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Implementing Recovery-based Care: Tangible Guidance for SMHAs - page 9 / 44





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NASMHPD/NTAC e-Report on Recovery – Fall 2004

The Final Report of the President’s New Freedom Commission on Mental Health, Achieving the Promise: Transforming Mental Health Care in America (2003), has undoubtedly accelerated the move toward recovery-oriented consumer- and family-centered care. In setting a direction to develop a recovery-oriented care system, the report calls for comprehensive planning for each state and individualized plans for each consumer as the two bookends within which Comprehensive Local Care Systems need to be developed. To be successful, these local care systems must be based on sound principles (Manderscheid & Hutchings, 2004). Over the next six months, SAMHSA/ CMHS will begin implementation of a federal partners action plan to make the vision of recovery a reality at the state, local, and personal levels.

These developments have a long history of incubation at the national level. The ingredients necessary for building recovery-oriented systems (resiliency-oriented systems for children) come from important work carried out in the past. They have been developed and nurtured in the Community Support Program (CSP) and the Child and Adolescent Service System Program (CASSP), operated in the past by the National Institute of Mental Health (NIMH) and SAMHSA/ CMHS. Both CSP and CASSP fostered the approach of consumer- and family-centered care. This means that consumers and family members are expected to participate in the design, implementation, and evaluation of care. The criterion of success is consumer employment and a life in the community. This is clearly the heart of recovery- and resiliency-oriented care.

Both NIMH and SAMHSA/ CMHS have also supported, in collaboration with the Department of Education, several Rehabilitation Research and Training Centers focused on recovery. The center at the University of Illinois has examined consumer self-determination; the center at Boston University has examined recovery models at the personal, provider, and system levels.

The Institute of Medicine (IOM) (2001) has undertaken an entire series of studies on the quality chasm between current health care practices (including mental health practices), and what could exist if consumer- and family-centered care were to be implemented on a broad scale. Recently, the IOM has undertaken a new study in this series focused explicitly on mental and addictive disorders. This project will be an appropriate vehicle for furthering practical work in the community on the essential linkage between recovery and transformed state, local, and personal care systems.

Simultaneously, the IOM is moving forward to implement the Crossing the Quality Chasm Framework for five key conditions (depression, asthma, diabetes, heart disease, and chronic pain). The essence of this work is the building of comprehensive recovery-oriented local systems, as well as work to bring national entities together to overcome fragmentation. Mental health can learn much from this endeavor. We hope that local recovery communities for consumers of mental health services would become part of this important initiative in the near-term future.

NASMHPD/NTAC e-Report on Recovery – Fall 2004

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