The Re-Formed Community Care

There is a shift going on in the delivery of services for adults (age 19+) in our state, Massachusetts.  In addition to being more clinically focused with evidence-based programs, there is a bona fide “family focus approach and emphasize role of peer support.”

The new model intends to promote (my comments in italics):

  • Active engagement and assertive outreach to prevent homelessness; since the vast majority of individuals with serious mental illness make up the largest quantity of homeless individuals
  • Clinical coverage 24/7/365 days a year because symptoms and illness do not have a time schedule nor a predictive reckoning other than cyclic episodes and patterns; these come when they do and it is good to recognize that sickness comes when it comes.
  • Consistent assessment and treatment planning Keep the focus on what is best at this time and consider what may be needed based on current behaviors or concerns.
  • Risk assessment, crisis planning and prevention Best laid plans do not always work.  Prevention increases the odds for improved outcomes.  Having a plan and a go to increases everyone’s confidence in managing crises.
  • Skill building and symptom management, The most essential skill for individuals with serious mental illness.  Their families and loved ones need assistance with this also.  Again, let’s look for improved outcomes, safety, and connection for all.
  • Behavioral and physical health monitoring and support Collaboration is key and this model depends on it.  Including family and loved ones needs to be emphasized, however, since we know that their loved ones matter to them.
  • Addiction treatment support;  So many of the seriously ill have co-morbid substance use disorders.  They are part and parcel of the same human system.  One cannot be treated without the other.
  • Family engagement; WE know how valuable our input it.  All of the research indicates improved outcomes when family is engaged.  It is nice to see this vital component of care added to the re-forming of service delivery.
  • Peer support and recovery coaching  With the additional training that these like-minded individuals have, they are often in the best position to engage an individual with serious mental illness to move forward on managing their symptoms and embracing recovery.  Like family members, tThey are an important bridge in treatment.
  • Reduced reliance on emergency departments, hospitals and other institutional levels of care.  With fewer beds, less restricted environments, and humane solutions, seriously mentally ill people can be offered the best opportunities for managing their chronic illnesses with the level of support and educaiton that they, and their loved ones, need.

The video below explains how the reforms were identified and the shift to this model which promises to be more effective than the previous community based model.  Let’s hope so, anyway.


Unconditional love; conditional participation

When I was walking around trees, following deer tracks, listening to the music of red-wing blackbirds, I realized that I love my family members unconditionally. It does not matter to my loving them that they are unwell. Where the conditional aspects of our relationships come in are around their behaviors when they are unwell. When they are hurtful, dangerous to me, unkind, disrespectful, scary – these are behaviors I don’t let into my life from anyone, and that means, not from them either. I am willing to have them in my life when they are able to behave in ways that I want to be a part of. The strings are, “As long as you are able to be around me, on my terms, we’re good.” I am not closing any doors. I am merely defining the parameters for participating in my life. And my (currently) estranged family members seem to be aware of this. I consider their estrangement from me as a way that they are protecting me from their unwellness. What are your thoughts?

Recovery: What does it mean?


From our Sept 2017 Newsletter!

The certified pet therapy pair went to the annual awards ceremony at the Bedford VA’s Veteran Community Care Program in Lowell.  Max visits with the veterans every week, performing a series of tricks, and providing nurturing and support to those who need a furry friend with a wet nose.  The ceremony was conducted by the veterans and they shared stories of their recoveries, their appreciation for one another, their service to the community there and the greater community of which they are a part of.  Their model of recovery is based on the SAMHSA (2015) working definition:

“recovery as a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential. Recovery is built on access to evidence-based clinical treatment and recovery support services for all populations. Learn more about SAMHSA’s Working Definition of Recovery — 2012.”

It is useful for family members to understand this focus on recovery because it includes management of the symptoms and offer hope, relief, and a call for strategies including setting appropriate limits.

The full discussion on this working definition can be found here:

Spring Seminars through Bedford Recreation

Learning how to actively schedule self-care is a vital skill when nurturing and supporting loved ones with mental illnesses. Give yourself the gift of an evening to acquire some skills that do not require huge amounts of time or commitments that you may not be able to fulfill. You might even have fun while remembering how to have fun!
Monday, March 13, 7:00-8:30pm (min 5/max 25) Fee: $25

Throughout the year, there are special times that families gather together and for some families, these can be quite stressful. In the spring, there are religious celebrations as well as Mother’s Day & Father’s Day, graduations, and weddings. This seminar offers effective strategies for moving through these potentially difficult times with our loved ones with mental illnesses or behavioral health issues. (min5/max25)
Monday, March 27, 7:00-8:30pm Fee: $25

Parenting is a challenge under the BEST of circumstances. Add a child with behavioral health issues and, well, it is MORE of a challenge! Learn how to step out of the fight of medical/mental health compliance. Examine some strategies to increase your effectiveness in establishing and setting limits. Consider how to have more fun as a parent! This introduction offers a framework for managing the challenges facing parents who are confronted with atypically developing children. (min5/max25)
Monday, April 3, 7:00-8:30pm Fee: $25

Please register through Bedford Recreation: