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March 15, 2012 Volume 3, Issue 10
Please share the Recovery to Practice (RTP) Weekly Highlights with your
colleagues, clients, friends, and family!

To access RTP's Weekly Highlights, quarterly e-newsletters, Webinar recordings,
and PowerPoint presentations,
please visit http://www.dsgonline.com/rtp/resources.html.

All of RTP's quarterly Webinars are available online. Archived recordings and PowerPoint slides can be downloaded from the RTP Resources page, including "Assessing for and Addressing Trauma in Recovery-Oriented Practice," a session devoted to trauma-informed care.

Recovery in the Workplace
by Deidra Dain
Workplaces that have drug-free policies can strengthen their programs by learning about and understanding the recovery movements in mental health and addictions. These movements have generated approaches that can be very useful in workplace counseling and conventional treatment.

The recovery movements in mental health and addictions have emerged over the last several decades as person-driven alternatives to traditional clinical care. They hold an array of meanings for people with mental health and/or substance use disorders. Although the two recovery movements have mostly evolved independently because of their separate histories (including vastly different approaches to training and education) and practice traditions, the increasing prevalence of "co-occurring disorders" has encouraged researchers to recognize effective care more often results from services integrated across the two fields. In fact, recovery has been documented as a new organizing principle for the fields, and is the impetus for considerable reorganization among public and private behavioral health systems. The core value of how person-centered care can transform an individual's experience and enable him or her to live a full life is a fundamental part of each belief system.

Implications of the role recovery plays in the workplace abound. The menu of options within departments of employee relations, human resources management, and organization development, for example, has been enhanced over the last several years, with more programs offering wellness and health promotion. Much has been documented by people seeking healthier lives about the substantial benefits—from personal fitness to improved productivity. Recovery embraces self-directed care: an individual learning about and selecting programs that work for him or her. Of course, there are rewards and responsibilities that come with such care. For people with mental illness and/or addiction, the same level of personal wellness and owning the plan to get there are stated successes of choosing a recovery orientation. With increased awareness and further research on the efficacy of various recovery-oriented care models, resources can provide meaningful insight on promising alternatives to what was once considered a chronic and desperate existence.

How Does Recovery Fit in the Workplace?
As evidence continues to define recovery as a process, an outcome, and a civil rights issue, employees and employers stand to benefit from understanding how their workplace is affected. Managers, administrators, and other staff are responsible for contributing to workplace wellness. They confront employees' health issues on a daily basis, from assessing stress levels, to managing how absenteeism influences performance and morale, to allowing time for work breaks and physical exercise.

It is additionally important for employers to understand that people with mental illness or psychiatric histories are due the civil rights stipulated by the American Disabilities Act (ADA). Honoring these rights is therefore part of an employer's basic legal responsibilities. Specifically, ADA legislation does not distinguish between type and severity of a disability: "the term 'disability' means, with respect to an individual [with] a physical or mental impairment that substantially limits one or more major life activities of such individual."

Underlying all definitions, recovery represents a strengths-based belief system about human behavior and potential, a person's sense of wellness, and attitudes toward treating illness that translate to individual and collective systems of care. Further, "as a core principle of the recovery movement suggests, identifying and building on strengths can often accomplish things that attending to deficits and dysfunction alone have not been able to do" (Davidson, 2007). This sharply contrasts with the traditional "treatment" model—either in addictions or mental illness—by offering a conceptual divergence from the traditional medical assumption that "patients" are plagued by chronic dysfunctions (they cannot work but rather must live "outside the mainstream," isolated and stigmatized from their communities and society). Workplaces have shared in discrimination against people with mental illnesses or addictions in their hiring practices, performance appraisal systems, and employee benefits. Such organizational constraints stereotype and label people because of their unique needs, perpetuating a sense of hopelessness and lack of motivation to improve or seek alternative treatment. Learning about recovery and incorporating its principles into other strengths-based practices and programs of team building, cultural competence, and goal setting will demonstrate a deeper commitment to developing a more productive workforce. As organizations assess their infrastructures and formal policies and address ways to adopt recovery-oriented values, they can make an even more robust statement about their investment in human capital for the long term.

Sustaining a Healthy Workforce Through Recovery
When integrated in program design and policies from the outset, it seems readily apparent that recovery principles contribute to workplace sustainability. Indeed, programs and policies that permeate a system's core identity support and subscribe to SAMHSA's assertion that everyone can live a full and independent life in the community.

The workplace is where people spend a large part of their lives, engaging in and contributing to occupational responsibilities and building relationships with peers and supervisors. A significant portion (20 percent or more) of the workforce consists of people with addictions and/or mental illnesses. Because of the interrelated nature of mental health and substance use disorders and the stigma associated with these conditions, employees might become frustrated or disenfranchised at work. These feelings can lead to further stress and eventually lower productivity levels, absenteeism, presenteeism,[1] job turnover, and increased abuse of alcohol and other drugs. Such effects equal real costs for employees and employers. Many people with mental illnesses do not even attempt to enter the job market because of the associated stigma, fear of failure, and lack of confidence.

Those who have discovered and engaged in recovery-oriented care know the value of contributing their skills in ways that are respected and appreciated. They live full lives at home and at work. In the workplace, the result is a win–win scenario. The hope and empowerment that come from a self-directed approach clearly help people gain a sense of worth and improved health, while unnecessary workplace expenses are prevented and/or recaptured. Similarly, managers need to not only be aware of recovery as an option for their personal mental health and wellness and that of their staff, but to understand their role in promoting and reinforcing a sustainable workplace by supporting recovery-oriented care. Estimates for recruiting and training a new employee in the private sector can cost up to half a position's salary—much more if special skills are needed.

Recovery Is Here to Stay
Changing paradigms and systems of care naturally takes time and dedicated, intentional effort. In recent years, much research has been underway to evaluate recovery-oriented practices. State, Federal, and private foundations that aim to determine the full value of such approaches are funding additional research all the time.

For example, the National Institute of Mental Health supports a number of studies assessing peer support's positive effect on people with serious mental illnesses, including those with depression, schizophrenia, and bipolar disorder. Two SAMHSA centers—the Center for Mental Health Services and Center for Substance Abuse Treatment—lead research, demonstration, and dissemination initiatives in recovery, with a goal to promote widespread acceptance and implementation. SAMHSA programs influence national policy direction by advocating recovery as a foundational and transformative principle of healing. Despite the fact that the addictions and mental health fields have had difficulty integrating their systems of care, the respective peer movements in both fields are leading the way toward convergence.

Finally, the health care reform law enacted on January 5, 2010, speaks to support for people in recovery through the provision of recovery-oriented care insurance coverage. The law recognizes mental health and addiction treatment benefits as fully equal to treatments for other medical and surgical conditions.

There is no question that recovery-oriented care is here to stay. Workplaces have a unique opportunity to take advantage of this breakthrough in behavioral health care, optimizing workers' wellness and productivity and benefitting both employers and employees.

1. Presenteeism refers to the phenomenon of a person being physically present at work, but not productive.

Deidra Dain is the Deputy Project Director of the RTP initiative.

References
Larry Davidson and William White. 2007. The Concept of Recovery as an Organizing Principle for Integrating Mental Health and Addiction Services. Journal of Behavioral Health Services and Research, 34(2), 109–20.

Larry Davidson. 2010. What Is Recovery? Recovery to Practice Initiative. Bethesda, Md.: Development Services Group, Inc.

Patrick Kennedy. 2009. In Reforming Our Health Care System, We'd Be Crazy to Ignore the Mind. Breaking News and Opinion on The Huffington Post.
Retrieved from http://www.huffingtonpost.com/rep-patrick-kennedy/in-reforming-our-health-c_b_242770.html.

America in Recovery: Home. (n.d.). Retrieved from http://www.americainrecovery.org.

Joe Light. 2010. More Workers Are Considering Quitting Their Jobs. The Wall Street Journal: WSJ.com. Retrieved from http://online.wsj.com/article/SB1000142405.

Register Now

Open Registration for "Understanding and Building on Culture and Spirituality in Recovery-Oriented Practice"
The next RTP Webinar* will describe three components of culture and spirituality in recovery-oriented care: cultural and spiritual assessments, culturally appropriate interventions, and ways in which spirituality and culture can shape an individual's recovery journey. Our presenters will introduce a range of strategies that ensure care is responsive to a person's cultural identity and discuss approaches for fostering cultural strengths and spirituality in care planning and recovery practices. An important facet of culture and spirituality in recovery-oriented care addresses the aging process—how can practitioners be cognizant of person- and family-centered culturally specific needs?

Date
April 4, 2012

Time
3–4:30 p.m. EST

Description
Three multidisciplinary specialists will share their perspectives. Reverend Laura Mancuso, M.S., CRC/CPRP, will describe practical tools for making assessment culturally and spiritually oriented. Dee Bigfoot, Ph.D., Assistant Professor of Pediatrics at the University of Oklahoma Health Sciences Center, will discuss recovery-oriented interventions that have spiritual and cultural components. Finally, National Association of Peer Specialists President Gladys Christian will address how spirituality and culture have affected her recovery journey.

Registration
Click here to register for the free Webinar.

RTP does not offer CEUs for Webinar participation. Certificates of attendance are available upon request.

Cultural Competency in Mental Health
The Nathan Kline Institute (NKI) Center of Excellence in Culturally Competent Mental Health conducted a research project on clear communication in mental health interventions. The center's overarching goal was for existing and new programs to work more effectively with cultural groups.

Three programs were assessed to formulate recommendations for similar initiatives. As part of the project, the center developed a video to portray recurring cultural competency themes. The video will serve as a training tool to help programs move toward culturally focused care.

In 2008, NKI's affiliate, New York University, piloted a new course devoted to culture and psychiatry. The curriculum—designed for third-year psychiatry residents—was based in part on a study sponsored by the Group for Advancement of Psychiatry and American Psychiatric Association/SAMHSA Minority Fellowship Program. Researchers held interviews with 20 faculty members in residency training programs that teach culture and mental health competencies. View the course materials.

SAMHSA's Recovery Support Resources
The Resource Guide describes SAMHSA services and programs—efforts geared toward reducing the impact of substance abuse and mental illness on America's communities. Download the free electronic version to learn more about the agency's call center, help lines, publications, and other useful resources. The section on recovery support can be navigated in many ways by practitioners and consumers.

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 practice.
The RTP Resource Center Wants to Hear From You, Too!
We invite you to submit personal stories that describe recovery experiences. To submit stories or
other recovery resources, please contact Cheryl Tutt, MSW, at 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 topic,
please contact the RTP Resource Center at
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.