Wrap planning for 2014

Family Mental Health Wellness Planning Created by Family Outreach and Response Program Toronto Canada

www.familymentalhealthrecovery.org

Family Wellness Planning

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Challenges and Barriers for Families AdopDng a Wellness/Crisis Plan •

Lack of informaDon about advanced direcDves and mental health wellness planning – not part of our mental health culture yet

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Tend to move on aIer crisis and hope for the best or find it very difficult to talk about crisis planning once things are going well

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A medical approach only -­‐ leaves family feeling helpless to the illness

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Families have not had the opportunity to learn the principles of recovery and the role of family in recovery

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The system does not always work in accordance with the advanced direcDve

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Wellness/Crisis Planning works best within a family that embraces a recovery approach to mental illness support and care •

Families believe that recovery is possible. Families believe that their relaDve can live well in the absence or presence of symptoms

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Families understand that their role is to create an atmosphere where recovery can happen – hopeful, focuses on strengths and resilience

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Families know the importance of their relaDonship

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Families uphold the key recovery principle of SELF DETERMINATION

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Self DeterminaDon & Families • • • • • • • •

Families need to embrace the idea that their family member is in charge of their recovery journey (self-­‐determinaDon) Family members should support & pracDce self-­‐determinaDon even when you don’t agree with relaDve’s choices When we make decisions for relaDves – it can lead to learned helplessness Families try to uphold the principle of the dignity to risk and the right to fail Tolerate uncertainty and view relapses as an opportunity for learning LeZng go – avoid power struggles Families have their own recovery process – Taking care of your own wellness.

SomeDmes it is the family in crisis, not the relaDve. Even when your relaDve is unwell – pracDce self-­‐determinaDon through wellness and crisis planning

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Real Life case study Peter is 23 years old and lives with his family in downtown Toronto.

For the last 4 years, Peter has experienced periods of psychosis.

When Peter is unwell, he hears voices, becomes suspicious and withdraws into the basement.

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Real Life case study In the past, Peter would miss school for lengthy periods and he would completely isolate himself from his friends. He would feel hopeless and become extremely depressed.

His family would become distraught and eventually would go to the JusDce of the Peace to have a form 2 issued. The police would come and take their son to hospital under difficult circumstances.

When Peter would return home, he would have bi_er feelings towards his family. Peter and his family wanted to find another way to help each other.

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What did the family do?

Peter joined a Wellness Recovery AcDon Plan Group (WRAP).

Peter developed a wellness toolbox, a daily maintenance plan, understood his triggers and his early warning signs. He developed a plan for when things are not going well.

He also now had a crisis plan including advanced direcDves.

The family joined a recovery educaDon program where they could learn about recovery and how to implement the concept of self-­‐determinaDon within their family.

The family also learned about Family Wellness planning. They created a plan for the whole family to idenDfy what keeps they well, their family triggers and what they will do as a family when there is a crisis.

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How did this help recovery?

The whole family became more hopeful – understanding that recovery is possible and that they can work on wellness and now have a plan if there is a crisis.

The family can idenDfy its strengths and know the resources they can draw on.

Peter feels a greater sense of control over his own recovery process.

Family feels a lesser sense of control over Peter’s recovery but more control over their own recovery process

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How did this change things when Peter experienced psychosis?

Peter realized that he stopped doing many of the things he had enjoyed. He rejoined his badminton club and began working out 3 Dmes/week.

He also knew that prior to exam Dme – he began to feel anxious. He spoke to the school about accommodaDon and they let him take his exams in a separate space and more Dme.

When Peter started to think that other students were talking about him – he now knew this was a warning sign that he was becoming unwell. He now brought in his supports including his family and his psychiatrist.

When the wellness strategies were not working, Peter knew that he had to reduce sDmulaDon – he needed a break from his rouDne. He needed a quiet place – someDmes this was his bedroom, and other Dmes he wanted to go to the Gerstein Centre (a community support organizaDon).

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How did the family s response change?

BEFORE

Family always felt on guard They felt preoccupied with Peter. Peter’s moods and behaviours were always watched through mental health lens.

Other family needs were being ignored or neglected.

They had put their lives on hold.

The parents had become isolated. They had stopped inviDng friends over.

Family felt anxious and wanted to try to control Peter’s well-­‐being. For example, as soon as Peter seemed quiet, they would ask him if he was taking his medicaDon. The family was constantly asking him how he was doing.

AFTER

Family felt more hopeful. They got back to regular acDvity. All family members focused on what they need to stay well. They understood that their despair was adding to Peter s burden.

They starDng going back to synagogue together which they had not done in years but had always enjoyed together as a family.

They understood that Peter s experience of psychosis had triggers. They also learnt that Peter s early warning signs triggered them into a state of distress.

They now had awareness of their own distress and how to alleviate it through seeking out their own supports – a close friend and their support program.

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How did the family’s response change?

BEFORE

The family lived in fear of relapse. This was constantly causing power struggles in the family by the family trying to convince Peter what he needed to stay well.

The family relied more on the others to make Peter well.

AFTER

While the family sDll did not want a relapse, they felt a sense of knowing what to do for themselves and Peter.

Peter had given them specific direcDons about what to do if he was in crisis. They would get help for themselves and follow Peter s wishes in his advanced direcDve.

They trusted that Peter would ulDmately figure out what he needed to recover even if that meant making mistakes along the way.

They worked hard at leZng go and avoiding power struggles.

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For more informaDon on :

Family Mental Health Wellness Planning Contact the Family Outreach and Response Program at www.familymentalhealthrecovery.org

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