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Evidence-Based Practices:
Shaping Mental Health Services Toward Recovery
Illness Management and Recovery Workbook
Chapter 10
Practitioner Guidelines for Handout #9:
Getting Your Needs Met in the Mental Health System
Introduction
This module provides an overview of the mental health system, including a
description of the services and programs commonly offered by community health
centers and the financial and insurance benefits to which people may be entitled.
People are given information to help them make choices about programs and services
that will help them in their recovery. It also provides strategies for people
to advocate effectively for themselves if they encounter a problem in the mental
health system.
Goals
- Convey confidence in people making their own decisions.
- Provide information about mental health services and benefits that will
help people make decisions.
- Provide an opportunity for people to discuss the services they are receiving
or would like to receive.
- Provide strategies for effective advocacy.
Number and pacing of sessions
“Getting Your Needs Met in the Mental Health System” can usually
be covered in two to four sessions. Within each session, most people find that
it is comfortable to cover one or two topics and complete a questionnaire.
Structure of sessions
- Informal socializing and identification of any major problems.
- Review the previous session.
- Discuss the homework from the previous session. Praise all efforts and problem-solve
obstacles.
- Follow-up on goals.
- Set the agenda for the current session.
- Teach new material (or review material from the previous session if necessary).
- Summarize the progress made in the current session.
- Agree on homework to be completed before the next session.
Strategies to be used in each session
Motivational strategies
Practitioners can help people identify whether there is a particular program
or service in the mental health system that could improve some aspect of their
lives or help them reach their goals. For example, if someone’s goal is
to increase his social support, he might be interested in learning more about
social skills groups that are available at his local community mental health
center.
Some people have been confused or frustrated by the mental health system and
welcome an opportunity to discuss solutions to some of the problems they have
experienced. For example, people who have felt that “no one listens to
me at the mental health center” may be especially motivated to learn some
of the strategies provided in this module for effective self-advocacy.
The following suggestions may be helpful:
- Practitioners can review the personal goals that people
have identified in previous sessions and help them identify how some of the
information in this module could help them achieve a goal. Practitioners can
help people identify which of the mental health services might help them achieve
their personal goals.
For example, if someone wants to reduce her substance use, she might be interested
in integrated treatment for mental health and substance abuse. If someone
is trying to improve his living situation, he might be interested in services
related to housing.
- When discussing mental health services, practitioners can
ask which services people have already tried, and whether or not they were
helpful. For example, under “emergency services,” the practitioner
could ask whether someone used the crisis hot line and whether it helped him
manage his crisis. If the hot line was not helpful, the practitioner could
explore strategies for a better outcome in the future.
- When talking about financial benefits, practitioners can
help people explore whether they are eligible for certain benefits that might
help them solve a problem or achieve a personal goal. For example, if someone
is interested in living independently but has insufficient funds, receiving
SSI or SSDI might be helpful. This may increase his or her motivation to learn
more about the eligibility requirements of SSI and SSDI.
- When discussing advocacy, practitioners can ask about people’s
experience with advocating for themselves. Would improved self-advocacy skills
help them pursue certain personal goals?
Educational strategies
Educational strategies for this module focus on increasing people’s
knowledge and understanding of services that are available to them and strategies
for advocating effectively for those services.
The following strategies were discussed in detail in Module 1:
- Review the contents of the handout, by summarizing or taking
turns reading.
- Pause at the end of each topic to check for understanding
and to learn more about the person’s point of view,
- Allow plenty of time for interaction.
- Pause to allow the person to complete the checklists and
questionnaires.
- Break down the content into manageable “pieces.”
- Find a pace that is comfortable for the person.
Cognitive-behavioral strategies
Cognitive-behavioral strategies focus on helping people learn strategies for
gaining access to services and for advocating for themselves. During the sessions,
practitioners can teach people these strategies through modeling, role-playing,
and practice.
The following examples may be helpful:
- The practitioner can help the person develop a plan for
getting the services he or she wants from the mental health system. For example,
if someone would like to work with an occupational therapist (O.T.) on budgeting
and cooking independently, the practitioner can help him locate the phone
number and hours of the O.T. who consults with his community mental health
center. The practitioner could help him role-play how to present his concerns
to the O.T. in the first phone call or meeting.
- The practitioner can help the person rehearse advocacy
strategies in the session. For example, if someone was frustrated because
of being on a long waiting list to see an individual counselor, she might
decide to talk to the consumer advocate at her mental health center. The practitioner
can help her role play how to state her concerns to the consumer advocate.
Homework
During the sessions, people identify services they would like to receive and
advocacy strategies they would like to use. Homework assignments follow up on
this by making specific plans for people to pursue services and use advocacy
strategies.
Practitioners should follow up on homework assignments in the next session by
asking how it went. They should reinforce completed homework or the effort people
have made to complete homework. If people are not able to complete the assignment,
practitioners can explore the obstacles they encountered and help them come
up with a solution for following through on the homework.
The following examples of homework may be helpful:
- To follow through with applying for SSI benefits, homework
could include locating information (phone number, eligibility requirements,
contact person, etc.) or forms (application form, release of information,
etc.) needed for the application process and bringing them to the next session.
- If someone is interested in a support group, the homework
could consist of following through on plans to call the support group coordinator
and finding the location of the most convenient group. The next week’s
homework could be to attend one group meeting.
- If someone is interested in getting a job, her homework
could be to contact the coordinator of the supported employment program or
other vocational program at her mental health center.
- If someone is interested in having support for advocating
for himself, he could ask a family member, friend, or other supportive person
to help. For example, he might want to ask a relative to accompany him to
certain appointments.
Tips for common problems
- Some people are “disillusioned” with the mental
health system.
The practitioners can explore what the person has experienced in the past
and identify some strategies from the handout that could lead to better results.
For example, if someone complains that the doctor did not pay attention to
her request to consider changing medications, the practitioner could encourage
her to talk to the doctor again and could offer to work together on communicating
more effectively.
Review Questions
At the end of this module, practitioners can use either open-ended questions
or multiple-choice questions to assess people’s knowledge of the main
points.
Open-ended questions
- What are some of the services that are offered by your mental
health center?
- What is one of the financial benefits that are available
to people with mental illness?
- What can you talk to if you have a problem with the mental
health system?
Multiple choice and true/false questions
- Which of the following professionals are usually available at mental
health centers?
Counselors
Insurance agents
Salespeople
- Which of the following is a financial benefit available to people
who are unable to work full-time because of their mental illness?
SSI (Supplemental Security Income)
AA (Alcoholics Anonymous)
OT (Occupational Therapy)
- Once you locate someone you feel comfortable talking to, it is a
good idea to stay in touch with that person on a regular basis. True
or False
- Raising your voice is an effective strategy for advocating for yourself.
True or False
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