Mental Health Recovery Plan of King County

Overview and Summary of Activities

In August 2005, the King County Mental Health, Chemical Abuse and Dependency Services Division (MHCADSD) released the Recovery Plan.

The Mental Health Recovery Plan has three phases covering five years:

• Phase 1 (2005-2006) creates a shared vision of recovery among system stakeholders.
• Phase 2 (2006-2008) creates the system structures, including financial and reimbursement structures, that will sustain the foundation for a recovery-oriented system.
• Phase 3 (2008-2010) will increase the system's recovery depth and complexity.

The Recovery Ordinance

On November 15, 2006 the Metropolitan King County Council passed The Recovery Ordinance (#15327), adopting the recovery model for the publicly funded mental health services for which King County is responsible. The ordinance is based on the Recovery Plan. (This is actually the second Mental Health Recovery Ordinance. Click here for more about the history of recovery in the King County Mental Health system.)

Phase I
MHCADSD created the Detailed Work Program for Completion of Phase I Implementation of the Recovery Plan for Mental Health Services for the Metropolitan King County Council in March 2006.

Phase II - Initiating Change
The Metropolitan King County Council required MHCADSD to submit a second ordinance and an updated detailed implementation plan in June 2007. The Recovery Plan for Mental Health Services - Phase II Implementation Plan was submitted to the King County Executive's office on June 15, 2007 and transmitted to the Metropolitan King County Council on June 29, 2007.

Activities through 2007 have included:

Phase I - 2005

Presentations and discussions were held throughout the network of mental health service providers to begin developing a shared understanding and language regarding the Recovery model of services.

MHCADSD hired an expert on recovery to provide leadership in the planning process.

The King County Mental Health Advisory Board created the Recovery Initiatives Committee (RIC) as a workgroup of the Quality Council, part of the advisory board. The role of the RIC was to review and comment on plans and documents related to recovery and make recommendations. The Board and its committees are comprised of consumers, advocates, and provider representatives.

2006

Recovery Roundtables were held at the mental health agencies. These included a presentation about recovery and time for questions and conversation. The Roundtables were attended by agency management, direct services providers and consumers. The presentation described what recovery is, where the ideas have come from and why the system transformation of the Recovery Journey is necessary.

A series of retreats with senior management of the mental health agencies was begun to share the vision of recovery and to share with one another the various efforts underway at each agency to further recovery for the people they serve.

Other implementation planning groups were begun. These included:

• Recovery Plan Coordination (RPC) a staff driven group chaired by Jean Robertson, the King County MHP Administrator worked to ensure a synchronized and coordinated move towards the goal of the Plan where activities of the various groups are consistent and policy and programming decisions are consistent with recommendations.
  
• Voices of Recovery, an exclusive group for consumers of the King County Mental Health Plan, with one division RPC staff liaison. This group reviews and provides input on all King County recovery transformation activities. Consumers are paid for their participation in this group, which is a permanent feature of the transformation process. The group is also developing other strategies to increase consumer voice and influence in the system.
  
• Recovery Implementation Group (RIG), composed of representatives from consumers, advocates, agency staff, division staff, and other interested parties. The workgroup worked to develop definitions and system goals, explored promising and best practices and developed a plan to increase consumer involvement at all levels of the systems.
  NOTE: The RPC, RIC and RIG ended their work at the end of 2007.
  
• Youth and Older Adult Provider Work Groups. Because recovery literature is primarily concentrated on adult services and outcomes, these work groups were formed to develop and articulate appropriate process and outcome measures for youth and older adults.

MHCADSD contracted with Technical Assistance Collaborative to develop strategies to align financial incentives with recovery practices.

2007

A training consultant was hired to design and develop intensive training to be provided at approximately 16 sites over the course of the next several years.

MHCADSD began using fiscal incentives to increase the use of supported employment.

A second and related incentive is new fiscal support for clubhouses pursuing ICCD certification. ICCD certification ensures fidelity to clubhouse standards including, among many other benefits, a commitment to helping 20% of members obtain community employment.

MHCADSD is also increasing the availability of peer counseling services. The plan envisions a future where any consumer desiring peer support will have access to these services. MHCADSD has developed local certified peer counselor training, with the first group of graduates completing their training in October, 2007. Training for mental health agencies was provided in November 2007 to assist in the development of new peer support services.

Mental health agencies completed a Self-Assessment of Recovery Practices and began development of a Recovery Plan.

Phase II - 2007 and beyond

MHCADSD announced an intention to focus on certain areas to improve in, also called outcomes. These outcomes were identified through all the planning activities of the last several years:

• Employment/ Education/ Life Activities
• Housing
• Community Tenure (staying out of the hospital and out of jail)
• Quality of Life (satisfaction with life, hopefulness about the future, sense of control in life)

MHCADSD will measure how the system change toward recovery is progressing by:

• Data collection
• Annual on-site reviews at mental health centers
• Client Self-Reports
• Agency-specific reports
• Annual written progress reports by MHCADSD

The Recovery Executive Committee was convened in late 2007. This committee is comprised of people in a position of leadership outside the mental health system to review progress toward established goals and make recommendations for course corrections should they be needed. The committee meets several times each year.

In 2008, a new stakeholder group, replacing the RIG and the RIC, came together. This group, the Recovery Advisory Committee (RAC) advises MHCADSD on the implementation of recovery initiatives. Also, in 2008, MHCADSD submitted a Mental Health Recovery Plan Phase II Progress on Implementation Report to the King County Council.

For more information about transformation activities in 2008, see the Mental Health Recovery Roundup.