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Introductory Session

Getting to know each other

Turn to the person next to you and interview each other using the following questions:  •What’s your favourite leisure time activity?•Where were you born?•What’s your middle name?•What’s something unique or unusual that you’ve done?

What the program offers Week One: Getting to know each other. History and basic facts about mental illness. What is recovery?

Week Two: Renewing a positive sense of self. Mapping our strengths and resources. What is stigma, how does it affect us, and what can we do about it?

Week Three: Healthy lifestyle activities that feel good and help us keep well. What are triggers? Learning about the Holistic Health Model.

Week Four: Stages of recovery model. Learning to plan and manage our recovery.

Week Five: Identifying our early warning signs. Getting organised in case of relapse. Advanced Directive statements.

Week Six: Communication skills and practice. How to communicate with doctors and workers so that we can get the best outcomes.

Week Seven: What is discrimination? What rights do people with mental illness have? How can I advocate for myself or find advocacy support?

Week Eight: What do I want to get out of life and what resources can help me get there? Getting back into work, study, volunteering.

Week Nine: Reflecting on our goals and what we’ve learnt. Valuing our peers and celebrating how far we’ve come on the recovery journey.

Mental Illness and Recovery Possibilities

Week One

Intentional Peer SupportThe Four Tasks:

Connection: being authentic, listening closely and developing trust. Relationship terms are discussed and negotiated.

World view: appreciating how we’ve come to know what we know, and accepting peoples’ different backgrounds and experiences, and different world views.

Mutuality: mutually working together to learn new knowledge and develop new approaches

Moving towards: moving out of what’s comfortable and familiar, towards new ways of being in recovery

Three Principles:

Learning versus HelpingRelationship versus the IndividualHope and Possibility versus Fear 

Your input

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

Definition of mental illness?

Mental illness is a term used to describe the experience of disturbing and harmful thoughts, moods, behaviours and perceptions.

Mental Illness Prevalence in AustraliaA 2007 survey by the Australian Bureau of Statistics estimated that around 1 in 5 people (20%) had experienced one or more mental disorders in the past 12 months, including an alcohol or substance use disorder. 8.5% of people experienced 2 or more disorders during a 12 month period. 

The most common mental illnesses in Australia are:-Anxiety disorders (1 in 7 people) – these include: panic disorder, agoraphobia, obsessive compulsive disorder and post-traumatic stress disorder-Substance abuse disorders (1 in 20 people) – the harmful use of and dependence on alcohol or drugs-Affective disorders (1 in 16 people) – includes clinical depression and bipolar mood disorder Psychotic disorders are less common. Around 3 in 100 people will experience psychosis at some time in their lives. Most (around 80%) will first be affected in their late teens or twenties. Some people experience a single episode, while others develop a longer-term illness, which includes episodes of psychosis, such as schizophrenia (around 1 in 100 Australians). (From http://www.responseability.org/site/index.cfm?display=134881

Recovery definition “Recovery is a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills, and/or roles. It is a way of living a satisfying, hopeful and contributing life even within the limitations caused by illness. Recovery involves the development of new meanings and purpose in one’s life as one grows beyond the catastrophic effects of mental illness.”

(W.A. Anthony 1993, ‘Recovery from mental illness: the guiding vision of the mental health system in the 1990s, Innovations and Research, 97:586-594)

The CHIME Model – 5 Recovery Processes •Connectedness: having peers, good relationships, support from others and being part of the community•Hope and optimism about the future: believing in recovery, motivated to change, positive thinking, having aspirations•Identity: rebuilding a positive sense of yourself and dealing with stigma•Meaning in life: making sense of mental illness, having a good life, rebuilding your life•Empowerment: being responsible for wellbeing, being in charge, focus on your strengths.

(From Leamy and others: 2011)

Recovering a Holistic Picture of Myself

Week Two

“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?”

There are different ways we can look at things

By discussing our stigma experiences and ‘stigmatised identities’, we can free ourselves up to create new meanings about our mental struggles and we can come to value what we have gained in our healing. We can be more aware of what we have to offer society and what we can look forward to in life.

Stigma

Treating Myself

Week Three

•Helps us to understand that traumatic events in the four main areas of our lives – the psychological, the social, the biological and the cultural – can all contribute to mental health problems

•Is accepted and referred to by both medical and social scientists as the ‘bio-psycho-social’ model, but in MI Recovery we’ll refer to it as the Whole Person Health Model

•Shows how the causes, symptoms and treatments for mental illness are related

•Can assist us in planning our recovery

Whole Person Health Model

Personal Treatment

Enjoyable 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.

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 can’t 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.

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?

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.

Planning for Recovery

Week Four

Unwell (confusion, withdrawal, negative

sense of self)

Thinking about getting better (hope and

awareness of positive aspects of self)

Deciding to get better & preparing (thinking about & using internal

and external resources)

Doing things that help(steps towards

meaningful goals, new knowledge and skills)

Getting on with life(meeting goals,

managing illness, resilience in the face of

setbacks)

Stages Of Recovery

Working with Relapse

Week Five

The Three P’shone Supports: Keep a list phone numbers in a handy place. These are people and professionals who you can call

any time of the day or night – friends, family members, psychiatrist, CAT,

ambulance etc. Prioritise who you need to call first

 

rofessional Involvement: Increase the involvement of your key worker, counsellor, doctor or psychiatrist. They

might recommend temporary increases in your medication under supervision (or

‘emergency’ medications), or using therapies like CBT to help manage thoughts and

behaviours.

 ersonal Treatment: Increase the lifestyle activities that help with managing stress and symptoms.

Consider temporarily limiting activities that can generate stress, like work or social

obligations.

P PP

Communication Skills

Week Six

Focus fully on the speaker, on their body language and emotions. If you are distracted then you will miss non-verbal clues in the conversation.Be interested, ask questions that help you understand what they are discussing. Avoid interrupting or hijacking the conversation by making it about you. Listening is not the same as waiting for your turn to talk. You can’t concentrate on what someone’s saying if you’re forming what you’re going to say next. Accept their viewpoint, which doesn’t mean you have to agree with them. Setting aside your views and opinions can help you understand where they are coming from, and you might learn something new.

Attentive listening skills

Communication StylesAggressive Passive Assertive

Forceful and hostile expression that tends to use blaming ‘you’ statements. Communications can result in upsetting the listener and forcing them out of the conversation or it might escalate into an aggressive dispute.

The individual struggles to express an honest point of view, or state their needs and beliefs. They rarely achieve satisfactory outcomes and might end up feeling resentful.

The person clearly expresses their point of view, feelings and desires without excluding the other person’s point of view or needs. Both parties know that they can work out a solution together.

Errors include: sarcasm, Negative comparisons, threats and labels.

Errors include: mind-reading, negative interpretations.

This style often needs practice, but is the style most likely to achieve a positive outcome.

Barriers to Effective Communication Environment Strong emotions Lack of facts Lack of skill

Where the conversation is set can cause stress or interference, ie. Heavy traffic, inpatient clinic.

Anger, anxiety, frustration and guilt can get in the way of clear communication.

We might make unfair demands or assumptions. It might make us unsure how to approach a discussion. It can lead to misunderstandings. You may not be able to solve the problem.

Unhelpful communication habits can lead to an unsatisfactory result.

Medical & 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)

Medical & Other Supportive Professionals

Be 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

Medical & Other Supportive Professionals

KeepYour 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

Medical & 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

Stigma, Discrimination, Rights and Advocacy

Week Seven

“The objects of this Act are:

(a) to eliminate, as far as possible, discrimination against persons on the ground of disability in the areas of: work, accommodation, education, access to premises, clubs and sport; and

the provision of goods, facilities, services and land; and existing laws; and the administration of Commonwealth laws and programs; and

(b)  to ensure, as far as practicable, that persons with disabilities have the same rights to equality before the law as the rest of the community; and

(c)  to promote recognition and acceptance within the community of the principle that persons with disabilities have the same fundamental rights as the rest of the community”

(from http://www.comlaw.gov.au/Details/C2012C00110)

The Disability Discrimination Act 1992

Taking Steps Towards Having a Meaningful Occupation

Week Eight

“Have a vision of where you want to be and try to find ways of getting there...Nothing should ever stop you from being what you want to be ... Don’t ever let anyone tell you. It’s not their life, it’s your life...”

(from Shepherd, Boardman, Slade “Making Recovery a Reality”, p. 4)

The Recovery Journey

The Importance of Work

“An important sign of progress in recovery is when illness no longer dominates a person’s life and identity, and they begin to contribute to external interests, such as work, family, friends or social causes, or to offer hope and inspiration to others.”

“Work and employment remain the primary means through which people connect with their communities and build their lives. Finding you ‘have something to give’, as well as needing help, is central to building a positive sense of self-esteem and this is at the heart of recovery.”

What Does Research Say About Employment & Recovery•Work improves physical and mental health

•Many people consider working as the first recovery step, as it is ‘normative’ and reduces self-stigma

•Biological benefits: International studies show that employment results in reduced symptoms and few hospitalisations

•Psychological benefits include: increased independence, improved sense of worth and improved relationships

•Sociological benefits include: income generation, structured use of time, and contact with people outside of family, enforced activity and involvement in shared goals

External Vocational ResourcesEmployment Services – Specialist, Disability or Generalist  These employ consultants who can work closely with you and they:•Can help you identify skills and goals, prepare you for employment, match you to a suitable job, and provide continuing support•Can help address any barriers to access work (transport, clothing, motivation)•Have a responsibility to educate employers about mental illness•Can link you into skill development opportunities•Can help you devise a holistic plan to maintain your mental wellbeing at work, and can involve family and medical practitioners in this plan•Can help you negotiate workplace accommodations as required, or flexibility, such as suitable hours, work from home, onsite support, unpaid leave if necessary

Visit www.jobsearch.gov.au to locate an employment service provider

Other ResourcesEmployment Personal Helpers and Mentors Service

PHaMs Employment Services provide support for people with a mental illness receiving the Disability Support Pension or other government support payment who are engaged, or willing to engage, with employment services and who have economic participation as a primary goal in their Individual Recovery Plan. 

Organisations are funded to provide specialist support and work with government employment services, such as Disability Employment Services, Job Services Australia, state-funded services and social enterprises, to assist PHaMs participants to address non-vocational issues that are barriers to finding and maintaining employment, training or education.

Natural Supports

Most jobs are found through the ‘hidden job market’ – positions that have not been advertised.

Think about your own networks and any possible opportunities that you could explore through these connections.

Program Review and Conclusion

Week Nine

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Reflections…