Session #B3b
October 5th __, 2012
Empowering Recovery in Hill
Country Crisis Stabilization Unit
Kris Steinke, MD, Medical. Director- Hill Country CSU
Vicki Herndon, MA, LPC, CPS- Hill Country CSU
Collaborative Family Healthcare Association 14th Annual Conference
October 4-6, 2012 Austin, Texas U.S.A.
Disclosure Statement
We have not had any relevant financial
relationships with any of our references
during the past 12 months.
Any references to Curriculums and
Products are for educational purposes only
Hill Country MHDD Centers
MISSION:
Promoting Independence,
Community Integration
and Recovery
Hill Country MHDD Centers
Serves 19 counties
22,000 square miles
Population base 560,000
Provides mental health, developmental
disability, early childhood intervention,
veteran, and substance abuse services
Hill Country MHDD Centers
Crisis Stabilization Unit
Local state hospital moved to all forensic
State remodeled
vacant facility on state hospital campus
to meet licensing requirements
Hill Country MHDD Centers
Crisis Stabilization Unit
Provides up to 14 days
inpatient care for individuals
suffering from a mental health crisis
primarily from 19 county service area
One of 2 licensed Crisis Stabilization Units
in rural setting in state of Texas
Hill Country MHDD Centers
Crisis Stabilization Unit
Operational Funding through:
Transfer of State Hospital Trust Funds
Legislative Appropriation
Competitive Award of Crisis Funds
Total of $2,820,775 annually
Hill Country MHDD Centers
Crisis Stabilization Unit
Additional Start Up Funding:
Private Foundations and
Local Businesses and Individuals donated
$232,000 for furnishings and equipment
County provided road to facility
Hill Country MHDD Centers Center
Crisis Stabilization Unit
Opened May 15, 2009
Patients Served during 1st Year of Operation
434 Unique Patients 488 Admissions
Average Stay 10 Days
Occupancy Percentage 74%
Hill Country MHDD Centers
Crisis Stabilization Unit
Staffing
2 Psychiatrists
5 Registered Nurses
3 Licensed Vocational Nurses
18 Direct Care Staff
2 Psychiatric Rehabilitation Staff
3 Mental Health Attendants
4 Support Staff
Hill Country Community MHMR Center
Crisis Stabilization Unit
Primary Services Provided
Medication Services
Psychiatric Nursing
Psychiatric Rehabilitation
Social Work
Peer Support
Hill Country Community MHMR Center
Crisis Stabilization Unit
Discharge planning
begins at admission
Services geared to
facilitate recovery
and reduce recidivism
Hill Country Community MHMR Center
Crisis Stabilization Unit
Studies show that medication doesn’t
change molecular structure of brain –
experiences do
Dr. Eric Kandel (Nobel Prize Winner)
New Intellectual Framework for Psychology
Hill Country MHDD Centers
Crisis Stabilization Unit
When enter unit asked
“Do you know why you are here and
what do you want to accomplish?”
Hill Country MHDD Centers
Crisis Stabilization Unit
Work on learning
opportunities and experiences
Reinforce experiences and behaviors
Hill Country MHDD Centers
Crisis Stabilization Unit
Connect to
local mental health clinic
through telemedicine
during staffing
Build relationship
for aftercare
Hill Country MHDD Centers
Crisis Stabilization Unit
Focus on goal of individual
Treat whole life
to help people reach potential
Therapy, art, yoga, exercise, etc.
Hill Country MHDD Centers
Crisis Stabilization Unit
Psychiatric Rehabilitation Specialist
Holds 1 group a day and
meets individually with patients rest of day
Mental Health Workers
Hold 3 groups a day including a
Relaxation & Sleepy Time Tea Group
Hill Country MHDD Centers
Crisis Stabilization Unit
Utilize Peer Support(2 Groups per week)
Peers help individuals relate experiences
and let them know they are not alone
Hear what never hear in clinic setting
Clients gain desire to be Peer Facilitators
Hill Country MHDD Centers
Crisis Stabilization Unit Goals
Reduction in Recidivism
Inpatient & Outpatient Continuity of Care
Consistent recovery based,
holistic treatment philosophy
Consistent and timely follow-up with patients
in outpatient setting after discharge
Empowerment Through Engagement
We empower recovery through engagement. We take a
partnership approach. We strive to use the following recovery
principles in our engagement of individuals and staff;
• Hope
• Choice
• Is trauma Informed.
• Trust
• Respect
• Willingness
• Accountability
The Partnership Pie Concept Within
Inpatient Crisis Setting
% Contribution to Individual’s Recovery Process
20%
40 %
20 %
20 %
Clinician
Peers
Providers
Individual
Empowerment through Group & Individual
Services
• We use two differing modes of psychiatric
rehabilitation services;
• Groups to introduce and educate individuals
about our recovery approach. Topics covered
in these sessions are structured tp facilitate
the understanding of recovery.
• Individual services are used to personalize
treatment and build hope & trust.
Group Sessions (5) Objectives
• Help You Help You move beyond you current crisis
and back into your life
• Identify Personal Blocks to Recovery
• Teach Symptom Identification/ Monitoring
• Increase Self Esteem through Participation
• Empower their decision to choose recovery as a
way of life. ( paradigm shift; Victim-SurvivorThriver)
Individual Sessions Objectives
• Assess for impact of childhood trauma on sense of self and
initiate supportive cognitive therapy/ coping skills
• Assess for degree of ruminative thoughts and initiate
supportive cognitive therapy/coping skills
• Assess for degree of emotional pain (self report) and
initiate supportive cognitive therapy/coping skills
• Recommend seeking outpatient therapy to solidify gains.
Operational Definition of Recovery
“Recovery is a process of readjusting our attitudes, feelings,
perceptions, and beliefs about ourselves, others, and life in
general.” Within systems of care, recovery applies to both the
individual and the service providers.
L1) Individual Recovery
Begin to see themselves as a person not a diagnosis.
Start to develop hope and confidence in the value of their lives
Begin to engage in trusting, supportive, and respectful
interactions with others.
They begin to take risk, make objective decisions and connect.
Operational Definition Cont.
• L2) Systemic Recovery
• Transforms the concept of treatment from a hierarchical to a
relational paradigm without minimizing the roles of the
service providers.
• It reduces stress because providers stop fixing patients and
begin partnering with them.
• It improves the work environment through respect and
appreciations of every team members’ contribution, including
the individual served.
Approach To Services for Team
• We function as a whole
• Administration, crisis stabilization and out patient
services are one organization.
• We strive for Improvement
• We not only attend trainings( ROCI) but we
implement what we learn.
• We empower recovery; one interaction at a
time!!!
Picture of Our Recovery Board
Picture of Our Recovery Board
Questions??
References
• Spaniol, Koehler,& Hutchinson, (2009) The
Recovery Workbook, Boston , University Center
for Psychiatric Research. Boston University
Press, MA. (p11)
Session Evaluation
Please complete and return the
evaluation form to the classroom monitor
before leaving this session.
Thank you!