Patient as Teacher

Grant Advances Mental-Health Push to Partner with Patients

Patients are helping MCG psychology and psychiatry residents become better practitioners.

They’re doing that by making decisions about their care, a departure from traditionally being told what to do, says Dr. Alex Mabe, the MCG training director for the MCG-Veterans Affairs Medical Center of Augusta Psychology Residency Consortium.

“Patients and practitioners working together collaboratively results in better health care,” Dr. Mabe says.

President Bush’s 2003 New Freedom Commission on Mental Health [emphasizes] patient freedom and choice. By incorporating the model, we will involve patients and families so they are actively engaged in their own
health care.”

Psychology Residency Consortium residents and faculty will attend workshops, lectures and Behavioral Health Advisory Council meetings to learn principles and tools used in the commission’s Recovery Model of Mental Health as part of a three-year, $90,000 U.S. Health Resources and Services Administration grant.

This is the third time the consortium has received the grant. It primarily supports psychology training, but includes training for psychiatry residents as well to enhance interdisciplinary training, says Dr. Mabe.

MCG Certified Peer Specialist Gareth Fenley leads the Behavioral Health Advisory Council meetings. (See inset.) In the council, MCG patients and families participate alongside providers in reviewing and improving mental health policies and procedures.

“The council provides input from the consumer’s perspective and is an excellent opportunity for residents to get hands-on experience,” says Dr. Peter Buckley, chair of the Department of Psychiatry and Health Behavior.

“Residents not only attend the meetings, but talk to counselors about how to apply the model so that they can become better-educated in using it,” adds Dr. Nettie Albrecht, the VA Medical Center’s training director for the consortium.

Residents and faculty will share what they have learned with health care providers in underserved areas in the state. This is in keeping with an ongoing partnership with Project GREAT (Georgia Recovery-Based Educational Approach to Treatment) to help transform the state’s health care system using the model.

“Essentially, we’re training residents and faculty to be trainers,” Dr. Mabe says.

Since the consortium first received funding in 2002, it has trained residents and faculty in dealing with mental health needs of women in rural settings and in mental health care delivery to those with HIV/AIDS.

“The training grant is a tremendous boost to the department, and I am particularly pleased that this time, it has incorporated our strengths in the area of recovery,” Dr. Buckley says. “Each part of it is consistent with the development and growth of psychiatry and psychology residents and faculty.”

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“Going into the hospital, I thought I was an angel,” she recalls. “I thought the hospital was Heaven, and the other patients and staff were angels. I thought I met Jesus three times.”

She was diagnosed with bipolar 1 disorder, which causes extreme shifts in mood, energy and functioning. More than 10 million Americans suffer from the disorder, and the illness affects men and woman equally, according to the National Alliance on Mental Illness. Antipsychotic and mood-stabilizing medicines soon helped Ms. Fenley function more normally.

“It was terrifying for me, though, because in my mind, I had to come back down from Heaven to Earth, and I didn’t want to,” she says. “I had to realize that I was a mental patient now, and that was very difficult to accept.”

But with acceptance came the thrilling prospect of recovery. “After I was diagnosed, I met people who were talking about getting better and looking for mutual support,” she says. “That was something brand new in my life, and I was very enthusiastic about it.”
Her enthusiasm led to her involvement with group support meetings and with the National Alliance on Mental Illness.

“I wanted to get involved in mental health care because I was so excited about the recovery movement that I had experienced in the hospital,” Ms. Fenley says.

After earning a master ’s degree in social work from the University of Georgia, she completed the Georgia Certified Peer Specialist Project, which trains patients to become certified peer specialists in mental health care systems.

“The point of being a peer specialist is not just to demonstrate how to be sick, but also how to be well,” says Ms. Fenley. “The overall message is about recovery and utilizing the Recovery Model of Mental Health. The model helps in finding meaning and purpose in your life after the catastrophe of what you’ve been through because it allows you to be the expert on your illness and experiences.”

In 2006, she became a certified peer specialist in MCG’s Department of Psychiatry and Health Behavior to teach the model to patients. “My goal is to be a role model for patients and to help residents and faculty better understand what patients are experiencing,” says Ms. Fenley. “I’ve seen different psychiatrists, so I have a sense of what it’s like, and that’s something residents and faculty can’t get out of a book.”

Bringing Ms. Fenley on board is part of MCG’s partnership with Project GREAT (Georgia Recovery-Based Educational Approach to Treatment), a program centered on educating psychology and psychiatry faculty and residents about recovery-based knowledge, attitudes and skills.

“It’s a very significant program because it puts the consumer at the center of education and evaluation,” Ms. Fenley says. “It’s a real triumph for the Recovery Model to have someone like me at the very heart of a project to evaluate training and to train doctors for the future.”

-- Amy Connell