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RTP Weekly Highlight Header - Issue No. 5, April 29, 2011

May 19, 2011 Volume 2, Issue 18
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Occupational Therapy’s Role in
Mental Health Recovery
By Tina Champagne, OTD, OTR/L, and Karla Gray, OTR/L, LICSW,
from the American Occupational Therapy Association
According to the National Consensus Statement on Mental Health Recovery, mental health recovery is defined as “a journey of healing and transformation, enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to reach his or her potential.”

The recovery model requires a shared decision-making process that is person centered and client driven. The client–provider partnership supports shared decision-making from the time the individual first engages in services, through developing intervention plans, and in all other aspects of the therapeutic process. A primary goal of the recovery model is to facilitate resiliency, health, and wellness in the community of the individual’s choice, rather than to manage symptoms. The National Consensus Statement identified 10 fundamental components of recovery: (1) self-directed, (2) individualized and person centered, (3) empowered, (4) holistic, (5) nonlinear, (6) strengths based, (7) peer supported, (8) respect, (9) consumer responsibility, and, “the catalyst of the recovery process,” (10) hope.1 These fundamental recovery principles are in full alignment with the philosophy of occupational therapy practice, which is inherently client centered; collaborative; and focused on supporting resiliency, full participation, health promotion, and a wellness lifestyle.

Occupational therapy practitioners work collaboratively with people in a manner that helps to foster hope, motivation, and empowerment, as well as system change. Educated in the scientific understanding of neurophysiology, psychosocial development, activity and environmental analysis, and group dynamics, occupational therapy practitioners work to empower each individual to fully participate and be successful and satisfied in his or her self-selected occupations. Occupational therapy practitioners assume a variety of roles, such as direct-care therapists, consultants, academic educators, managers, and administrators. They may also work in State and national mental health organizations to help assist in local, State, and national transformation efforts.

The following are examples of how the knowledge and skill base of occupational therapy is used in the process of assisting individuals in all phases of mental health recovery:
  • Teach and support the active use of coping strategies to help manage the effect of symptoms of illness on one’s life, including being more organized and able to engage in activities of choice
  • Help to identify and implement healthy habits, rituals, and routines to support a wellness lifestyle
  • Support the identification of personal values, needs, and goals to enable informed decision-making, such as when considering housing and employment options
  • Support the creation and use of a wellness recovery action plan in group or individual sessions
  • Provide information to increase awareness of community-based resources, such as peer-facilitated groups and other support options
  • Provide information on how to monitor physical health concerns (e.g., diabetes management, smoking cessation), develop strategies to control chronic symptoms, and recognize and respond to acute changes
  • Support the ability to engage in long-term planning (e.g., budget for major purchases, prepare advance medical and mental health directives) that leads to meeting personal recovery goals
Occupational therapy practitioners are also teaming with individuals, families and caregivers, interdisciplinary professionals, and other mental health stakeholders—including behavioral health organizations, payers, and communities—to help transform the culture of mental health care through the promotion and active implementation of recovery-based principles and practices. Together, these teams are designing innovative agency- and community-based supportive programming based on recovery principles. The recent Recovery to Practice Federal initiative has been set in motion to provide the assistance and resources necessary to “foster a better understanding of recovery, recovery-oriented practices, and the roles of the various professionals involved in promoting recovery” (p. 2).2

Where are occupational therapy mental health recovery services provided? Occupational therapy practitioners provide mental health services in the following settings:
  • Acute and long-term-care facilities
  • Private and public hospitals
  • Forensic and juvenile justice centers
  • Residential and day programs
  • Skilled nursing facilities
  • Community-based mental health centers
The practice of occupational therapy, like the recovery model, is based on the philosophy and evidence that individuals diagnosed with mental health conditions can and do recover and lead meaningful, satisfying, and productive lives. It is the profession’s emphasis on holism, function, participation, and partnership that is used to help support people with mental illness to develop skills, engage in activities of interest, and meet individual recovery goals.

To access the full PDF article, please visit
http://www.aota.org/Practitioners/PracticeAreas/MentalHealth/Fact-Sheets/MH-Recovery.aspx?FT=.pdf

References
1Substance Abuse and Mental Health Services Administration (SAMHSA). (2005). National consensus statement on mental health recovery. Retrieved from http://mentalhealth.samhsa.gov/publications/allpubs/SMA05-4129

2SAMHSA. (2005b). Recovery to practice—Project overview.
Retrieved from http://www.dsgonline.com/rtp/RTP%20Overview.pdf

$100 Million in Affordable Care Act Grants to Help Create
Healthier U.S. Communities
The U.S. Department of Health and Human Services (HHS) announced this week the availability of more than $100 million in funding for up to 75 Community Transformation Grants. Created by the Affordable Care Act, these grants are aimed at helping communities implement projects proven to reduce chronic diseases, such as diabetes and heart disease. By promoting healthy lifestyles and communities, especially among population groups experiencing the greatest burden of chronic disease, these grants will help improve health, reduce health disparities, and lower health care costs.

“Community Transformation Grants will empower local communities with resources, information, and flexibility to help make their residents healthier,” said HHS Secretary Kathleen Sebelius. “By helping to transform communities at the ground level, these efforts can have a major impact on the health of Americans.”

“It is critical that we sustain our work to develop and spread effective programs that address leading killers like heart disease, cancer, and stroke,” said Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention (CDC), which oversees the Community Transformation Grants program. “These funds will allow us to build on successful programs that have helped people lead healthier lifestyles and help us save millions in healthcare costs in the future.”

Chronic diseases, such as heart disease, cancer, stroke, and diabetes, are taking a devastating toll on our Nation’s health. Seven of every 10 deaths are from a chronic disease—mostly caused by tobacco use, obesity, poor diet, and too little physical activity. Treatment for people with chronic conditions accounts for more than 75 percent of the more than $2 trillion spent on annual U.S. medical care costs. Obesity is a significant healthcare cost driver; in 2008, about $147 billion of medical bills were weight-related.

Consistent with the law, these grants will focus on five priority areas: 1) tobacco-free living; 2) active living and healthy eating; 3) evidence-based quality clinical and other preventive services, specifically prevention and control of high blood pressure and high cholesterol; 4) social and emotional wellness, such as facilitating early identification of mental health needs and access to quality services, especially for people with chronic conditions; and 5) healthy and safe physical environments.

Successful applicants must use evidence-based strategies and ensure that their activities not only have broad population impact, but also help address health disparities. Examples of projects that could qualify for grants include eliminating food deserts and increasing access to healthy food options, including efforts to improve school nutrition or bring healthier food to corner markets in urban areas. Other examples include promoting blood pressure and cholesterol screenings.

Communities may also address additional areas of disease prevention and health promotion that will contribute to the overall goal of reducing chronic disease rates. These areas include adolescent health; arthritis and osteoporosis; cancer; diabetes; disabilities and secondary conditions; educational and community-based services; environmental health; HIV; injury and violence prevention; maternal, infant, and child health; mental health and mental disorders; health of older adults; oral health; and sexually transmitted diseases.

State and local government agencies, Tribes and Territories, and State and local nonprofit organizations are eligible to apply for Community Transformation Grants. At least 20 percent of grant funds will be directed to rural and frontier areas. Applications are due to the CDC in July 2011, with awards expected to be announced near the end of summer. The grants are expected to run for 5 years, with projects expanding their scope and reach over time as resources permit.

The Community Transformation Grants are one piece of a broader effort by the Obama Administration to address the health and well-being of our communities through initiatives such as the President’s Childhood Obesity Task Force, the First Lady’s Let’s Move! campaign, the National Prevention Strategy, the National Quality Strategy, and HHS’ Communities Putting Prevention to Work program. The Prevention and Public Health Fund, as part of the Affordable Care Act, is supporting this and other initiatives designed to expand and sustain the necessary capacity to prevent disease, detect it early, manage conditions before they become severe, and provide States and communities the resources they need to promote healthy living. For more information about how the Fund is helping promote prevention in every State, visit http://www.HealthCare.gov/news/factsheets/prevention02092011a.html.

The official funding opportunity announcement for the Community Transformation Grants can be found at http://www.Grants.gov by searching for CFDA 93.531. For more information about the grants, visit http://www.healthcare.gov/news/factsheets/grants05132011a.html or http://www.cdc.gov/communitytransformation.

Want information on Federal mental health grants, publications, meetings, policies, programs and other useful material for mental health consumers? Join the CMHS Consumer Affairs Listserv at: http://www.samhsa.gov/ConsumerSurvivor.

Conference of the Five Continents – Lyon 2011
Psychosocial Effects of Globalization on Mental Health:
Toward an Ecology of Social Links
Where
Lyon France

When
Oct. 19—22, 2011

This timely conference offers an opportunity to begin building a worldwide network of people—practitioners, peers, policy makers, researchers/scholars, and others—to address the multiple opportunities and challenges that we face as our prospects become more intertwined worldwide, for better for some, and for worse, no doubt, for others.

For more information, visit: http://www.congresdescinqcontinents.org/en

National Coalition for Mental Health Recovery Releases Guidelines
for Promoting Recovery Through Choice and Alternatives
The National Coalition for Mental Health Recovery (NCMHR), a national coalition of statewide consumer/survivor organizations and others, has released guidelines to educate people about the values-based needs of individuals with mental health challenges. The guidelines—“Enhancing the Effectiveness of Psychiatric Care and Other Services and Supports: Guidelines for Promoting Recovery Through Choice and Alternatives”—were developed by a diverse group of people with the lived experience of mental health recovery from across the United States. They are available at http://www.ncmhr.org/press-releases/4.28.11.htm#guidelines.

The NCMHR ensures that consumer/survivors have a major voice in the development and implementation of health care, mental health, and social policies at the State and national levels, empowering people to recover and lead a full life in the community.

For more information about the National Coalition, see http://www.ncmhr.org.

The RTP Resource Center Wants to Hear From
Recovery-Oriented Practitioners!
We invite practitioners to submit personal stories that describe how they became involved in recovery-oriented work and how it has changed the way they currently practice.
The RTP Resource Center Wants to Hear From You, Too!
We invite you to submit personal stories that describe recovery experiences. To submit personal stories or other recovery resources, please contact Stephanie Bernstein, MSW, at 1.877.584.8535,
or email recoverytopractice@dsgonline.com.

We welcome your views, comments, suggestions, and inquiries.
For more information on this topic or any other recovery topics,
please contact the RTP Resource Center at
1.877.584.8535 or email recoverytopractice@dsgonline.com.

The views, opinions, and content of this Weekly Highlight are those of the authors and do not necessarily
reflect the views, opinions, or policies of SAMHSA or the U.S. Department of Health and Human Services.