Patients and staff collaborate in an innovative approach to care

The Challenge: Improve staff members’ uptake of recovery-oriented care values and practices

Staff working with people living with schizophrenia see them at their most unwell. Few, if any, see what happens after discharge, when their former clients are recovering and getting on with their lives. This reality makes it difficult for some staff to take a recovery-focused approach to care as opposed to a custodial approach. Toronto’s Centre for Addiction and Mental Health (CAMH) was challenged to shift staff attitudes and beliefs about their clients.

The Improvement Project: Work with former clients to deliver the message of recovery

This Improvement Project funded by the Canadian Foundation for Healthcare Improvement, is engaging former clients to teach them how to deliver a message to staff about the importance of the recovery approach. Sean Kidd, Head of Psychological Services in the Schizophrenia Program at CAMH, is spearheading the project, which trains former clients to speak about their experiences with small groups of inpatient unit staff.

“If you give inpatient staff a chance to have that kind of human connection and see where people’s lives go, then it might change their perspectives on care,” says Kidd. “It can carry forward into care being more recovery oriented—a little bit different than focusing on medication and stabilization.”

Kidd employed a carrot-and-stick approach to achieve staff buy-in on the initiative. First, he generated enthusiasm with presentations that drove up the excitement about the chance to hear from former clients. He also made it clear that the exercise was mandatory.

The Result: Staff learned about the importance of small gestures

The approach has worked, says Kidd, with some valuable lessons emerging from the experience of working with former clients—including that it is often the ‘little things’ that make a big difference.

“Many staff have said they found it amazing to hear some of the feedback about what makes a difference in care.” He said one client came back to say that her recovery was greatly helped by small gestures such as the staff member who used to play a game of ping pong with her every day, or say good morning. “Often, an impediment to change in psychiatric care can be the notion that some huge effort, some complicated initiative needs to take place to improve the quality of care,” he says. “That’s not always the case.”

The Impact: New approach bridges gap between clients and staff

Former clients are returning to participate more deeply in the process of teaching staff how to take a recovery approach to care. For example, Kevin Hareguy, a former inpatient client in the schizophrenia unit, returned to participate in the speaker series. “Being able to go up over the distance that was created by my illness and being diagnosed—I was able to bridge that gap,” he says.

Sean Kidd image Sean Kidd
Head of Psychological Services
Schizophrenia Program
Centre for Addiction and Mental Health
Toronto, Ontario

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