thinking out of the box with recovery r y - nhs …/media/confederation/files/public... · ·...
TRANSCRIPT
© Recovery Innovations, Inc
R e
c o v e
r y
1
Thinking Out of the Box
with Recovery
Eugene Johnson, President/CEOCreating Extraordinary Opportunities
www.recoveryinnovations.org
© Recovery Innovations, Inc
R e
c o v e
r y
We Changed Our Mind
Mission 2000
To create opportunities and environments that
empower people to recover,
to succeed in accomplishing their goals,
and to reconnect to themselves, others, and
meaning and purpose in life.
© Recovery Innovations, Inc
R e
c o v e
r y Recovery
Our Definition
Remembering who you are
and using your strengths to
become all you were meant to be.
© Recovery Innovations, Inc
R e
c o v e
r y “We arrive in this world with birthright gifts
– then we spend the first half of our lives
abandoning them or letting others disabuse us
of them. As young people, we are surrounded
by expectations that may have little to do
with who we really are, expectations held by
people who are not trying to discern our
selfhood but to fit us into slots…..under
social pressures like racism and sexism our
original shape is deformed beyond
recognition; and we ourselves, driven by fear,
too often betray true self….5
Parker Palmer in his book Let Your Life Speak says it like this
© Recovery Innovations, Inc
R e
c o v e
r y
Innovation
• Something we haven’t done before. Something
unexpected that we thought was impossible.
• It’s disruptive. A penetrating alternation of the
status quo.
• Do it together. Share the risk.
© Recovery Innovations, Inc
R e
c o v e
r y
“Fail often to succeed faster”
Performance Improvement Motto. Samsung. 2005
Innovation is Learning from Our Mistakes
Fareed Zakaria, CNN, 2011
“The ability to fail efficiently
is the key to innovation.”
© Recovery Innovations, Inc
R e
c o v e
r y
8
Michelangelo, 1475 – 1564
I hope that I may always desire more than I can
accomplish.
The greater danger for most of us lies not in setting our aim too
high and falling short; but in setting our aim too low, and achieving our mark.
We envision a future
when everyone with
a mental illness will
recover.
It Starts with a Vision
© Recovery Innovations, Inc
R e
c o v e
r y
9
Stop the Violence!
"Nonviolence is the greatest force at the disposal of humankind. It is
mightier than the mightiest weapon of destruction devised by the ingenuity of man." - Gandhi
I declared a BIG vision
© Recovery Innovations, Inc
R e
c o v e
r y
10
No-Force-First
“There is no such thing as forced recovery.”
“The conditions that generate forced treatment are easily trumped by our seeming indifference to the massive use of force in the mental health culture…
“Let us commit to figuring out how to stop our mindless use of force. Let us use our best minds to figure out how to extricate our field from being society’s purveyors of force.”
Anthony, William. An Elephant in the Living Room.
Psychiatric Rehabilitation Journal, Vol. 29 Number 3, Winter 2006. p. 155
© Recovery Innovations, Inc
R e
c o v e
r y
11
Zero Restraint
• Stop violence that results in trauma, injury and even death of people served and our staff.
• Listen to the experience of those we serve.
• Stop all use of force.
© Recovery Innovations, Inc
R e
c o v e
r y
12
Getting to Zero; The Results
• Achieved zero restraint in month eight,
dropping from 5.5/month.
• In the second Center it took 15 months.
• Once we achieved zero, elimination
became imbedded in our practice.
© Recovery Innovations, Inc
R e
c o v e
r y
13
Getting to Zero; The Results
• No increase in staff injury.
• No increase in police events.
• No increase in chemical restraint.
• Today our Centers, AZ, WA, NC, are
licensed with no seclusion/restraint room.
© Recovery Innovations, Inc
R e
c o v e
r y
14
Peer support
• Hope and Engagement. Sharing personal recovery experiences. “If she/he can do it, so can I.”
• Empathy. Understanding through the personal experience of having “been there”.
• Mutuality. Giving and receiving help and support with respect based on a shared experience.
• Being with rather than fixing.
• Mutual Responsibility for the relationship
• Intentional Relationship
© Recovery Innovations, Inc
R e
c o v e
r y
15
A Critical Mass of Peers on the Team
• A minimum of 25%.
• Today, 62% of Recovery Innovations direct
service staff are Peer Specialists, 392 out of
633.
• Results; seclusion and restraint were
eliminated in 8 months and in 15 months
• Results; 180 bed County Hospital after one
year reported a 36% reduction in seclusion
and a 48% reduction in restraint.
© Recovery Innovations, Inc
R e
c o v e
r y
16
What Shows Up with Peers on the Team?
• The Peer Support Specialist’s own recovery is strengthened through service.
© Recovery Innovations, Inc
R e
c o v e
r y
Survey of Peer Employees
• Anonymous Internet survey sent to 355 peer employees with at least 2 months of employment.
• 253 responded, 70% response rate.
• Prior to employment, 66% were unemployed.
• 35% had been unemployed more than three years.
• Average hours worked per week = 30.
17
© Recovery Innovations, Inc
R e
c o v e
r y
Results
• 20% went off disability benefits.
• Another 37% reduced disability $$.
• 45% went off Medicaid.
• 16% discontinued a housing subsidy.
• 69% discontinued food stamps.
18
© Recovery Innovations, Inc
R e
c o v e
r y
Financial Impact
• $8 million in annual salaries.
• $1.2 million paid in income taxes.
• $488,280 estimated savings in
disability payments.
19
Personal benefits from being a peer support provider Percent
Helping others has helped me in my own recovery 87.1%
I feel more self-confident 78.7%
I feel more emotionally stable 72.7%
I am more satisfied with my life in general 72.3%
I am more interested in my future career opportunities now 68.7%
I am more financially stable 67.1%
I have been able to connect more with family 44.2%
I am able to do more recreational/leisure time things 42.6%
I have been able to socialize more with friends 39.8%
I have been able to begin saving money 38.2%
I have taken a paid vacation 34.9%
I have a nicer place to live 32.5%
I now have company benefits like medical or dental coverage 31.3%
I purchased my own vehicle 26.5%
I have been able to reduce the medication 20.5%
© Recovery Innovations, Inc
R e
c o v e
r y
21
What Shows Up with Peers on the Team?
• The Peer Support Specialist’s own recovery is strengthened through service.
• Peer Support Specialists help others recover through engagement, hope, and mutual relationship/friendship.
© Recovery Innovations, Inc
R e
c o v e
r y
• 56% reduction in re-hospitalizations.
• 36% reduction in seclusion.
• 48% reduction in restraints.
In the first year peers worked in the
hospital….
Recovery Impact
© Recovery Innovations, Inc
R e
c o v e
r y
23
What Shows Up with Peers on the Team?
• The Peer Support Specialist’s own recovery is strengthened through service.
• Peer Support Specialists help others recover through engagement, hope, and mutual relationship/friendship.
• Helps the organization/system recover.
– As staff work alongside people in recovery, staff find new hope.
– Confronts system and professional stigma
– Moving from “mental patient” to colleague redefines our roles and boundaries.
– Saves $$$
Psychiatric Recovery Center Hospitalizations
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
Jul-0
3
Sep-0
3
Nov-
03
Jan-
04
Mar
-04
May
-04
Jul-0
4
Central West Total
One hospitalization
costs $9,900 ($550
per hospital day with
an average length of
stay of 18 days).
During the period
shown there were
an average of 900
PRC admissions per
month.
A reduction in
hospitalization rate
from 20% to 10%
=1,080 annual
hospital admissions
= $10,692,000 per
year.
© Recovery Innovations, Inc
R e
c o v e
r y
Financial Impact ~ Pierce County
System Redesign; 2010
• 19.5% reduction in hospitalizations. $1.5M saved.
• 32% reduction in compulsory treatment. $2M
saved.
• 32% reduction in readmission rate.
• Reduction in average hospital length of stay from
19.6 days to 12.1 days. $4.4M saved.
25
Better Access, Better Care, Better Outcomes
© Recovery Innovations, Inc
R e
c o v e
r y
Financial Impact ~ Pierce County
Peer Recovery Team. 2011
• 120 served
• 131 hospital admissions in 12 month
before PRT.
• 23 hospital admission in 12 months
since PRT.
26
Better Access, Better Care, Better Outcomes
© Recovery Innovations, Inc
R e
c o v e
r y
Implementing Peer Support
• Organizational commitment.
• Quality training prior to employment.
• Recovery training for all staff to embed the new peer support discipline.
• Supervisor and leadership training.
• Create job-specific peer support roles.
• Create the transformation “tipping point” quickly with a critical mass of peer support workers.
Tips for Success
© Recovery Innovations, Inc
R e
c o v e
r y
Implementing Peer Support
• Develop career ladder for the peer
support discipline.
• Parity for peer support workers;
supervision and support, performance
expectations, pay, promotion, ethics.
• Remember, it’s real work, not sheltered
work or therapy.
Tips for Success
© Recovery Innovations, Inc
R e
c o v e
r y • Be courageous. Provide
opportunities to experience
increasingly challenging
assignments.
• Be generous. Provide frequent
positive interactions pointing out
growth and success.
• Create hope. Provide sincere
positive feedback to the person of
appreciation for their
contribution.
• Stay connected. Tell everyone
Yes We Can!