Last week PsychOdyssey attended its first national gathering of the US Psychiatric Rehabilitation Association. What a good year to do so. In all, 1900 delegates attended, the largest gathering ever in USPRA’s 36 year history. The occasion also marked the retirement of a titan in psychiatric rehabilitation, Dr. Bill Anthony of the Center for Psychiatric Rehabilitation at Boston University.
Among so many wonderful experiences, here are some highlights.
Keynote Speech by Patricia Deegan: Being a student of psychiatric rehabilitation, I had read many articles by and heard much praise for Pat Deegan, the doyenne of the self-directed recovery movement. Knowing that she has a large following among PsyR
practitioners, I was ready to enjoy her speech—and an adoring audience’s reaction. Alas, it was even better than I expected. Deegan’s deeply personal, poetic account greatly moved me. Diagnosed with schizophrenia in high school, for many years she was just “smoke and Coke”, sitting on her couch smoking cigarettes and drinking Coca-Cola while watching daytime TV. After nearly two decades, somehow an ember of hope was lit. Somehow a spark of hope caught hold. So began Pat’s remarkable “journey of hope” which ultimately lifted Pat to the vanguard of the consumer/survivor movement. Now she tells her story about the power of the lived experience to “disrupt and transform the behavioral health system”. This speech alone was worth the whole price of the conference.
Possible New Residential Support?
Adult Family Care: Michael Seibold of Alternatives Unlimited in Massachusetts spoke about his agency’s program of adult family care. Qualified homeowners take in certain individuals with psychiatric disabilities to provide a supervised, home-based living environment. Like foster parents for children, these foster families for adults receive financial support from their states’ Medicaid programs. Washington has the largest number of adult family care slots, over 15,000. New Jersey has only 34 adults in such arrangements. Alternatives’ experience in Massachusetts suggests that Adult Family Care could be a cost-effective means to increase community integration of individuals with psychiatric disabilities. A recent report about Adult Foster Care by AARP provides a state-by-state analysis of the current state of the practice.
IDEA! Advocate for more Adult Family Care beds in states with severe housing shortages for individuals with SMI, like New Jersey.
What? Psych Rehab Practitioners Really Don’t Know about NAMI’s Family-to-Family? Professor Alicia Lucksted from University of Maryland made a fine report on her newly released research proving the benefits of NAMI’s Family-to-Family™ education course. As an active supporter of F2F, PsychOdyssey was gratified to hear the news. Less gratifying, however, was the response of other 200 conference delegates in the break-out room. Lucksted began by asking how many had heard of Family-to-Family. Only 8 hands rose. How many had taken the class? About 5. How many teach the class? Only 3. Finally, Prof. Lucksted asked how many coordinate Family-to-Family programs? To our great surprise, PsychOdyssey was the only one! Then, in the Q&A, one delegate remarked that, in her view, for many consumers families are not a help, but a trigger for their symptoms. Such sentiment must be an aberration. In light of the family-friendly orientation of psychiatric rehabilitation generally, surely there cannot still be vestigial medical model thinking among some in the PsyR ranks. On the other hand, it might confirm at least this family member’s perception that often the dialogue of recovery is still too bilateral, primarily between about about consumer and provider, with family members at best grudgingly included and at worst still considered as an ailment cause or trigger.
IDEA! At the forthcoming USPRA Leadership Summit in Austin next October, a joint panel of psych rehab practitioners and NAMI Family to Family leaders should discuss how to integrate this easy, efficient, and effective evidence-based practice into care plans.
Job Interview Simulations: In a talk called “Simulation Job Interview Training and Learning Based Recovery”, Professor Morris Bell of the Yale School of Medicine introduced his research on video simulated job interview training for individuals with psychiatric disabilities. Working with an innovative software company called SIMmersion, Bell has shown through research that video simulation training is highly effective for Supported Employment application. (SIMmersion is developing a range of interactive training software applications for government, health care, and commercial use.)
IDEA! PsychOdyssey imagines that Simmersion’s software could be extended to family psychoeducation applications, helping train family members how better to interact and communicate more effectively with loved ones.
Visit to Center Club Boston: All the delegates were invited to a reception for international colleagues attending from China, Taiwan, Singapore, Nigeria, Israel, Sweden, and Canada. The venue was down near Faneuil Hall, at the Center Club Boston, one of the founding members of USPRA. Under the loving direction of Mary Gregorio, Center Club Boston (started in 1959) belongs to the International Center for Clubhouse Development, an important factor in the mental health self-help and recovery movement. Mary and the club members fêted us all with fine music and finger foods, and we were inspired to hear so many heroic stories of the members’ lived experiences. Later, watching the local hockey fans dancing in the streets after the Bruins victory was a bonus.
Psych Rehab in Singapore: also can, lah! Another treat was meeting Singapore delegate Dr. Joseph Leong. “Dr. Joe” is one of 40 psychiatrists at Singapore’s Institute of Mental Health/Woodbridge Hospital, a 2000 (!) bed psychiatric facility serving the entire island nation. Singapore is beginning to look at psychiatric rehabilitation as a modality of care. About five of IMH/Woodbridge’s doctors now have some training in the area. Dr. Joe is an enthusiastic first adopter 0f the practice—and, if his infectious exuberance is any indication, will surely inspire others to join in the practice very soon.
The Business of Psych Rehab
“Bridging The Chasm”: The Experience of Vinfen: On our last day, PsychOdyssey joined a field trip to Vinfen Corporation, a $110 mm human services agency with 18 offices in eastern Massachusetts and operations in other states as well. We were received by SVP Susan Abbott and her incredible management team. We learned about the epic 2009 decision by the Massachusetts Division of Mental Health to
change its contracting methods. We also heard the incredible challenge it presented to Vinfen. Within a year, Vinfen reinvented its entire business across all its platforms, and in so doing proved itself to be a true national leader in psychiatric rehabilitation service delivery. The Vinfen transformation is a worthwhile case study. And the most amazing thing? Vinfen restructured all its operations by itself, without the assistance of consultants and outside experts. Turns out that Susan Abbott is a autodidact on the subject of leadership, and Vinfen’s success clearly shows how she has mastered the art.
IDEA! Develop a graduate level case-study course in the business, management, and economics of psychiatric rehabilitation, with Vinfen as one of the model cases, as well as other notable agency successes like Thresholds, The Village, and Seven Counties, just to name a few. The psych rehab sector urgently needs its PsyR students to know more not only about care modalities, but also corporate management.
All in all, a great gathering of enormously dedicated professionals advancing a critical cause: personalized, self-directed, non-linear, humane, individual recovery of all who experience psychiatric disabilities.