Recovery & Serious Mental Illness
Serious Mental Illness (SMI) refers to conditions that can result in significant difficulties in functioning. Recovery oriented care can support individuals in moving towards greater life satisfaction.
Overview
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.
Recovery oriented care can help individuals living with Serious Mental Illness (SMI) move towards improved life satisfaction.
Veteran Voices
Supporting and encouraging a Veteran’s recovery
Tass met her husband, Anthony, after his service in the Marines. Whenever they left the house, she noticed he was on edge. He would jump up and talk while sleeping. Tass recognized how important it was to support her husband during his recovery and how effective treatment can be.
Video source: Make the Connection

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.
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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.
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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.

Action Planning
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:
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Collaborative assessment of each Veteran's strengths, resources, and goals
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Veteran-directed planning: the goals are established and written in the language of the Veteran
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Shared decision-making: collaboratively determining steps towards or actions directly relevant to each Veteran's client's goals and concerns
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Crisis planning
Substance Abuse and Mental Health Services Administration (SAMHSA) Tools:
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Learn more about shared decision-making and access useful tools for your practice
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Illness Management & Recovery (IMR)Practitioner Guide & Handouts
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Recovery to Practice: This training focuses on the principles of person-centered care planning which emphasizes recovery as a collaborative process between the client and practitioner.
Peer Support:
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 empowering individuals to engage successfully in their recovery journey. Please see the following links for peer support information and resources:
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Recovery-related resources about peer supports and services: SAMHSA Recovery Support Tools and Resources
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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:
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The Wellness Self-Management (WSM) Manual was developed by the New York State Office of Mental Health to guide self-management of wellness and recovery for clients with serious mental illness.
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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 wsm@omh.state.ny.us.

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:
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Resources for family involvement and engagement
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Intensive Case Management
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Peer Counseling
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Social Skills Training
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Wellness Management and Recovery
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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:
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VA Program Locator: The program locator can help you find your local VA Medical Center.
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Vet Center: Eligible Veterans can also find support and resources at Readjustment Counseling Centers. To learn more about the services provided at these centers please see their website.

Online Resources
Practitioner Resources:
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Illness Management and Recovery: SAMHSA developed practitioner guide and tools to guide the process of wellness and recovery action planning.
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Substance Abuse and Mental Health Services Administration's (SAMHSA) Wellness Initiative: Find resources and information about wellness through this initiative.
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Wellness and Recovery Action Planning (WRAP): This website provides WRAP information and resources including examples of WRAP exercises and resources for peer support.
Consumer Resources:
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The National Mental Health Consumers' Self-Help Clearinghouse
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Make the Connection Facebook Page: Connect with Resources and other Veterans coping with mental health concerns
Additional Online Resources and Organizations:
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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.
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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.
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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.
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National Center for PTSD: Find resources and information related to Posttraumatic Stress Disorder (PTSD).
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Depression and Bipolar Support Alliance (DBSA): This organization is a peer-directed wellness-oriented national organization with a focus on depression and bipolar disorder.
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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.
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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.
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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: https://www.veterantraining.va.gov/movingforward/