I have a very personal connection to wellness and recovery as it relates to mental illness. If you haven’t read my older blog on living with depression, you can read it here. Or if you want to watch my video blog on mental illness and stereotypes that emerged in the wake of Sandy Hook, you can watch that here.
Because I have a personal connection to wellness and recovery, I suppose it should come as no surprise that it is one of my favorite areas to provide training to housing case managers, and to help homeless serving agencies truly understand and embrace. This is a four-part blog that examines wellness and recovery in the process of supporting people in housing, and working to prevent homelessness from happening again to that person/family.[serialposts]
In Part Three of this blog series on Wellness and Recovery, I want to focus on how support workers can promote recovery with the clients that they are engaged with, while supporting them in housing and life stability.
There’s a catchy tune called Recovery by Frank Turner. While the song seems to focus more on addiction recovery (in my opinion) than mental health recovery, there is a stanza in the song that I love:
If you could just give me a sign, just a subtle little glimmer
Some suggestion that you’d have me if I could only make me better
Then I’d stand a little stronger, as I walk a little taller all the time.
Because I know you are a cynic but I think I can convince you
Yeah, ’cause broken people can get better if they really want to
Or at least that’s what I have to tell myself
If I’m hoping to survive.
How does a housing case manager support recovery? It all starts with exuding positivity as it relates to hope. Hope in what? That “broken people can get better”, as Mr. Turner would say.
Doing so requires that the support worker first understands that recovery is a process. There are no magical steps to follow. Each journey is going to be different. It is hope that connects each of the personal journeys together.
The support worker must always keep in mind that the personal journey is about supporting people, not trying to find a cure or absence of symptoms. This isn’t about forcing people to go to a particular type of treatment or take a particular medicine. This is about empowering choice and understanding to live life to the fullest while having a mental illness. In the context of a housing support worker, this occurs while promoting housing stability.
In the delivery of Intensive Case Management in housing, support workers are not expected to be counselors, therapists, psychologists, nurses, psychiatrists, concurrent disorders therapist or other like professional. The support worker is expected to have expertise in how to broker and advocate for effective service access based upon the articulated needs of the client they are working with. When it comes to supporting recovery, the support worker must be knowledgeable of the full range of community resources related to mental health and wellness – from how and when to access different types of peer groups to when and how to engage with mental health professionals at low or no cost.
It can be said that the housing support worker has nine essential tasks in promoting recovery with those clients that have experienced compromised mental wellness. They are:
- Educate – the support worker should be knowledgeable of formal and informal sources of information that can help them and their clients understand mental illness and recovery resources. The support worker should not pretend that they are a mental health professional when they are not one. Educating oneself on mental illness and recovery does not mean the support worker should play “armchair psychiatrist”.
- Address stigma – the support worker should work with the client to identify the negative stereotypes and experiences that may interfere with accessing and maintaining housing, as well as in being a barrier to accessing a full range of community resources (mental health and other resources). Addressing stigma also requires coming up with a plan on how to address those potential interferences and barriers, and this should be led by the client with the support of the worker.
- Connect to clinical care – the support worker should be well-positioned to help the client access a mental health team with all of the necessary disciplines that can support the individual’s preferred pathway to recovery. Brokering and advocacy is again likely necessary. Pulling together case conferences can also be very useful to get the range of resources on the same page. The individual client determines the type, frequency, duration and intensity of supports they want to receive through clinical supports, as opposed to the support worker dictating what they expect by way of connection to clinical care.
- Help enhance friend and family supports – when the individual wants additional supports to relate to their friends and family as it pertains to their mental wellness, the support worker can play an important role in helping to transfer knowledge and set up communications. It is important that the support worker, however, first explore whether there are any legal impediments to communication with family or friends. Furthermore, the support work should be supporting the individual in making contact with friends and family, not making the contact on her/her behalf.
- Connect to peer supports – the support worker can help expand knowledge of the groups and resources that exist within the community amongst others that have lived experience of having a mental health issue, and possibly compromised housing stability in the past as well. Types of peer supports vary widely across and within communities. Therefore, the support worker needs to have knowledge on the wide-range of peer activities that may be of interest to their client…from peer facilitated discussions and strategies related to a specific type of illness, to more advocacy oriented and educating types of peer groups (like this one, The Dream Team, which is one of my all-time favorites for the degree of impact they have on helping people understand housing and mental health issues).
- Empower the client to make decisions – each individual supported in housing and working on mental health recovery can work towards making their own informed decisions. Not only do clients need to be empowered by their support worker to make decisions, then, but they also need to be empowered and allowed to make mistakes that they can learn from.
- Be knowledgeable and access community supports – beyond just mental health supports, because recovery is holistic the support worker must have working knowledge of a wide-range of community supports. A focus just on mental health services is too narrow of a scope of activity for the support worker. Individuals will need more than just mental health supports to have a rich, well-rounded experience of being housed.
- Help clients engage with meaningful daily activities – the support worker needs to work intentionally with the person they are supporting to identify interests that bring personal fulfillment and happiness, counter-act boredom, and which occupy a good amount of time each day and each week. Meaningful daily activities encompass all possible things that provide fulfillment intellectually, spiritually, emotionally, socio-recreationally, etc.
- Assist with residential stability – as a housing support worker that is also providing assistance with recovery, support workers start with helping people access and maintaining housing. This includes helping people identify relationships that may impact their housing, ensuring basic needs are taken care of, promoting safety, and, helping clients stay connected with mental health and other community supports throughout the housing and support process.
Providing these supports well should translate in the individual being supported feeling that the support worker is demonstrating and verbally conveying that they believe in them and are hopeful for the future along with them. Providing these supports well should translate in the client feeling that they are being heard and understood. Providing these supports well should translate in the client feeling empowered. And, providing these supports well should translate in the client feeling their support worker is expressing empathy, but not sympathy, while promoting recovery.
There are several resources that workers can put into their “toolbox” to help encourage, promote and support recovery. Some of these include: Wellness Recovery Action Plans; DREEM; and, Recovery Star. Each has a slightly different orientation and history, and depending on the specific needs of a specific client, each may be worthy of application in your work.[serialposts]