Margaret Swarbrick

A wellness approach.

There is a significant paradigm in the field of public mental health practice that encompasses a wellness approach. This paper will present a wellness approach by comparing it to the traditional medical model. A personal application of the wellness approach will be discussed.

Wellness coaching: a new role for peers.

TOPIC This brief report presents the conceptual framework for the development of the peer wellness coach role including the definition of a new job role for peer providers and an overview of the knowledge and skills required for this role. PURPOSE People with serious mental illnesses are at greater risk of living with untreated chronic medical conditions that severely impact their quality of life and result in premature mortality. Wellness coaching represents an intervention that can help individuals persist in the pursuit of individually chosen health and wellness goals. SOURCES USED Literature and our personal and professional experiences developing this role and training are presented. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Wellness coaching seems an ideal role for peers in recovery that has potential to address health and wellness issues facing persons living with mental illnesses who are at high risk of comorbid medical conditions.

Psychiatric Nursing Practice & the Recovery Model of Care

This article provides an overview of the national actions by key groups on recovery from psychiatric disability and how a shift is needed to transform health care service delivery in mental health. Fundamental components of recovery are outlined, and examples are provided from the literature in nursing and related disciplines that reflect similar research and evidence-based practice interventions. It is recommended that professional nursing include consumers as active participants in the design of evidence-based practices in all settings.

Sharing the Message of Hope, Wellness, and Recovery with Consumers Psychiatric Hospitals

The concept of wellness has been emerging in the recovery field as an exciting new paradigm for understanding health and encompasses the following dimensions: physical, social, emotional, intellectual, occupational, and spiritual (Swarbrick, 1997). Efforts are underway in New Jersey to incorporate this concept into the programming of consumer-run mental health services (e.g., self-help centers) and there has been some interest on the part of more traditional rehabilitation settings to incorporate this philosophy into their treatment practices as well. A statewide, consumer-run project was developed whereby consumers of mental health services go back into state psychiatric facilities in New Jersey as consultants, teaching wellness and recovery principles and strategies to current patients and staff. This article will describe how a small cadre of consumers (ex-patients) gained access to training opportunities and enough support to present a curriculum in basic principles and strategies of wellness and recovery at state hospitals. The challenges in bringing recovery-oriented thinking into settings that historically have been resistant to change will be shared as well as the success of the Recovery Network Project.

Integrated care: wellness-oriented peer approaches: a key ingredient for integrated care.

People with lived experience of mental illness have become leaders of an influential movement to help the mental health system embrace the notion of whole health and wellness in the areas of advocacy, policy, and care delivery. Wellness-oriented peer approaches delivered by peer-support whole-health specialists and wellness coaches can play an important role in integrated care models. This column examines the wellness definitions and peer models and some specific benefits and tensions between the peer-oriented wellness approach and the medical model. These models can work in unison to improve health and wellness among people with mental and substance use disorders.

Consumer-Operated Self-Help Centers

Consumer-operated services (COS) are viewed as a legitimate alternative for mental health consumers living in the community. This article provides an overview of, outlines a consumer-operated self-help center model that has evolved in New Jersey, and illustrates how it has become a viable component of the mental health system. The goal is to inspire psychiatric rehabilitation practitioners to create COS alternatives as part of their state-run services transformation efforts.

A Wellness and Recovery Model for State Psychiatric Hospitals

There has been a paradigm shift in the field ofmental health toward recovery and wellness. This shift has been influenced by scientific research and first-person accounts of individuals living with serious mental illnesses who have been able to learn to manage their illnesses and return to the community and become a contributing member of their living, learning, and working environments. State hospital settings are designed to assist a person experiencing a significant psychiatric episode that impacts the individual’s ability to assume personal responsibility for managing the illness and daily living tasks. The goal of treatment is to help the person experiencing a significant psychiatric episode (crisis) to restore physical and emotional equilibrium (wellness) and to help them to efficiently establish plans for discharge to continue their recovery in the least restrictive setting. In February 2006, The Division of Mental Health Services issued a transformation statement that required state hospital settings to provide an environment and treatment interventions that promotewellness and recovery in addition to crisis stabilization. The following will outline a framework for wellness and recovery as it applies to a state psychiatric hospital setting.

Health risks and changes in self-efficacy following community health screening of adults with serious mental illnesses.

Physical health screenings were conducted by researchers and peer wellness specialists for adults attending publicly-funded community mental health programs. A total of 457 adults with serious mental illnesses attended health fairs in 4 U.S. states and were screened for 8 common medical co-morbidities and health risk factors. Also assessed were self-reported health competencies, medical conditions, and health service utilization. Compared to non-institutionalized U.S. adults, markedly higher proportions screened positive for obesity (60%), hypertension (32%), diabetes (14%), smoking (44%), nicotine dependence (62%), alcohol abuse (17%), drug abuse (11%), and coronary heart disease (10%). A lower proportion screened positive for hyperlipidemia (7%). Multivariable random regression analysis found significant pre- to post-screening increases in participants’ self-rated abilities for health practices, competence for health maintenance, and health locus of control. Screening identified 82 instances of undiagnosed diabetes, hypertension or hyperlipidemia, and 76 instances where these disorders were treated but uncontrolled. These results are discussed in the context of how this global public health approach holds promise for furthering the goal of integrating health and mental health care.

Historical Perspective—From Institution to Community

Over the course of history, people living with mental illness who have the experience of being confined in institutional settings have made significant impacts in their efforts to reform and transform the mental health service delivery system. This article will examine individual, social, and political forces influencing a movement of interested stakeholders, once confined, who became inspired to create a peer-operated service model. This model will be described, including types of the peer-delivered services. An overview of peer-operated services research will be discussed briefly, including the development of two fidelity instruments. This article will provide the historical context in regards to how the peer-operated service model evolved and why the peer-operated service model should be considered an important resource for mental health systems transformation.

Impact of peer delivered wellness coaching.

OBJECTIVE People receiving publicly funded behavioral health services for severe mental disorders have shorter lifespans and significantly impaired health-related quality of life compared to the general population. The aim of this article was to explore how peer wellness coaching (PWC), a manualized approach to pursue specific physical wellness goals, impacted goal attainment and overall health related quality of life. METHOD Deidentified archival program evaluation data were examined to explore whether peer delivered wellness coaching had an impact on 33 service recipients with regard to goal attainment and health-related quality of life. Participants were served by 1 of 12 wellness coach trainees from a transformation transfer initiative grant who had been trained in the manualized approach. RESULTS Coaching participants and their coaches reported significant progress toward the attainment of individually chosen goals, 2 to 4 weeks after establishing their goals. After 8 to 10 weeks of peer delivered wellness coaching, improvements were evident in the self-report of physical health, general health, and perceived health. These improvements were sustained 90 days later. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE PWC is potentially a promising practice for helping people choose and pursue individual goals and facilitating positive health and wellness changes. Rigorous controlled research with larger samples is needed to evaluate the benefits of peer delivered wellness coaching. (PsycINFO Database Record