PSYCHOSOCIAL REHABILITATION AND RECOVERY SERVICES SECTION



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Jeffrey Burk, Ph.D., Associate Chief Consultant PSYCHOSOCIAL REHABILITATION AND RECOVERY SERVICES SECTION

UNIFORM MENTAL HEALTH SERVICES HANDBOOK 5. b. (2) Mental health services must be recovery-oriented. According to the National Consensus Statement on Mental Health Recovery... : Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of the person s choice while striving to achieve... full potential.

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

IN VHA, RECOVERY ALSO INCLUDES: Privacy Security Honor Support for VA patient rights

RECOVERY TREATMENT PLANS Mental health treatment plans must be recovery oriented. Must reflect Veteran s values and preferences. Must be developed with input from Veteran and, with consent, with appropriate family members.

PSYCHOSOCIAL REHABILITATION AND RECOVERY SERVICES SECTION All Veterans challenged with serious mental illness can recover. Veterans challenged with serious mental illness can define, pursue, and achieve personal goals that support their personal identity, result in improved health and well-being, and that promote full participation in the communities of their choice. Mental illness must not be a barrier or a stigma against seeking mental health services or pursuing a meaningful and productive life.

PSR&RS SCOPE Initially, Veterans with serious mental illness Axis I disorder resulting in significant functional impairment and/or disruption in major activities of daily living (schizophrenia and other psychotic disorders, bipolar disorder, major depression, and severe PTSD). Veterans with other Axis I diagnoses in conjunction with a GAF of 50 or lower. Eventually, all mental health services must be recovery oriented wherever delivered.

PSR&RS STAFF Associate Chief Consultant Jeffrey Burk, Ph.D. Recovery Services David Carroll, Ph.D. Consumer-Liaison Services Peggy Henderson, Psy.D. Family Services, Women s Mental Health, & Military Sexual Trauma Susan McCutcheon, RN, Ed.D.

PSR&RS STAFF Peer Support Services Daniel O Brien-Mazza Outpatient Services Timothy Smith, Ph.D. Clerical Support Vacant, Secretary to Associate Chief Consultant Suzan Hoopengarner-Shonk, Program Support Assistant

PSR&RS STAFF Therapeutic and Supported Employment Services Anthony Campinell, Ph.D. Charles McGeough, Program Specialist, Marketing Judith Patten, Program Specialist Donna Tasker, Program Specialist Vacant, Program Specialist Ralph Zaccheo, MBA, Administrative Officer

PSR&RS STAFF

PSR&RS ACTIVITIES Documents Psychosocial Rehabilitation and Recovery Services Handbook: in concurrence. Veterans Mental Health Council Guide: in concurrence.

LOCAL RECOVERY COORDINATORS Deployed at each medical center across country. National conferences. Report to mental health leader or equivalent. Lead recovery transformation for mental health through education and consultation. Provide recovery-oriented clinical duties up to 25% of time.

LOCAL RECOVERY COORDINATORS Developing 3-5 year strategic plan at VISN and facility level. Conducting a recovery assessment: in development. Promote recovery in development of treatment plans. Reduce stigma associated with mental illness.

CONSUMER AND LIAISON SERVICES Develop and maintain positive relationships with Veteran consumers, mental health-related organizations, Veteran Service Organizations. Facilitate communication and increase participation of Veteran consumers and, as appropriate, their family members in development and implementation of mental health services.

CONSUMER AND LIAISON SERVICES Veterans Mental Health Councils (a.k.a., Consumer-Advocate Liaison Councils) strongly encouraged at each facility Consumer developed and run. VA staff liaison. Input into operation of mental health services. National conference in June.

FAMILY SERVICES Involvement of family members, when appropriate and as directed by the Veteran, is important to recovery. At least annually and at discharge from inpatient unit, providers discuss family involvement with Veterans with SMI. Guidance to field on provision of family services: in development.

FAMILY SERVICES Family Psychoeducation underway; impart to families information about Veteran s mental illness, develop coping and problem-solving skills. MOU with NAMI to provide Family-to-Family Education Program in at least one VA facility per state.

PEER SUPPORT SERVICES Provide support to Veterans with mental illness through shared life challenges. Serve as role models; trained to assist with goal setting, problem solving, symptom management. Facilitate recovery by providing hope.

PEER SUPPORT SERVICES Peer counseling for Veterans with SMI must be provided at all medical centers and very large CBOCs when clinically indicated. Currently, approximately 120 Peer Support Technicians (Health Technicians) in 55 medical centers. HR developing Peer Support Specialist job series.

PEER SUPPORT SERVICES VA-developed competencies for Peer Support services: pilot testing. Directive to allow PSTs to document in CPRS: in development. Support for obtaining certification: in development.

PSYCHOSOCIAL REHABILITATION AND RECOVERY CENTERS Outpatient program to provide Veterans with SMI the skills needed to integrate into society. Transform Day Treatment/Day Hospital programs into recovery-oriented programs. Medical centers with > 1500 Veterans on National Psychosis Registry must establish PRRC. Medical centers with > 1000 Veterans on NPR strongly encouraged to have PRRC.

PSYCHOSOCIAL REHABILITATION AND RECOVERY CENTERS Currently, 26 existing PRRCs; 73 DTCs need to convert; 14 medical centers need to develop (total = 113). DTCs must convert to PRRC by end of FY 2009. PRRCs must be CARF-accredited by end of FY 2012.

THERAPEUTIC AND SUPPORTED EMPLOYMENT SERVICES Meaningful employment important part of recovery. TSES encompasses continuum of vocational services. Incentive Therapy CWT/Transitional Work Experience CWT/Supported Employment Consultations about need for vocational rehabilitation must be available to all veterans at all facilities.

THERAPEUTIC AND SUPPORTED EMPLOYMENT SERVICES CWT programs at almost all medical centers. FY 2008, over 8000 Veterans provided with IT services; over 20,000 Veterans provided with TWE services; and over 10,000 Veterans provided with SE services. MOU signed between VA and National Archives Records Administration to provide CWT opportunities.

PSR&RS: NEXT STEPS Continued roll-out and expansion of existing programs. Partnering with other OMHS sections (e.g., infusing recovery in RRTPs). Spreading like kudzu throughout all of mental health and elsewhere (e.g., Primary Care).

QUESTIONS? Contact Information: Jeffrey P. Burk, Ph.D. Associate Chief Consultant, Psychosocial Rehabilitation and Recovery Services c/o North Florida/South Georgia Veterans Health System 1601 SW Archer Rd. (116B-1) Gainesville, FL 32608 Phone: 352-376-1611 ext. 4642 E-mail: jeff.burk@va.gov