Wednesday, July 29, 2009

More great mental health recovery articles

Hey crew:

I have some more great mental health recovery articles to shoot your way. Read over them and let me know what you think about them!

1) What Mental Health Recovery Means
2) Peer Mentoring and Mental Health Recovery
3) 10 Tips for Staying Mentally Healthy

Hope you enjoy the read as much as I did!

Until next time, stay healthy, stay happy
MHCD Research and Evaluations

Tuesday, July 28, 2009

A Recovery Story

Greetings all!

I thought this was a very touching story, this is a recovery story that a very close friend of mine sent to me. Please feel free to comment and discuss your own recovery stories as well! If you have a great story, email me and we will of course put it up as a main post! Here is the recovery story:

It all started with an idea that I could achieve something I wanted. That idea was to learn computers. I had already fought to have a medication that would not make my arms or hands shake. That way it did not look like I was on medication. I was already going to school and using an apple computer to learn typing, using a program called Typing Tutor. I was also learning math.

While I was going to school I was getting the necessary documents together to start college. I was accepted to the Metropolitan State College at Denver in August of 1993. I had already taken a year of WordPerfect on an IBM computer. My first week at college, I was sick and they had to re-adjust my medication. I had already missed a whole week of classes and had to re-arrange some due to the fact that you could only have four absences throughout the entire course; a limit I had already exceeded.

One of my new classes was creative writing/sociology and that teacher taught me something I have used ever since and that is never give up. I only attended college part-time to better concentrate on my classes. I never gave up; I had a dream to get an education. I finally graduated in 2001 after completing an internship in private practice counseling. I did not like it, so I enrolled at University of Colorado at Denver and started in May of 2002.

I took Public Administration and graduated in December of 2005 with my masters degree. All the time that I was going to college I was also at the Mental Health Center of Denver for treatment. I had several psychiatrists while I was there. I liked them all but some had to move on. I had the same counselor while I was there, and I always discussed school with him. He helped a lot because he knew others that had gone to, and successfully completed, college while in the recovery process.

I went one time to get a letter from my nurse and we were talking about how I would be finishing college soon. She told me about 2Succeed and how they would help with me making a resume. 2Succeed is a vocational program run through MHCD which helps people in recovery get further education, employment, etc. When I graduated, I went there and they signed me up and told me they could help me find a job and help me make a resume.. They did and my first job was on the survey team. I was on the first survey team in 2006. In 2007, I was also part of the survey team. I also worked as the survey manager for the PRO survey. Several of the consumer team members went on to find jobs elsewhere. Being part of the survey team gave us confidence to go and find work elsewhere. If you would like to find out a little more about the survey team then follow this link. Now I work as a full time employee for MHCD. I have been a consumer with MHCD for sixteen years.
I recently changed medicine and it had to be adjusted, although it is the best medicine I have been on since I was diagnosed with a mental illness. It allows me to work and do everything I want to do. It all has not been without struggles, but they are easier to deal with than before I had my mental illness. My old life was not so good, I could not achieve what I have achieved today. To me, recovery is changing your life for the better no matter what you want to do with your new life.

How inspiring! What a great contribution. Continuing through college to obtain a masters degree! And having a better life than before due to recovery.

Please feel free to comment and share your own experiences!

Until next time my friends, stay happy, stay healthy.
MHCD Research and Evaluations

Thursday, July 23, 2009

Non-Medicinal Methods to Help Speed Recovery

Greetings All:

I would like to take a post to recognize the importance of the non-medicinal aspect of a recovery-based treatment. I once came across a rather apt metaphor, the standard medical approach of mental health treats the body as a hydraulic system. It treats mental healthcare consumers as if a problem is purely a questions of one’s fluids or chemicals being out of balance; thus with dogged determination (and much painful experimentation to the consumer) finding the right combination of medications will solve the problem.

Unfortunately, mental health ailments to not exist in a vacuum. They are very much influenced by social situations, environmental stimuli, and many many other factors. The mental health recovery model takes these other factors into consideration, and treats all levels of the consumer (rather than just the chemical level), leading to much more systematic, holistic remedies.

An ammendment to my earlier post, this metaphor is compliments of Larry Drain's creative works, so for more reading of his work click on the link and read up on his great blog!

Thus I would like to spend a few moments to talk about common approaches in the mental health recovery model for aspects of one’s life that cannot be resolved with medications. Importantly I do not mean to say the recovery model does not use medications, it absolutely does, and should, for many mental illnesses stem from biological imbalances, but medical intervention is just one factor of treatment, rather than THE factor of treatment.

Below are some of the two most popular and beneficial activities that one might find helpful that do not require medication:

1) Meditation: this seems to be coming up more and more frequently. Meditation, whether religious or non-denominational, seems to have power in the act of self-reflection. It also internalizes one’s locus of control thus making one much more responsive to their own actions. Meditation is actually now being taught in a form of recovery-based treatment known as dialectical behavior treatment, and is proving to be most effective! If you check out the online community, you will also notice countless posts of people with severe mental illnesses stating that they have effectively eliminated their symptom interference through a disciplined schedule of meditation.
2) Exercise: exercise is just as important as meditation as for recovery from a mental illness for exercise often takes the form of active meditation. It also releases stress and is just good for you in general! On a more medical side, exercise releases a chemical known as brain derived neurtropic factor, which recent research indicates is linked to recreating brain cells. An active lifestyle does wonders for recovery!

Of course if you would like to find out more information, there is a wealth of knowledge out there! Check out this article in particular: What Is Mental Health Recovery, and the Wiki is also surprisingly informative about the mental health recovery model!

Just a few ideas on natural ways to aid recovery!

Until next time,
MHCD Research and Evaluations

Funding Issues and Reimbursement and the Mental Health Recovery Model

Greetings all:

I have come across this argument against the mental health recovery model in many situations, and after talking with Larry Drain initially on the subject I would like to address the issue of funding reimbursement in recovery-based clinics.

There seems to be several factors that can increase a recovery-based clinic’s funding reimbursement possibilities. Among the most important are:

1) Having large, well organized advocacy support groups: advocates are of huge importance in lobbying state legislature to insure minimal budget cuts to mental health occur. They also are instrumental in bringing in donations, corporate funding, and many other services that would be nearly impossible for a clinic operating on its own to procure. Get several great advocacy groups active in your community, if there aren’t any, create some. A good source for finding national advocacy groups is by clicking here.

2) Crunching your Research Numbers: if your clinic is involved in research or filters clinical data into a research facility, figure out the value added from your data and be able to present these for grant proposals and meetings with state and national officials. If the state can see a higher return on their dollar invested, they will likely continue to give your organization funding. This is a form of cost-benefit analysis for the state which is provided by the clinic; if your organization does not have the capacity to perform such calculations, seek out one which does. This type of consulting is actually in the works at the organization I currently am doing research with, so if your at a loss by all means contact one of their team members to see if they can get something started for you at the research and evaluation homepage.

3) Analyze your consumer population: what type of consumer your clinic treats can definitely affect funding allocations. For example, facilities that treat consumers with severe and persistent mental illnesses tend to get further grant funding than general clinics. If a certain consumer group makes up a large amount of your clientele, highlight the fact and seek out advocacy groups and grant sources which focus upon treatment and research in that area.

4) Consider an Evidence-Based Approach: the mental health recovery model and evidence-based practices are not mutually exclusive. Recently government officials are actually calling for an alliance of the two practices for the purpose of providing evidence that the recovery model is actually effective. In order for this approach to work, your organization needs to start collecting data pronto. More important than the collection of data, however, is the processing of said data. If your clinic does not have the data expertise required to do this, look for large research facilities in the surrounding area that do. This will allow you to provide actual figures for grant applications which can be invaluable. The quality of information gathered is also of huge importance. The use of psychometrics for this purpose is a popular approach. A rather inexpensive solution is to explore options with Basis 24 surveys; also a possibility is MHCD’s own Reaching Recovery Initiative. Again I cannot stress the point enough, gathering data is only 1/3 of the battle, you have to actually do something with that data for it to be worth the collection!

These are just a few suggestions; Larry and I will continue our conversation and hopefully I can perhaps offer more solutions based on our discourse. Data analysis in mental healthcare is becoming increasingly important; if your clinic does not have the capabilities to crunch such numbers, consider bringing on a programmer, an information systems specialist, or a statistician for that very purpose.

Just a few ideas on funding reimbursement solutions for the mental health recovery model! If you have more suggestions feel free to post a reply! Also if your looking for an active advocacy group shoot a reply my way as well. If you ARE an active advocacy group, hit a reply too, maybe we can do some cyber mental-health match-making and get the communication flowing!

Until next time,
MHCD Research and Evaluations

Wednesday, July 22, 2009

UK’s Approach to the Mental Health Recovery Model

In doing a bit of cross-cultural examination a co-worker of mine has been looking into characteristics the mental health recovery model in England has taken on. As discussed in an article ”What Is Mental Health Recovery”, there are definitely cultural differences in the mental health recovery model between countries.

More specifically, the United Kingdom tends to use more peer mentorship and peer counseling programs than American practitioners of recovery do; this is allowed to a large extent because mental ailments in the United States are often followed by alienation from one’s social network whereas in the U.K. the social network not only stands by, but views it as an obligation to support a friend or loved one who is trying to recovery from a mental illness.

The UK Mental Health Recovery Model video introduces an interesting topic. The speed at which UK practitioners can get someone into mental healthcare is amazing; generally a mental healthcare worker will receive a referral from a general practitioner, and the consumer will receive a call three days later regarding an appointment.

In Essex, those consumers recovering from a mental illness are employed on an organic farm wherein they raise cabbages, Brussel sprouts, and a number of other vegetables for both consumption and for sale at the local market. This keeps those recovering from a mental illness busy (which is very beneficial for those who are suffering from ailments such as depression), while empowering them with a purpose of employment.

A very interesting take on the mental health recovery model. American practitioners are likewise aiming at providing employment opportunities for mental health consumers, but as of yet I haven’t heard of a work-group for organic farming! The recovery rate seems to be fairly spectacular, so something in the equation is right. Perhaps it’s something in the ground water, right? No no, all joking aside, very interesting article, and an inventive take on the mental health recovery model.

Check it out if you can and comment here on what you think!

As always, for access to further free research on mental health recovery, check out MHCD's Research and Evaluations homepage.

Until next time my friends,
Research and Evaluations

Criticisms of the Mental Health Recovery Model

Hello all:

As per Will’s direction on his blog, WillSpirit, I was pointed to a number of criticisms for the recovery movement that I would like to address. Some of them are very valid, others are somewhat misconceptions, but as with every model the mental health recovery model is not without its faults, so in an attempt to give you an unbiased view, I will review such shortcomings and my opinions on them here:

1) The recovery model adds to the burden of the providers

Recovery in fact decreases the burden of the mental healthcare provider. As is demonstrated by both the American Clubhouse model and the U.K. model, recovery oriented clinics tend to lean towards the use of peer mentorships and peer counselors. These advisors (usually individuals on the road to recovery or recovered who suffered from the same or a similar diagnosis) take some of the burden away from case managers and physicians by re-acquainting mental healthcare consumers with basic social interactions, going to the movies, etc.

2) Recovery must involve cure

This is probably the battle that is fought the most in the recovery movement, as the term recovery implicitly refers to absence of ailments, a return to normalcy, and no symptom interference at all. While perhaps a different name would have lead to less confusion, that is the name and there is not much to be done about it now, but recovery in a mental health setting certainly does not imply complete absence of symptom interference. Some mental illnesses are severe and persistent and may never go away; the mental health recovery model merely focuses on empowering individuals to allow them to lead long, fulfilling lives in spite of symptoms and to teach them how to maintain a successful career and meaningful relationships.

3) Recovery-oriented care can only be pursued through new resources

Well…this one is a yes and no. Yes new trainings will need to take place and should a clinic wish to purchase psychographic measurement tools those will need to be brought on, along with their supporting technologies and data-management system. But in terms of actual resources nothing overly extravagant is required of a recovery-clinic that a normal clinic wouldn’t already have.

4) Recovery-oriented care is not reimbursable or evidence based

This argument is flat-out incorrect. The development of psychographics is a growing industry and millions of dollars of funding is going towards research institutes and clinics for the exploration into such quantifiable measurements of recovery. Reimbursement has never been an issue for recovery-clinics. What is a bit of a concern is the expertise needed to analyze the aggregated psychographic indicators; this often times will require an advanced multidisciplinary team, but smaller clinics without such researchers can of course outsource the data analysis to more equipped research facilities or to independent contractors.

5) Recovery devalues the role of professional intervention

Not so, recovery values the role of professionals but creates a relationship between professional and consumer as a team effort towards recovery, rather than in a traditional sense wherein the professional instructed the consumer as to what they were doing wrong and how to fix it. This leads to more constructive internal motivations for the consumer thus is more effective. Recovery does change the role of the professional, as is implied via the team- rather than boss-relationship, and the use of peer mentors and councilors does take away some day-to-day duties of professionals, but this freeing of time should be seen as a relief and an opportunity to devote one’s time to more complicated and intricate matters rather than spending that time showing a consumer where to get a bus pass, etc (which is now a duty taken on by peer support groups and case managers).

These were just some of the biggest criticisms I found on the web. If you have more pressing concerns that haven’t been addressed I would love to address them so just shoot me a comment!

Until next time,
MHCD Research and Evaluations

Monday, July 20, 2009

Some Great Recovery-Based Articles

Hey all:

I've been doing some research and some writing of my own, and thought I might direct you to some great general articles for Mental Health Recovery. If you have time to read through them I'd love to hear what you think here on the blog!

They reference MHCD a decent amount but that is simply because that is where my knowledge-base is coming from. They are not intended to be salesy at all, so I welcome discourse from all aspects of the mental healthcare field! The links are below:

1) 10 Tips to Staying Mentally Healthy
2) MHCD and Mental Health Recovery
3) Measuring Recovery in Mental Health
4) The Mental Health Recovery Movement

I have also written about eight much more informative academically based articles that I have submitted to and am awaiting clearance for publication, so I will keep you posted on those but if they get cleared I'd love for you to check those out and give me your opinion as well!

Until next time!

Warm Regards,
Lex Douvasa
MHCD Research and Evaluations

The Importance of 'Play' and Recovery

Fun, meaningful, playful activities are proving to be of growing importance to mental health recovery. Physical activity serves as a form of active meditation, which allows for introspection and self-reflection. Self meditation is reminiscent of a form of treatment for mental illnesses often referred to as dialectic behavioral treatment (DBT).

Self-reflective importance aside, recent research has indicated modern man’s minds evolved moving 12 miles per day. This physical activity is now believed to re-from brain derived nuertropic factor, the chemical responsible for creating and repairing brain cells.

Where it was once believed that one’s brain cells was a static number, and if you do something damaging to destroy said brain cells they were gone for good, now it is believed that a regiment of elongated physical activity produces brain derived nuertropic factor, which in turn can lead to the creation of more brain cells.

This holds incredible implications for substance abuse mental health consumers and mental healthcare consumers in general and begins to explain why practitioners are so ardent about stressing physical activity. I will be researching this more and posting an article about it shortly!

For more links to publications, check out MHCD’s Research and Evaluation Publications.

John Gale on Recovery

I recently posted a comment asking about recovery on John Gale's blog, which can be reached at John's Blog, his comments were:

Thanks for your comments. I'm not aware of the connection between shock
treatment and dementia although this does sound interesting. As far as the
Recovery movement goes we get quite a bit of interest in it here at the Bethlem
Library and it is generally thought to be a good thing. The idea is - broadly
speaking - not to aim at a medically-defined cure but to enable people with
mental-health problems to feel properly part of society with fulfilling work,
personal relationships etc even if they still have some symptoms. One of the
most popular books we have on it is Social Inclusion and Recovery: a Model for
Mental Health Practice by Julie Repper and Rachel Perkins published by Bailliere
Tindall, 2003 ISBN 9780702026010

Best Wishes,


Thanks for the input John! As you can see, many look at recovery in different lights. John and I definately see eye to eye in the fact that Recovery is about making someone feel like they are a productive member of society through empowerment; much of this comes from confidence in housing, employment status, and living arrangments.

I tend to believe that Recovery is focused upon medical symptomes however, and that it is more a systematic treatment/intervention at multiple levels of an individual's life. This is often referred to as a hierarchy approach in systems-thinking methods as related to healthcare.

The hierarchy that affects one's health is often, from the highest level to the micro-level, regarded as everything from society at large to molecules in the individual. Typically, medical professionals are very focused on the micro-level and leave the macro-level untreated. Psychology and psychiatry often try to bridge the gap for recognition of social conditions can represent themselves via medical conditions.

Thus Recovery is a full-hierarchy approach to mental healthcare. It attacks the molecular level through correcting chemical imbalances via medication, but also focuses on social factors as well. This allows for a multi-tiered recovery treatment plan, which I believe will be much more effective for mental healthcare consumers.

Thanks again for your response John! Your input was invaluable and we'd love to hear back from you for further discussion on this if your time allows!

For more information on recovery research, check out MHCD's Research and Evaluation Homepage.

Thursday, July 9, 2009

Measuring Mental Health Recovery

Greetings again. In my earlier two posts I made frequent reference to mental health recovery and the meaning of recovery therein. Through my work experience as an Evaluation's and Information Systems Specialist, I have come to learn that one of the leading research facilities in the field, the Mental Health Center of Denver, has developed instruments to quantifiably track psychological recovery.

Such instruments, in a project they are calling the Reaching Recovery Initiative, are designed to quantitatively track and measure a mental health consumer's progress and condition throughout their clinical treatment. The instruments were developed and tested by MHCD’s Research and Evaluation’s Department, which is comprised of a multi-disciplinary team of biostatisticians, Ph.D.’s in experimental psychology, computer programmers, data specialists, clinical case managers, and other clinicians.

The data to create said recovery instruments was initially gathered from, and is currently supported and utilized by, their out-patient treatment facilities throughout the Denver-metro area, wherein the organization, staffed with some 500 employees, treated over 11,000 consumers in the last year.

For professionals, check out their recent research and publications by following this link, or access the Research and Evaluation’s home page here, and let us know what you think about the recovery research, research on child resiliency, adult recovery, etc.

For mental health care consumers, if you are interested in a recovery-based treatment plan, or just in finding out what one is like, check out the MHCD Homepage. If you have actually been a consumer whose case manager utilizes the recovery instruments, we’d love to hear more on your experience with them.

Keep posting my friends! We are trying to create a platform for meaningful communications; and by that I mean communication between professionals, between mental healthcare consumers, and a dialogue of consumers and professionals communicating with one another. None of that would be possible without your help and your comments!

Until next time, stay healthy, stay happy.

What Recovery Means

In my first post, I made reference to the idea of mental health recovery, which is a unique movement among mental health practitioners that I would like to explore. The term recovery is perhaps a bit misleading in regards to mental healthcare, for some of the more frequently seen definitions of recovery include:

1) The regaining of or possibility of regaining something lost or taken away
2) Restoration or return to health from sickness
3) Restoration or return to any former and better state or condition
4) The regaining of substance in usable form, as from refuse material or waste products

Such definitions are problematic. In mental healthcare, nothing is truly taken away or lost, there is simply a change in condition. Restoration from a sickness is associated with being cured, or with the absence of said sickness; when mental ailments are concerned, however, the truth is in some situations there will never be a total absence of symptoms. Restoration to a better state is entirely too ambiguous, and regaining substance in usable form is entirely irrelevant. So what does recovery mean in the terms of mental health?

Recovery, as leading expert Pricilla Ridgeway defines it, is an ongoing process of self directed healing and transformation. The Mental Health Center of Denver, a leading research facility, and one of the largest community-based mental health treatment facilities in the nation, further expands upon the definition by stating it is a non-linear process of transformation involving one’s fulfillment in hope, growth, social network satisfaction, symptom interference, and a feeling of personal safety.

Recovery, in terms of mental healthcare, does not mean an absence of all symptoms. Such a situation is often not a reality. But it means continuing to live a rich and fulfilling life regardless of, not in spite of, one’s condition.

The recovery movement seems to be spreading across the world rather persistently. In the U.S., several research facilities have taken on such an approach and are obtaining some rather remarkable results.

If you are a practitioner who has recently begun working in a research-oriented facility, please comment about what you feel the difference in cultures is and whether this new recovery-based approach or the traditional method of treatment is more effective.

Likewise if you are a mental healthcare consumer, please share your opinions on the differences between different oriented facilities! Your opinions are incredibly important, for they will let readers determine which type of facility would best suit their needs so please share with us.

I will do some more research on this recovery approach and let you know what I find!

Until next time, stay healthy, stay happy.

Welcome to the Recovery Blog

If you examine different cultural approaches to mental healthcare, one begins to notice some remarkable differences. In the United Kingdom, mental healthcare is treated as a component of the entire self, treatments are focused upon not just the individual ailment, but on the individual’s surroundings, cultural practices, and societal norms.

In New Zealand, mental healthcare practitioners were mandated, per a government act, to take on a culturally-based recovery approach. What does this mean? As the New Zealand Health Commissioner put it, it involves dealing with recovery in a manner that takes cultural and societal actions, norms, discriminations, and manifestations into account when dealing with recovery.

Unfortunately in the United States, mental health has often taken a back seat, or even a shameful seat, but why? When you have a heart problem what do you do? You see a cardiologist pronto! Why should things be any different when one is trying to protect their most prized position, their mind? Taking action is something one should be proud of.

With that in mind, I would like to share my hopes for this blog. There is a lot out there on mental health, mental illnesses, and advice, but I would like to start a dialogue, both for clinicians and for mental health consumers alike, about what the process of a recovery-based treatment feels like from both sides. What do you go through? What do you expect? What are the obstacles?

For those receiving mental healthcare, I would love to hear what you found was the most helpful thing for your caregiver to do? What lent itself most aptly to your recovery? Or, if you haven’t seen what you want to see, what do you want to see?

For mental health caregivers, tell us what actions you see people taking on their own that is inspirational or leads to the fastest recovery, or prevention, from a mental illness? What are your own struggles?

Basically, this blog is designed to be an open dialogue to really discover what the process is from both sides. If your reading a post or responses and have a though, please, I know you are all very busy, but take the time to comment, because it is only through collaboration and communication that true progress in mental health recovery can occur.

Until next time, stay healthy, stay happy.
Lex Douvasa
Evaluations Specialist