Project GREAT
(Georgia Recovery-Based Educational Approach to Treatment)
Project GREAT - Bringing Consumerism to Mental Health Education and Services
A pioneering initiative at the Medical College of Georgia's Department of Psychiatry and Health Behavior is changing how mental health care professionals are trained, leading to a fundamental change in mental health practice in the hospital, outpatient clinic, and community settings.
 The project is funded by the Georgia Department of Human Resources, Division of Mental Health, Developmental Disabilities, and Addictive Diseases to evaluate and amplify the impact of Georgia's Certified Peer Specialist (CPS) program. The division sponsors this internationally recognized program that created the "Georgia model" of training individuals recovering with mental illness to provide services to peers including role modeling, support, and education.
Project GREAT (Georgia Recovery-Based Educational Approach to Treatment) is piloting an effort to assist in system transformation to a Recovery model of care through teaching and dissemination. The Recovery approach, which was endorsed in 2003 by President Bush's New Freedom Commission on Mental Health, advocates inclusion of consumers and family members at every level of a person-centered system. |
 Recovery-oriented care requires a fundamentally different role for a person with a mental illness or disability. It transcends the exclusive focus on symptom reduction that marks the traditional medical model. Recovery sees that the course of life with mental illness can be an empowered one filled with hope, while at the same time being a non-linear process or journey that includes setbacks and challenges. People living with mental illness have strengths, goals, and dreams to be honored with holistic care that provides for well-being of the total person. Practitioners also consider the family integral to care (as defined by the consumer's choice based on biological, legal, or emotional ties) and draw upon surrounding resources in the environment.
Project GREAT is designed to immerse psychology and psychiatry faculty and residents in this new vision. To implement the plan, Medical College of Georgia is involving people who receive mental health services and their family members in advisory, teaching, and care-giving roles.
|
|
Project GREAT Core Team and Curriculum
|
Department Chairman Peter F. Buckley, MD, initiated Project GREAT. Dr. Buckley works with P. Alex Mabe, PhD, Gareth Fenley, CPS, and Margaret Tuck, MSN, APRN, BC as the core project team. This group has developed a workshop curriculum that incorporates innovative role plays, live and video presentations, and interactive discussions - all created and presented by practitioners and consumers working together. Consumers who have experienced disabling symptoms of the mental illnesses considered most severe address the audience as teachers and role models.
|
Peter F. Buckley, MD
Chairman, Department of Psychiatry
|
|
P. Alex Mabe, PhD
Director, Psychology Residency Training |
|
Margaret Tuck, MSN
Instructor, Psychiatric Mental Health Nursing
|
|
Gareth Fenley, CPS
Peer Support Specialist
Project GREAT |
|
Denise Noseworthy , CPS
Peer Support Specialist
Project GREAT |
An in-depth didactic presentation by a psychiatrist instructs participants in the specific components of the Recovery model, based on a comprehensive literature review and the recent consensus-building work of the Substance Abuse and Mental Health Services Administration (SAMHSA). Learners receive new tools toput Recovery concepts immediately into practice, including pre-assessment, intake interview, and follow-up appointment documents that guide the clinician to focus on strengths, self-directed treatment planning, a systemic orientation, and other aspects of the model.
|
|
Certified Peer Specialist on Medical College Staff
In concert with the workshops, faculty and resident psychiatrists and psychologists at MCG have the opportunity to refer their patients to a Certified Peer Specialist (Gareth Fenley) for innovative services. Ms. Fenley meets one-on-one and in groups with those who wish to experience peer support with no session fee charged. The services are tailored to the person-centered treatment plans created in the collaborative approach fostered by Project GREAT. Patients and those they choose to define as family members (who will be intimately involved in their care) work as partners with clinicians to select holistic goals for treatment, rather than practitioners defining the goals for each patient centering solely on the reduction of psychiatric symptoms. An article on Ms. Fenley's work titled, "Patient as Teacher" was published in MCG Today in Spring 2008. Ms. Fenley has also created the following educational materials for consumers and practitioners available in PDF format:
Certified Peer Specialists do not treat symptoms. Their role is to support the multidisciplinary treatment team through role modeling and teaching about Recovery in severe mental illness. Recovery, in the context of this work, means the process of gaining control over one's life after a psychiatric diagnosis and diminishing the losses usually associated with such a diagnosis. A CPS focuses on dispelling the disabling power of stigma and a negative self-image that often becomes part of receiving repeated stigmatized messages from others. The cornerstone of his or her work is to instill hope, which can be conceived as the belief that one has both the ability and the opportunity to engage in the recovery process. A CPS has a hopeful outlook toward his or her own life, while also possessing an intimate understanding of what it is like to lack hope during difficult periods in a Recovery journey. CPS's also understand the special impact of a hope that is derived from first-person experience and sharing this experience with peers.
Georgia's CPS program was the first ever to be rewarded with Medicaid reimbursement. Kathryn Power, Director of the U.S. Center for Mental Health Services (CMHS), declared the Georgia model to be a national best practice. As noted by Thomas Bornemann, EdD, Director of the Mental Health Program at the Carter Center, Georgia has become renowned worldwide for its accomplishments in this area. Peer specialists from Canada and 13 U.S. states have graduated from the Georgia trainings. And, at home, the number of Georgians who have passed the challenging oral and written certification exams now exceeds 400.
|
|
Medical College of Georgia's Commitment
Mental health is the latest in a series of medical practice fields to benefit from MCG's commitment to Patient-and Family-Centered Care. The achievements of the organization in clinical work were recently featured in a documentary episode of the PBS series "Remaking American Medicine." For MCG, this approach is a natural fulfillment of the health system mission: To Care, To Serve, To Educate, To Discover. Project GREAT defines advocacy as a key element of the Recovery model. The MCG CPS advocates for consumers of mental health services in the clinic, the hospital, and the community at large. Ms. Fenley serves in a staff support role for MCG's Behavioral Health Advisory Council. In the Council, MCG patients and families participate alongside providers in reviewing and improving mental health policies and procedures.
Initially, the educational interventions of Project GREAT were limited to the MCG campus, with a control group studied at a partner university. Outcomes were measured scientifically using questionnaire scales. The curriculum is now being disseminated to mental health agencies, hospitals, and medical schools throughout Georgia and North America.
Project GREAT is made possible by the support of Georgia's Division of Mental Health, Developmental Disabilities, and Addictive Diseases within the Department of Human Resources, with special assistance by the Carter Center in Atlanta. Noted researchers and Recovery leaders around the country have contributed to the project, particularly Larry Davidson, PhD (Yale University), and Larry Fricks (Appalachian Consulting Group).
Forthcoming articles about Project GREAT will be published by Academic Psychiatry, Psychiatric Clinics of North America, Clinical Schizophrenia & Related Psychoses, and other esteemed professional journals. Presentations on Project GREAT (see links below) were made at the Third International Conference on Patient-and Family-Centered Care in Seattle, Washington in July 2007, as well as the US Psychiatric Rehabilitation Association (USPRA) convention in metro Chicago, Illinois in June 2008. The Project GREAT team is confident that these initial articles and presentations are the start of a burgeoning literature that demonstrates the effectiveness and utility of a Recovery-based educational intervention.
|
|
|
| |
|
