On Our Way: Recovery News Vancouver Acute & Community Mental Health Services Volume 1, Issue 5
Summer/Fall 2010
Hope Goal-Directed Self-Determination Awareness & Potentiality Meaning & Purpose
South Team’s Recovery Pathway: A Shared Challenge for Growth, Learning & Better Service By Cathy Crozier From the editor:
Recovery: Moving Forward Welcome to the fifth edition of “On Our Way: Recovery News”. This issue continues to explore the theme of recovery looking at recovery oriented initiatives like: South Team’s Recovery Pathway; the CONKER project; the Recovery Narratives Project and new book Evening the Frayed Edges; the annual Family Conference; a three day workshop series on Recovery: From Theory to Practice; and an update on Tertiary Services. Also, our last issue focused on the theme of extended leave and recovery, and we are pleased to be able to continue our discussion on that topic with an article by “Certified Anonymous” about her thoughts and experience. As well we have reflections on recovery from the perspective of a mother, plus “Words of Wisdom” about recovery. As always, we welcome your articles, letters and ideas on topics related to recovery. Please send to renea.mohammed@vch.ca. Happy Reading!
At South Team we are striving for new ways to support the people who attend our team. For each person, recovery is uniquely personal and consumers have told us repeatedly and in different ways that the kinds of therapy, support, information and practical assistance they need varies according to their situation at any given point in time. At South we needed to better understand recovery from each client’s point of view so we could work in partnership to figure out how we might best help. We looked at different, successful recovery models in other places, reviewed their stories and then had very focused discussions that involved all clinical staff, our physicians, consumer contractors and peer support workers. The result is the South Team Recovery Pathway, a way to map out our understanding of a process of recovery as
On Our Way: Recovery News our clients have described it, paired with suggestions of what kinds of treatment, support and services might be most helpful. Our pathway has six main places. 1. When someone is at high risk and often in great distress 2. When they are at less risk but still distressed and not really involved with anyone who is able to be helpful 3. When they start to work collaboratively in relieving their distress and managing their illness 4. When they are feeling more in control of their lives and their recovery 5. Where they feel they are making real progress and reconnecting with many aspects of their lives that were put on hold; and finally, 6. Advanced recovery / sustaining wellness - when someone benefits from knowing that help is simply available if and when they need our support. For most people this is not a straightforward progression but rather a journey with many twists, turns and unexpected challenges on the way. The Pathway offers us a way to have a conversation about how someone’s life is feeling, without needing a lot of medical labels or jargon, and a way for the team and the client to understand his/her particular journey; to recognize progress together, and to find our way back on the path when things go sideways. It focuses us together on working on people’s lives and aspirations instead of working only on health problems. It also makes us look at whether what we think might help is actually working for the person. It requires that we constantly listen, customize our approach and improve our own training to be able to help.
Page 2 For staff this is a challenge and an opportunity to look critically at how we practice now and how we need to grow; for clients it is a tangible way to take charge of their own recovery journey. For us together, it is a chance to make real changes in putting a recovery philosophy into team practice on a daily basis. The South Team Recovery Pathway is only the beginning of a work in progress to challenge our thinking and help us be better at the work we have chosen. We are pleased to share our thoughts so far and welcome your input. Please wish us well in our journey!
On Our Way: Recovery News Vancouver Acute & Community Mental Health Services
Credits Renea Mohammed, Editor Contributing Writers: Certified Anonymous, Michael Crain, Cathy Crozier, Eternal, Sue Garries, Marge Johnson, Susan Reznek and Susan Trapp.
On Our Way: Recovery News
From Infancy to Evolution: How CONKER Mental Illness got its Start By Michael Crain The evolution of a concept or idea is a funny thing. Someone somewhere comes up with a notion and people then play follow the leader behind this idea. The latest notion in mental health that’s steering this trend is recovery. Eric Lennon once wrote a song called Power to the People. One of the ways that the recovery model gives power to the people is through a group called CONsumers for Knowledge Exchange and Research on Mental Illness, or CONKER Mental Illness. Vancouver Mental Health Services wanted to help recovery hit the road in the area of research. The organization was kind enough to give some seed money to a new group in 2006 called the Vancouver Coastal Research Centre for Mental Wellness, or VCRCMW. The group was created as a way for research on mental health to happen. The thing that made this research unique and different is that it was to be done by mental health consumers, and what was researched was determined by consumers as well. The group formed under the guidance of several mental health practitioners who had a background or ties to academia, research, and being published. Simon Davis, Regina Casey, and Lyn Jongbloed have been invaluable in providing support and direction to the group. Part of the hope as well was that any consumer who became involved would have the opportunity to acquire skills in the areas of research and publication. Slowly but surely consumers joined the group and research started. The first area of research identified by several consumers outside of the group that they would like to see studied was medication.
Page 3 Ruth Gumpp, a long standing member of VCRCMW, pursued this study for over two years. Ruth struggled with wanting to present what people with mental illness had to say about medication in as objective and unbiased a way as possible. The solution she came up with was brilliant. In the final report, she kept every idea in the voice of the people interviewed. Whether feelings were positive or negative about medication, she never strayed from the actual words and language used by the participants by using direct quotes throughout. Ruth now has the incredible opportunity to have this study published as a book by the University of Toronto Press. She also has been pleased to give presentations on the study, sharing both the ideas and concepts of the study as well as the evolution of peer research as relates to VCRCMW. Last fall, two new consumers joined the group and the evolution continued as branding became more emphasized. Pithy acronyms are all the rage these days, and so the group changed its name to CONsumers for Knowledge Exchange and Research on Mental Illness, or CONKER Mental Illness. A logo contest helped the group choose a very attractive logo. Another step in the evolution of the group is the beginning of a website that Sara Lapsley developed and maintains. You can find it at http://conkermentalillness.wordpress.com/ab out/. Sara has been great at suggesting ideas for things that CONKER should do, such as the website, and then helping CONKER to move in that direction. The newest addition to the team is Debbie Sesula. Debbie is well known in the field of mental health for coordinating three peer support programs in the Lower Mainland of British Columbia. She will soon have a Master’s Degree, which shows how valuable she feels research is. Debbie has put many a smile on the face of CONKER members with her sense of humor and seemingly endless energy.
On Our Way: Recovery News
From Infancy to Evolution Continued … At this time, CONKER is at a crossroads in the evolutionary process. Identifying the next area for research, pursuing the previous study as a publication, and getting the word out about the group are the three main focuses currently. The hope that we all have is that in some way we can improve the services that mental health consumers receive, and not just do research for research’s sake. So evolution is a funny thing. Eric Lennon also said in his song Beautiful Boy, “Life is what happens while you’re busy making other plans”. Things may not always go the way current and past members of CONKER might envision, but we do believe that through recovery, power can be given to the people. Right on!
Words of Wisdom
“Patience and perseverance are the first words that come to my mind regarding my own experience of mental health recovery and what I have witnessed with others. We need to have patience first of all with ourselves, especially because the path to recovery never takes a straight or direct route and can often be very long and slow. We also need to cultivate an attitude of patience towards others, our families, friends, loved ones, those involved in our recovery, since not everyone is going to understand what we are going through. Finally, I think that the Phoenix is an excellent metaphor to hold onto: rising in a new and beautiful form from the ashes of our humiliation.” – Aaron Zacharias
Page 4
Recovery Narrative Project: Evening the Frayed Edges By Susan Trapp
The Recovery Narrative Project first met as a project of the Consumer Initiative Fund (CIF). We met for a year or so. We were not all experienced writers, but we wrote about our experiences of mental illness and our viewpoints of Recovery. We critiqued each other’s writing and progressed in our writing skills. Eventually the idea of putting our articles together in an anthology and publishing a book became an option. At that point our funding as a CIF project ended. We continued to meet, and our dream of publishing a book continued to inspire our writing. As fortune would have it, some of our members came up with sponsorship from PeerNetBC and Kickstart--Disability Arts and Culture, as well as funding from private donors. Our editor, Susan J. Katz, has worked very hard at editing our manuscripts, and with our help, put them together into a book: Evening the Frayed Edges. The book can be purchased from any of the authors or from: http://eveningthefrayededges.blogspot.com You can also get it from PeerNetBC, Odin Books, and People’s Co-op Bookstore. There will be a book signing and reading on Nov. 14, opening at 4:00 pm, at The John Braithwaite Community centre, 145 West 1st St. in North Vancouver.
On Our Way: Recovery News
The Family Conference By Susan Reznek “This year best conference to date”; “Great choice of presenters”; “Conference should be semi-annually”; “Make it longer”; “…fantastic…” These were some of the written responses from the evaluation forms received after the 5th Annual Family Conference, held on May 1, 2010. There was an amazing turnout of people who came to hear a varied selection of people speak on many subjects revolving around the support of families and their loved ones who live with mental illness. Dr. Bill MacEwan, Psychiatrist at St. Pauls’ Hospital, and schizophrenia expert was the keynote speaker. He has a reputation in the community as being a psychiatrist who is open to communicating with family members and considers the family a key part of the treatment team. He spoke on ways that families and physicians can improve communication. Our theme of improving communication and collaboration between mental health professionals and families carried on with a panel discussion. The ever-popular Stories of Recovery was back and as inspiring as ever. As we read through the evaluations, the power of personal stories was evident. For some of the families dealing with a new diagnosis, the personal story is often the only way information can be synthesized. Some of the evaluations talked about the vast amount of information imparted at this conference and the “jam-packed” nature of the day leading to information overload; the stories are often what remains at the end of an information-laden day. Speaking from the view of a conference planner, the task of deciding what to include can be daunting. We have one opportunity each year to expose an often “Shell
Page 5 shocked” audience to a vast array of ideas, support services, and professionals. Our approach has been to get the information “out there” whether it is a passing comment, a few sentences, a pamphlet, or a website address. Some of this information can be literally life-saving. We had some criticism regarding the fact that one of our afternoon sessions, “Financial and Legal Planning” was only one hour and could have used more time. Our response to that is that we try to expose the idea and then provide contact information for future support. Topics such as the Registered Disabilities Savings Plan, for example, are vast and confusing even to the professionals working with them, but just hearing a snippet of information is enough to provoke a family to look further into educating themselves. The other important aspect of the Family Conference is the opportunity to meet other consumers and family members in similar situations. This conference was no different than past ones in that as organizers we literally had to order people to stop talking to each other at breaks so we could continue with the sessions! It was as if people were starved for meaningful connection. Personally, I found this heart-wrenching. The delicate and stigmatized nature of mental illness combined with the catastrophic budget cuts keep us all struggling to connect. So, fortunately, I can report that The Family Conference 2011 will be held on April 30, 2011. The same committed and passionate group is already working on ideas for next year. They are: Shirley Rogers, Coordinator of Family Support and Involvement, Susan Inman, Dick Doerkson, Penny Ford, and Susan Reznek (members of the FAC), Linda Proudfoot (B.C.Schizophrenia Society) and Vicki Rogers and Pat Merret (Mood Disorders Association of BC). Kim Calsaferri of VCH provides unlimited and inspiring support for us all.
On Our Way: Recovery News
Recovery: From Theory to Practice By Sue Garries With the objective of deepening the message of the value of a client-focused culture in community mental health, three days of workshops were held in March. These workshops were facilitated by Chris Summerville, the CEO of the Schizophrenia Society of Canada. Day 1 Workshop participants included staff and leaders from community mental health, as well as stakeholders from the service provider, consumer and family community, and representatives from the addictions and acute sectors of VCH. The presentation included information on the history and theory of the philosophy of recovery and a discussion of the current research and evidence supporting recovery focused mental health systems. In addition, practical tools were provided, that can be used to widen the capacity of a recovery focused culture within Vancouver’s community mental health. The importance of a system that fosters peer support and collaboration with client and family members were highlighted and presented as essential elements in recovery focused culture. Day 1 ended with a panel that included a family member, a case manager, a psychiatrist, an occupational therapist and a peer support worker, who reflected their personal impressions of the culture of recovery in community mental health today. Feedback on the workshop was mixed. Some participants felt the session was too theoretical, some felt the information was too basic, while others described the day as inspirational. However, it is clear that in
Page 6 community mental health, we all realize the value of collaborating with our clients to support their recovery and potential for a meaningful future. Day 2 On the second day, the workshop’s focus was on training interested staff, family and consumers to become facilitators of the workshop series titled Your Recovery Journey-Meaning, Management and Medication. Those in attendance found the session to be ‘motivating’; helping them to acquire a deeper understanding of the philosophy of recovery. People left the session with skills and practical tools to facilitate “Your Recovery Journey”. Since the training, consumers and service providers have collaborated to offer the program at the Strathcona Mental Health Team and will be offering it as a servicewide group this fall. Day 3 Day 3 was unique because the workshop’s audience was limited to consumers of mental health services. The session opened with the history of the consumer movement and then information related to consumer rights. In addition Chris Summerville reviewed recovery philosophy, assisting the audience with defining recovery as it related to them. The day was rewarding as Chris and the audience shared personal stories of self determination and self discovery. All of the feedback received from that day was positive. One feedback form summed the day up, with their description of what they learned: “[the workshop] cemented what I practice each and every day. Never, never give up! I’m a mental Olympian!”
On Our Way: Recovery News
PERSPECTIVES PAGES Extended Leave By Certified Anonymous This is my second letter. The first one I wrote two months ago to the Minister of Health with no reply. I wasn’t expecting a response. I mean, of course they probably wouldn’t reply to me if my doctors have been saying I should be injected every two weeks for the last 12 years. Obviously, because doctors have a higher written IQ than most of the population then they must be right…don’t you think? It doesn’t make a difference that I’m allergic to the medication, and can never wear a bathingsuit ever again because of the reactions. I mean, I could sue…but seeing as I work in the legal profession, it may be kind of humiliating. I know I could win perhaps, but I haven’t been able to win review panels over so many years. It’s truly unfortunate. Perhaps they think that the only way to live your life is to be medicated. It may be kind of simplistic, but I do view the medical industry purely as a money-making industry. Psychiatrists aren’t therapists – all they do is inject and make notes. Are injectors really what we need? Does the $600 they spend on my Risperadone Consta every second Wednesday really helping society, or the government’s debt problems? I’ve been in hospital now a total of 4 years over a span of 12 years. Why? Purely because I refuse to believe I need to be there. And also because I don’t believe I have an illness. Now, is that a reason to medicate someone? I am not harmful to myself, or to anyone else for that matter. My main issue is that I can’t get pregnant on these medications – I’m 27 and get a period twice every year because of them – and now I can’t adopt.
Page 7 Can I take a trip to Hawaii and spend my hard-earned money on a vacation for longer than two weeks? Nope, they don’t trust me with finding a local doctor and getting injected while on holiday. Why doesn’t any doctor want to stop injecting me? For fear that if I have a tiff with a family member they’ll send me back to hospital. They opened Riverview again. How convenient. Maybe I’ll just forget I produced two music albums, wrote a 70,000 word book, run two online businesses and work a 9 to 5. Perhaps then I can have a holiday at an institution that has better food than a hospital. If psychiatrists were in their profession because they loved people and what they have to say, rather than because they are atheists who want fat pay cheques, perhaps the world would be a better place. What do you think mental health industry?
Words of Wisdom
"When I couldn't get motivated or get any housework done, I would call someone; a friend or a professional. I would then do some housework, while talking to them. By the time I got off the phone, I had something started or done, and felt better." -Eternal What is recovery? “To live a happy, satisfying life doing what I want and being all I can be.” -Anonymous
On Our Way: Recovery News
Recovery: A Mother’s Perspective By Marge Johnson Recovery for Eric began before he returned to his apartment after two years in Riverview. At that time we had a meeting with all the people and agencies who would be working with him when he returned to Vancouver. We all crowded into a small room and planned how we would support him and what each person’s responsibilities would be. The room included his case manager, a home support person who would help him monitor his diabetes and meds on a daily basis, people from Act Bridging, staff from Riverview, Eric and myself. The message: the last discharge didn't work. Let’s make it happen this time!!! We shared ideas for programs, a concrete schedule and plans for immediate follow up and ongoing dialogues. A year has gone by, and even though progress is slow and difficult, the two constants have been: 1) Eric’s strength, and resilience; a wish to make a good life for himself, his sense of humor, courage and gentle soul as well as, 2) the people who have constantly included me in discussions and plans. We have been a team, dealing with a young man who is extremely anxious, doesn't eat properly, can't handle crowds and at times has poor cognition skills. He also is one of the kindest and most courageous young men I know. He, like other mental health consumers, has hopes for his future and never gives up. It has been a challenge, but slowly Eric’s life is filling up with the help of a peer support worker, Community Link, staff from Act Bridging, community agencies, and a very supportive case manager at Kits team. They are constant, caring and call me on a regular basis. Dialogue is there and Eric is supported.
Page 8 What has he accomplished in his recovery? He became a Canadian citizen. Yea!!! He has a very small part time job at Coast Clubhouse. He is on the Conquering Waves dragon boat team which won a silver this year. He walks once a week with CMHA. He hopes to begin an art class. He keeps a clean home. He is slowly learning how to shop in a more healthy way. He is a good neighbor and is a gentle hugging machine. His goals are ones he is proud of. They are small and simple, but he likes his life, is making friends, feels welcomed in the Coast Clubhouse, and CMHA, and he has hopes for future activities. His recovery lies in the supports he has from the people who work with him...he knows they care for him. They also are in constant contact with each other and know to network when a problem arises and when to call me in order to resolve a problem. As a mother I have praise for the professionals who have constant open dialogue with me and help us through difficult times. Eric feels he is guiding his recovery process and people understand his goals. He also has hope for our future. What recovery means to Eric: I enjoy my life and my new projects. People at the Coast Clubhouse and CMHA make me feel welcome. Some have become my friends. I like them and look forward to going there. Sometimes I become very anxious and talk loudly. They understand and try to help me calm down. They are helping me start new activities like my job at Coast and walking with CMHA . People on the dragon boat team help me get ready for practice and understand my anxiety. I like being part of a team. I am beginning to have a useful, productive, rewarding life. I think I am "going onward and upward."
On Our Way: Recovery News
Page 9
Tertiary Mental Health Services Update September 2010
VCH tertiary mental health services project update We have reached key milestones in our project to bring tertiary (specialized) mental healthservices to the VCH region. Our tertiary mental health sites We will be renovating six existing facilities to accommodate specialized mental health services. •
• •
Renovation designs completed for: o Detwiller Pavilion at UBC Hospital o Langara Residence o Youville Residence o Willow and Willow-Chest Pavilions at Vancouver General Hospital Gibsons site design currently underway. Renovation to Detwiller Pavilion and demolition at Willow Pavilion began this month
Our tertiary mental health services We have completed our functional program for the Adult Tertiary Rehabilitation service at Detwiller Pavilion, UBC Hospital. It was created with the input and approval of Riverview Hospital and VCH clinicians. A functional program describes in detail how a particular service will operate. We are developing central access and discharge processes for our tertiary mental health services, in partnership with various stakeholders across VCH including mental health and residential care staff.
Jobs at our tertiary mental health sites We are beginning the process of hiring specialized health care workers who will staff our tertiary mental health units. Jobs are being posted on VCH’s internal and external posting sites. For questions about jobs at our tertiary mental health sites, contact Nicole Jantzi, External Recruitment Services Lead, HR Services for PHC, PHSA and VCH at 604.875.5183 or nicole.jantzi@vch.ca
Embracing a recovery-oriented model of care at VCH Tertiary mental health services at VCH will be person-centered and embrace the values and principles of the recovery philosophy. The recovery philosophy promotes autonomy and empowerment, nurtures hope and encourages individuals to live from a position of wellness. Our continuum of older adult, adult and neuropsychiatric tertiary mental health services will share these elements: Hope: services promote the motivating message that an improved quality of life is achievable - that people can and do overcome the barriers and obstacles that confront them. Strengths-Based: services focus on valuing and building on the multiple capacities, resiliencies, talents, coping abilities and inherent worth of individuals
.
On Our Way: Recovery News
Page 10
Tertiary Services Update Continued…
living tasks as part of the recovery-oriented psycho-social rehabilitation services provided.
Respect: relationships are founded on a spirit of mutuality and respect.
“I do my own grocery shopping and cooking. I do my laundry and I try to keep my room clean,” Said Ducharme.
Holistic: services acknowledge an individual’s whole life, including mind, body, spirit and community. Individualized and Person-Centered: treatment is planned in partnership with the client based on their unique strengths and resiliencies, needs, preferences, experiences and cultural background. “Recovery is the hard work a person does him or herself, with the kindness and compassion of the people they choose to support them – in an environment that acknowledges and believes in their potential for wellness.” Centre for Building a Culture of Recovery
Rachelle Ducharme knows first-hand the difference that a recovery-oriented care model makes. Rachelle is a former client of Riverview Hospital. Last year, she transferred to Memorial Cottage – a tertiary mental health facility in Langley operated by Fraser Health. Memorial Cottage is a smaller, home-like, community-based mental health facility that embraces the same recovery philosophy as VCH’s tertiary mental health services. Best practices show that people who need long-term psychiatric treatment/rehabilitation are better served in smaller, more home-like settings rather than in large institutions. Rachelle says she loves “having [her] own room” at Memorial Cottage and takes on daily
Since moving to Memorial Cottage in June 2009, Rachelle has made great strides in her journey toward recovery. Supported by the vocational services available at Memorial Cottage, Rachelle returned to school to obtain her high school diploma and found a job working in the cafeteria of a local college. “I like to work and earn my own money… I like to be busy,” said Ducharme. With the support of the specialized mental health services she receives at Memorial Cottage, Rachelle has been able to further develop her life skills and experience a more fulfilling life. People living in the VCH region will soon have access to a range of specialized, recovery oriented mental health services as a result of the tertiary mental health project. The first VCH tertiary mental health service to open will be the Adult Tertiary Rehabilitation Program at UBC Hospital’s Detwiller Pavilion in February 2011. This service will embody a positive culture of healing that offers choice and promotes self direction, supporting people in their unique journey toward recovery.
Keeping you informed If you have questions or would like more information about the tertiary mental health plan for the VCH region, email us at tertiarymentalhealth@vch.ca