ny office of mental health lessons learned conference ~ may 25, 2011 janice lebel, ph.d. ma...
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NY Office of Mental HealthNY Office of Mental Health
Lessons Learned Conference ~ May 25, 2011Lessons Learned Conference ~ May 25, 2011
Janice LeBel, Ph.D. Janice LeBel, Ph.D.
MA Department of Mental Health & NASMHPD MA Department of Mental Health & NASMHPD ConsultantConsultant
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OutlineHiring: Who & How?
Tips & pearls of wisdom
Orienting: What do you Teach?More tips, more pearls
Promoting Growth: How do you Do it?Still more wisdom from colleagues
What’s New in Talent Development?
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According to the Experts: DO NOT...DO NOT...Kevin Huckshorn – DE Commissioner:
Do not ever hire “just to fill vacancies”
Lydia Todd – NFI Assoc. Executive Director:“Do not hire by the pound... Bigger is not always
better.”
NY OMH Learning Collaborative Facilitators:Do not start your hiring process without consulting
with peers, youth and families. Get their input on key qualifications, competencies and the role being considered
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According to the Experts: DO...DO...Per Anders Rydelis, Sweden, Chief C/A
Psychiatry: “We hire people we like ... the friends of our good
staff”Kathy Fuentes, BU IRTP:
“I’d rather hire someone with no experience in residential or inpatient care then someone who has been using restraint and seclusion for years.”
Alex at House of Good Shepherd:“Hire staff who know how to have fun – if they can’t
tell you what they like to do for fun – how good can they be with kids?”
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According to the Experts: DO...DO...Bill Anthony, BU Ctr. for Psychiatric Rehab:
“Clarify your organizational values – and make sure it is in writing. They are the ‘glue’ that bind vision with the operations.”
Kevin Huckshorn, DE Commissioner:“... adopt the IOM (2003) recommendations toward
developing the health care workforce, including: developing core competencies, providing consumer-centered care, working in interdisciplinary teams, using evidence-based practices, understanding the principles of quality improvement, and using informatics.”
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According to the Experts: DO...DO...Kevin Huckshorn, DE Commissioner:
decide on your job descriptions and describe the knowledge, skills and attitudes you want in your workplace
Include the value and focus on violence-free care and improved safety in your job descriptions & postings
talk about creating a culture of recovery and resiliency
inform candidates that you work closely with families and peers to create your system of care
focus on the importance of trauma informed care, preventing violence, ensuring safety, and consumer inclusion 7
According to the Experts: DO...DO...Lori Hollinger, Dir. Human Resources
Fulton State Hospital - MOConduct your own Values-Driven Hiring InitiativeConduct a pre-interviewConduct a values survey with potential employees Centralize the hiring practices and make more uniform
decisions Ensure staff are literate , organize literacy classesInclude consumers in the employee hiring &
orientation process: what it is like to have mental illness the experience of RS a client-lead Tour
A member of the initial interview team follows up with the new employee (post hire) to ensure a smooth transition to the job/role
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Interviewing QuestionsAsk applicants about:
their thoughts about working with consumers in recovery as staff
how they view families, their role, working with families
their knowledge of trauma, mental illness and any personal experiences (friends/family, etc.)
their knowledge of S/R and national trends when would it be used and be specific e.g. not when
person is sitting on the floor, or refuses to attend a meeting, or refuses medications, or curses, etc.
what they would do if they saw a staff member act in a way that was punishing, neglectful, abusive, hostile or disrespectful?
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Human Resource Essentials Do criminal background checkGet reference from most recent supervisor,
make this a mandatory reference if possibleDo a drug screenDo a credit checkProvide a vignette of a clinical event and ask
applicant to record what they would write in the medical record as a result
Do observe candidates with consumers & solicit consumer feedback
Do supervise closely, especially during probationary period
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Reconsider Who the Workforce Is! Many Peer Roles are EmergingDirector of Consumer AffairsDirector of Mission
EffectivenessPeer BridgerPeer SpecialistsPeer MentorsPeer Coaches / Wellness
CoachPeer AdvocatesRecovery SpecialistsPatient Liaison / DebrieferResident Support SpecialistRespect Speaker
Director of Consumer & Family Engagement
Director of Family ServicesParent PartnerParent AdvocateFamily LiaisonExecutive DirectorCommissioner*Community Service Advisor*WRAP FacilitatorWRAP Instructor (College !)Trauma Specialist
*NZ
“Peers have helped us transform our organization making it recovery oriented in design and in service delivery. Our peer employees have helped us achieve and maintain a new way of being with people that does not require seclusion and restraint interventions...”
Lori AshcraftDirector Recovery Education Center
Recovery Innovations
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Orientation: Leadership Sets the Stage
Lisa Hilton, COOMillcreek Behavioral HealthMagee, MS
Largest provider of c/a services in MSReduced R/S 99% x 4 years>225 youth served: RTF &ICF MRJoint Commission AwardFirst message, first meeting
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Orientation Recommendations from Some NY RTFsAlex & Peers at House of Good Shepherd:
Teach staff how to have patienceTeach staff how to give kids time and space
Jasmine at SCO-Ottilie:Teach staff how to forgive kids if kids hurt themTeach youth what staff are taught
Mickey Toker, W. NY Parent Advisor:Teach parents what staff are taught
Fran Bahi at SCO-Ottilie:Teach with simulations/scenariosAsk what makes you think you’ll be a good
counselor 15
Orientation RecommendationsGraham Varney, CAMH:
“I teach our staff to not say ‘no!’”Kathy Fuentes, BU IRTP:
“Keep your hands to yourself. Put your hands in your pocket. If you want to get hit – touch someone without their permission.”
“You have more time than you think you do.”“The louder youth get, the quieter you get.”“The more agitated they are, the more space you
give them.”TCI:
Space and time relieve pressure
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Orientation RecommendationsKatie McLeese Stephenson – Cedars, NE:
“We realized by using R/S we were only solving the staff’s’ problem – not the youth’s problem.”
Established 2 broad goals for treatment: Youth to become more proficient in language skills,
communicating & problem solving Youth to become more proficient in self-regulation
& managing their physical stateTaught mediation, dispute resolution &
negotiation to youth & staff at orientation and ongoing
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Orientation RecommendationsCo-teach with peers/youth/families to
maximum extentEmphasize the importance of:working with consumers and familiesperson-first languagedocumenting clearly, descriptively, without
jargoncontinuous quality improvement and every
staff’s role in thisaccountability for the program culturereporting problems to their supervisor
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De-escalation Skill BuildingBoston Medical Center:
Teach pre-de-escalation skills, being present, observation & surveying for earliest sign of problem
Cambridge Health Alliance:4 hours/week supervision/skill building with CPS
MO State Hospital System: Shifted to 3:1 ratio (verbal: physical skill technique)
PA State Hospital System: Annual training quarterly trainingChanged focus: now more time spent on
verbal/relational skills than physical techniques
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Novel Approaches to Prevent R/SCaroline McGrath Pre-Witnessing
Westboro Adol. Svcs.
George Bell Resident Support TeamChauncy Hall IRTP
Simon Taylor Cell phones for parents, they NCCF are the first call for first
response to a problem
Andrew Benedetti Walk in My ShoesTransitions IRTP
Kim Sanders Schedule of SupportGrafton
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Trained Extraordinary Blocking techniques to prevent R/S & injuries
Introduced many natural, soft items into the environment
Novel Approach to Prevent R/S: Grafton
Novel Approaches to Change R/S PracticeAndrew Benedetti Surpass minimum standards
Transitions IRTP
Lydia Todd Break up R/S training, teachNFI physical skills with CPR, not
with verbal skill training
Mary Guilfoyle Not everyone is taught R/SDevereaux Glenholme
Brian Farragher R/S cannot be used until atAndrus Children's Ctr. least 3 months of experience
with close supervision
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Novel Approaches to DevelopmentStaff have safety plansStaff sign non-violence commitmentPreceptors / mentors assignedUpward / 360 reviews: consumers evaluate
staff; staff evaluate supervisorsDirect-care staff co-lead/co-facilitate treatment
teams, presents cases, etc.Professionalize staff – have them present at
conferences, work on quality improvement projects
Teach manners & customer service, everyone is the: Director of First ImpressionsDirector of First Impressions
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Map Staff Skills & CompetenciesMaria Tebeau (right) Chauncy Hall IRTPDeveloped roster of skills &
competencies by role and tenureto supervise and evaluate staff overtime and promote growth andmovement thru the organization
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Use Data to Teach & Supervise StaffJT Tormey (center) - Merrimack CenterClose observation and daily tracking
of youth and staff behavior generatespragmatic information that informstreatment, supervision, change of shift-report, etc.
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Involve Staff in Creative Problem Solving & Culture BuildingRob Terreden (left) Three RiversCreated ‘massive doses of signals of caring’Continual effort to maximize:
FunFlexibility & early interventionFacilitate soothing & self-soothingPartnership with familiesStaff influence & creativity
Rainbow Dance
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Supporting StaffBob Quam Town Hall meetings
So. Florida State Hospital
Tommy Davis Lunch with TommyCentral LA State Hospital
Ann Bailey Branding & marketing theCentral St. Hospital - VA new culture
Greg Smith / Ray FlanneryPERT Team / ASAP TeamPA St. Hospitals / MA St. Hospitals
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Supervising, Mentoring & AcknowledgingBob Roca “Green Beaders”
Shephard Pratt HCS
Candy Ingalls Walk AboutCenterpoint IRTP
Andrew Benedetti Caught in the ActTransitions IRTP
Marty Martin Recognition &Fulton State Hospital Encouragement
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Rewarding StaffLinda Rivera Golden Bed Pan Award
Elmhurst Hosp. Ctr. – Forensic Svc.Ellen Flowers Life Saver Awards
Tewksbury State HospitalGayle Bluebird Good Stories - Nurses Day
So. FL State Hospital
Russ Hughes Random acts of kindnessSo. Carolina DMH with no expectation
of reciprocityJim Gaynor Gain-sharing
GraftonKen Duckworth DMH R/S Awards
MA Dept. of Mental Health
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Supporting Workforce & Service Transformation2005 - SAMHSA awards 9 states 5-year
State Incentive Grants ($13.5M/each) to support a cross-systems approach to implementing significant broad-ranging reforms in service delivery.
2010 – SAMHSA awards 20 states/agencies 5-year grants ($3.7M/each) to implement systemic trauma informed care as transformation framework
Workforce TransformationNASMHPD – OTA NEW Curriculum (2011)18 modules: Preparing the Adult Mental
Health Workforce to Succeed in a Transformed System of Care
Presentations, References, Post Test/AnswersTraining direct care staff working in
inpatient and community residential adult mental health treatment settings in a “shared understanding” of the key components, competencies and principles of a transformed mental health system
Recovery to Practice InitiativeThe RTP Initiative is a 5-year project
funded by SAMHSA’s Office of theAssociate Director for Consumer Affairs,to translate the vision of recovery intothe concrete and everyday practice ofmental health professionals of all disciplines.
Gayle Bluebird, RN serves on the nurses initiative which is training nurses how to integrate recovery in their practices
http://www.apna.org/i4a/pages/index.cfm?pageid=4416
Building Bridges Transforming residential care through partnershipJoint resolution (2006): “... identifies an urgent
need for transformation and envisions a comprehensive, flexible family-driven and youth-guided array of culturally competent and community-based services and supports, organized in an integrated and coordinated system of care in which families, youth, providers, advocates, and policymakers share responsibility for decision making and accountability for the care, treatment outcomes and well-being of children and youth with mental health needs and their families. ..”
Building Bridges Resources
Innovative Practices White PaperTip Sheets for FamiliesTip Sheets for YouthSelf-Assessment Toolkit for Staff & AdvocatesSelf Assessment Toolkit for Youth & Families
Available at http://www.buildingbridges4youth.org/get-involved/contact-us
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Resources
NASMHPD-Office of Technical Assistance
Preparing the Adult Mental Health Workforce to Succeed in a
Transformed System of Care Training Curriculum Available at:
http://www.nasmhpd.org/WFPresentations.cfm
ResourcesMillcreek of MageeLisa Hilton, COO
Email: [email protected] Phone: (601) 849-4221
900 1st Ave. NEMagee, MS 39111
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ResourcesGrafton School, Inc.
Jim Gaynor, President & CEOKim Sanders, EVP/Chief Outcomes
OfficerPO Box 2500
Winchester, VA 22604540-542-0200 x6412
Paving New Ground & Peer RolesContact Information
Gayle Bluebird, RNDPC Peer Support CoordinatorDelaware Psychiatric Center
1901 DuPont Hwy.New Castle, DE 19720
Office: 302-255-9701 Cell: 352-219-1095
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