Massachusetts on the Move
Dr. Robert Lees at the podium. (slide ehanced for clarity purposes)
Photo credit: Employment Options
Mark Littlefield and I were privileged to spend time in the Greater Boston area attending the first conference on parental mental illness hosted by Employment Options (www.employmentoptions.org). People from BC interested in parental mental illness will know the name of Dr. Joanne Nicholson. Joanne has been influential with the group in Massachusetts. Mark gave two workshops on the Ulysses Agreement; one on theory the other on practice. I gave a keynote on building community capacity. This included a review of what our Provincial Working Group has been doing. A researcher from the Netherlands gave a workshop on his work developing tools and a program for assisting parents with psychiatric disabilities. Katy Kaplan, a researcher from University of Pennsylvania reported on their collaborative and outstanding website “UPENN Collaborative Resources for Parents” (http//www.upennrrtc.org/resources). Other workshops explored legal issues and rights for parents with mental illness.
Although Boston is the home of a number of leading initiatives, we came away feeling that BC is on the right track and in fact, probably a bit further in terms of raising general awareness of the needs of families with parental mental illness. Those attending seemed to appreciate the “4 – Ps”;- Policy, Protocols, Program and Practices that are discussed in the 2004 paper written by Desiree Blume. The group thought we should add “parents and peers “to the list of “Ps”.
There are a few specific ideas that we may want to champion in BC; namely;
1) the idea of paid “parent navigators” who assists parents who have mental illness, through the system. As the FORCE Society for Kids Mental Health motto states so well, as parents, we’ve been there”. Navigators have been there too and can be more readily accepted by parents who feel vulnerable in complex systems of care. Navigators can help parents with matters from legal representation to really understanding what is going on in care teams or wraparound process, so they work better for families.
2) the idea of encouraging Club Houses in BC to consider the "Family Options” program that has developed in Employment Options in Marlboro, MA. Rob was on a panel with a parent who had regained custody of her child from the local child welfare service because of the steady development work of the Family Initiatives developed by Employment Options.
3) the need to work with service providers in adult mental health and child welfare, to insure that they come into a meaningful dialogue about their concerns regarding how well a parent with mental illness may be managing their parenting role. The Family Options model seemed to be making a real difference in this area.
4) we learned that many patients in the adult system, particularly the clubhouse setting, didn’t want to have the clubhouse deal with parenting at first, because it brought up too many painful ghosts. They have had to sensitively respond to the issues of loss that many parents with psychiatric disability have suffered.
5) I personally would like to think more about the role of complex trauma in child welfare cases. A panelist from the Department of Social Services, their MCFD Child Welfare Service, spoke eloquently about the need to identify and assist parents who have complex trauma that is a significant subtext to their difficulties with substances and parenting. In a review of their child welfare cases they found that 300 of 800 parents had mental illness. This is higher than the 31% we identified in a review in Fraser Region.
6) Family Options has a position for people who are called a “Family Coach” These people act in an outreach role to assist parents with mental illness. They work from a strength finding perspective doing whatever is needed to help that parent accomplish their goals. They are called “generalists” because they get to know the parent in the clubhouse environment as well as home environment. The focus is on seeing the whole family, not just a segmented view. Child and Youth Care and Social Work students would find a very useful role here.
Issues in Massachusetts are similar to ours – people seem to know how important it is to see “whole families” and yet services are still organized around “individuals”. Although there are some promising practices like wraparound and care teams, there is still a great deal that needs to be done to bridge the connections between adult mental health, child welfare and child and youth mental health.
Massachusetts is moving into an era focused on the motto “one family, one plan” that may move the agenda forward. For the most part, this thinking is anchored in the child serving system and like with us, they need to find ways to make connections with partners in the adult system.
It is always great to meet with colleagues who share the passion for helping families with parental mental illness. Although the movement is small, the quality and commitment of our colleagues in Massachusetts, Pennsylvania and the Netherlands is an inspiration. We are not alone.
Dr. Robert Lees, R.Psych.
Winds of Change- Transforming Systems and Services for Parents Recovering From Mental Illness and their Children. April, 2008. Hosted By Employment Options, MA
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