Building Healthy & Holistic Communities: Inspiration, Innovation, Integration Lauren Spiro 2012

1. Building Healthy & Holistic Communities: Inspiration, Innovation, Integration Lauren Spiro 2012

2. Outline • Values-driven leadership Healing trauma NCMHR Emotional CPR (eCPR) II. National trends SAMHSA – Wellness & Recovery Health Care Integration

3. A better system is not something that can be introduced like a new car. It must become more than just a new variation on an older generation. A better system will not automatically ensure a better life. In fact it is through helping a person create a better life that a better system will be created. Former President Havel of the Czech Republic

4. How are you creating a better life for yourself and for others?

5. Unleash the power:Believe in yourself Your are powerful beyond your imagination. What is your plan of action?

6. Our greatest impacts lie in our relationships with one another and the way we are in the world. Life: An Unfolding Becoming

7. I experienced such a profound lack of safety when I was growing up—it led me to cling to anyone who offered safety and anything that could numb the pain. . My life force had been stifledby the impact of human disconnection in my early childhood.

8. Creatively Expressing My Story …The innocence, The intelligence, The radiance The joy, The light, The love, What happened? To extinguish that flame… It is about historical trauma, heaped upon the infant and the child and the adolescent. It is about living in a violent, racist, competitive, greedy, shallow, exploitive, mind-numbing, TV tranquilized, grab it now -or lose it, gimmicked-to-death magic pill culture that Leaves little room to be human. Brief excerpt of poem by Lauren Spiro

9. NCMHR Values Recovery: Recovery is real and possible for everyone. To recover, we need services and supports that treat us with dignity, respect our rights, allow us to make choices, and provide assistance with our real-life, self-defined needs. This range of services must include consumer-run and -operated programs. Self Determination: Self-determination is essential for recovery to occur. We need to be in control of our own lives. Holistic Choices: We need choices that meet our self-defined needs. We need a wide range of recovery-oriented services and supports to assist us in achieving our goals. These include assistance with housing, education, and career development, all of which can be consumer-run.

10. NCMHR Values (cont.) Voice: We must have a voice in our recovery and in the policies facilitating our recovery. We must be central in any dialogues and decisions about mental health issues at all levels. This is empowerment. Personhood: We are whole human beings and will campaign to remove stigma and discrimination. We have the same dreams as all members of the community and the ability to make our own decisions. A barrier-free community is one free from discrimination and stigma.

11. NCMHRGrowing Stronger Activities in Washington, D.C. & beyond Education and Advocacy $960,000 from Congress White House policy meetings Emotional CPR www.emotional-crp.org Building Bridges with Law Enforcement

12. eCPR is a public health education program that teaches people to assist others through an emotional crisis and regain a sense of hope and purpose in their lives. C = Connection, P = emPowering, & R = Revitalizing. Emotional CPR (eCPR)

13. SAMHSA Wellness Initiative: Our Vision. Our Pledge. • We envision: • A future in which people with mental and substance use disorders pursue optimal health, happiness, recovery, and a full and satisfying life in the community via access to a range of effective services, supports, and resources. • We pledge: • To promote wellness for people with mental and substance use disorders by taking action to improve the quality of life and reduce early mortality.

14. Wellness “Wellness is a conscious, deliberate process that requires awareness of and making choices for a more satisfying lifestyle.” Source: Swarbrick, M. (1997). A Wellness Model for Clients. Mental Health Special Interest Section Quarterly, 20, 1–4.

15. Early Mortality Factors • Factors contributing to preventable, premature death: • Modifiable risk behaviors (e.g., smoking, poor nutrition, inactivity, substance use, lack of sleep) • Higher rates of poverty, homelessness, unemployment, incarceration • Some psychotropic medications • Social isolation, trauma, stigma, and discrimination See page 14-15 of: http://www.nasmhpd.org/general_files/publications/med_directors_pubs/Technical%20Report%20on%20Morbidity%20and%20Mortaility%20-%20Final%2011-06.pdf Parks, J., Svendsen, D., Singer, P., & M. E. Foti eds. (2006). Morbidity and Mortality in People with Serious Mental Illness. Alexandria, VA: NASMHPD.

16. Our Higher Risk: Data • Why people are at higher risk: • 31.7% live below the poverty line.1 • 72% are unemployed.2 • 75% smoke cigarettes as compared to 23% of the general population3 and represent 44.3% of the U.S. tobacco market.4 • 46% of people who are homeless have a mental illness.5 1Erickson, W., & Lee, C. (2008). 2007 disability status report: United States. Ithaca, NY: Cornell University Rehabilitation Research and Training Center on Disability Demographics and Statistics. 2Ibid. 3Parks, J., Svendsen, D., Singer, P., & M. E. Foti eds. (2006). Morbidity and Mortality in People with Serious Mental Illness. Alexandria, VA: NASMHPD. 4Ibid. 5The President's New Freedom Commission on Mental Health (2004). The State of American Mental Health Care: Where Have We Been, What Have We Done, and Where Are We Going?

17. The Eight Dimensions of Wellness Adapted from Swarbrick, M. (2006). A wellness approach. Psychiatric Rehabilitation Journal, 29(4), 311–314.

18. Wellness Tools Visit http://store.samhsa.gov Wellness posters and brochures Web sites and informational webinars: http://samhsa.gov/wellness http://fda.gov/women http://www.cdc.gov/mentalhealth/about_us/micd.htm http://millionhearts.hhs.gov http://www.welltacc.org

19. National Wellness Week Credits clockwise from top left, from Town Hall webinar kicking off the first National Wellness Week: Angélica García, Wellness activities of the spirit—giving back, social and balance—nurturing yourself; Mary Ellen Copeland—Remind someone that there is hope … and that their life can be the way they want it to be; Joe Powell—7,000 people walk across a New York City bridge for Recovery Month 2009.

20. Put It On the Map! Let us know what you have planned for National Wellness Week, September 17–23, 2012, by emailing wellness@samhsa.hhs.gov Sign the Pledge for Wellness and join the Wellness Initiative email list: http://www.samhsa.gov/wellness

21. Co-creating our future: Health Care Integration Maintenance-based systems are dangerously out of date and must become aligned with the holistic, hope and strengths based philosophy that now prevails. Dialogue and shared decision-making are essential processes in service delivery at the organizational change levels. Foster networking, relationship building, finding common ground about issues and approaches so that together we will work towards the goals that integrate these different systems of care

22. Co-creating our future: Health Care Integration 1. Community integration is an overarching unifying concept. It brings communities together and contributes to vibrant social networks 2. Holistic health 3. People with lived experience being full participants in their care 4. Maximum consumer/survivor/peer choice 5. Optimal involvement of persons with lived experience in driving the continued transformation of care/service delivery, supports, evaluation and outcomes, and society

23. Nothing About Us Without Us How will the system look? We need to be involved in forming policy at the state level. Co-located, for example at CMHC or FQHC There may be a need for thousands of people with the lived experience of recovery to be navigators, peers, coaches a whole variety of ways we can help people in their recovery & wellness. Coalition building amongst cross-disability groups within the state to amplify our voice. Negociate with the Dept that oversees Medicaid. Educate & negociate with HHS state level.

24. Nothing About Us Without Us Think in terms of outcomes – the affordable care act talks about improving quality but also looking at costs and linking payment to costs. There is an intent to base payment on outcomes. There is an opening here to defining outcomes on wellness & recovery instead of symptom reduction. On Our Own of Maryland received (1 of 8) * BRSS TACS HCR grants; they are creating a HCR education tool. * Bringing Recovery Supports to Scale Technical Assistance Center Strategy

25. BRSS TACS A consortium focused on promoting wide-scale adoption of Recovery oriented supports, services, and systems for people in recovery from substance use and/or mental health conditions. With a fiscal restraint and health care integration we have unprecedented opportunities and challenges in the behavioral health and human services fields to develop a state and national systems of care based on principles of wellness, resiliency and recovery.

26. Nothing About Us Without Us Lauren Spiro, M.A. Director, National Coalition for Mental Health Recovery www.ncmhr.org laurenspiro1@gmail.com