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NASMHPD/NTAC e-Report on Recovery – Fall 2004

System Recovery in the Northeast

“The average age of people who come into our system is about 35 years old,” said Thomas Kirk, Ph.D., commissioner of the Connecticut Department of Mental Health & Addiction Services (DMHAS). “No matter who you are, at 35 years old, you have some kind of a life, for example, most people at 35 have a partner, or a family, maybe a job, a home. But these people who come into our system have a psychological illness so devastating that it knocks them out of their life,” he said. “Our goal is to reunite people with their life.”

Connecticut has traveled down the path of instituting recovery-based care by reinventing their system based on the belief—and the right—to recovery from mental illness. From its executive team leadership and departmental mission, to its hospitals, local settings, and frontline providers, Connecticut has emerged as an example of progress in system transformation.

A few years ago, when Kirk’s term as commissioner was renewed, he and his executive team set a single, overarching strategic goal for the agency: “Developing and maintaining a value-driven, recovery-oriented healthcare system.” While this was by no means the start of recovery efforts in Connecticut, it was a symbol of how simple the basic ideology of recovery can be, even within the context of a business plan.

Kirk explains, “By ‘value-driven,’ I mean the highest quality of care at the most appropriate or realistic cost. When you look at your existing funding, you must ask, ‘Is the cost to be invested going to produce a measurable increase in the effectiveness of the service’s outcome?’” According to Kirk, this is a simple business question, a question that a CEO of a healthcare organization would ask to ensure his/her dollars are being expended in the most effective way. “Why shouldn’t state mental health agencies do the same?” he asked.

Kirk, along with his deputy commissioner Arthur Evans, PhD, and others, traveled across the state with the recovery message to visit as many providers as they could. Evans started to move the message forward by working with small groups of people, utilizing technical assistance resources to teach new outcome measures, as the measures are often different in a recovery system than a traditional system, according to Kirk.

They also entered into partnerships with educational institutions, notably Yale University, to conduct a Recovery Institute. “Yale developed courses for rethinking our services, including teaching motivational interviewing, being more effective at engaging people into care, new recovery principles, etc.,” said Kirk. Approximately 800 people have gone through the recovery institute, according to Kirk.

The DMHAS hosted all-day retreats, inviting the CEOs and senior clinicians from local mental health and substance abuse provider organizations to discuss the nuts and bolts of what it would take to transform the system from the ground level. From suggestions at these retreats, Kirk and his staff then met with the boards of directors from some of the

NASMHPD/NTAC e-Report on Recovery – Fall 2004

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