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With mental health reform on the forefront
of issues facing many American families we must look to both
evaluate and improve the system in place. Former Nebraska
Governor Mike Johanns has stated that mental health reform
“Is about restructuring a fragmented system of mental
health services to provide a more appropriate level of care.”
Appropriate levels of care produce higher qualities of life,
an important and attainable goal for every human being.
Transforming Mental Health Care in America,
submitted by President Bush’s New Freedom Commission
on Mental Health states, “Recovery, as defined by the
Commission, is the process by which people are able to live,
work, learn and participate fully in their communities.”
For some individuals, the Commission noted, recovery is the
ability to live a fulfilling and productive life despite a
disability. For others, recovery implies the reduction or
remission of symptoms. For many people, recovery is a transformative
process, one that is less about returning to a former self
and more about discovering who one can become. Unfortunately
for some persons, who also have a mental illness, the opportunity
to experience recovery on any level is limited.
Individuals with mental illness have
identified a need of securing housing appropriate to their specific
levels of care. The gap exists when any of these individuals
is in need of hospitalization. The ideal situation following
such hospitalization is for individuals to have a complete recovery
with a return to life as close to “normal” as possible.
For a number of reasons, this is not always an option. Hospital
stays are limited for a variety of reasons. Funding objectives,
as well as the understood importance of community-based treatment
contribute to this. The glitch occurs when individuals leaving
a hospital setting are not yet ready to return to their previous
living arrangements or an independent living situation. The
availability of transitional programs in such circumstances
is inadequate. Through a collaborative
effort, Maple Crest Care Center, a skilled nursing community,
The Friendship Program, which offers a variety of services
to persons with mental illness, and The Kim Foundation, whose
financial support funds the effort, developed a pilot program
with the aspiration of restoring hope to those seemingly “stuck”
in the system.
The joint project began in September of 2005. The goal was
identified to address the unmet needs of residents diagnosed
with mental illness. These are individuals who no longer need
a skilled level of care, but have remained in long term care
for lack of more appropriate living arrangements. The program
assesses and evaluates each individual’s skills to assist
in identifying the level of care appropriate. Following this
identification, the next step was to enroll the participants
in the Community Based Rehabilitation Program at Friendship
Program.
The Community Based Rehabilitation program
offered each of the participant’s classes and programs
designed to assist in an individual’s capacity to live
independently. Groups presented were designed to enhance knowledge
not only of mental illness, but the symptoms, medications,
relapse prevention, and self-advocacy attached. In addition
the program provides, nursing services including health promotion,
screening and education, and weight and exercise groups, coordination
with physicians, psychiatrists, family and other community
services, prevocational skills training, outings which encourage
interest in and awareness of the community, and discussion
groups on participant interests, current events, and lifestyle
changes.
Friendship Program further implemented peer
support programs known as WRAP, Wellness Recovery Action Planning.
WRAP is a skills based group that focuses on the development
of recovery and relapse prevention skills. With target group
identified as those individuals recovering from mental illness,
a connection was made. WRAP values peer-to-peer interaction,
“lived experience”, and growth opportunities available
for all participants. WRAP was not meant to take the place
of treatment but to further enhance personal growth and insight.
Providing an infrastructure for recovery and growth, groups
discuss hope, personal responsibility, self-advocacy, education,
support, and self-esteem. Participants are given the opportunity
to be and feel like experts by sharing their experiences.
As participants proceeded through the program, social workers
from both Maple Crest and the Friendship Program worked together
to complete appropriate paperwork and authorizations for alternative
living situations in lower levels of care. Since beginning
the program in September of 2005, three individuals have transitioned
to a more independent living situation, more appropriate to
their individual level of care.
It has taken a team effort to get this program
running. There are numerous nurses, aides, social workers,
chaplain, environmental services, dietary, front office staff,
and more, that participated to make this opportunity a successful
one. The involvement needs to continue.
For additional information or to request a copy of the full
report, please contact Mary Beth Wahlmeier at (402) 891-6964.
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