Creating Safe Environments With Strengths-Based Approach
"What happens is that when people graduate from AB109 programs, they enter traditional mental health clinics where staff aren’t used to working with this specific population," said Marcelo Cavalheiro, Telecare Regional Operations Director for Los Angeles County.
"Due to what has been going on recently in the news, staff have been going to their supervisors with safety concerns. They have the belief that the people entering the program are dangerous, or are criminals, and that can inhibit the quality of care."
As one of Telecare’s operations leaders, Marcelo partners with David Heffron, VP of Operations, to oversee all of our programs in Los Angeles, including two AB109 programs. The number of Telecare’s AB109 slots has grown dramatically since the legislation passed in 2011, from 48 slots originally to more than 270 slots today. In Telecare’s LA AB109 programs, clients typically stay for about two years before transitioning to other programs in the Los Angeles Department of Mental Health’s Adult Systems of Care (ASOC) and Older Adult System of Care (OASOC).
“AOSC heard the concerns of their direct providers and wanted to do something to support the staff. They reached out to us to see if we could create a training for those programs and staff to help them not only feel safer personally, but also feel more comfortable and confident in their work with this population.”
David and Marcelo created a six-hour, strengths-based training, grounded in Telecare’s Recovery-Centered Clinical System (RCCS) principles. Overall, it’s a fun, engaging training that helps staff look at five key areas such as common misconceptions, day-to-day practices, maintaining a supportive recovery culture, and specific conversations that staff can have with clients that can transform recovery and staff/client relationships. The goal is to help staff see a wide variety of ways they can shift the program—and their own interactions with clients—to create a safer environment, better services, and better results.
We’ve included a brief overview of the principles. If you’re interested, you can view the full training here.
Start by Challenging Misconceptions
One of the most essential steps in the training is challenging misconceptions, the most common one being that those living with a mental illness are violent and are prone to acts of violence. Although these instances are few and far between, they carry more weight when brought into the public eye. This stigma is extremely harmful to both participants and staff of mental health programs. Furthermore, these preconceived notions can influence how we interact with program members and how we design our environments, as well as create an undercurrent of prejudices and negative expectations for what we think might happen. In actuality:
Tools for Maintaining a Recovery-Centered Environment
When working with the Justice Involved Mental Health (JIMH) population, it is important to keep in mind that they need a caring and supportive environment, not a punitive and power-over one. Marcelo and David's training, "Justice Involved Mental Health: Community Re-Entry and Recovery," recommends the following practices and program changes.
- Create a welcoming environment. The choices a provider makes about the use of control can convey a lot to the people who are receiving services there, which can also affect how people behave and interact. For example, an environment that has metal detectors at the door feels like a very different place than one with a reception area that’s welcoming and inviting, with someone who greets you with a handshake. A welcoming environment sets the stage for a good partnership with the client.
- Treat members with respect and dignity. When a program promotes a collaborative verses a provider-driven approach to treatment, members can take comfort in knowing their voices are being heard, and can truly express their hopes and dreams without fear or hesitation.
- Reconstruct their narrative. By helping members reconsider and rebuild a strong personal identity, one that goes beyond the limiting definitions of being someone who has been in jail or has a mental health need to address, programs can better support members in successfully aligning their goals and choices to move forward in their recovery. Members who transition out of correctional facilities or programming need to be treated as people who have the capacity to make good choices and achieve personal goals, instead of being treated as former inmates who do not get to have a say in their recovery.
- Encourage mistakes. Recovery is not a simple, linear process. Relapse happens. It is extremely important for a program to have a culture that allows mistakes to happen, and lets members know that they have a place to come back to that won’t give up on them.
- Focus on criminogenic needs. In order to successfully reduce recidivism, providers need to offer a wraparound approach that addresses both a member’s mental illness and the risk factors that can contribute to the member re-offending, and provide treatment options appropriate to the member’s risk level.