- Recovery & SMI Basics
- Strengths Based Assessment
- Action Planning
- Referring to VA
- Online Resources
- Cool Tool
Recovery & Serious Mental Illness
Mental health recovery is a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. (Substance Abuse and Mental Health Services Administration (SAMHSA))
Within the context of this Directive, Serious Mental Illness (SMI) refers to an American Psychiatric Association Diagnostic and Statistical Manual (DSM) Axis I disorder resulting in significant functional impairment and/or disruption in major activities of daily living. This typically includes schizophrenia and other psychotic disorders, bipolar disorder, major depression, and severe Posttraumatic Stress Disorder (PTSD). Veterans with other DSM Axis I diagnoses may also be included in this domain, usually in conjunction with a DSM Axis V Global Assessment of Functioning (GAF) Scale score of 50 or lower.
What is Recovery Oriented Care?
Recovery oriented care is patient centered care and can help individuals living with Serious Mental Illness (SMI) move beyond managing symptoms of mental illness and towards improved life satisfaction and quality of life. In the VA, recovery oriented care is Veteran-directed which means the Veteran is actively engaged throughout the treatment planning and recovery process. Through the Recovery Support Strategic Initiative, the Substance Abuse and Mental Health Services Administration (SAMHSA) has delineated four major dimensions that are essential to a life in recovery:
- Health: overcoming or managing one's disease(s) as well as living in a physically and emotionally healthy way
- Home: a stable and safe place to live
- Purpose: meaningful daily activities, such as a job, school, volunteerism, family caretaking, or creative endeavors, and the independence, income and resources to participate in society
- Community: relationships and social networks that provide support, friendship, love, and hope
Just like physical health, mental health is important at every stage of life and is essential to overall health. Our mental health helps to determine how we adapt to a range of demands, relate to others and make choices. Recognizing one's strengths and having access to the resources necessary to engage in one's recovery journey is important to all individuals.
Learn More About the Components of Recovery Based Care:
Visit the Make the Connection website to listen to Veterans discuss their experiences with Serious Mental Illness and related difficulties.
Strength Based Assessment
First Step in Recovery Planning - Understanding the Client's Strengths:
Taking a strengths-based approach to psychological assessment means identifying and prioritizing a client's positive abilities and resources within the assessment process. The assessment process is Veteran directed and he or she remains an active participant throughout. For example, the Veteran engages with the clinician in the process of identifying his or her strengths. Listed below are resources to support the integration of Veteran directed strengths based assessment into one's practice.
- Read about assessment of recovery, recovery attitudes, and recovery related areas such as hope, well-being, and community living in the PDFs Review of Recovery Measures and Compendium of Recovery Measures.
- The U.S. Psychiatric Rehabilitation Association (USPRA) provides a list of various assessment tools relevant to recovery and psychosocial rehabilitation.
- A list of assessment tools for measuring outcomes in psychosis compiled by the VA VISN 22 MIRECC, including tools for measuring life satisfaction and quality of life.
Treatment planning in the context of recovery oriented care means attending to whole health and wellness. This includes consideration of each Veteran's social engagement, spirituality, relationships, and community engagement.
Recovery action planning is goal oriented. The components of a recovery action plan include:
- Collaborative assessment of each Veteran's strengths, resources, and goals
- Veteran directed planning: the goals are established and written in the language of the Veteran
- Shared decision-making: collaboratively determining steps towards or actions directly relevant to each Veteran's client's goals and concerns
- Crisis planning
Substance Abuse and Mental Health Services Administration (SAMHSA) Tools:
- Download or order a free guide about action planning for prevention and recovery
- Learn more about shared decision-making and access useful tools for your practice
- Illness Management & Recovery (IMR)Practitioner Guide & Handouts
- SAMHSA Recovery to Practice: Person Centered Care Planning Webinar & Slide Show: This slide show discusses the principles of person centered care planning which emphasize recovery as a collaborative process between the client and practitioner.
Many Veterans find that that peer support is crucial to recovery. Peer support is important in conveying information, providing support, facilitating skills building, improving social networks, and empowers individual's to engage successfully in their recovery journey. Please see the following links for peer support information and resources:
- Best Practices Identified for Peer Support Programs: White paper from the Defense Centers of Excellence (DCoe) for Psychological Health and Traumatic Brain Injury
- Vet to Vet: This is an organization of Veterans who have been consumers of VA mental health programs. They provide trainings on peer counseling to Veterans and guidance on establishing peer support programs.
Self-help Treatment & Recovery Resources for Clients:
- Wellness Self-Management (WSM) Manual: A manual developed by the New York State Office of Mental Health to guide self-management of wellness and recovery for clients with serious mental illness.
- About the Development of the WSM Manual: Please note, no person or agency may reproduce, reprint or distribute the WSM Workbook without the prior written approval of the New York State Office of Mental Health. Requests for approval should be directed to firstname.lastname@example.org.
Referring to VA
In order to support the rehabilitation and recovery of every Veteran with a mental illness, VA has identified recovery as a guiding principle for its entire mental health service delivery system. Recovery is a journey that involves developing hope, self-direction, empowerment, respect and peer support.
Mental Health Service Delivery at VA Medical Centers and Outpatient Clinics emphasizes recovery-oriented Psychosocial Rehabilitation. Such programs and services for Veterans with Serious Mental Illness (SMI) often include:
- Resources for family involvement and engagement
- Intensive Case Management
- Peer Counseling
- Social Skills Training
- Wellness Management and Recovery
- Evidence-based psychotherapies
Visit the VA Recovery Services in Mental Health website to learn more about these services
Connect to Services at Your Local VA Medical Center or Vet Center:
- Illness Management and Recovery: SAMHSA developed practitioner guide and tools to guide the process of wellness and recovery action planning.
- Substance Abuse and Mental Health Services Administration's (SAMHSA) Wellness Initiative: Find resources and information about wellness through this initiative.
- Wellness and Recovery Action Planning (WRAP): This website provides WRAP information and resources including examples of WRAP exercises and resources for peer support.
- The National Mental Health Consumers' Self-Help Clearinghouse
- Make the Connection Facebook Page: Connect with Resources and other Veterans coping with mental health concerns
Additional Online Resources and Organizations:
- National Institute of Mental Health (NIMH): The NIMH is a Federal agency for research on mental and behavioral disorders. Learn more about serious mental illness on their website.
- Substance Abuse and Mental Health Services Administration (SAMHSA) : SAMHSA focuses on improving resources and care for individuals coping with substance use and mental health concerns.
- After Deployment: Information and materials on PTSD and other associated conditions for the Veteran and his/her family.
- Make the Connection: Veteran stories and educational information about a variety of signs, symptoms, and conditions for your client. This site also provides direction for the Veteran about next steps to take to seek treatment or resources.
- National Center for PTSD: Find resources and information related to Posttraumatic Stress Disorder
- Depression and Bipolar Support Alliance (DBSA): This organization is a peer-directed wellness-oriented national organization with a focus on depression and bipolar disorder.
- Mental Health America (MHA): MHA is an advocacy organization focused on addressing the full spectrum of mental and substance use conditions and their effects nationwide.
- National Alliance on Mental Illness (NAMI): NAMI is a mental health advocacy organization working to improve the lives of individuals and families affected by mental illness through improving access to mental health resources and treatment, support, education, advocacy and research.
- US Psychiatric Rehabilitation Association (USPRA): USPRA is an association advancing the practice of psychiatric rehabilitation and recovery.
Start Moving Forward:
Moving Forward is a free, on-line educational and life coaching program that teaches Problem Solving skills to help one to better handle life's challenges. It is designed to be especially helpful for Veterans, Military Service Members and their families. However, Moving Forward teaches skills that can be useful to anyone with stressful problems.
The Start Moving Forward website can be found at: http://www.startmovingforward.org/