Power Point Slides

1

Power Point Slides

2

3

WHAT THE PROGRAM HAS TO OFFER

MI Recovery Week One

4

What the Program Has To OfferWeek 1 - What does the program have to offer? Theory on mental illness and factors that enable recovery

Week 6 – Communication Skills and Strategies

Week 2 - Reframing my Whole Self, and Understanding Stigma

Week 7 – Stigma, Discrimination, Rights and Advocacy

Week 3 - Treating Myself: Doing enjoyable and healthy activities for myself that decrease stress and symptoms

Week 8 – Making the most of the National Disability Insurance Scheme

Week 4 - Planning for Recovery Week 9 – Motivating Purposeful Activity

Week 5 – Working with Relapse Week 10 – Review of recovery Aspirations and program conclusion

5

What is expected of participants

• Participation• Step outside of your comfort zone sometimes• Commitment• Work together• Being on time• Regular attendance• Confidentiality

6

What is mental illness?What is Mental Illness?

Mental illness is an illness of the brain that affects a person’s mood, thoughts, behavior and perception.

7

Science and Mental Illness• Over half of what we know about the brain in relation to mental illness has been discovered by scientists in the last 10 years. • New imaging technology (X-ray’s) allow the brain to be looked at whilst the person is experiencing mental illness whereas before we relied on information found in the brain after a person had died.• Research shows that physical changes commonly occur within the brain in mental illness.• The pathways in the brain that are responsible for feeling emotions and interpreting information are affected.• Brain research has improved medications and other physical treatments and will continue to do this in the future.• For different mental illnesses, different aspects of the brain are affected.

8

The main mental illnesses and disorders experienced by Australians are

(in order of frequency)• Mood disorders – such as depression, dysthymia, mania, hyperactivity, and bipolar affective disorder

• Anxiety disorders – such as panic disorder, agoraphobia, obsessive-compulsive disorder, generalised anxiety disorder, and post-traumatic stress disorder

• Disorders caused by alcohol and drug use

• Psychotic illnesses – including schizophrenia and personality disorders.

9

Causes of mental illness The Biopsychosocial theory helps us understand what

causes any form of illness, specifically in regards to mental illness.

It gives us a way of understanding how:

• the causes,• the symptoms,• and treatments, are linked.

“The biopsychosocial theory is a great tool for taking control of our illness and planning our recovery.”

10

Biopsychosocial causes

Biological aspect – How the brain chemicals affect our thinking and behaviour

Social aspect – How we interact with others and our environment

Psychological aspect – The way we think about things

The diagram shows three aspects of ourselves that can be vulnerable to mental illness.

Disruptive experiences, in each of these areas can bring about distress, which in turn can cause symptoms of mental illness. Of course, all these aspects of ourselves and our lives are connected and interact with each other and can spiral into further experiences of distress.

Biological

Psychological Social

11

Causes of mental illness

• Poor social and coping skills• Poor communication skills• Trauma

Psychological Social• Family conflicts• Major life events• School/Work/Social problems• Low social supports• Rejection by others• Drug illicit taking• Poverty• Loneliness

Biological• Chemical imbalance• Neurodevelopmental factors• Birth complications• Drugs – prescription and elicit• Injury

12

Treatment of mental illnessBiological


• Medication• Electric convulsive treatment (ECT)• Exercise and diet

• Talking therapies• Communication skills• Coping skills

• Support from family/ friends/ school/ employer• Improved environment• Increased social connection• Meaningful occupation/ education/ volunteering/ employment• Improved life skills• Financial security

13

What is Recovery?

Recovery does not mean that one is ‘cured’ nor does it mean that one is simply stabilized or maintained in the community. Recovery often involves a transformation of the self wherein one both accepts one’s limitations and discovers a new world of possibility.

14

• Acceptance of illness• Hope and Courage• Managing symptoms• Education• Reconstructing identity and purpose• Supporting others• Choice, responsibility, control and empowerment• Meaningful activity• Advocacy

Extensive research has identified nine key factors that promote recovery from mental illness. Basically, it comes down to having the best resources in place to manage the biological and psychological aspects of mental illness and to maintain social connection and purpose.

Factors That Assist Recovery

15

16

REFRAMING MY WHOLE SELF AND UNDERSTANDING STIGMA

MI Recovery Week Two

17

“Having bi-polar disorder messed my life up. When I was really sick I didn’t know who I was or what I wanted to get out of life. I started to doubt whether I could ever be ‘myself’ and have a normal life again?”

18

There are different ways we can look at things

19

- There is more to me than my illness and I need to learn how to value my whole self.

- Society, families and the individual can work together and support me in doing this.

- Our stories and relationships change when we learn to value our whole self.

- (Russell)

20

21

MI Recovery Week Three

TREATING MYSELF

22

Personal TreatmentEnjoyable and

healthy activities that I do for myself, that decrease stress and symptoms, help my moods, and help me manage the things

that trigger my symptoms.

23

“My bi-polar triggers include sleep deprivation, jet-lag, hormonal fluctuations and change of seasons”(Russell: 38)

24

Research-Based Personal Medicine Lifestyle Strategies Sleep: Adequate sleep every night has a positive impact on your mood and energy. Poor sleep patterns can trigger symptoms. If you have trouble sleeping talk to your doctor, but try the following first:

· Avoid coffee, coke, tea and chocolate as they can keep you awake· Wind down for a period before sleep time, doing quiet activities like reading, or a hot bath· If you cant sleep get up after 30 minutes in bed and do something relaxing for a while (not TV)· Avoid daytime naps· Make your bedroom dark, quiet and comfortable.

25

Research-Based Personal Medicine Lifestyle Strategies

Exercise: Regular exercise can lift your spirits, reduce stress, and produces natural endorphins (happy brain chemicals). Exercise can be as easy as walking the dog, riding a bike to the supermarket, swimming or throwing a ball with a friend.

Reduce Drugs and Alcohol: Reduce or eliminate alcohol and illicit drug intake. These interfere with brain chemicals and prescription medicines. Alcohol is a depressant.

Brain-food: Exercise your brain: Read books and newspapers as an alternative to TV. Escape to the library. Find out more about your diagnosis.

Other People: Check in with people about your mental health: doctors, family, friends. Ask them if they think you’re travelling okay. Have they noticed any changes? Can they help you keep up your personal medicine strategies?

26

Research-Based Personal Medicine Lifestyle Strategies

Creative pursuits: What do you like doing that you’re good at or want to improve? Cooking, writing, knitting, craft, woodworking, painting, music?

Diet: Eating well can help your moods and minimise weight gain:· Healthy food: eat more fruit and vegies than meats and sweets· Keep away from food with artificial colors , flavours, fats and sugars, and fast foods.

Being: Take time out to ‘just be’, so that you can reflect positively on your life and manage stress. Try meditation, relaxation exercises, spiritual pursuits, breathing exercises, walking at sun-up or sun-down.

27

28

MI Recovery Week Four

PLANNING FOR RECOVERY

29

DOING THINGS THAT HELP

ACTION

DECIDING TO GET BETTER AND PREPARING

DETERMINED/ PREPARED

MAINTENANCE AND WELLNESS

MAINTENANCE

THINKING ABOUT GETTING BETTER

CONTEMPLATING

RELAPSE

RELAPSE

UNWELL

PRE-CONTEMPLATING

WHAT MOVES US ON

Stages of Change and Recovery Model

30

Stages of Change and Recovery Model ‘Unwell’ stage

WHAT MOVES US ON

UNWELLPRE-CONTEMPLATING


CONTEMPLATING




ACTION

MAINTENANCE

AND WELLNESS

MAINTENANCE

RELAPSE

RELAPSE

31

Stages of Change and Recovery Model ‘Thinking about getting better’ stage

WHAT MOVES US ON

UNWELL

PRE-CONTEMPLATING

THINKING ABOUT GETTING BETTERCONTEMPLATING




ACTION

MAINTENANCE

AND WELLNESS

MAINTENANCE

RELAPSE

RELAPSE

32

Stages of Change and Recovery Model ‘Deciding to get better and preparing’ stage

WHAT MOVES US ON

UNWELL

PRE-CONTEMPLATING


CONTEMPLATING

DECIDING TO GET BETTER AND PREPARINGDETERMINED/ PREPARED


ACTION

MAINTENANCE

AND WELLNESS

MAINTENANCE

RELAPSE

RELAPSE

33

Stages of Change and Recovery Model ‘Doing things that help’ stage

WHAT MOVES US ON

UNWELL

PRE-CONTEMPLATING


CONTEMPLATING




ACTION

MAINTENANCE

AND WELLNESS

MAINTENANCE

RELAPSE

RELAPSE

34

Stages of Change and Recovery Model ‘Maintenance and wellness’ stage

WHAT MOVES US ON

UNWELL

PRE-CONTEMPLATING


CONTEMPLATING




ACTION

MAINTENANCEAND WELLNESSMAINTENANCE

RELAPSE

RELAPSE

35

Stages of Change and Recovery Model ‘Relapse’ stage

WHAT MOVES US ON

UNWELL

PRE-CONTEMPLATING


CONTEMPLATING




ACTION

MAINTENANCE

AND WELLNESS

MAINTENANCE

RELAPSERELAPSE

36

Planning for Recovery Method 1. Understanding the aspects and triggers

of your illnessBiological


37

(Planning for Recovery Method)2. Recovery Factors - Consider how you can include “Recovery Factors” in your plan. How can we draw on the experiences of those that have travelled the recovery journey before us to assist our planning

1. Acceptance of illness2. Hope and Courage3. Managing symptoms4. Education5. Reconstructing identity and purpose6. Supporting others7. Choice, responsibility, control and empowerment8. Meaningful activity9. Advocacy

38

(Planning for Recovery Method)

3. Reflect on the best use of your resourcesWe already have many internal resources we can harness to assist our recovery journey, eg. strength, willpower, sense of purpose, personal experience.

We can also draw upon the resources that are external to us or that others can share with us. These can give us additional support on our journey

39

(Planning for Recovery Method)

4. Develop strategies than can help you manage all aspects of illness

What strategies assist us with our symptom management

Biological triggers/stressors

Psychological triggers/stressors

Social triggers/stressors

Strategies and lifestyle changes I would like to try

40

Recovery Action PlanningWithin recovery action planning we use a cycle of reflection, planning, action and review.

It looks like this -

1.Understanding the

biopsychosocial aspects and

triggers of your illness

2. Include researched based Recovery Factors

in your plan

3. Reflect on the best use of your

internal and external resources

4. Develop strategies and

lifestyle changes to help manage biopsychosocial aspects if illness

Review Reflection

Planning Action

41

Personal Recovery Action Planning1. What biopsychosocial aspects and triggers of my illness do I need to address?

2. Which research based recovery factors will I include and what activities will I use to address these?

3. How can I best use my internal and external resources

(eg, strength willpower, sense of purpose, friends, community resources)

4. What strategies and lifestyle changes can I put in place to help manage biopsychosocial aspects of my illness (include steps required to achieve and by when or how often.)

42

43

MI Recovery Week FiveWORKING WITH RELAPSE

44

Relapse Prevention involves:• Including personal medicine in my daily or weekly

life • Being aware of what causes me stress • Maintaining a healthy lifestyle • Recognising my early warning signs • Responding to early warning signs

45

The three P’s

athway to support:

Knowing who you can call at any time of the day or night, and having phone numbers ready. None of us is an island and we all need a little help from our friends.

rofessional interventions: This may mean increased involvement of your key worker, temporarily increasing your medication

under supervision (or for psychotic illnesses or bi-polar you may require ‘emergency’ medications), or using Cognitive Behavioural Therapy – this can help for low level delusional thoughts

ersonal Medicine: It’s time to employ the coping strategies that you’ve used in the past and to increase your dosage of

personal medicine. Less stress, regular sleep, good diet and other lifestyle factors are essential to avoiding relapse!

PPP

46

47

MI Recovery Week SixCOMMUNICATION SKILLS AND STRATEGIES

48

Medical and other supportive professionals

“The best professionals walked alongside me,…sharing and supporting my inner search for meaning and understanding of self in relation to illness”

Simon Champ (1999)

49

Medical and other supportive professionalsBe InformedEquip yourself with:- information about the service and its approach, what it can provide, and what

your rights are.- information about treatment options. The more you know, the more empowered

you will be to get the treatment that works for you.

Create a partnershipYour doctor should :- respect your wishes and value your input - know your hopes and expectations - provide the information you require- help you identify options You should: - communicate the facts clearly and ask questions, - keep appointments at regular intervals to monitor your health.

50

Medical and other supportive professionals

Keep your own records - Keep a file of information about your treatment: medications you’ve

taken, side effects, sleep patterns, symptoms, and other information that you think relates to your treatment plan.

- Offer information that’s relevant to your treating professional.

Plan ahead- Plan (write down) your questions and what you want to say to the

doctor. - Plan what information you need to tell your doctor.

51

Medical and other supportive professionalsSupport person- Take a support person with you to the appointment if symptoms are getting in the way of communicating well.- Inform the support person about what you want to say to the professional.- Keep your support person informed about your recovery plans, hopes and expectations.

After your doctor’s appointmentDon’t hesitate to phone your doctor if:- You have any questions.- Your symptoms get worse, or you have problems with medication.- You have had tests and you don’t hear from your doctor.

52

These are: - A way to maintain self-determination and authority in your recovery journey, in

the event of being very unwell.- A formal plan that you can develop when you are well, that describes your

treatment preferences in the event of relapse, crisis or involuntary order.- A method to assert the right to refuse unwanted or ineffective treatment

processes.

You could develop it in partnership with your treating professional and/or support people or advocate.

- You should give your treatment team and support people/advocates copies of your Advance Directives.

- Currently these don’t have a legal status, but ought to be taken seriously. - See Cath Roper’s article (handout)

ADVANCE DIRECTIVES

53

54

MI Recovery Week SevenSTIGMA, DISCRIMINATION, RIGHTS AND ADVOCACY

55

Advocacy is a means of supporting and helping people to speak up or act for themselves.

• The key aims of mental health advocacy are to empower people who use mental health services and to protect the rights of citizens by helping them to get their views across.

• Empowerment is an essential aspect of advocacy. It supports and promotes peoples rights to speak and act for themselves and to regain some control over their lives.

56

MI Recovery Week EightMAKING THE MOST OF THE NATIONAL DISABILITY INSURANCE SCHEME

57

NDIS National Launch: Stage One· South Australia: for eligible children from 0-14. This is expected to benefit a

total of around 4,800 children with disability in South Australia.· Tasmania: across the state for around 1,000 eligible young people aged 15 to

24, is hoping to ensure a smooth transition between school and work or higher education.

· NSW Hunter local government areas of Newcastle, Maitland and Lake Macquarie: 10,000 people

· Barwon area of Victoria including the local government areas of the City of Greater Geelong, the Colac-Otway Shire, the Borough of Queenscliffe and the Surf Coast Shire: 5,000 people.

· ACT: 6,000 people.

NDIS National Launch: Stage One•South Australia: for eligible children from 0-14. This is expected to benefit a total of around 4,800 children with disability in South Australia.•Tasmania: across the state for around 1,000 eligible young people aged 15 to 24, is hoping to ensure a smooth transition between school and work or higher education.•NSW: Hunter local government areas of Newcastle, Maitland and Lake Macquarie: 10,000 people •VIC: Barwon area of Victoria including the local government areas of the City of Greater Geelong, the Colac-Otway Shire, the Borough of Queenscliffe and the Surf Coast Shire: 5,000 people.ACT: 6,000 people.

58

National Disability Insurance Scheme1. Referral into NDIS 2. Assessment by NDIS Local Area Coordinator •Assessment of need – may involve family/carers; may draw on existing assessments; may include specialist assessment.

3. Planning and choosing services and supports •Local Area Coordinator supports person to complete a goal plan – may involve family/carers, may draw on existing plans•Local Area Coordinator assists with identifying and accessing services and supports that are seen as reasonable and necessary in supporting the person to achieve their life goals.

4. Review process• Local Area Coordinator meets person to review outcomes of support assessed,and changes are made as needed.

59

What does ‘Reasonable’ and ‘Necessary’ mean?Supports and Services:•should support the individual to achieve their goals and maximise their independence; •should support the individual’s capacity to undertake activities of daily living to enable them to participate in the community and/or employment; •are effective, and evidence informed; •are value for money; •should reflect community expectations, including what is realistic to expect from the individual, families and carers; and •are best provided through an NDIS and are not more appropriately provided through other systems of service delivery and support, including services that are offered by mainstream agencies as a part of their universal service obligations to all citizens.

60

How can I ensure that the NDIS operates as a self-directed support model?by....•Knowing what helps me manage my illness•Knowing what I want from life and what I need so that I can reach my goals•Being knowledgeable about evidence that can justify my NDIS service preferences •Being empowered to communicate my choices well•Knowing who can support or advocate with me to negotiate for the services I need and help me to reach my goals

“I can be in the driver’s seat of my recovery and life – not the backseat or the boot!”

.

61

.

Life Domains: Work - What do you want to achieve?Financial - How much do you want to earn, by when? How is this related to your career goals?Education - Is there any knowledge you want to acquire in particular? What information and skills will you need to have in order to achieve other goals?Family – How do you want your family to feature in your life? Artistic - Do you want to achieve any artistic or creative goals? Physical and mental – What fitness or health goals do you want to achieve?Social - How do you want to enjoy yourself and with whom?Advocacy/volunteering - Do you want to make the world a better place? Do you want to be involved in a social cause? If so, how?

62

MOTIVATING PURPOSEFUL ACTIVITY

MI Recovery Week Nine

63

Quote- Recovery “From the perspective of the individual with mental illness, recovery means gaining and retaining hope, understanding of one’s abilities and disabilities, engagement in an active life, personal autonomy, social identity, meaning and purpose in life, and a positive sense of self. It is important to remember that recovery is not synonymous with cure. Recovery refers to both internal conditions experienced by persons who describe themselves as being in recovery – hope, healing, empowerment and connection – and external conditions that facilitate recovery – implementation of human rights, a positive culture of healing, and recovery-oriented services.”

Jacobson and Greenley, (2001, p. 482)

64

tRecovery Factors

Acceptance of illness (understanding of abilities and limitations)Hope and CourageManaging SymptomsEducationSense of Self and Purpose Supporting Others (Participating in the community)Self direction and responsibilityMeaningful activity (vocation, work, study, volunteering etc)Systemic Activities (peer support, advocacy, destigmatising activities)

65

Personal Recovery Planning Tool1.Understanding

the biopsychosocial

aspects and triggers of your

illness

2. Include researched based Recovery Factors

in your plan

3. Reflect on the best use of your

internal and external resources

4. Develop strategies and

lifestyle changes to help manage biopsychosocial aspects if illness

Review Reflection

Planning Action

Information and Skills we learned in the Engagement Phase of MI

Recovery

Theories of mental illness including the biopsychosocial model; recovery factors; sense of self; stigma; personal treatment; recognising our triggers; working with relapse; identifying early warning signs; communication skills; discrimination, rights and advocacy.

66

tEmployment: A Powerful

Recovery FactorWork improves physical and mental healthMany people consider working as the first recovery step, as it is ‘normative’ and reduces self-stigmaBiological benefits: international studies show that employment results in reduced symptoms and fewer hospitalisations. Psychological benefits include: increased independence, improved sense of worth and improved relationships. Sociological benefits include: income generation, structured use of time, contact with people outside of family, enforced activity and involvement in shared goals.

67

tExternal Vocational Resources

Can help you identify skills and goals, prepare you for employment, match you to a suitable job, and provide continuing support, Will help address any barriers to accessing work (transport, clothing, motivation etc),Can play a role in educating employers about mental illness,Can link you into skill development opportunitiesCan help you devise a holistic plan to maintain your mental wellbeing, and can involve family and medical practitioners in this plan.

Employment consultants:

68

tExternal Vocational Resources

(cont’d)Will help you negotiate workplace ‘accommodations’ as required, or flexibility, such as suitable hours, work from home, onsite support, unpaid leave if necessary

Job Access (www.jobaccess.gov.au):

A service that assists employees who have mental illness to remain in the workforce, and provides information, education and support to employers.Provides a ‘jobs in jeopardy’ scheme to assist with workplace challenges.

Employment consultants:

69

70

MI Recovery Week TenREVIEW OF RECOVERY ASPIRATIONS AND PROGRAM CONCLUSION

71

A world without stigma

72

Reflections…

Documents

Power Point Slides