroads. Navigating Decisional Uncertainty. First: the framework. Working from a Recovery Orientation is required. People with Serious Mental Illness Do Recover. Recovery Rates Panic Disorder: 80% Major Depression: 65% Obsessive Compulsive Disorder: 60%

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Medication Crossroads

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  1. Medication Crossroads Navigating Decisional Uncertainty

  2. First: the framework Working from a Recovery Orientationis required.

  3. People with Serious Mental Illness Do Recover Recovery Rates • Panic Disorder: 80% • Major Depression: 65% • Obsessive Compulsive Disorder: 60% • Bipolar Disorder: 80% National Institute of Mental Health Council: Health Care Reform for Americans With Severe Mental Illness National Institute of Mental Health - 1993

  4. …and for people diagnosed with schizophrenia…

  5. …and for people diagnosed with schizophrenia… That’s 1/2 to 2/3!

  6. Why a Recovery Orientation Works • Higher expectations create higher outcomes while low expectations decrease the potential for recovery and foster lifelong dependence on the mental health treatment system.

  7. Why a Recovery Orientation Works • Holding the belief that a person can recover from the trauma of their mental illness and support themselves in the community creates HOPE.

  8. Why a Recovery Orientation Works • HOPE leads to a sense of self-efficacy* and self-esteem; the cornerstones of recovery and the path to improved outcomes. * The power to produce an effect

  9. Peer services, mutual support and self-help enhance the goal by adding an emphasis on the individual’s right to direct her/his own affairs, including the mental health services they receive and the medications they take.

  10. We must change how we work with people!!!

  11. Breaking News… This Just In….. Training primary care physicians in shared decision-making improves physician satisfaction in caring for patients with chronic pain and promotes the use of patient treatment agreements. Journal of General Internal Medicine: 2006

  12. Shared Decision Making Resolves Decisional Conflict • Who experiences decisional conflict? • Everybody!

  13. Shared Decision Making Resolves Decisional Conflict • What’s Decisional Conflict: • Uncertainty or difficulty in identifying the best alternative due to… • The risks or scientific uncertainty about benefits or harms • The need to make value-based judgments • Anticipated regret over the positive aspects of the rejected choice

  14. An Emerging Intervention CommonGround: Decision Support Center

  15. Concept 1: Pill Medicine What we TAKE to be well

  16. Concept 2: Personal Medicine What we DO to be well

  17. Concept 3: PowerStatement “My kids are the most important thing in mylife and they are vital to my recovery. I’m not willing to sacrifice being a good Mom to schizoaffective disorder or to medication side effects. We must work together to find a medication that will support, not interfere with, my ability to be a good Mom.”

  18. A Peer-Run Decision Support Center

  19. The Peer Staff Create… • A welcoming environment • Hope through sharing their own recovery story • Support to navigate around obstacles • Resource development • A safety net • Training & orientation for Medical Staff

  20. CommonGround is anEmerging Best Practice Created by people with the lived experience for people living the experience CONTACT:Pat Deegan PhD and Associates, LLC www.patdeegan.com Melody Riefer, MSW heymelody@gmail.com

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