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ACHIEVING
RECOVERY
Mental
Health Services
Mental Health Professionals
Choosing a Mental Health Professionals
Working with Your Mental Health Professional
We are now learning more about what works
in treating mental illness. We are also learning that traditional treatment
is only one aspect of recovery. A recovery plan should include:
- Traditional mental health services
- Medication when appropriate
- Involvement in self-help or other peer
directed programs
- Vocational or educational services
- Social services such as entitlements (SSI
or SSDI), housing
- Adequate medical care
- Family support and family involvement
- Opportunities for spiritual development
MENTAL HEALTH SERVICES
The following definitions can help you
understand more about the kinds of traditional mental health services
that you can include in your recovery plan.
If you are receiving outpatient services,
you will go to a community mental health center or to a professional who
is in private practice. The private practice provider may have an individual
practice, or be part of a group of providers. Some providers are associated
with hospitals.
Community mental health centers usually
offer a wider range of services than individual providers do. If your
needs are extensive, a community mental health center may be a better
choice for you. There are many kinds of mental health services and it
is helpful to understand what each kind of service is supposed to accomplish.
If you have a question about a certain type of service, talk to your therapist,
because not every program provides all of these services.
- Outpatient Counseling is provided
in an office or other community setting and usually lasts under one
hour. Outpatient counseling can include one-to one therapy, where you
will talk to a counselor individually; group therapy, where you talk
about problems with a group of people; and family therapy, where you
and family members who are important to you, talk to a counselor.
- Intensive Case Management - Some
people have multiple needs, and require a variety of special services.
Intensive Case Management services are community-based services, provided
to people who need extra support to live in the community. A case manager
will coordinate these services or connect you to other services and
agencies.
- Home-based Treatment Services are
therapeutic services provided in a person’s home, when the home environment
is an important aspect of treatment.
- Medication Management is an ongoing
evaluation of the effectiveness of prescribed medications and is done
by a doctor or other trained and licensed professional.
- Partial Hospitalization (day hospital)
- This intensive program provides
all the treatment services of a psychiatric hospital, but the patients
go home each evening.
- Emergency/Crisis Services These
services are provided for mental health emergencies. They are available
24-hour-per-day and can be provided in a hospital emergency room, or
by a mobile crisis team.
- Therapeutic Group Home or Community
Residence - Therapeutic Group
Homes are structured living situations for people who do not require
inpatient hospital services, but do require 24-hour therapeutic services.
- Hospital treatment - Patients
receive comprehensive psychiatric treatment in a hospital setting, 24
hours a day. These programs are appropriate for people who also need
hospital services.
- Acute Treatment Unit –
This facility provides comprehensive
psychiatric treatment in a structured 24 hour a day setting. This level
of care is appropriate for people who need 24 hour structured services,
but do not require hospital services.
- Consumer-run or peer programs – These
programs are run by people who themselves are recovering from mental
illness. They include drop-in centers, clubhouses and job clubs. They
may be exclusively run by consumers or in partnership with professional
programs. They offer social opportunities, support groups, peer counseling
and recreational activities. Until recently, these programs and peer
counseling (see below) would only have been included in a discussion
about alternatives to treatment. Today, they are gaining respect among
professionals and seen as good resources for people in recovery. Many
mental health professionals refer consumers to these kinds of programs
and consumers report positive results.
- Community Support Programs
are structure programs that provide mental health services and daily
living skills training. Daily living skills training includes budgeting,
hygiene, social and recreational skills, housekeeping and other skills.
It’s important to advocate for your needs,
so you should always ask questions when a professional recommends a certain
kind of mental health treatment. Questions you should ask include:
- How long do you expect that I will be
in this level of treatment?
- What are the advantages and disadvantages
of this particular service or program?
- How will this kind of treatment help with
my particular problem?
- Will my insurance or Medicaid cover the
cost?
If your are uneasy about the answers you
get, or still have questions, get a second opinion.
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MENTAL HEALTH PROFESSIONALS
The following professionals may be involved
in your evaluation, service planning and care. Each has a specific specialty,
but is also part of the treatment team. The duties and responsibilities
will vary in different agencies:
- Psychiatrists are physicians (M.D.
OR D.O.) with specific training in psychiatry. A psychiatrist will evaluate,
make the diagnosis, and prescribe medications. Sometimes, a psychiatrist
will give other kinds of treatment as well. They work with the treatment
team to plan for care in the hospital and after discharge. Some psychiatrists
also provide psychotherapy (counseling), either individually or with
groups. The only other type of professional who can prescribe medication
is a nurse practitioner.
- Psychologists
have special training to evaluate and treat emotional disorders. In
most states, a person who is licensed to practice clinical psychology
has a Ph.D. Psychologists do psychological testing to help them make
a diagnosis. They may also provide individual, group and family therapy.
Some have other responsibilities similar to those described for psychiatric
nurses and social workers.
- Psychiatric nurses
have specific training in psychiatry. They generally have major responsibility
for direct care of patients in a hospital setting, day treatment programs,
and community mental health center clinics. They may also provide individual,
group and family counseling.
- Social workers
work with the individual, family and community to coordinate care in
all areas of a person’s life. Some people have extensive needs and may
be involved with numerous systems (i.e. mental health, the court system,
vocational services, medical services, etc.) Care coordination is important
to getting good care. Social Workers may also offer individual, family
or group counseling.
- Counselors have special training
in counseling principles to help their clients find solutions to problems.
Licensed Professional Counselors (LPC’s) and Licensed Marriage and Family
Therapists (LMFT’s) are trained to work with families and family issues.
Both LPC’s and LMFT’s have master’s degrees.
- Case managers
coordinate care and services in the community. They help their clients
get services from a variety of community agencies. They generally work
for a Community Mental Health Center or an agency under contract to
Community Mental Health.
- Indigenous healers are individuals
who know about traditional healing practices. Many people have found
practices such as curanderismo and Native American healing practices
to be extremely helpful.
- Peer Counselors – are people
who are recovering from mental illness and have had training in basic
counseling skills. They can provide support from the perspective of
someone who has experienced mental illness or substance abuse first
hand.
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CHOOSING A MENTAL HEALTH PROFESSIONAL
- Ask the professional for his or her
background and experience.
- Get a second opinion if you feel uncomfortable
about the diagnosis or treatment that is prescribed.
- It is just as important to feel comfortable
with your therapist as it is to have a therapist with good credentials.
If you don’t relate well to the therapist, find another one.
In the first meeting with your professional,
there are also some questions you can ask to get an idea of her understanding
of recovery and mental illness.
- "How long have you been counseling people
with problems like mine?"
- ‘What can you contribute to my recovery?"
- "How often are you willing to meet with
me?"
- "Are you willing to work with other service
providers along with my family or friends of my choosing as a partner?
- "Do you have any concerns about my problems?"
- "Do you mind that I want to be involved
in all the planning and decision-making about my treatment?
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WORKING WITH YOUR MENTAL HEALTH PROFESSIONAL
It is important to be patient and work
with your mental health professional. Sometimes it may take weeks or even
months before you see any changes. Medications that are used to treat
mental health problems take time to work. Therapy that requires a person
to talk about their problems also takes time.
While it is important for you to be patient,
it is also important for you to be open and honest about what you think
is best for you. The mental health professional has special training,
but the bottom line is that you know what’s best for you. If a certain
medication or other treatment is not working, be assertive and let the
mental health professional know.
Service Planning
Once you have been evaluated by your mental
health professional, you and your therapist or treatment team will develop
a service plan. This plan will identify goals you want to accomplish in
treatment and the specific kinds of therapy that will be used to help
you reach those goals. In a partnership model, you need to be willing
to identify those goals. The service plan shouldn’t just talk about your
problems, but should also talk about your strengths and strong points,
and how you can use them to reach your goals.
Evaluating Your Care
After you’ve been in therapy for a while,
it is important to evaluate the experience. The reality is that some therapists
work better with some individuals. It is just as important to have a good
personality match with your therapist as it is to have one with expertise
in a certain subject. Consumers and the Colorado Mental Health Association
suggest you ask yourself the following questions:
- Do I feel the mental health professional
is genuinely concerned about me?
- Does my mental health professional work
with me when I set goals and help me decide whether the goals are workable
and realistic?
- Does he keep his appointments?
- Does he concentrate on my problems or
does he spend time talking about his own feelings and problems?
- Do I feel comfortable raising any issues
with him?
- Is he available when I am in a crisis?
- Am I using the mental health professional
appropriately and getting the most out of therapy?
- Does she listen to me if I disagree with
her? Do I feel good about these interactions?
- Is she helping me to solve problems
for myself?
- Does she encourage me to try new things
or does she discourage me because I may have a relapse?
If you answered more "no’s than "yes’s"
it may be time for you to find another therapist.
The best treatment experience happens when
you and the professional work together. If you feel like the professional
is ignoring your needs or your opinions, find another professional. It
may take one or two tries before you find a good match.
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