This document was initiated in 2016 as the Oregon Health Authority’s Behavioral Health Collaborative convened to develop recommendations.
We asked:
“What is our collective North Star in the B/H arena?”
Here are conversation notes:
* “Nothing About Us Without Us” – Peer Input & Direction – Inclusiveness – The voice of persons with lived experience drives the service planning process. The optimist invented the airplane…the pessimist invented the parachute…each voice, every mind matters!
* Self Determined
* Individualized
* Person Centered
* Respectful of the Person (autonomy, dignity, independent/least restrictive, freedom)
* True Informed Choice (incl. service array “menu” with treatment diversity and alternatives, not a one-size-fits-all approach and no coercion–coercion is a sign of system failure in a system-of-care–least desirable–least effective; it’s not okay when people don’t know what they don’t know and so suffer without services that otherwise would help them – thus it’s not a completely informed choice)
* Equitable / Non Discriminatory
* Trauma Sensitive / Trauma Free / Trauma Informed
* Integrated Healthcare incl. Traumatic Brain Injury services & supports
* Wraparound Care
* Flexible Funding (e.g. air conditioner instead of heat stroke, services like hippotherapy may be in a different CCO region)
* True “Medical Home”
* Recovery and Wellness Oriented (care to achieve wellness, not just crisis sick care only)
* Hope and Resiliency
* Strength Based (not Deficit Based, identify and build on individual strengths and assets)
* Community Integration (affording least restrictive care setting, independence, etc.)
– sustainable connection to community
– sustainable connection to friends
– sustainable hope
– funded community drop-in centers with positive activities in the service array
– social inclusion recognized as a medical necessity
* Diversity and Worldview
* Person First / Holistic (the whole person, more than their diagnosis, not a diabetic but a person with diabetes)
* Collaborative Problem Solving
* Measurements and Incentives connected to the Progress of the Individual, not just the Provider and System
* Relevance (policies and services fit the actual needs of individuals not the other way around)
* No Wrong Door Approach
* Single Point of Contact (e.g. Case Coordination)
* Single / Independent Point of Accountability
* The Missing Piece: Advocacy, Navigation, Liaison & Support at the Point of Entry into the System (incl. Peer Support, and if applicable, Family Support); at point of entry, they should be informed of their options available such as a healthcare navigator, case coordinator, social worker, DRO materials (Disability Rights Oregon)
* Peer Support that is flexible and responsive, not restricted into 9-5 schedule
* 24/7 crisis response
This list reflects many items in the Peer Principles draft document in review/development within the OCAC PDS committee, last updated in May 2015.
NOTE: Many of these items might be specifics for the quality and fidelity of care for which may be limited in how many selected indicators they connect with and/or what reliable data collection instruments etc. are in place or comparison, etc.
Work is underway in the peer community regarding research and evaluation, and it would be good to coordinate
with national and local organizations in this effort. This problem doesn’t have to be solved overnight, either, there are probably at least a few weeks and months to prepare.
For example, it appears several groups and/or individuals have worked on development of instruments related to some of these concepts, etc.
These are preliminary topic exploration lists, a mere sprinkling, for illustrative purpose…
1. Self-Determination
a. Self Determination Theory (https://en.wikipedia.org/wiki/Self-determination_theory)
b. Presentation on aspects, outcomes, etc. (http://slideplayer.com/slide/5116948/) incl. metrics
c. Self Determination Assessment Tools (http://www.ou.edu/education/centers-and-partnerships/zarrow/self-determination-assessment-tools.html)
d. Michigan Self Determination Initiative (http://www.michigan.gov/mdhhs/0,5885,7-339-71550_2941_4868_4897-14782–,00.html)
e. Self Determination: Taking Back Our Lives by Mary Copeland (http://www.cmhsrp.uic.edu/download/sdconfdoc06.pdf)
f. Mental Health America – Statement – Position (2015 Jun) – mentions positive outcomes in multiple examples. (http://www.mentalhealthamerica.net/positions/self-determination) – HAS A CALL TO ACTION FOR STATES, MENTIONING WAIVER 1915(j) and 1115
g. Center for Self Determination (http://www.centerforself-determination.com/)
2. Consumer Engagement / Involvement
a. Community Catalyst – Best Practices for Meaningful Consumer Input in New Healthcare Delivery Models (http://www.communitycatalyst.org/doc-store/publications/meaningfulconsumerinput_healthcaredeliverymodels.pdf)
b. NCQA/HEDIS (2014 Feb) – Building a Strategy to Leverage HIT to Support Patient and Family Engagement (http://www.ncqa.org/hedis-quality-measurement/research/building-a-strategy-to-leverage-health-information)
c. SAMHSA Statewide Consumer Network Grant – Excerpt: “A primary goal of the program is to strengthen the capacity of consumers to act as agents of transformation in influencing the type and amount of services, so they must be an integral part of an organization that supports individuals with a serious mental illness or who have received public mental health services, and ensures that their mental health care is consumer-driven with access to recovery support services. Therefore, only organizations controlled and managed by mental health consumers are eligible to apply.” (http://www.samhsa.gov/grants/grant-announcements/sm-16-002)
d. Consumer Engagement Guide http://www.advocacytasmania.org.au/publications/consumer_engagement_guide_Tas_ATOD_sector.pdf
e. Person Centered Care Planning Capacity metric mentioned (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4409728/)
f. NASHMPD (2010) – Consumer Involvement in State Operated B/H Services – Metrics etc. in appendices (http://www.dhhs.nh.gov/dcbcs/bbh/documents/consmrinvolvwithsmhas1.pdf)
g. Massachusettes Consumer Involvement Tookit – Evaluation – http://www.mass.gov/eohhs/docs/eohhs/olmstead/stg/consumer-involvement-toolkit.pdf
h. Consumer Participation Questionnaire (http://www.ncbi.nlm.nih.gov/pubmed/10459513)
i. Consumer and Family Involvement Measure (http://gaincc.org/_data/files/Consumer%20and%20Family%20Involvement%20Measure%20final.docx)
3. Recovery Oriented
a. Power2U / Empowerment Center – Measuring the Promise: Recovery Measures Compendium – ROSI (Recovery Oriented System Indicator) (https://www.power2u.org/downloads/ROSI-Recovery%20Oriented%20Systems%20Indicators.pdf)
b. Review of Recovery Measures (http://www.mentalhealth.va.gov/communityproviders/docs/review_recovery_measures.pdf