June Chao, SOT QMH on behalf of

Mental Health Service Group,

Service Development Subcommittee, OTCOC.

Overseas learning:

From Therapy to Recovery in

Adult Mental Health Services

What should we change? What should we preserve?

Places of Visit 5 teams, 3 countries, 15 Occupational Therapists

Postgraduate Overseas Training St. Vincent Mental Health, Melbourne,

Australia

The Program for Recovery and Community Health (PRCH) Yale School of Medicine and Yale University

USA

Institute of Psychiatry, Maudsley International, United Kingdom

Institute of Psychiatry, Maudsley International, United Kingdom

18-29 January, 2010 Flora Ko, DM(OT), NDH

Maurice Wan DM (OT), UCH Mary Chu, DM(OT), QMH

Dorothy Kwong DM(OT), PYNEH Kenny Wong OTI, KCH

13-24 September, 2010 Tony LEUNG OTI, KH Bacon NG, SOT, CPH

River House

(Forensic ward)

Addiction Service

Behavioural

Disorders Unit

Central OT

Department

&

Affective

Disorder

Unit

Mother & Baby Unit

In-patient Services

&

Subspecialties

Community Link

Centre of Maudsley

(In and out)

Mental Health Promotion Team

of Guys Hospital

(peer support)

Community

Mental Health

Team of Lambeth

generic and

vocational lead

Social Inclusion &

Hope Recovery Project

(SHARP)

Team of Lambeth

Case management

My Care Plan

Lambeth Vocational Service of Stockwell

(Beale House)

Mosaic Clubhouse

of Balham

Community Services

St. Vincent Mental Health,

Postgraduate Overseas Training, Australia

15 February- 12 March,2010 Menza Chu, OTIKCH Terry Lam, OTI KCH June Chao, OTI QMH

27/9/2010 to 15/10/2010

Frank Chiu, OTI AHNH

Raymond Wong, OTI, UCH

Mobile Support

Team (MST)

Crisis Assessment Treatment

Team (CATT)

Primary Mental

Health Team

(PMHT)

Substance Use

and Mental Illness

Treatment Team

(S.U.M.I.T.)

Doutta Galla Community Health Service (DGCHS)

Homeless Outreach Psychiatric Services

(HOPS) Community Based Services

Continuing

Care Team (CCT)

St. Vincent Mental Health

In-patient

Hospital Based Service

Orygen Youth Health In-patient

Royal

Melbourne Hospital

Norfolk Community Care Unit

(CCU)

Prevention and

Recovery Care (PARC)

Foorbridge

Community Care Unit

(CCU)

Ozanam House Residential Services

Youth Access Team (YAT)

Early Psychosis Prevention and

Intervention Centre (EPPIC)

Youthscope

Personal Assessment and Crisis Evaluation (PACE)

Intensive Case

Management (ICM)

Psychosocial Recovery Services

Youth Services Orygen Youth Health

The Intensive Mobile Youth Outreach Service

(IMYIOS)

The Program for Recovery and Community

Health (PRCH)

31 October-11 November, 2011

Davis Lak, OTI, KH

Alan Lai, OTI, CPH

Wendy Chan, OTI, CPH

Jointly sponsored by the

Connecticut Mental Health Center of the Department of Psychiatry,

Yale School of Medicine and the

Institution for Social and Policy Studies of Yale University

Recovery Oriented service

State policy

Advisory body (e.g. PRCH)

Staff training

Recovery assessment tools

Peer support service

Empowerment

Advocacy enhancement

Recovery oriented service

Community based services

In-patient services

Learning Points

From Therapy to Personal Recovery

Recovery Oriented Service

Clinical

Recovery

Personal

Recovery

Service User and Carer Involvement

Program of recovery and Community Health

(Consultation agency for states)

Patient/ Staff steering Committee

Library for consumers and staff

Peer Support Resources Corner

Consumer / Family consultants

Peer & Carer Support Work

Peer workers in various program

Wards and activity programs

Community mapping, social activities, Peer Utilizating Skills for Healing (PUSH)

Peer Employment Training (PET)

Peer support technique to be employer as peer mentor

Recovery Education Center (REC)

Peer mentor led WRAP

Peer specialists / Carer specialists

Patient-centered care plans

Case Manager & Individual Service Plan , Victoria

Automated recovery planning in GBCMHC, Yale

Journey to Wellness in CMHC, Yale

Participating effectively in your treatment plan in

CVH, Yale

Wellness Recovery Plan

My Care Plan in SLaM, UK

Programs supporting Recovery

Illness Management and Recovery

Substance Abuse Education

Criminal Justice Compliance

Interpersonal Skills

Daily Living Life Skills

Employment

Stress management

Conflict resolution

Health Living Symptom Management

Assessing recovery-oriented service

Recovery Self Assessment Revised (RSA-A)

Element of A Recovery Facilitating System

Survey on Involvement of Consumers

Recovery Markers

Measuring the Promise

Our learning in Personal Recovery

Staff training

Empowerment of service user and carer

Consumer involvement

Peer support service and training

Program-base learning

Advocacy enhancement

Person-centered Care Plan

Assessment on Recovery Oriented Service

In-patient service

Person-centered care plan (PCP)

Peer and consumer involvement

Programs

Level 1 Engagement eg. Artwork, cooking for leisure

Level 2 Enhance coping skills eg. Stress coping, Wellness

Level 3 Individualized therapeutic intervention

e.g MOHOST as standard assessment in UK

A Model of Therapeutic Activity for In-Patient Care (Easton, Dorey, Barnett)

Personal identity

Home like

Pantry

Laundry service

Activity area

Ward Environment

Clinically informed patient-centered design features can

positively affect social, cognitive, motivation, emotion

and physical process among patient and staff.

Karlin, B.E. & Zeiss, R.A. (2006)

Community and ambulatory support

Fellowship Place, Yale

full service psychosocial rehabilitation center

Community Link Centre, Maudsley Hospital

provide activity and program based training

Mosaic Clubhouse, Balham

Lambeth Vocational Service of Stockwell, Beale House

bidding funding to support Individual Placement

Mental Health Promotion Teams, Guts Hospital

promote wellbeing with peer support

SHARP Social Inclusion & Hope Recovery Project, Lambeth

multidisciplinary team providing psychosocial intervention

Use of generic community activities and employment service in Melbourne

Advocacy and Empowerment

Patient information pamphlets

Websites

Promotion functions

Attractive artwork

Cultural consideration

Citizen Community Enhancement Project

Consumers involvement

Occupational Therapists

in diversified roles

Case managers and Senior case managers

Social Inclusion Lead, Maudsley Hospital

Psychosocial Recovery Support of Orygen responsible for Group

Program, Family Peer Support and Youth Participation

Unit manager of Footbridge Community Care Unit

Training and Communication Team

Center i/c of Vocational Service of Stockwell

Good Practices in

Hong Kong

Training supporting Recovery Oriented Practices

Understanding eg. Coaching

Focus on the person e.g Model of Human Occupation,

Functional-based training

Strength-based eg. Solution Focused Therapy

Based on hopes and dreams eg. Occupational Life Style

Redesign

Foster Empowerment eg. Motivational Interviewing, Family

Intervention

Self Management eg. Illness Management and Recovery

Ba Duan Jin,

Yoga,

Tea art

Wellness Promotion

Transforming Relapse and Instilling Prosperity (TRIP)

4-session illness management program for in-patients

multi-center double blinded randomized control

study in progress

Illness management program

Occupational Lifestyle Redesign

Vocational Rehabilitation

Common Mental

Disorder Clinic

And

Changeways

Psychosocial program

Phoenix Clubhouse, established in 1998, is a community adult psychiatric rehabilitation service under the auspices of the Department of Psychiatry, Faculty of Medicine, The University of Hong Kong and the Queen Mary Hospital.

Phoenix Clubhouse is the first Clubhouse that has been certified and recognized by the International Center for Clubhouse Development (ICCD) in providing world-class rehabilitation services to people with mental disorders in Hong Kong.

Phoenix Clubhouse

New program initiatives

Promoting recovery-oriented practice

Collaboration with clinical teams

Presentation and sharing

What have we changed ?

Football Team in Kowloon Hospital

Illness Management and Recovery translated

Evidence-Based Practice KITs offered by the Substance Abuse

and Mental Health Services Administration (SAMHSA)

36

360

()

Respecting and empowering patients

The care plan should be written in the patients own words

(Pereira S., Woollastom K 2007)

Therapeutic engagement in acute psychiatric inpatient services

My Care Plan (SLaM)

(Plant tomato, strawberry,

cabbage and plants)

GROW If you are interested in being outside and learning about gardening we offer: A regular gardening group at Effra Road Resource Centre Skilled tuition from a horticultural therapist The opportunity to learn how to grow your own food

A report presented to the Foresight Project on communicating the

evidence base for improving peoples well-being

Written by: Jody Aked, Nic Marks, Corrina Cordon, Sam Thompson

centre for well-being, nef (the new economics foundation)

Five Ways to Well-being

Promoting Recovery Oriented Practices

Recovery Self Assessment (RSA)

Report result of RSA

Identify and sharing of good practices

Framework to promote recovery

Tools on promoting recovery oriented service

1.00

1.50

2.00

2.50

3.00

3.50

4.00

3.04

3.41

2.28

2.82 2.90

3.17

3.63

3.86

3.15

3.38

3.65 3.78

3.16

3.42

2.71 2.81

3.12 3.21

Administrators Providers Service Users

Recovery Self Assessment for OT centers By Administrators, Providers and Service Users

Ranking :

1. Life goals

2. Individually tailored service

3. Choices

4. Diversity of treatment

5. Involvement

Recovery-oriented service OT framework from Clinical Recovery to Personal Recovery

Personal Recovery

Service Users Life Goals

Service Users Involvement

Service Users Choice

Clinical

Recovery

Functional

Recovery Social recovery

Diversity

Ind

ivid

ua

lly

tailo

red

Multi-disciplinary Patient Journey

Steering Group on Recovery-

oriented Services, CPH

Collaboration with Clinical Teams

Presentations and sharing

Sharing session by each team

Mental Health Recovery for Psychiatric Inpatient

Service, HA Convention 2011

Defining Recovery- Content Analysis of the

Definitions, Intitute of Mental Health Conference,

2011

What Else are we changing?

2012/2013 Target Mental Health Service Development Group

Advancing Recovery Oriented Practice

IMR manual & study, ongoing RSA, sharing forums, training

Program for promotion of Well Being

Plan effectiveness study for large volume diagnosis

Develop Clinical Standards of for OT practice in In-patient

Training

Understanding eg. Coaching

Focus on the person e.g MOHO

Strength-based eg. SFBT

Based on hopes and dreams eg. OLSR

Foster Empowerment eg. MI, Family Intervention

Self Management eg. IMR

Consumer and peer involvement

In-patient service enhancement

Level 1

Includes therapeutic engagement and the practical application of

psychological principles within daily activities. Utilises skills common to all

mental health practitioners and can be provided by unqualified staff.

Level 2

Interventions aimed at developing basic coping mechanisms and daily living

skills. Provided by staff with some further training in a specific theoretical

model and/or technique

Level 3

Specialist assessments and formal, short-term therapeutic interventions.

Provided by OT with formal training.

Standards of Occupational Therapy Care for Psychiatric Inpatients in HA

Langley Green Therapeutic Activities Committee Report for

Workforce Planning published in August 2006.

Some Reflections

What should we change? ,

From Functional Recovery to Personal Recovery

Diversity Involvement Choices

Individual tailored Life Goals

Programs Attitude

Staff training

Consumer involvement

Framework Work practice

Leadership

Assessment our service

Roles

What should we preserve? ,

From Functional Recovery to Personal Recovery

Client-centre Practice vs Generic Worker Model

Jacks of all trades and master none

The autonomous and diversified need of service

users should not be limited by professional

capacity of mental health worker.

People with mental health problems can experience

a range of occupational needs and it is essential

that skilled professionals be provided to address

them.

While preserving

cohesive and dedicated workforce of Occupational Therapist who

expertise in functional and skill based training,

we can be

flexible and competent to take up new roles to walk through the

Recovery Journey with our Service Users in different service

delivery models.

What should our Recovery Garden look like?

Special gratitude to all the people

who has contributed to make the

Overseas Corporate Scholarship Programme

for Occupational Therapists in Mental Health Service possible

Thank you!