# Presentation: 084131

## “Transforming Mental Health Care Together”

*“**Transforming Mental Health Care Together”*

**Maryland Mental Hygiene Administration**
**Annual Conference**
**Baltimore, MD**
**May 9, 2006**

**A. Kathryn Power, Director**
**Center for Mental Health Services**

## A very active and invested Governor and dynamic leaders in pertinent government agencies

- A very active and invested Governor and dynamic leaders in pertinent government agencies

**Maryland and Other Transformation ****SIG Awardees Demonstrated...**

***Transforming Mental Health Care Together***

## A very active and invested Governor and dynamic leaders in pertinent government agencies
Activities built on existing strengths and the leveraging of other grant monies to enhance SIG funds

- A very active and invested Governor and dynamic leaders in pertinent government agencies
- Activities built on existing strengths and the leveraging of other grant monies to enhance SIG funds

**Maryland and Other Transformation ****SIG Awardees Demonstrated...**

***Transforming Mental Health Care Together***

## A very active and invested Governor and dynamic leaders in pertinent government agencies
Activities built on existing strengths and the leveraging of other grant monies to enhance SIG funds 
A strategy for sustainability and the expansion of services

- A very active and invested Governor and dynamic leaders in pertinent government agencies
- Activities built on existing strengths and the leveraging of other grant monies to enhance SIG funds
- A strategy for sustainability and the expansion of services

**Maryland and Other Transformation ****SIG Awardees Demonstrated...**

***Transforming Mental Health Care Together***

## A very active and invested Governor and dynamic leaders in pertinent government agencies
Activities built on existing strengths and the leveraging of other grant monies to enhance SIG funds 
A strategy for sustainability and the expansion of services
Consumers and families who are active in and central to the process

- A very active and invested Governor and dynamic leaders in pertinent government agencies
- Activities built on existing strengths and the leveraging of other grant monies to enhance SIG funds
- A strategy for sustainability and the expansion of services
- Consumers and families who are active in and central to the process

**Maryland and Other Transformation ****SIG Awardees Demonstrated...**

***Transforming Mental Health Care Together***

## Maryland and Other Transformation SIG Awardees Demonstrated...

**Maryland and Other Transformation ****SIG Awardees Demonstrated...**

- A very active and invested Governor and dynamic leaders in pertinent government agencies
- Activities built on existing strengths and the leveraging of other grant monies to enhance SIG funds
- A strategy for sustainability and the expansion of services
- Consumers and families who are active in and central to the process
- Collaboration across agencies, with the private sector, and within communities.

***Transforming Mental Health Care Together***

## Achieving the Promise:

*           **New Freedom Commission on Mental Health*

**Transforming Mental Health Care in America**

**Achieving the Promise:**

## Federal Partners Workgroup

**Department of Health**_**               **_**and Human Services**
**     ****AoA****	****	****NIH/NIDA**
**     ****ACF****	****	****NIH/NIMH**
**     ****AHRQ****	****HHS/OS**
**     ****CDC****	****	**** - ASPE**
**     ****CMS****	****	**** - OCR**
**     ****HRSA****	**** - OD**
**     ****IHS****	****	**** - OPHS**
**	****	**** ****SAMHSA**

**Other Partners**
**Department of Agriculture**
**Department of Education**
**Department of Defense**
**Department of Housing and Urban Development**
**Department of Justice**
**Department of Labor**
**Department of Transportation**
**Department of Veterans Affairs**
**Equal Employment Opportunity Commission **
**Social Security Administration**

**Federal Partners Workgroup**

***Transforming Mental Health Care Together***

## Recovery is a... 

**Recovery is a... **

***Transforming Mental Health Care Together***

## Self direction
Individualized and person-centered
Empowerment
Holistic
Non-linear 
Strengths-based
Peer support
Respect
Responsibility
Hope

- Self direction
- Individualized and person-centered
- Empowerment
- Holistic
- Non-linear
- Strengths-based
- Peer support
- Respect
- Responsibility
- Hope

**Fundamental Concepts of Recovery **

***Transforming Mental Health Care Together***

## Engage all stakeholders in a collaborative effort to create a recovery focus.
Do providers, consumers, and others believe recovery from severe mental illnesses is possible?
Do providers actively collaborate and build relationships with “community providers,” such as schools, businesses, faith-based organizations, and landlords?

- Engage all stakeholders in a collaborative effort to create a recovery focus.
- Do providers, consumers, and others believe recovery from severe mental illnesses is possible?
- Do providers actively collaborate and build relationships with “community providers,” such as schools, businesses, faith-based organizations, and landlords?

- Questions adapted from
*A Recovery-Based Program Inventory*,
- Mark Ragins, M.D. (2005)

**Step 1  ****̶****  Engage**

***Transforming Mental Health Care Together***

## Let consumers and their families take the lead.  Have them share their vision of recovery.
Are consumers included in advisory boards, planning and quality management committees, and research planning groups?
Do consumer decisions substantially affect the overall program design and operation?

- Let consumers and their families take the lead.  Have them share their vision of recovery.
- Are consumers included in advisory boards, planning and quality management committees, and research planning groups?
- Do consumer decisions substantially affect the overall program design and operation?

**Step 2  ****̶****  Empower**

- Questions adapted from
*A Recovery-Based Program Inventory*,
- Mark Ragins, M.D. (2005)

***Transforming Mental Health Care Together***

## Bring in evidence-based practices.
Does treatment include practices proven effective in:
Illness management and recovery?
Medication management?
Supported employment?
Family psychoeducation?
Assertive community treatment?
Integrated treatment for co-occurring disorders?
Are providers encouraged and funded to build their own expertise?

- Bring in evidence-based practices.
- Does treatment include practices proven effective in:
- Illness management and recovery?
- Medication management?
- Supported employment?
- Family psychoeducation?
- Assertive community treatment?
- Integrated treatment for co-occurring disorders?
- Are providers encouraged and funded to build their own expertise?

**Step 3  ****̶****  Enlighten**

- Questions adapted from
*A Recovery-Based Program Inventory*,
- Mark Ragins, M.D. (2005)

***Transforming Mental Health Care Together***

## View each person holistically and not as a categorical disability.
Do treatment plans and goals reflect expectations of growth and development?
Do treatment plans and goals reflect meaningful community roles:
Employment?
Reconnecting with family?
“Giving back” to others?

- View each person holistically and not as a categorical disability.
- Do treatment plans and goals reflect expectations of growth and development?
- Do treatment plans and goals reflect meaningful community roles:
- Employment?
- Reconnecting with family?
- “Giving back” to others?

**Step 4  ****̶****  Expand**

- Questions adapted from
*A Recovery-Based Program Inventory*,
- Mark Ragins, M.D. (2005)

***Transforming Mental Health Care Together***

## Embrace change―commit to transformation goals over time. 

Do providers actively collaborate and build relationships with other social service agencies (e.g., child welfare and justice)?
Do providers actively engage in mental health advocacy and stigma reduction activities?

- Embrace change―commit to transformation goals over time.
- Do providers actively collaborate and build relationships with other social service agencies (e.g., child welfare and justice)?
- Do providers actively engage in mental health advocacy and stigma reduction activities?

**Step 5  ****̶****  Embrace**

- Questions adapted from
*A Recovery-Based Program Inventory*,
- Mark Ragins, M.D. (2005)

***Transforming Mental Health Care Together***

## A series of many exploratory  medium jumps
Pushing the boundaries of core competencies, trying to create something new within the existing paradigm.

**Continuous **
**small steps  **
- A focus on core missions, improving what the system is already doing.

**A series of many exploratory  medium jumps**
- Pushing the boundaries of core competencies, trying to create something new within the existing paradigm.

**A few big jumps **
- New rule sets that leverage new ideas.

**Transformation...An Ongoing Process**

## Monitor outcomes. Use the results to guide further improvements.
Is treatment focused on improving lives as well as on treating illnesses?
Do consumers demonstrate progress in quality of life areas such as:
Stability of living situations?
Employment?
Social connectedness?
Decreased involvement with the judicial system?
Decreased substance abuse?

- Monitor outcomes. Use the results to guide further improvements.
- Is treatment focused on improving lives as well as on treating illnesses?
- Do consumers demonstrate progress in quality of life areas such as:
- Stability of living situations?
- Employment?
- Social connectedness?
- Decreased involvement with the judicial system?
- Decreased substance abuse?

**Step 6  ****̶****  Experience: ***Learn from it!*

- Questions adapted from
*A Recovery-Based Program Inventory*,
- Mark Ragins, M.D. (2005)

***Transforming Mental Health Care Together***

## Abstaining from drug use and alcohol abuse, decreasing symptoms of mental illness, and improving functioning
Getting/keeping a job, staying in school
Decreasing criminal justice involvement
Finding safe and stable living conditions
Improving social connectedness to others in the community
Increasing access to services
Reduced use of psychiatric inpatient beds
Improving client perception of care  
Increasing the use of evidence-based practices
Maintaining cost effectiveness

- Abstaining from drug use and alcohol abuse, decreasing symptoms of mental illness, and improving functioning
- Getting/keeping a job, staying in school
- Decreasing criminal justice involvement
- Finding safe and stable living conditions
- Improving social connectedness to others in the community
- Increasing access to services
- Reduced use of psychiatric inpatient beds
- Improving client perception of care
- Increasing the use of evidence-based practices
- Maintaining cost effectiveness

**SAMHSA’s National Outcome Measures (NOMs)**

##  ...Each and every member of a community is accountable and has a shared responsibility to contribute...

*From Common Good Common Ground:*
*Building Commitment and Community*

-  ***...******Each and every member of a community is accountable and has a shared responsibility to contribute...***

***“******Once we have started to think together, we must act together...***

***...******Community is an amazing gathering place, ***
***a wishing well for our thoughts, our hopes, ***
***our fears, and our dreams.”***

***Transforming Mental Health Care Together***