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Implementing Recovery-based Care: Tangible Guidance for SMHAs - page 36 / 44





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NASMHPD/NTAC e-Report on Recovery – Fall 2004

collaboration between patients and providers.

Knight: The field of psychology generally teaches a “psychology of respect” for people without problems and for people with minor problems such as mild depression, and it teaches a “psychology of adjustment” for [people with SMI]. The field of psychiatry is the same. Although, at the University of Colorado Medical School, I get invited in to talk about recovery. Other consumer/survivors have told me that some universities invite them in to talk as well. Judith Cook and the University of Illinois, Boston University, UCLA, University of Kansas – they all have some recovery orientation. One of the most important things to do is to look at the evidence on recovery from schizophrenia that Courtenay Harding has put together. Look at her body of work; look at the work around recovery from bipolar illness. Some of these studies of longer than 12 years show a 75%-or-better recovery rate. From that body of evidence, you can develop a platform from which to begin to approach recovery. The next most important thing is for universities to invite in their local consumer/survivors to speak about recovery. They are eloquent about discussing what hinders and helps their own recovery. Next, universities should hire some staff from the four or five institutions that are teaching recovery to be on their faculty. They can also improve the research agenda at universities, which flows from NIH and NIMH. They are not very open to recovery studies themselves. We have a series of article we’ve written on a research grant and the methodology is excellent. It’s top-notch research, and we are having trouble finding journals to accept our articles that are oriented toward consumer issues. The fact that NIMH almost always does research based on diagnosis, rather cross-diagnosis research, is not very helpful for recovery. Most research done on mutual support and cross-diagnosis, such as Double Trouble and Recovery, has been studied by the National Institute of Drug Abuse. This all relates to academia, and the flow of ideas has to follow the flow of money. As long as NIMH has their priorities where they are, you won’t see much inroad into academia for recovery research.

4) What are the two largest workforce-related obstacles to implementing Recovery-based care in existing systems and settings, and how can they be addressed?

Deegan: The creation of service models, and the organizing of services around models, as opposed to encouraging individualized supports with individual budgets for living in the community. This is the biggest obstacle to having true, recovery-based care. The corollary to this is in the workforce itself. The workforce is trained to offer services according to models—and being accountable to agencies which are also organized around such models—instead of service workers being accountable and paid by the person with the psychiatric disability, via an individual budget and as negotiated with a fiscal intermediary. In a transformed mental health system, we see more about person-centered planning and person-centered budgets. We see a different sensibility regarding tax dollars. These dollars are not owned by social service vendors, but rather, through the aid of fiscal intermediaries, these dollars go into personal accounts for individual support and are then spent in a planned way by the person with psychiatric disabilities who has developed a personal recovery plan and an individualized budget. The person has a plan to be accountable for the expenditure of those dollars, to maximize the value of those

NASMHPD/NTAC e-Report on Recovery – Fall 2004

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