Sharing on Overseas Corporate Scholarship Program for Clinical Leaders 2015/16 Psychiatric Rehabilitation Nursing

Transcription

1 Sharing on Overseas Corporate Scholarship Program for Clinical Leaders 2015/16 Psychiatric Rehabilitation Nursing Yale Program for Recovery and Community Health (PRCH), Yale University, the USA (2 May May 2016) TSANG Ho-wing APNP (PYNEH) / PANG Pui-ling, Nancy APNP (KH) WONG Choi-wan APNP (UCH) / CHENG Lai-ki APNP (KCH) / FONG Siu-yin, Vincent APNP (KCH) 1

2 Learning Objectives To acquire knowledge and experiences on following aspects: 1. Understand the recovery-oriented practice in in-patient and community psychiatric rehabilitation services; 2. Understand the recovery-orientated psychiatric rehabilitation models, practice and therapies across different healthcare institutions; 3. Understand the knowledge and skills for psychiatric nurses to support the recovery of people with severe mental illness. 2

3 Highlight of Prioritized Observations Today 1. Peer Support Service (PSS) (Phased launching in Hong Kong in recent years) 2. Trauma Informed Care (TIC) 3. Citizens Project 4. International Recovery & Citizenship Council Symposium Person Centered Recovery Plan (PCRP) (Practicing in HK for years) 3

4 Peer Support Service (PSS) PSS are paid staff who are also people in recovery from mental illness and/or substance abuse, and "have shown success in their recovery journey" (Rebecca Miller, 2016). 4

5 Other Names of Peer Support Role model/ mentor Resource broker Motivator/ cheerleader Ally/ confidant True-teller Advocate Community organizer (White, 2006) Recovery coach Recovery specialist Recovery experts (Program for Recovery & Community Health {PRCH}, 2016) 5

6 Recovery University Recovery University Design and provide detailed curriculum, core competencies and certification examination 80-hour training, internship, examination, continuing education for re-certification Run by the Advocacy Unlimited, a peer run / client advocacy agency obtaining state support 6

7 Training to Become Peer Support Worker Basic Training Peer support specialist training by Recovery University; and Mandatory training of the hiring organization such as collaborative safety strategies, environment of care, infection control, workplace violence, CPR. Job Specific Trainings Intentional peer support training (Shery Mead s model) Recovery coach and recovery support specialist Person-centered planning Employment services Self-esteem and healthy relationship 7

8 Roles of Peer in Peer Support Service of PRCH Peer Supporter (PRCH) Researcher/ Research Assistant (PRCH) Forensic Peer Specialists (PRCH) Peer Mentor (PRCP) Receptionist (CMDC) Health Navigator (Hispanic Clinic) Direct support to out-patient team Serve in governing committees (CMHC) 8

9 Recovery Speaks For Primary Care Providers to reduce stigma, 2011 "Recovery Speak" performers (speakers) are RSS, present with real life experiences of mental illness, addiction and incarceration, sharing own lived recovery stories 5 hours' workshop - 2 hours storytelling sharing by 5 speakers - 3 hours group discussions For high school & colleges' students in 2012, inspire and motivate them to do better in lives Pre and Post Feedback survey 9

10 Supervision to Peer Support Service Supervisors work on coaching & mentoring peer support worker (PSW) Peers have a weekly group supervision to discuss concerns, rewards, and challenges Individual supervision on regular and as needed basis Peers on clinical teams are supervised directly by the team leader 10

11 Reflection of Peer Support Local Situation Integration of Primary Care in different community settings 1. HA has officially launched PSW services in 3 Clusters (KCC, KWC, NTW) in and other 4 remained clusters in PSW training curriculum framework is standardized among HA hospitals in Peer Support Workers (PSW) positioned as supporting staff & holding a post of PCA IIIA {Patient Care Assistant(III)A} and /or PCA II. 4. Base on our available information, there is no foreseeable career pathway for local PSW as what we seen in USA. 11

12 Reflection of Peer Support Challenges in Local Situation 1. Lack of long term government policy on peer support service development in HK; 2. No regional recognized governing board in HK; 3. Lack of standardized accredited PSW trainings in Hong Kong, different organizations (NGOs, HA) develop their own PSW services and training programs; 4. Uncertain HA / management Policy; 5. No independent Career Job Rank in the HA organizational structure (i.e. PSW recruitment under PCA Post) 6. Unclear career pathway 12

13 Trauma Informed Care (TIC) 13

14 Trauma-informed care (TIC) A trauma-informed care is an approach to deliver behavioral health services includes an understanding of trauma and an awareness of the impact it can have across settings, services, and populations. It involves viewing trauma through an ecological & cultural lens and recognizing that context plays a significant role in how individuals perceive and process traumatic events, whether acute or chronic. TIC involves vigilance in anticipating and avoiding institutional processes and individual practices that are likely to re-traumatize individuals who already have histories of trauma, & it upholds the importance of consumer participation in the development, delivery, and evaluation of services. (SAMHSA, 2014) 14

15 Key Assumptions in Trauma Informed Care Applying to program, organization, or system that is trauma-informed (Substance Abuse and Mental Health Services Administration, 2014) 15

16 Core Features of Trauma-Informed Care Safety Trustworthiness Choice Collaboration Empowerment Ensuring physical and emotional safety Making tasks clear and maintaining appropriate boundaries Prioritizing choice and control Maximizing collaboration and sharing of power Prioritizing empowerment and skill building Source: Adapted from Roger Fallot, PhD and Maxine Harris, PhD, Community Connections, Inc. 16

17 REFLECTION: Trauma Informed Care (TIC) An concept of systematic quality customer service TIC not confine to service users but also service providers Demand us have a systematic view to realize trauma & its impacts, Enhance our vigilance to recognize trauma cues, signs & symptoms in our clients and staff Strengthen our readiness to respond with full integrated knowledge Make concerted efforts to resist re-traumatization 17

18 Citizens Project Anything is possible when citizens come together! is designed to assist people with mental problems, trauma, co-occurring with substance abuse and having involved in criminal offences to Understand and exercise their Rights Identify ways to fulfill goals & Responsibilities Enhance Roles as community members Enrich knowledge to access community Resources Strengthen ability to develop Relationship networks 18

19 What s Up Group? (Peers Co-learning Group) Is a therapeutic group Facilitated by target who claimed as student Students share successes & offer feedbacks around challenges of daily lives US$10 for each attendance, food incentives Certificate of completion & Graduation Ceremony at City Hall 19

20 Reflection of Citizenship Project Get respect, peer support & hope; Realize their rights & strength; Gain relationship & resources; & Learn their roles & responsibilities. 20

21 International Recovery & Citizenship Council Symposium 2016 Recognition addresses the needs of people with mental health problems. Recognition makes every individual being valued; not being measured and not being viewed as perfect. Recognition is the way to empower person in recovery (PIR) to be reconnected with social solidarity & acquire social recognition through partnership. Recognition emphasizes the connection between people. Recognition of people has a goal to do something & helping them to understand how to make their ways to reach their goals in sustaining recovery movement in mental health service 21

22 Reflection of the IRCC Symposium Scottish Mental Health Arts & Film Festival is one of world s largest Social Justice festivals Attendance over 25,000- over 300 events throughout the country Use Arts to inspire social change e.g. dance, theatre, music performance, magic, poetry & literature, motion picture, stories telling etc. Promote recovery Challenge stigma Promote understanding & recognition 2016 The rise of Mad Studies in Canada to promote mental health & mental illness education for younger generations. Mad Studies courses launched in the early 2000s in university Recovery movement in the United Kingdom emphasized social inclusion, recognition of role & trauma, value of experience and partnership, shift power to service users 22

23 Person Centered Recovery Plan (PCRP) GOAL as defined by person in recovery Strengths to draw Upon Barriers / Assessed Needs Short-Term Objectives Behavioural, Achievable, Measurable Interventions/ Methods/ Action Steps Professional service Clinical & Rehabilitation Action PIR/ Roles and Actions by natural supporters 23

24 Reflection of PCRP Transform from Care for to Care with culture; Staff training, coaching and supervision; Commitment in coproduction process; Standard strength-based and PCRP documentation Consistent recovery coaching approach 24

25 REFLECTION: Psychiatric Nursing in Rehabilitation 1. The progress of recovery work in Hong Kong is not bad, we should try our best even it is a tiny step, we still moving forward. 2. Teamwork, open-minded culture, support from policy can help development of recovery in Hong Kong. 3. To facilitate shifting from tradition medical model to recovery model among staff, it is important to offer skill training with engagement of persons in recovery (PIRs) 4. Research study on providing the important role of nursing in recovery oriented practice is the way to avoid mental health nursing being marginalized. 25

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