Executive Summary

2012 – State of Recovery in Ohio

Ohio has been at the forefront of the Recovery Movement in Community Mental Health. In the early 1990s, ODMH supported research in the exploration of recovery from the perspective of the people with the lived experience. The knowledge from this helped to facilitate the development of consumer operated agencies and services that supported mental health recovery in unique ways which included self-help and the development of peer supported services. Additionally, through the leadership at ODMH, the first toolkit on mental health recovery was developed for providers as an emerging best practice for transforming service delivery and the behavioral healthcare system. As Ohio continued its growth in the Recovery Movement, we saw the implementation of evidence-based practices and a shift toward more integrated and holistic health.

In partnership with ODMH, the Wellness Management and Recovery Coordinating Center of Excellence (WMR CCOE) has advanced the technology of promoting recovery in Ohio. This partnership has helped us to learn more about the types of approaches, resources and support that are necessary in fostering person-centered healthcare. This partnership has also supported greater continuity of care to increase access and efficiencies in service delivery.

The purpose of this document is to provide an overview on the evolution of systemic recovery technology that has been implemented throughout the state of Ohio to further develop sustained communities of wellness.

The Technology of Recovery

To date, over 1200 Ohioans have participated in WMR and 287 peer and provider facilitators in 25 organizations have been trained to facilitate WMR groups. Outcome data indicates that 64% of individuals who complete WMR demonstrate greater efficacy in their mental health recovery and that these positive gains are sustained for at least 6 months or longer.

The ongoing research and evaluation of WMR has examined the elements (domains) that contribute to the outcomes achieved thus far. These domains are congruent across service delivery, education and training, consultation, and ongoing assessment and evaluation. The CCOE has identified the following domains of WMR that contribute to increased person-centered mental health recovery:

Open Space – Creates a safe environment for WMR participants, their families and providers to engage in continuous personal growth and development. It also provides the necessary support for person-centered wellness and recovery along with fostering authentic relationship building, collective learning, deliberative dialogue, consultation, technical assistance, and empowerment. In essence “open space” is a contextual pedagogy that promotes voice, choice, shared-power, community building, awareness, knowledge and skills.

This technology supports the idea that all who gather have the strengths and resources to learn and discover ways to create or sustain their own wellness. For WMR facilitators, they help to establish an open space by utilizing the other domains listed.

Voice/Choice –the individual’s lived experience is valued as well as how the individual makes meaning of that experience. The person has the right and power to make choices about what is needed to support their recovery and wellness.

Accountability/Responsibility – Participants obtain increased self-awareness and make an on-going commitment to take charge of their personal wellness and recovery, while supporting the wellness and recovery of others.

Reciprocity – Understanding of how taking charge and being responsible for one’s own holistic health contributes to the health and well being of others as well as the community.

Activism and Advocacy – Behavior and voice that creates social justice and change; these actions support and acknowledge recovery from psychiatric illnesses as a historical social justice movement for the purpose of building healthcare systems that honor the welfare and dignity of all humanity. These activities challenge individuals, organizations and systems that adhere to a medical model with professional experts in the center of health care delivery to become more aligned with the values and practices of person-centered wellness and recovery practices.

Power Sharing (Flipping the Center of Power) – Affirms the concept that everyone is an expert on his or her own experience and has something to contribute without imposition or coercion from dominant centers of power. (peers in collaboration with providers).

Multicultural Competency – Multicultural Competency refers to an ability to interact effectively with people of different cultures. Cultural competence comprises four components: (a) Awareness of one's own cultural worldview, (b) Attitude towards cultural differences, (c) Knowledge of different cultural practices and worldviews, and (d) Cross-cultural skills. Developing cultural competence results in an ability to understand, communicate with, and effectively interact with people across cultures. (American Counseling Association, 2010). WMR infuses Multicultural Competency in all aspects of its Recovery Technology and actively builds authentic relationships across human differences.

Sustainability – Utilizing resources to the fullest without exploiting or harming the resources of others. WMR seeks greater efficiencies and sustainability through its building of communities of wellness.

Deliberative Dialogue – A communication process of genuine interaction through which people listen to each other deeply enough to be changed by what they learn. In deliberative dialogue groups, participants have the opportunity to make a serious effort to take others’ concerns into their own picture, even when disagreement persists. No person gives up their identity, but each recognizes enough of the other’s perspective that he or she will act differently toward one another. In deliberative dialogues people have the opportunity to open their minds to absorb new views, enlarge perspectives, rethink biases, assumptions, create new knowledge and transform.

Building Community – An active process of interaction, inclusion and relationship building that supports the development of authentic engagement, discovery of common ground, and the enhancement of relationships across human differences.

Safety – Is a condition that is co-constructed among the WMR group members, so that individuals can be fully present and bring their “whole” selves into the relationship or into the group interactions. When the learning environment does not appear safe to adult participants, they will disappear or resist the program dramatically to protect themselves. (Jane Vella, Training Through Dialogue)

Collective Learning – An interactive process that values each individual as both a teacher and a learner. Participants actively engage in meaning making, mutual exploration, goal setting, develop collective insight, understandings, work through complex issues and build capacity together to create the results they want to achieve.

Leaderfulness – The belief that all people have leadership capacity, unique gifts and strengths as well as the capacity to direct their own wellness. People who experience a new kind of leadership change their approach to their communities and thus affect the way others experience community.