Person-centered planning in mental health : a transatlantic collaboration to tackle implementation barriers

Collaborative, person-centered approaches to care planning are increasingly recognized as instrumental in supporting attainment of personal recovery outcomes. Yet, while much is known about factors which support person-centered planning, successful implementation often remains an elusive goal. This paper reviews international efforts to promote Person-Centered Care Planning (PCCP) in the context of a randomized clinical trial in the United States and in the “Meaningful and Measurable” initiative, a collaborative action research project involving diverse provider organizations in Scotland. The authors review the history of international efforts to implement PCCP and offer preliminary evidence regarding its positive impact on both process outcomes (i.e., the nature of the primary therapeutic relationship and the service-user’s experience) and personal recovery outcomes (e.g., quality of life, community belonging, and valued roles). PCCP will be defined through description of key principles and practices as they relate to both relational aspects (i.e., shifts in stakeholder roles and conversations) and documentation/recording aspects (i.e., how person-centered relationships are captured in written or electronic records). Similarities and differences across the US and Scottish experience of person-centered care planning will be highlighted and a series of recommendations offered to further implementation of this essential recovery-oriented practice

Shared decision making within the context of recovery-oriented care

Purpose: This article will consider the role of shared decision-making as one component of recovery-oriented care. Design/Methodology/Approach: This article is conceptual and reviews literature relevant to recovery-oriented care, person-centered recovery planning, and shared decision-making. Findings: To the degree to which shared decision-making offers tools for sharing useful information about treatment options with service users and family members or other loved ones, it can be considered a valuable addition to the recovery-oriented armamentarium. It is important to emphasize, though, that recovery-oriented practice has a broader focus on the person’s overall life in the community and is not limited to formal treatments or other professionally-delivered interventions. Within the more holistic context of recovery, shared decision-making regarding such interventions is only one tool among many, which needs to be integrated within an overall person-centered recovery planning process. More emphasis is given within recovery-oriented care to activating and equipping persons for exercising self-care and for pursuing a life they have reason to value, and the nature of the relationships required to promote such processes will be identified. In describing the nature of these relationships, it will become evident that decision-making is only one of many processes that need to be shared between persons in recovery and those who accept responsibility for promoting and supporting that person’s recovery. Originality/Value: By viewing shared decision-making within the context of recovery, this article provides a framework that can assist in the implementation of shared decision-making in routine mental health care

Principles for Recovery-Orientation Inpatient Care

This chapter defines and distinguishes between two related concepts of “recovery” in relation to serious mental illnesses and the provision of “recovery-oriented care.” With this distinction in place, the chapter then outlines four key principles for applying the principles of recovery-oriented care to inpatient psychiatry. This first principle is that it is the person’s own recovery, reframing the aim of inpatient care to preparing the person to manage his or her condition and life following discharge. The second principle that follows from this is that Recovery-oriented care needs to be person/family-centered and culturally responsive to be relevant to the person’s life. Given the high prevalence of trauma among persons with mental illness and the potentially traumatic nature of hospitalization itself, the third principle is that inpatient staff should anticipate, and welcome, trauma survivors through the provision of a safe, respectful, and collaborative environment. Finally, principle four is that the interdisciplinary team needs to be expanded to include the person him or herself, his or her identified family members, and the community-based providers who have worked with the person in the past and/or will work with the person following discharge. In closing, the respective role of each of these team members within the context of recovery-oriented inpatient care is described