RCCS Tidbit of the Month: Suicide Prevention

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The RCCS Tidbit of the Month is part of Telecare's Recovery-Centered Clinical System curriculum to reinforce a culture of recovery in mental health service programs. For more information, click here.



September is National Suicide Prevention Awareness Month. Each year, more than 41,000 individuals die by suicide, leaving behind their friends and family members to navigate the tragedy of loss. In many cases, friends and families affected by a suicide loss (often called “suicide loss survivors”) are left in the dark. Too often the feelings of shame and stigma prevent them from talking openly. Currently, suicide ranks as the second leading cause of death for ages 10-24.

What Leads to Suicide?

 Click the image above for a list of suicide prevention resources and support.

Click the image above for a list of suicide prevention resources and support.

There’s no single cause for suicide. Suicide most often occurs when stressors and health issues converge to create an experience of hopelessness and despair. Depression is the most common condition associated with suicide, and it is often undiagnosed or untreated. Conditions like depression, anxiety, and substance problems, especially when unaddressed, increase risk for suicide. Yet it’s important to note that most people who actively manage their mental health conditions go on to lie meaningful lives.

Suicide Warning Signs

Something to look out for when concerned that a person may be suicidal is a change in behavior or the presence of entirely new behaviors. This is of sharpest concern if the new or changed behavior is related to a painful event, loss, or change. Most people who die by suicide exhibit one or more warning signs, either through what they say or what they do. Warning signs can include health factors as well as environmental and historical factors. Warning signs can include:

  • Threats or comments about killing themselves, also known as suicidal ideation, can begin with seemingly harmless thoughts like, “I wish I wasn’t here” but can become more overt and dangerous

  • Increased alcohol and drug use

  • Social withdrawal from friends, family and the community

  • Talking, writing, or thinking about death

  • Access to weapons and/or other lethal means

  • Prolonged stress, such as harassment, bullying, relationship problems, or unemployment

  • Previous suicide attempts

  • Family history of suicide

  • Childhood abuse, neglect, or trauma

Protective Factors

There is good news. There are factors that provide individuals protection and strength.

HOPE: In the RCCS, we know that our efforts to increase one’s hope about the future is an important protective factor. RCCS Conversations can re-awaken individuals to dream again and develop a meaningful recovery plan.

RESILIENCE: The clients an members our programs serve are strong and resilient people. Within the RCCS, we can have guided conversations that help reveal these strengths and assist our clients/members in using their strengths in the recovery. Conversations help clients/members tell their story as a “hero” and survivor rather than a sufferer.

CONNECTIONS: The important connections people have in their lives are protective. Connections can include:

  • Important people in one’s life (family and friends)

  • Connections to pets and animals

  • Connections to a community of people

  • One’s spiritual connections

Finally, we can engage with the individuals we serve to complete full and timely risk assessments to identify risk and planned preventative interventions. For more insight into the value of connections, click here.

More Information:

As a team, view and discuss Kevin Hines’ story. Kevin attempted suicide by jumping off the Golden Gate Bridge. Kevin survived and is using his story to help others. Watch his story from a suicide prevention series by Los Angeles Department of Mental Health and Power 106:

 
 

Read More About the RCCS

From Member to Employee: Christina’s Journey Through Telecare's WIT Program

 Christina Roberts, driver at Telecare steps orange county and former WIT member

Christina Roberts, driver at Telecare steps orange county and former WIT member

September is National Recovery month. It is a time dedicated toward educating Americans that substance use treatment and mental health services can enable those with symptoms of a mental health diagnosis and/or substance use to live healthy, rewarding lives.

At Telecare, we not only treat those with co-occurring disorders, but also take pride in employing former clients who have lived experienced and continue in their recovery journey. Christina Roberts, a driver at Telecare STEPS Orange County, shares her inspiring example. By harnessing life’s setbacks, Christina has shown that it’s possible to navigate to destinations the previously may have seemed impossible.

“When I come into work now, I'm giving back. I can relate. I had a drug and alcohol problem. I now have two years clean. I struggled with homelessness, drug addiction, and mental illness. I hope that I can just take one member and lead them in the right direction and help change their life like it's changed my life,” said Christina.

 
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After getting into trouble and ending up in front of a judge for sentencing, Roberts was given two choices: serve jail time or participate in the Orange County Collaborative Court (WIT) program. WIT, which stands for “Whatever It Takes,” began in 2012 as a collaboration between Telecare and the mental health courts of Orange County. It’s a four-phase, voluntary program where members who have a demonstrated history of mental illness are put on conditional release from prison.

While in WIT, they are required to be sober, transition up to new phases, and ultimately graduate from the program. The goal is to equip those in recovery with new skills and resources—things they might not receive through incarceration.

“To be honest, I had a relapse. It was too much. It was overwhelming. I was scared. I didn't want to follow directions. I wouldn't submit to the program,” she admitted. “I got arrested. When I got arrested, I had to serve some time, but then Telecare took me back. They gave me a second chance. WIT stands for ‘Whatever It Takes,’ and they stood by what that means.”

Christina then fully embraced WIT, the support groups, and most importantly, her peers. Actively participating in the programs is also what helped her find her true calling—wanting to go from Telecare member to Telecare employee.

“When I came back from my relapse, I told my probation officer and the staff at Telecare that I was going to work for Telecare. I didn't know how it was going to happen. A few months later, I spoke at an FSP luncheon and I got three job offers,” Christina said.

She chose to accept the offer as a driver at STEPS and hasn't looked back.

Christina credits Telecare for being the driving force in her personal recovery—a force that stood with her and believed in her when no one else did.

“Telecare saved my life,” said Christina. “It provided stability, and it's shown me how to become a productive member of society. It taught me that I can make it in this world and have a mental illness.”

Leading from the Heart — and Personal Experience

Raksmey Castleman, Ph.D., is administrator of Telecare Early Intervention and Recovery Services and Jeremy House Crisis Residential Services, both in San Joaquin County. Born and raised in a refugee camp in Thailand for survivors of the Cambodian genocide, she is passionate about serving the Southeast Asian community, where trauma and PTSD are common experiences, but engagement in mental health services is low. Raksmey's experiences have inspired a life -- and career -- of passionate service, and incredible impact.

Telecare is honored to have Raksmey as part of our diverse team of dedicated, creative, compassionate, and effective staff and leaders.

 Raskmey Castleman, Ph.D., Telecare Program Administrator

Raskmey Castleman, Ph.D., Telecare Program Administrator


As mental health service providers, we can get lost in the jungle trying to navigate complex systems and symptoms to deliver care to our most vulnerable populations. Sometimes it’s hard to harness motivation to keep pace while at the same time maintaining a semblance of self-care, but Raksmey Castleman, Administrator of or Telecare’s Jeremy House and TEIR in Stockton, California has some advice: "We don't stop. If we hit a roadblock we will make a detour, and we will create a path to where we find whatever we can, any resources, to make sure that individuals that we serve are able to meet their needs, if they're willing."

Moving Through the Jungle

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For nine years, the jungle was Raksmey's reality. In the 1970s, Raksmey was born and raised in the Sok San Tai camp in Thailand along with 60,000 survivors of the Cambodian genocide. Raksmey’s father was the camp doctor and worked with the United Nations High Commissioner for Refugees (UNCHR) and the International Red Cross to advocate for health care services and support for refugees. Her mother was a midwife and a teacher.

Providers and prescribers kept on telling us, ‘stress is a normal part of life, go outside, go shopping,’ but they didn’t understand the historical context or the implications of how history can impact a community. For many Southeast Asian communities and especially the Cambodian communities, there are no words to describe PTSD.

"I remember going along with my dad from one hut to the next to provide treatment or to assess the villagers. That was a part of my life. I really liked being part of the community and learning from my father at a young age of the importance of making sure that peoples' needs were taken care of," she said. "As for my mom, I saw her always giving back."

As Raksmey got older, she became captivated by the stories of her fellow Cambodian and Southeast Asian villagers. Many would tell her about the war and how they lived in a constant state of fear. Some had trouble sleeping. Others had nightmares. The more she listened, the more she wanted to better understand why the people she loved were experiencing such distress.

"For my family, at first, nobody wanted to go get help because they didn't know what to say. They were afraid…ashamed that they were feeling the way that they were feeling. Providers and prescribers kept on telling us, ‘stress is a normal part of life, go outside, go shopping,' but they didn’t understand the historical context or the implications of how history can impact a community. For many Southeast Asian communities and especially the Cambodian communities, there are no words to describe PTSD."

Continuing Education

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Raksmey moved to Stockton at the age of nine after her grandparents sponsored her family's entry into the United States. Her early college career was nursing, but after one year into the nursing program she re-directed her path to cultural anthropology and public health.  After working with diverse communities for many years and witnessing the health disparities among individuals with mental illness, she strengthened her advocacy to address the stigma surrounding mental health and access to mental health services, especially among Southeast Asian Communities. She eventually went back to graduate school and earlier this year graduated with a Ph.D. in public health with a focus on community health education, and disease prevention.

"Mental health found me, and I’m so grateful. I realized that if we don't start to integrate our mental health with our overall health, the whole dimensions of health, we're not going to be healthy," said Raksmey. 

As a big advocate of Telecare’s Recovery-Centered Clinical System (RCCS) and the Whole Person Care, Raksmey uses those approaches and her unparalleled resilience to deliver services to Transition Aged Youth at TEIR and crisis residential services at Jeremy House.

"With the knowledge in community education and disease prevention and, thank goodness, with the Whole Person Care, I'm able to understand where people are coming from. I don't look at a person for their symptoms. I usually ask people, ‘How can I support you? How are you doing medically? How are you doing physically? How are you doing mentally?' We have to be able to see a person as a whole, using a holistic approach, to fully serve them and meet them where they are."

Community Connections

The city of Stockton has the fifth-largest population of Cambodians in the nation and the second-largest in California. To create a space for healing, three years ago, Raksmey, her husband, and community leaders, started the Peace and Light Festival as a way for the community to honor their ancestors and come together for a moment of healing.

I don’t look at a person for their symptoms. I usually ask people, ‘How can I support you? How are you doing medically? How are you doing physically? How are you doing mentally?’ We have to be able to see a person as a whole, using a holistic approach, to fully serve them and meet them where they are.

Beyond Stockton, Raksmey has her sights set out on informing communities across the United States of the impact of PTSD and trauma. She recently came back from a Overseas Khmer Summit 2018 in Minnesota where she presented her dissertation and discussed the issue of PTSD in the Cambodian community. After posting the presentation on her Facebook page, a Cambodian professor contacted her and requested she does a virtual presentation for his class at the University of Phenom Phen.

“He said, ‘I don’t think people are aware, or people are afraid to talk about it.’ And he’s right. After the summit, a person came up to me and said, ‘Thank you for bringing this up, I am done hiding, I am done suffering silently alone, I want help, we all need help, and we need to come together as a community to explore this topic even more."

Using Life as Inspiration

As you can probably tell, Raksmey rarely stops moving (but regularly meditates). In addition to being an administrator at two Telecare programs, she is a mother of five, a wife, a yoga instructor, a kickboxing enthusiast, and much more.

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"I don’t know what it is, I'm just so grateful for life. I always say I am literally from the jungle. Not the concrete jungle, I mean the actual jungle. I am like Tarzan’s sister, you know?" said Raksmey. 

In mental health, her life experience translates to joy in helping people connect and engage in services that inspire hope when all feelings are lost.

"We encourage, we educate and we help people explore ways to allow for them to find their own journey to health and recovery," said Raksmey. "Our own individualized recovery journey is a journey that only the person who is going through it can understand. It doesn't matter how old we are, where we're from or what color we are. Regardless of whichever mental health challenges we have, each one of us deserves to feel appreciated, accepted, respected, and cared for."
 

The Significance of Your Surroundings: Using Healing Environments to Support Recovery in Three New Crisis Programs

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At Telecare, we believe that a person's environment plays a significant role in his or her recovery journey. Of course, there are many factors that contribute to a person's overall environment, including physical, social, and natural. When a person is going through a crisis, it is essential that the program environment they walk into is one based on healing so the recovery can begin the second they walk through the doors.

This summer, Telecare partnered with San Bernardino County Department of Behavioral Health to open three new crisis programs to meet the needs of their community and use the physical environment, RCCS-practices, and personal compassion to transform the crisis experience into a healing opportunity.

"This project highlights the vision and elements of public safety," said Third District Supervisor James Ramos at the July 19 open house for Windsor Center. "No longer will those community members have to suffer in silence. No longer will they have to travel to an emergency room. They can receive services right here in their own community, where they can knock on the door, walk in, and get the services they need because we came together as a community, as a county, and a state to make sure that they know that they are not alone in their journey to move forward—that we are standing side by side with them to see that change come forward in our community because no one should struggle or be alone with it comes to health and wellness."

Now Open: Windsor Center (San Bernardino, CA)

 Open house for Windsor Center

Open house for Windsor Center

Windsor Center is a 20-chair Crisis Stabilization Unit (CSU) serving residents of San Bernardino County aged 13 and older, 24-hours a day, 7-days per week.

"People feed off energy. If you go into toxic environment, you’re going to feel it. If you go into a healing environment, you'll feel that as well," Theresa McKinley, Administrator at Windsor Center said. “When you create a healing environment, it makes the statement to members that they’re worth being treated well."

Individuals in crisis can access CSU services on their own or by referral (walk-ins welcome). Referrals to the Windsor Center will be accepted from the San Bernardino County Department of Behavioral Health (DBH) outpatient clinics, full service partnerships (FSP), DBH Community Crisis Response Teams (CCRTs), law enforcement and first responders, hospital emergency rooms, mental health assessment teams, and other county medical clinics and departments.

Now Open: Merrill Center (Fontana, CA)

 Open house for Merrill CEnter

Open house for Merrill CEnter

Merrill Center is a 20-chair Crisis Stabilization Unit serving residents of San Bernardino County aged 13 and older, 24-hours a day, 7-days per week.

“This experience here is an expression of an incredible partnership,” Anne Bakar, President and CEO of Telecare said. “We’ve been in San Bernardino County for 15 years, and we’re delighted to have the opportunity to create an inpatient environment for people that really reflects shared values.”

Individuals in crisis can access CSU services on their own or by referral. Referrals to the Merrill Center will be accepted from the San Bernardino County Department of Behavioral Health (DBH) outpatient clinics, full service partnerships (FSP), DBH Community Crisis Response Teams (CCRTs), law enforcement and first responders, hospital emergency rooms, mental health assessment teams, and
other county medical clinics and departments.

Now Open: Wellspring Center (Fontana, CA)

 Open House for Wellspring Center

Open House for Wellspring Center

Wellspring Center is a 16-bed Crisis Residential Treatment (CRT) center serving adult residents of San Bernardino County. Wellspring Center offers short-term, recovery-based treatment options, as well as services and interventions in a home-like setting for up to 90 days. 

“The goal is to get the members motivated to start a recovery journey. To believe that they can engage in a recovery journey,” Larry Lawler, Administrator at Wellspring Center said. “The environment needs to be such where pretty much everything we do is related to trying to get them to understand that they can recover.”

Referrals to the Wellspring Center will be accepted from the San Bernardino County Department of Behavioral Health (DBH) outpatient clinics, full service partnerships (FSP), DBH Community Crisis Response Teams (CCRTs), law enforcement and first responders, hospital emergency rooms, mental health assessment teams, and other county medical clinics and departments.

RCCS Tidbit of the Month: Connections

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The RCCS Tidbit of the Month is part of Telecare's Recovery-Centered Clinical System curriculum to reinforce a culture of recovery in mental health service programs. For more information, click here.

 

 

Our lives are filled with connections. Our loved ones, family members, friends, co-workers, neighbors, our pets, our community, our spirituality, and more. At Telecare, we believe connections are also a key component of a person's recovery. Connections are an important part of living a healthy, happy life. Research indicates connectedness reduces symptoms of depression and anxiety, and increases resiliency and hope. In fact, loneliness is now being considered as a new social determinate of health. Recognizing the importance of connections to a society, the United Kingdom has even created a Minister of Loneliness to assist citizens who are feeling disconnected.

In Telecare's Recovery-Centered Clinical System (RCCS), we view connections on multiple levels: Connection to Self; Connection to Others; Connection to Community; and Connection to Something Bigger.

  • Connection to Self involves understanding your values; creating internal boundaries; and being aware of our feelings.

  • Connection to Others are those relationships you have with close friends, family, partners, and pets.

  • Connection to Community refers to your living environment and relationships in your neighborhood, clubs, church, work, and school.

  • Connection to Something Bigger refers to the meaning or purpose in your life, your spirituality, or your recovery journey.

Below is a simple exercise that strengthens connections to your self, others, and your community. Click here to download a PDF version to use at home or in the office.

Practice:

  1. In a group of any size, have everyone sit in a circle with a blank piece of paper and pen.

  2. Have everyone write their name on the top of the paper.

  3. Now, everyone passes their paper to the right and writes down one thing they appreciate or admire about the person whose name is at the top.

  4. After 15-20 seconds, everyone passes the paper they have to the right and repeats the exercise.

  5. Continue until the papers go full circle and everyone ends up with the paper with their name on it.

  6. Review what others wrote about you. Are you surprised? What stands out to you? Do they see things that you don't? What strengths of yours do they see? Consider how you are connected to this community of people.

  7. Practice with clients or members of programs, groups, or however you'd like. This practice is geared to help individuals connect to Self, Others and Community.

Read More About the RCCS

 

Recovery Spotlight: Morton Bakar Center Celebrates Connections Through Recovery

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In May, Cigna health insurance released a nationwide study on loneliness, declaring it an epidemic in the United States with nearly 50 percent of respondents reporting that they sometimes or always feel alone or left out. As research professor at the University of Houston and author Dr. Brené Brown points out in her 2017 book, Braving the Wilderness, "To combat loneliness, we must first learn how to identify it and to see that experience as a warning sign." The best response to that warning sign? Finding and making connections.

At Telecare's Morton Bakar Center, a Skilled Nursing Facility (SNF) in Hayward, California, the feeling of loneliness can be a significant part of the people they serve. Unchecked, loneliness can lead to hopelessness, isolation, and despair. Staff commonly hear that it isn't so easy to make friends, and therefore individuals feel discouraged in their recovery. In Morton Bakar Center's treatment settings, they use a guided conversation taught in Telecare's Recovery-Centered Clinical System (RCCS) to inspire hope and resiliency through building connections.

"Some of the most powerful connections happen with fellow consumers," said Julia Egan, Clinical Director at Morton Bakar Center. "Finding another like-minded soul who helps them feel loved and cared about can turn around their life. The power of friendship is universal and something to be treasured."

To read more about building connections to your self, others, and your community, check out our latest RCCS Tidbit of the Month: Connections [link to final blog here] and find a simple practice to try at home or in the office.

For more information on Telecare's RCCS, click here.

RCCS Tidbit of the Month: Identity

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The RCCS Tidbit of the Month is part of Telecare's Recovery-Centered Clinical System curriculum to reinforce a culture of recovery in mental health service programs. For more information, click here.

 

In Telecare's Recovery-Centered Clinical System (RCCS), we say we are all on a journey heading somewhere. For some of us, the path is clear. For others, it's not.

Regardless, all journeys require a vehicle to transport us. In the RCCS, we think about identity (who we are) as the vehicle we use to take us on our life's journey.

In our national culture today, we’re constantly asked to think about who we are — and who we’re not. Whether it's through identity politics, immigration status, tribalism, racial bias, or privilege, the conversation about identity is growing bigger and, sadly, often more divisive.  If we're not careful, our relationships and recovery culture can also get defined by labels of people (job titles, roles within the team, staff vs. managers).

At Telecare, we strive to remind ourselves to remain curious and approach our relationships by seeking to understand each other, not from what we think we know, but rather from a more humble position of recognizing what we don't know. We call this cultural humility.

 to download a pdf version of the rccs tidbit of the month,  Click here .

to download a pdf version of the rccs tidbit of the month, Click here.

The RCCS works from the perspective that each of us is uniquely different. This uniqueness encompasses an individual's lived experiences, and how they interpret the outside world. If we see and know others by being curious and open to other's values, beliefs, and worldview -- rather than building relationships based on assumptions -- our relationships become deeper and stronger. Judgment is reduced. And we can provide services that are respectful and culturally curious. The RCCS thus helps to counter the assumptions and stigma that permeate the dominant culture.

We also know that who we are today may be, in some ways, different than who we were five years ago today. Who we are five years from now might be different than who we are today. The RCCS includes two conversations to help begin this exploration. The conversations are: 1) My Story, My Values, My Identity – Now, and 2) My Identity - The Future. These conversations can be used between staff and clients, as well as between staff and staff. They help people get to know each other and remain curious. They also help us to see and know each other, not as labels or as a member of a group, but as individuals with unique stories, gifts, and talents.

Practice:

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  1. Complete the My Identity - Now conversation tool.

  2. Partner with someone and share your completed
    Identity Now circle.

  3. Be curious. Ask your partner questions about who they are.

  4. Is there any part of your identity you would like to change in
    any way?

  5. How might your identity be different five years from today?

Read More About the RCCS:

Recovery Spotlight: Gresham Creates a Wellness Labyrinth

 The team at Telecare's Recovery Center at Gresham view their completed labyrinth on the east lawn of their campus.

The team at Telecare's Recovery Center at Gresham view their completed labyrinth on the east lawn of their campus.

At Telecare, the program environment is a foundational part of our recovery model. This means we strive to create environments that are inclusive, welcoming, and create a space where recovery can thrive.

Telecare's Recovery Center at Gresham program in Oregon recently added a unique feature to their recovery environment : a wellness labyrinth created with staff and resident participation. 

 The Labyrinth design.

The Labyrinth design.

When you visit the Gresham campus, you will find a low-profile design with handcrafted stepping stones interspersed with pavers. The design, created at the direction of art therapy intern, Glee Lumb, is conducive to mindfulness and taking time for reflection and serenity in a fast-paced world. 

Labyrinths have long been used as a tool for mindfulness and meditation all over the world. A specific path is laid out to create a structured walking meditation that offers a pattern thought to enhance the right-brain activity. Walking the path can be a relaxing, often spiritual experience, which aids our members to safely and gently explore their own thoughts, emotions and memories as well as practice a new form of grounding and being.

 Research shows that labyrinths can offer other common benefits, including:

  • Creating greater awareness of thoughts, emotions, and memories
  • Reducing stress, agitation, and anxiety
  • Replenishing energy
  • Creating more clarity, focus, and peacefulness
  • Decreasing somatic stress and worry
  • Stabilizing blood pressure, gain higher physical and mental relaxation
  • Improving overall wellness and health
  • Nurturing a spiritual connection to the earth and a higher power
  • Aiding in the practice of letting go and living one day, one step at a time

Read More About Recovery Environments at Telecare:

Morton Bakar Center "Goes Wild" for National Nursing Home Week

National Nursing Home Week was recognized from May 13-19 and is celebrated annually at Telecare's Morton Bakar Center. Each day of the week was centralized around a theme. On Wednesday, May 15, the team celebrated "MBC Goes Wild" — staff dressed up in safari gear and animal print while others brought their pets into work. Birds, dogs, and bunnies paraded through the building throughout the day so that residents could touch and play with them.

One staff member was able to bring her relative's horse, Jugete ("toy" in Spanish), to MBC for the residents to interact with. MBC had never brought Jugete in before, and it was such a special treat for residents and staff alike to touch and take photos with the horse. They opened up the back patio area for the horse to stand in and for residents to be able to view and play with the horse safely. Residents of MBC were pleasantly surprised and thoroughly enjoyed the experience.

How to Fill in a Garden with Gratitude (and Ditch the Dirt)

Telecare Gratitude Garden

As mental health service providers, the benefits of practicing gratitude have been on our radar for quite some time. Research tells us taking the time to cultivate a regular practice, gratitude improves sleeping habits, lowers blood pressure, and can significantly increase life satisfaction and a sense of wellbeing.

At Telecare, we strive to create a company culture in which gratitude thrives. For most people, the biggest challenge of practicing gratitude is finding the time, so we wanted to find an easy way for our staff and the people we serve to practice wherever they are. What we found was even better: a simple way to practice gratitude and connect with others that also promotes a healing environment. We planted a Gratitude Garden.

What is a Gratitude Garden?

 Shannon mong, Director of Innovation Initiatives, found destiny at the solar exclipse in 2017. A few months later, Telecare began piloting a gratitude program based on these cards.

Shannon mong, Director of Innovation Initiatives, found destiny at the solar exclipse in 2017. A few months later, Telecare began piloting a gratitude program based on these cards.

Unlike an actual garden, a Gratitude Garden includes far less dirt and worms. The idea stems from two women who created Gratitude Blooming, a card deck created by them with handwritten themes based in nature to inspire mindful reflection. The founders later expanded their idea to create a Gratitude Garden Kit, "a playful and interactive gratitude experience designed to create inviting spaces for people to contribute their seeds of gratitude and wisdom with the messages they leave behind."

Each kit contains a poster and postcards featuring the designs from their card deck with a prompt written on them.

So, how did Telecare get involved with Gratitude Blooming?

"I was at the solar eclipse last year in Oregon and sat beside people pulling cards from an unusual looking deck," said Shannon Mong, Director of Innovation Initiatives. "I'm a curious person, so I asked what they were. They told me to pull a card, and I got one with a beautiful flower on it and that said destiny. I thought, okay, here we go! I want to learn more."

Growing Gratitude

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Inspired by the properties gratitude and nature have, Shannon later  tracked down the women and learned Gratitude Blooming was based near Telecare's corporate office in the Bay Area – destiny! They met and discussed putting together a gratitude project to engage both employees and clients, breaking down barriers around education or personal experience.

Shannon recruited sixteen Telecare leaders to pilot the use of large Gratitude posters at their programs. Each month the program employees and clients plant "seeds" of gratitude by writing and posting reflections in response to a unique prompt on each poster. 

Highlights from the Field

Our Gratitude Garden pilots at our programs ended in spring. Below is feedback from our programs that implemented a garden at their facility. 

This July, Telecare's corporate office is planting a "gratitude garden" in Alameda, and in the future, we're excited to continue collaborating with Gratitude Blooming to explore new ways to spread gratitude more deeply throughout the organization. 

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  • "People who never talk in our group sessions were sharing stories and opening up with their peers. By the end, they were having conversations without the facilitators." – Melissa Planas, Clinical Director at TEIR, a community-based Transition Aged Youth program in Stockton, California.
  • "When we first took the idea to members, the response to ‘gratitude’ was instant: I’m very grateful for Telecare. It was nice to hear for the staff, because it isn’t always verbalized." – Rachel Schwartz, Administrator at Kaiser Downey, a community-based Intensive Recovery Treatment Program in Bellflower, California.
  • "Clients are so happy to fill the posters with messages. One client is really involved and consistently promotes it during community meetings. The clients and staff are more positive, motivated, and engaged with one another." – Jennifer Sevilla, Director of Nursing at Gladman MHRC, a 40-bed Mental Health Rehabilitation Center in Oakland, California.       

Programs that Piloted a Gratitude Garden

Interested in Learning More?

Gratitude Garden kits vary in the number of items and price and have corporate and community options available.


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RCCS Tidbit of the Month: Judgment

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The RCCS Tidbit of the Month is part of Telecare's Recovery-Centered Clinical System curriculum to reinforce a culture of recovery in mental health service programs. For more information, click here.

 

 
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According to the report of the President's New Freedom Commission on Mental Health, stigma is "a cluster of negative attitudes and beliefs that motivate the general public to fear, reject, avoid, and discriminate against people with mental illnesses." The report also says, "Responding to stigma, people with mental health problems internalize public attitudes and become so embarrassed or ashamed that they often conceal symptoms and fail to seek treatment."

Stigma perpetuates two significant myths about people with mental illnesses: 1) They are violent; and 2) They do not recover from their mental illness.

Both are false. Studies show that, at most, mental health status contributes a trivial amount to the overall violence in society (as we know, people with serious mental illness are far more likely to be victims of violence). Studies also show that people who have mental illnesses can and do recover from their illnesses.

Stigma and discrimination can have a negative impact on someone's physical and mental health care. Health care providers may not provide the necessary treatments to people with mental illnesses. For example, people with schizophrenia who are hospitalized for reasons unrelated to mental illness are at least twice as likely as patients without schizophrenia to experience medical problems associated with poor outcomes, including death. One hypothesis is that a lot of the increased risk may result from inferior medical care. For example, studies have indicated that healthcare professionals might not take the medical symptoms of people with schizophrenia seriously, leading to a delay in treatment. Mental health care providers may act coercively or impose mandatory treatment on people with mental illnesses.

So, what can you do to fight stigma? One of the first steps is to acknowledge that we all harbor some level of stigma and judgment toward others or toward ourselves. Discussing the source of those judgments can assist in fighting our myths and giving us real information to bust those myths. Participating in NAMIWalks and joining others trying to educate our society and bust stigma and myths can be energizing and raise our hope. Programs hiring and supporting Peer Staff in their important and unique roles, also reminds us all that recovery is possible.

Watch:

Practice:

View any or all of the videos with your team. Following the video, have a group conversation using the following questions:

  1. What about the video stood out for you?

  2. What surprised you?

  3. Can you connect or relate to anyone in the video or any of the messages you took from the video?

  4. Did you find yourself feeling judgment or stigma about anyone in the video? Why do you think? View the videos with clients/members and have a similar

Read More About the RCCS:

Telecare Supports Legislative Bill AB1971

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Telecare Corporation is a mental health care provider that offers recovery-centered programs and solutions for people with serious mental illness and complex needs. We serve 30,000 individuals per year, many of whom have severe mental illness and are gravely disabled.

As such, we are in full support of AB1971, co-sponsored by the California Psychiatric Association with the Steinberg Institute and the County of Los Angeles. We support this important step toward helping people receive respectful, necessary, quality care. The bill has passed out of its house of origin and is awaiting committee hearings in the second house. 

What AB1971 Does

AB1971 updates the criteria to consider someone gravely disabled, expanding the definition to include those who are unable to recognize or care for their own urgent physical medical needs because of their mental illness.

Why We Support AB1971

The number of homeless people who are dying on the streets has nearly doubled since 2013. Last year, Los Angeles County alone reported 831 deaths, with the total number statewide reaching into the thousands. Many of these deaths were due to untreated physical illnesses such as sepsis and other infections, diabetes, heart conditions, and life-threatening injuries.

This bill helps to support those gravely ill persons who are unable to care for their own physical needs due to mental illness.

For More Information

The full text of the bill is here (click)

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May is Mental Health Month!

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Each year, we recognize May as Mental Health Month to build awareness and decrease stigma around mental illness. Telecare program staff and members participate in health fairs, NAMIWalks, and other local events to provide information on supportive services and promote wellness in their communities. 

Check out the images below for a glimpse into what programs did for Mental Health Month!

A Walk in the Woods: Recovery Center at Gresham's Team Retreat

 Oxbow Regional Park, Multnomah County, OR. Photo by Ilya Yakubovich/Flikr

Oxbow Regional Park, Multnomah County, OR. Photo by Ilya Yakubovich/Flikr

In March, the staff at Telecare's Recovery Center at Gresham program in Oregon enjoyed a fun and recovery-centered retreat at the YMCA Camp Collins alongside Oxbow Regional Park in Multnomah County.

This was the second annual retreat for the Gresham team. Each year, they break into groups for single-day trips away in the woods to take advantage of the majestic landscapes Oregon has to offer. The days are filled with activities that incorporate some "awarenesses" from Telecare's Recovery-Centered Clinical System (RCCS), a clinical approach to recovery that puts respect, nonjudgment, and power-awareness at the forefront of treatment.

"As an office coordinator, the role-playing definitely connected me to the everyday issues recovery specialists, nurses, and peers are facing," said Don, Office Coordinator at Gresham. "I liked the peripatetic meetings: it was good to walk and talk, especially in nature."

"We really focused a lot on power-awareness and discussed possible scenarios that can often lead to power struggles, which we obviously want to avoid," said Rachel, Medical Records Technician. "I have worked here a long time so it is amazing to see that this list has diminished greatly."

Read more about the RCCS in action and download some available resources by clicking here.

What is Telecare's RCCS?

In 2002, Telecare rolled out the Recovery-Centered Clinical System (RCCS), an innovative clinical approach to delivering mental health services that we developed in the course of 20 years. Below, we've outlined a few highlights for you to learn more about the basic structure of the RCCS and what it looks like at our programs.

The Culture

The RCCS promotes culture as a primary intervention. It addresses losses brought on by years of living in and being served by “power-over” systems and living in the greater dominant culture. The goal is to create increased awareness and behaviors that reverse the loss of power, judgment, motivation, individual uniqueness, and respect and dignity.

The Conversations

The RCCS has five conversation areas to help engage staff with clients and begin building relationships that will support an individual’s recovery journey. Staff use conversational tools to help re-awaken hope and support people in resuming their unique recovery journeys. Find more details about the five conversation areas by downloading our Culture & Conversations: The Basic Framework of RCCS handout.

The Measures

The Recovery Centered Measures (RCM) is a validated tool that Telecare programs use to measure their recovery-centered culture. Staff as well as individuals served give feedback on how the culture impacts them and services being delivered. Results are used to identify and grow strengths within a program as well as provide an opportunity for culture improvement initiatives.

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RCCS in Action

From the development of programs to the delivery of services, the "awarenesses" of the RCCS show up in all sorts of ways. The model continues to evolve with our industry and is adaptable to the many types of programs we have. Our programs also serve a wide array of populations, and to be the most effective we need to have strong partnerships with our customers, communities, and the individuals we serve.

Recovery-Centered Environment

To support the RCCS, Telecare designs its programs to create an environment where recovery can thrive. When a person chooses to walk through the doors of one of our programs, our goal is to welcome them to a home-like space where they feel safe and supported. We use art and color to inspire tranquility and mindfulness. Our nursing stations are typically open, not enclosed, to promote inclusivity and engagement with residents.

Resilience in the Workplace

While we know the work we do can be both rewarding and inspiring, it can also be demanding and stressful. It was Maya Angelou who said it best: "Nothing works unless you do."

Finding a self-care practice for healing from or managing these stressors at work is essential for the wellbeing of staff, as well as for those they are supporting in recovery. Telecare staff use the RCCS's guided conversations and our Staff Resiliency Toolkit to build relationships with each other based on trust, teamwork, and wellness. 

Showing Up and Being Present

We believe recovery is all about partnership—we partner with our members, our customers, and our local communities to ensure we do whatever it takes to engage individuals in our services and deliver the best possible outcomes.

Training for Staff and Leaders

Telecare is committed to creating programs where recovery thrives and where culture is sustained to reinforce the values and principles of the RCCS. With that in mind, we have designed a robust training program for all staff and leaders of the organization. These trainings target new Telecare staff by introducing them to the two components of the RCCS: the program culture with its five awarenesses, as well as the five conversations of the RCCS.

In addition, clinical supervisors attend in-person trainings that dive deeper into the five conversations: exploring identity, awakening hope, making choices, reducing harm, and making connections. These trainings help clinical supervisors develop their understanding of the intent and purpose of each RCCS conversation; understand the characteristics of being a good mentor, including giving and receiving feedback; learn and practice a strategy for skill building practice using a coaching feedback tool; and learn treatment/service planning using the RCCS conversations as targeted interventions.

Additionally, program leaders attend the annual "RCCS for Leaders" training. This in-person training helps leaders develop skills to evaluate where and how the program practices exert power and control, and how to evaluate when and how to safely increase authentic control. Leaders also understand their role in facilitating the importance of staffs rituals that build hope and resilience.

Downloadable Resources

Check out some resources we developed for the RCCS by clicking the links below!

Learn More

If you'd like more information about our RCCS, tools we use to measure recovery culture, or related presentations and materials, please email: RCCSusage@telecarecorp.com.

La Casa Skills Day Event

Submitted by Matt Ehler, Administrator of La Casa MHRC

In February, La Casa had their second annual Skills Day for the nursing departments of all three program: the MHRC, MHUCC, and PHF.

This year the Skills Day was on 2/22 (1:00 p.m. to 7:00 p.m.) and 2/23 (7:00 a.m. to 1:00 p.m.) to cover all three shifts—AM, PM, and NOC—to help our nursing staff get their annual competencies. Additionally, it provided us an opportunity to cover any areas that may need special attention in a structured format. This year, there were 10 booths with the following topics:

  1. Infection Control/Employee Health/Flu Vaccine (All)
  2. Fire Safety and SDS (All)
  3. Client Monitoring and Observation (All)
  4. Vital Signs (All)
  5. CPR/Chocking Prevention (All)
  6. Emergency Procedures - Codes - CPI (All)
  7. Head to Toe Assessment and Medication Safety/Destruction/Donation (Licensed staff)
  8. Code Blue Documentation/Adverse Event Reporting (Licensed staff)
  9. DTO/DTS/Elopement Risk Assessments (RNs)
  10. Employee Handbook (All)

In order to staff the tables, we utilized a mixture of all staff including nursing staff and interns, HR, and department managers. In addition to the training benefit, it also allowed us the opportunity to reconnect with different staff members and work together as a campus. It was a great success and we trained about 120 staff members!

Recovery at the Santa Ana Riverbed

Bringing our recovery model to life: Telecare partners with Orange County Health Care Agency in helping the homeless relocate from the Santa Ana Riverbed.

In Orange County, 30 Telecare staff members showed up to help the county’s Health Care Agency provide clinical assessments to more than 700 individuals experiencing homelessness who were being transitioned from the Santa Ana Riverbed to motels throughout the county.

“We were proud to be able to respond to their call,” said Ed Bienkowski, Telecare’s Regional Director of Operations in Orange County. “I got a request on Saturday night over President’s Day weekend to see if we had anyone available to assess the mental health needs of people being moved the next week. I texted our administrators, and within an hour they all got back to me with staff lined up to help.”

That Sunday and Monday, staff members and interns from Telecare’s TAO, TAO South, STEPS, and Orange County AOT programs came with their cars and trucks to assist the county with moving belongings and providing clinical assessments.

"I was there to offer compassion and support for those who wanted to take advantage of the opportunity of getting into a motel," said Jyoti Gustafson, Personal Service Coordinator (PSC) II at Orange County AOT. "Some had jobs, some had pets and family, others had not been homeless for long and just needed a place to regroup. They were people in their community who would benefit from linkage to a variety of resources. By us being there on a united front with the county and interacting with those who needed placement, we may be a familiar face down the line if that person is ever referred to our program or in need of services."

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"Going to the riverbed was a reminder of why it is so important to do what we do every day," said Angela Pierce, PSC II at TAO South. "It was a humbling experience and a great reminder of the cultural diversity of both our members and Orange County in general, and the need to provide resources and the support to allow people to have fulfilling lives. It was also a reminder to be mindful of each other's uniquenesses and to be present when engaging with individuals—comforting people when they express sadness, celebrating people when they achieve their goals. We were able to show people we are there to support as best we could, even if it was just to ease the stress, anxiety, fear, or whatever they were experiencing at the time."

We are grateful to have such a committed team of Telecare staff members who respond with great heart to help others in times of need. We are honored to be a helpful resource to our customers and in our local communities.

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SHOP/TRAC/TMRS Participate in Stanislaus County’s Point-In-Time Count

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The U.S. Department of Housing & Urban Development (HUD) mandates an annual Point-In-Time count and survey of individuals and families experiencing homelessness. Telecare’s SHOP/TRAC/TMRS, initially just SHOP, was asked by Stanislaus County in 2003 to assist with the Point-In-Time count and have assisted every year since then. There are various other county and community agencies that either volunteer to participate in the count or donate bags of goodies to include snacks, socks, blankets and lists of local resources. The Point-In-Time count is an important effort that ensures the voices of people experiencing homelessness in our communities are heard and efforts are made to provide appropriate services. It also helps Stanislaus County develop more effective plans and measure progress towards ending homelessness.

The Performance Improvement Team has provided a survey tool that provides a means for gathering information directly from the individuals and families that are experiencing homelessness about their needs and causes of homelessness. One of the most prominent issues is the lack of stable and affordable housing options. Efforts to target this area are evident with the creation of the Stanislaus Homeless Outreach & Engagement Center.

Telecare’s Outreach & Engagement Team enjoys participating in the annual count to build and maintain relationships, listen to the amazing stories told and to better understand the needs of this population. Huge shout-out to this team for never complaining about such an early start and always being willing to serve others the best way they can!

San Bernardino ACT Goes Above and Beyond in their County!

San Bernardino County’s Department of Behavioral Health recently recognized a staff member at Telecare’s San Bernardino ACT program for going above and beyond. Check out what our county customer said below, and congratulations to Rebecca for the great work!

Last night, one of your Telecare ACT’s staff, Rebecca, was very helpful to me and my partner. We had a difficult case, in which a client came to ARMC with very little information, except that she is a Telecare client and her name, due to her low cognition. Rebecca assisted us with trying to piece together of which Telecare program. She helped us contacted other Telecare programs to see if the client is open with them. Once we’ve came to the conclusion that the client is from Riverside County, she provided us with RISE number. She contacted us back to ensure that we made contact with RISE at the end of our shift. Please extend our appreciation to Rebecca (I don’t know her last name) for assisting us during her after hour call. She spent about an hour with us trying to figure out who and where our client came from and was very gracious and patient with us.
— Ann Pham, County of San Bernardino, Department of Behavioral Health