System Changes for a Green Mental Health Movement

What we have learned about ten areas in need of system change--what's worked and what barriers need to be addressed.

System Changes for a Green Mental Health Movement

What we have learned about ten areas in need of system change--what's worked and what barriers need to be addressed.

This 10 webinar course will focus on areas of programming that need changes on a system level in order to sustain reforms at clinical and service levels. The goal of each webinar will be to describe changes needed and the real world experiences of the presenters in implementing the changes--what has worked and as well as what lessons can be learned from those that have not yet resulted in system changes. The goal of the series will be to show how changes can move toward a "Green Movement" in mental health systems.

What is a Green Movement? A Green Movement respects and supports the choices and interests of people who encounter mental health challenges in order to sustain healthy environments of living and working.

The series will begin on September 17 with an introduction to a Green Movement in Mental Health and how system changes can lead in that direction. The integration of Medicaid health care services in Oregon will be used as an illustration of what worked and what didn't and why.

That will be followed by 9 monthly webinars starting in October which will focus on program improvements and strategies that will move systems forward so that Green Mental Health is the standard of care, not just exemplary but isolated programs.

The 9 webinars will present on these topics:

  • supported employment as key to adult services
  • counseling in public schools that help parents and children without resorting to drugs,
  • trauma-informed care,
  • changing systems at local, regional, and state levels,
  • using research to make system change
  • changing cultures and programs in state hospitals;
  • decreasing the prescription of psychiatric drugs to children and adolescents;
  • serving children and families in community settings rather than state hospitals;
  • expanding peer supports into all systems

Note: This series does not currently provide continuing education credit.

Webinar Schedule

Note: All webinars will be recorded and available for viewing after the live event.

Bob Nikkel, MSW: September 17, 2019, 1:30pm Eastern/10:30am Pacific

System Changes for a Green Mental Health Movement: Lessons from Oregon's Integration of Healthcare Services

Learning Objectives:

Participants will be able to:

1) Describe the similarities between the green movement in the broader world and the issues in applying the similarities to mental health reform

2) Define the clinical skills and abilities necessary in an integrated healthcare system

3) Describe key lessons in system change

4) List key assumptions behind the need for an integrated scorecard

5) Describe ways to use the scorecard in actual practIce

Robert Drake, MD, PhD: October 15, 2019, 1:30pm Eastern/10:30am Pacific

Supported employment as a key to recovery in mental health and how it can be become an essential part of every mental health program.

Learning Objectives:

Participants will be able to:

1) List reasons most clients want to work

2) Describe briefly 4 trends in IPS research

3) Compare the competitive employments rates between IPS and control groups

4) List areas that have not been rigorously studied for IPS employment services

5) Compare the percentage of clients in public systems who have access to IPS vs those who express a desire to work

6) Identify factors that promote the spread of IPS outside the US

Michael Cornwall, PhD: November 19, 2019, 1:30pm Eastern/10:30am Pacific

How counseling, family therapy and parent support groups can be provided in the most difficult public school systems in a way that makes referral for psychiatric medications completely unnecessary

Learning Objectives:

Participants will be able to:

1) Identify ways to establish crucial trust-based relationships as a clinician with diverse, struggling children, teens and families even in a very stressful and traumatic social environment.

2) Design methods to help families change patterns without using psychiatric medications

3) Demonstrate ability to more effectively function and make changes in systems while adopting a dissident, activist stance.

4) Describe ways to more effectively build coalitions with a broad range of systems based and grassroots natural allies, while becoming more adept at seeking and preserving common ground with all change agent coalition stakeholders.

Leah Harris, MA: December 17, 2019, 1:30pm Eastern/10:30am Pacific

Theoretical and practice guidance for implementation of trauma-informed approaches in any program, organization, setting, or system

Learning Objectives:

Participants will be able to:

1) Critique key myths and misconceptions about trauma-informed organizational change;

2) Identify stages in a developmental trauma-informed change process, from trauma-aware to trauma-informed; and

3) Discuss key characteristics of trauma-informed organizations;

4) List best practices in implementation of trauma-informed care across systems.

Trauma-Informed Approach and Trauma-Specific Interventions

The six key principles of a trauma-informed approach and trauma-specific interventions address trauma’s consequences and facilitate healing.

Trauma-Informed Approach

According to the concept of a trauma-informed approach, “A program, organization, or system that is trauma-informed:

  1. Realizes the widespread impact of trauma and understands potential paths for recovery;
  2. Recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system;
  3. Responds by fully integrating knowledge about trauma into policies, procedures, and practices; and
  4. Seeks to actively resist re-traumatization."

A trauma-informed approach can be implemented in any type of service setting or organization and is distinct from trauma-specific interventions or treatments that are designed specifically to address the consequences of trauma and to facilitate healing.

Gina Nikkel, PhD: January 21, 2020, 1:30pm Eastern/10:30am Pacific

What real world experience has taught about making system changes at local, regional and state levels. A description of how partnerships, program ideas, budget development, legislation and advocacy come together.

Learning Objectives:

Participants will be able to:

1) Identify "secrets" to systems change

2) Discuss ways to act strategically

3) List four essential "catalytic" tasks

4) Assess the ways in which media can be used to promote systems change

David Hughes, PhD: February 18, 2020, 1:30pm Eastern/10:30am Pacific

How to use research and a data driven approach to support and guide system change based on decades of the Human Services Research Institute's experience studying behavioral health systems.

Learning Objectives:

Participants will be able to:

1) Define system change essentials that involve data and data collection

2) Describe a system vision for a good and modern behavioral health system

3) Compare strategies in “complicated” systems vs “complex” systems

4) Identify the percentages of factors in affecting determinants of health

5) Discuss the models of integrated behavioral and physical health care

6) Select tracking tools for evaluating integrated health care systems

Malcolm Aquinas, MA: March 17, 2020, 1:30pm Eastern/10:30am Pacific

Lessons learned in making program and institutional culture changes needed to respect human rights and dignity in state hospitals.

Learning Objectives:

1) List the steps in Kotter’s 8-Step Change Model

2) Discuss the importance of creating a vision for change

3) Explain the way in which short-term hopes are different from short-term wins

4) Identify the 4 main characteristics of total institutions

5) Describe the survival strategies employed by patients in total institutions

6) Recite the 4 survival strategies used by staff in responding to their role in total institutions

7) Apply the elements of a harm reduction approach to making changes in state hospitals

Jennifer McLaren, MD: April 28, 2020, 1:30pm Eastern/10:30am Pacific

A description of de-prescribing psychotropic medications to children and adolescents. How to develop these approaches in a systematic way with outpatient, inpatient and child welfare settings.

1) Describe the children most vulnerable to overprescribing

2) Discuss concerning prescribing practices: polypharmacy, antipsychotic use, off label use and long-term use of psychotropic medications

3) Review deprescribing and examine facilitators and barriers to deprescribing

4) Discuss some practical recommendations for deprescribing children and adolescents

Kim Scott, MPA: May 19, 2020, 1:30pm Eastern/10:30am Pacific

How a community program's wide range of services for children, adolescents and families successfully transferred state hospital units to community programs and lessons learned in what system changes were needed to accomplish that.

Learning Objectives:

1) Describe the theory of change in creating health and wellness in a trauma-informed setting

2) Review the principles of a sanctuary model of treatment

3) Identify the system changes in moving from a state hospital to a community-based service for children and adolescents

4) Discuss the elements of Collaborative Problem Solving Principles

5) Discuss the principles of DBT and skills training more broadly in trajectories of recovery

6) Describe the major challenges, past and future, in making the system changes to transfer state hospital programs to community services for children and adolescents

Nev Jones, PhD and Shira Collings: September 9, 2020, 1:30pm Eastern/10:30am Pacific

In this webinar, Nev Jones and Shira Collings will cover the foundations and history of peer support, and the innovations that have been developed by peers as alternatives to traditional mental health services. They will discuss research on the effectiveness and implementation of peer support, and share some of the challenges and successes of the peer support movement.

Learning Objectives:
1) Describe the history of peer support services in the US.
2) Identify different types of peer-run services and roles of peer specialists.
3) Understand the research that had been conducted on the effectiveness and implementation of peer support.
4) Describe some of the challenges the peer support movement has faced.
5) Identify successes and effective implementations of peer support within the mental health system.

Accommodations for the Differently Abled

Mad in America Continuing Education webinars are handicap accessible. Individuals needing special accommodations, please contact Bob Nikkel at [email protected] or (503) 929-9346

Who should view this series

This series is designed for mental health professionals, advocates, psychiatric survivors, people with lived experience, family members, and the general public.

Grievance Policy

Commonwealth Educational Seminars (CES) seeks to ensure equitable treatment of every person and to make every attempt to resolve grievances in a fair manner. Please submit a written grievance to: Bob Nikkel, [email protected], Phone: (503) 929-9346.Grievances would receive, to the best of our ability, corrective action in order to prevent further problems.

Your Instructors

September 17, 2019

Bob Nikkel, MSW, is director of Mad in America Continuing Education and former commissioner of mental health and addictions for the state of Oregon. In this role he worked on system changes in a number of areas including enhanced integration of peer recovery and supports in the community and state hospital settings. He studied integrated health systems for several years and facilitated planning meetings for physical health and dental care providers along with mental health and alcohol/drug providers as the state moved Medicaid funding into coordinated care organizations. He is a founding Board Member of the Foundation for Excellence in Mental Health Care and was asked to chair the Board of Dual Diagnosis Anonymous of Oregon. He provides consultation formally and informally to many advocacy and peer support services.

October 15, 2019

Dr. Robert Drake is the Andrew Thomson Professor of Psychiatry, Community and Family Medicine, and Health Policy and Clinical Practice at the Geisel School of Medicine at Dartmouth and a Vice President of the Westat Corporation, and the former Director of the Dartmouth Psychiatric Research Center. Dr. Drake has studied psychiatric rehabilitation for nearly 40 years. He is recognized internationally for his many contributions to transforming services toward greater alignment with client goals and the recovery process. He is co-developer of the Individual Placement and Support (IPS) model of supported employment, one of the most successful and influential evidence-based practices in psychiatric rehabilitation. Dr. Drake has devoted his career to the conceptualization, development, evaluation, and dissemination of evidence-based practices, including IPS, integrated dual disorders treatment, and many other models. He has directed numerous randomized controlled trials, has extensively reviewed the psychiatric rehabilitation literature, and has published more than 20 books and 600 research articles.

November 19, 2019

Michael Cornwall, PhD has conducted therapy with adults and children in extreme states since 1980 in medication-free sanctuaries and community settings. He completed doctoral research on Diabasis House, the San Francisco based medication-free extreme state sanctuary founded by Jungian John Weir Perry He leads Esalen workshops and conferences on compassionately being with people in extreme states. He blogs on Michael is also the Editor in Chief of the 2019 and 2020 volumes of “The Journal of Humanistic Psychology’s Special Edition on Extreme States,” and is the Director of “SPAC!-Stop the Psychiatric Abuse of Children”- an international activism project co-founded with Peter Breggin MD.

December 17, 2019

Leah Harris, MA has written and spoken widely about her lived experiences and learned expertise regarding trauma, drug use, mental health challenges, and healing/resilience. From 2012-2018, she was a trainer and curriculum developer with SAMHSA’s National Center for Trauma-Informed Care. In her work with the National Association of State Mental Health Program Directors’ Center for Innovation in Behavioral Health Policy and Practice, she has helped to develop and adapt psychosocial trauma education curricula for incarcerated youth and adults. Leah also provides workshops and public talks on 'Trauma-Informed Suicide Prevention' and critical suicidology concepts. She is a political correspondent with Mad In America, covering the trauma-informed policy developments and other news.

January 21, 2020

Gina Firman Nikkel, PhD is the President and CEO of the Foundation for Excellence in Mental Health Care, a Global Community Foundation that funds research and innovations. Dr. Nikkel's experience includes Executive Director of the Association of Oregon Community Mental Health Programs and as a Community Mental Health Therapist, Program Director and Clinical Supervisor. She has worked extensively in mental health and addictions policy, leadership and management, health care financing and political advocacy at the local, state, and federal levels. Dr. Nikkel's public service includes two terms as a Tillamook County Commissioner and Vice-President of the Association of Oregon Counties. She has a BA in Theatre and Dance, an MS in Counseling and a PhD in Social Public Policy and Leadership. She was recently named one of the 100 most influential alumini of the University of Oregon.

February 18, 2020

David Hughes, PhD is President of Human Services Research Institute. Dr. Hughes is nationally recognized for his expertise in behavioral health research and systems change. His career has been devoted to working with public agencies and other researchers to transform systems and inform policy development. and systems change. He has helped many organizations design programs and policies that are data-driven, person-centered and sustainable. In addition to his PhD in social policy, he also holds Master's degrees in both social policy and applied sociology. He serves as Board Treasurer for the Foundation for Excellence in Mental Health Care and chair of the board of the National Association of County Behavioral Health and Developmental Disabilities Directors.

March 17, 2020

Malcolm Aquinas, MAT CPSS LPE, is the Peer Trainer & Mentor Coordinator at the Oregon State Hospital. He is a board member of the Oregon Consumer Survivor Coalition. He is a past Chairperson for the Oregon Consumer Advisory Council. He is a professional consultant for the National Center for Trauma Informed Care. Malcolm has lived experience of the mental health system in Oregon and Alabama. He has been given multiple diagnoses, been placed on numerous medications, experienced both voluntary and involuntary hospitalizations, and survived restraints, solitary confinement, and electroshock. Malcolm is passionate about restoring a human and civil rights focus to the Mad Liberation Movement.

April 28, 2020

Jennifer L. McLaren, MD is Assistant Professor of Psychiatry, Geisel School of Medicine at Dartmouth. She is also Assistant Professor of Psychiatry at the Dartmouth Institute. Her current areas of focus include autism spectrum disorders, developmental disabilities and child and adolescent psychiatry. She has published extensively on healthcare quality for children and adolescents with suicidality in acute care hospitals, the overuse of psychotropic medications in children with intellectual and developmental disabilities, and psychotropic medications in other vulnerable children. She is current involved with establishing a project for deprescribing psychiatric medications in children and adolescents.

May 19, 2020

Kim Scott, MPA is President and CEO of Trillium Family Services, Oregon's largest provider of a full range of services to children and families. He provides statewide and national leadership in the development of intensive treatment services that are family focused and integrated with local communities and planning structures. He serves on the CEO Advisory Board of the National Alliance of Strong Families and Communities. Trillium successfully managed the transfer of the state hospital units to a community setting. Over the past several years, he and his team at Trillium have adopted a trauma-informed lens to the work of the organization.

September 9, 2020

Shira Collings is a graduate student in Clinical Mental Health Counseling and an Assistant Editor at Mad in America. As a person with lived experience of mental health challenges, she is a strong believer in recovery-oriented services and an advocate for peer-designed approaches to mental health. In addition to her studies, she provides training and consultancy on the topics of suicide prevention, disability justice, peer support, harm reduction, and eating disorder prevention and treatment.

Nev Jones, PhD is an assistant professor of psychiatry at the University of South Florida. Major areas of focus include strengthening user/survivor leadership in mental health research and policy and addressing structural inequalities as they intersect with mental health systems.

Please Note: We especially encourage and welcome managers, clinical supervisors and leaders at all levels to view and participate in these webinars.

The format for each webinar is 1 hour of presentation and 30 minutes to respond to questions and comments.

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