thinking out of the box with recovery r y - nhs confederation/media/confederation/files/public...

© Recovery Innovations, Inc

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Thinking Out of the Box

with Recovery

Eugene Johnson, President/CEOCreating Extraordinary Opportunities

www.recoveryinnovations.org


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We Changed Our Mind

Mission 2000

To create opportunities and environments that

empower people to recover,

to succeed in accomplishing their goals,

and to reconnect to themselves, others, and

meaning and purpose in life.


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Recovery

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What Does Our Name Mean?

PLUS

Innovation


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Our Definition

Remembering who you are

and using your strengths to

become all you were meant to be.


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– then we spend the first half of our lives

abandoning them or letting others disabuse us

of them. As young people, we are surrounded

by expectations that may have little to do

with who we really are, expectations held by

people who are not trying to discern our

selfhood but to fit us into slots…..under

social pressures like racism and sexism our

original shape is deformed beyond

recognition; and we ourselves, driven by fear,

too often betray true self….5

Parker Palmer in his book Let Your Life Speak says it like this


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Innovation

• Something we haven’t done before. Something

unexpected that we thought was impossible.

• It’s disruptive. A penetrating alternation of the

status quo.

• Do it together. Share the risk.


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“Fail often to succeed faster”

Performance Improvement Motto. Samsung. 2005

Innovation is Learning from Our Mistakes

Fareed Zakaria, CNN, 2011

“The ability to fail efficiently

is the key to innovation.”


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Michelangelo, 1475 – 1564

I hope that I may always desire more than I can

accomplish.

The greater danger for most of us lies not in setting our aim too

high and falling short; but in setting our aim too low, and achieving our mark.

We envision a future

when everyone with

a mental illness will

recover.

It Starts with a Vision


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Stop the Violence!

"Nonviolence is the greatest force at the disposal of humankind. It is

mightier than the mightiest weapon of destruction devised by the ingenuity of man." - Gandhi

I declared a BIG vision


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No-Force-First

“There is no such thing as forced recovery.”

“The conditions that generate forced treatment are easily trumped by our seeming indifference to the massive use of force in the mental health culture…

“Let us commit to figuring out how to stop our mindless use of force. Let us use our best minds to figure out how to extricate our field from being society’s purveyors of force.”

Anthony, William. An Elephant in the Living Room.

Psychiatric Rehabilitation Journal, Vol. 29 Number 3, Winter 2006. p. 155


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Zero Restraint

• Stop violence that results in trauma, injury and even death of people served and our staff.

• Listen to the experience of those we serve.

• Stop all use of force.


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Getting to Zero; The Results

• Achieved zero restraint in month eight,

dropping from 5.5/month.

• In the second Center it took 15 months.

• Once we achieved zero, elimination

became imbedded in our practice.


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Getting to Zero; The Results

• No increase in staff injury.

• No increase in police events.

• No increase in chemical restraint.

• Today our Centers, AZ, WA, NC, are

licensed with no seclusion/restraint room.


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Peer support

• Hope and Engagement. Sharing personal recovery experiences. “If she/he can do it, so can I.”

• Empathy. Understanding through the personal experience of having “been there”.

• Mutuality. Giving and receiving help and support with respect based on a shared experience.

• Being with rather than fixing.

• Mutual Responsibility for the relationship

• Intentional Relationship


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A Critical Mass of Peers on the Team

• A minimum of 25%.

• Today, 62% of Recovery Innovations direct

service staff are Peer Specialists, 392 out of

633.

• Results; seclusion and restraint were

eliminated in 8 months and in 15 months

• Results; 180 bed County Hospital after one

year reported a 36% reduction in seclusion

and a 48% reduction in restraint.


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What Shows Up with Peers on the Team?

• The Peer Support Specialist’s own recovery is strengthened through service.


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Survey of Peer Employees

• Anonymous Internet survey sent to 355 peer employees with at least 2 months of employment.

• 253 responded, 70% response rate.

• Prior to employment, 66% were unemployed.

• 35% had been unemployed more than three years.

• Average hours worked per week = 30.

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Results

• 20% went off disability benefits.

• Another 37% reduced disability $$.

• 45% went off Medicaid.

• 16% discontinued a housing subsidy.

• 69% discontinued food stamps.

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Financial Impact

• $8 million in annual salaries.

• $1.2 million paid in income taxes.

• $488,280 estimated savings in

disability payments.

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Personal benefits from being a peer support provider Percent

Helping others has helped me in my own recovery 87.1%

I feel more self-confident 78.7%

I feel more emotionally stable 72.7%

I am more satisfied with my life in general 72.3%

I am more interested in my future career opportunities now 68.7%

I am more financially stable 67.1%

I have been able to connect more with family 44.2%

I am able to do more recreational/leisure time things 42.6%

I have been able to socialize more with friends 39.8%

I have been able to begin saving money 38.2%

I have taken a paid vacation 34.9%

I have a nicer place to live 32.5%

I now have company benefits like medical or dental coverage 31.3%

I purchased my own vehicle 26.5%

I have been able to reduce the medication 20.5%


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• Peer Support Specialists help others recover through engagement, hope, and mutual relationship/friendship.


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• 56% reduction in re-hospitalizations.

• 36% reduction in seclusion.

• 48% reduction in restraints.

In the first year peers worked in the

hospital….

Recovery Impact


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• Peer Support Specialists help others recover through engagement, hope, and mutual relationship/friendship.

• Helps the organization/system recover.

– As staff work alongside people in recovery, staff find new hope.

– Confronts system and professional stigma

– Moving from “mental patient” to colleague redefines our roles and boundaries.

– Saves $$$

Psychiatric Recovery Center Hospitalizations

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

Jul-0

3

Sep-0

3

Nov-

03

Jan-

04

Mar

-04

May

-04

Jul-0

4

Central West Total

One hospitalization

costs $9,900 ($550

per hospital day with

an average length of

stay of 18 days).

During the period

shown there were

an average of 900

PRC admissions per

month.

A reduction in

hospitalization rate

from 20% to 10%

=1,080 annual

hospital admissions

= $10,692,000 per

year.


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Financial Impact ~ Pierce County

System Redesign; 2010

• 19.5% reduction in hospitalizations. $1.5M saved.

• 32% reduction in compulsory treatment. $2M

saved.

• 32% reduction in readmission rate.

• Reduction in average hospital length of stay from

19.6 days to 12.1 days. $4.4M saved.

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Better Access, Better Care, Better Outcomes


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Financial Impact ~ Pierce County

Peer Recovery Team. 2011

• 120 served

• 131 hospital admissions in 12 month

before PRT.

• 23 hospital admission in 12 months

since PRT.

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Better Access, Better Care, Better Outcomes


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Implementing Peer Support

• Organizational commitment.

• Quality training prior to employment.

• Recovery training for all staff to embed the new peer support discipline.

• Supervisor and leadership training.

• Create job-specific peer support roles.

• Create the transformation “tipping point” quickly with a critical mass of peer support workers.

Tips for Success


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Implementing Peer Support

• Develop career ladder for the peer

support discipline.

• Parity for peer support workers;

supervision and support, performance

expectations, pay, promotion, ethics.

• Remember, it’s real work, not sheltered

work or therapy.

Tips for Success


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opportunities to experience

increasingly challenging

assignments.

• Be generous. Provide frequent

positive interactions pointing out

growth and success.

• Create hope. Provide sincere

positive feedback to the person of

appreciation for their

contribution.

• Stay connected. Tell everyone

Yes We Can!


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celebrate…

the best is yet to come!

thinking out of the box with recovery r y - nhs confederation/media/confederation/files/public...

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