An approach to treatment that focuses on recovery from mental illness, not the treatment of it, is gaining national acclaim for the Medical College of Georgia Department of Psychiatry and Health Behavior at Georgia Health Sciences University.
Project GREAT, or the Georgia Recovery-Based Educational Approach to Treatment, encourages health care providers to empower patients to be part of their own care, while also changing the way providers think about treatment. It is based on the Recovery Model of psychiatric care, which developed in the 1980's as a way to deinstitutionalize mental illness.
"The model is really about a broader sense of hope for consumers," says Dr. Alex Mabe, a Professor of Psychiatry and Health Behavior and faculty leader for the program. "The goal of our program is to let people be experts in their own care and offer them treatment plans that connect with life goals they provide."
While recovery-oriented treatment programs are sprouting up across the country, GHSU is one of the first academic departments of psychiatry to take on the challenge of changing clinical services and educational curriculum.
The effort has earned the department the 2012 Award for Creativity in Psychiatric Education from the American College of Psychiatrists. The award was presented Saturday, Feb. 25, at the College's annual meeting in Naples, Fla.
Project GREAT was the brainchild of Dr. Peter Buckley, former Chairman of the department and now MCG Dean. "Recovery was not a concept in my training," he says. "We took that concept and said we should be treating our consumers in a new way and we should be training our future workforce. Project GREAT has been a collaborative effort and would not have been possible without the invaluable support of The Carter Center, the state's Department of Behavioral Health and Developmental Disabilities, and Georgia's Mental Health Consumer Network."
The treatment portion of program combines shared decision-making with support from Certified Peer Specialists, people who have gained control over their lives after a psychiatric diagnosis. In shared decision-making, providers ask patients about their life goals and incorporate them into their treatment.
"Traditionally psychiatry has been very symptom focused," says Dr. Gina Duncan, Assistant Professor of Psychiatry and Health Behavior and the psychiatrist for the Project GREAT team. "We have focused on the diagnosis of illness and the treatment of its symptoms, often to the point of excluding other elements of well-being. The recovery movement has been such an important part of empowering those who have suffered from mental illness to take back some control of their lives and determine in what direction they want to go."
The approach is about teaching people there is meaningful life beyond the illness and engaging them in things they find meaningful, she says. "We come up with wellness plans that move beyond treating symptoms," Duncan says. "Plans might include things like getting a job or volunteering, for example."
The Certified Peer Specialists draw on their own experiences to help the patients see their potential.
"I see my role as being a missionary of hope to others," says Gareth Fenley, one of two Certified Peer Specialists on the Project GREAT team. "I talk to people about my recovery story - the idea that we can and do recover, even when we face continuing struggles. My own recovery isn't over. It's a journey, where I will face continuing challenges."
Project GREAT is about more than treating patients, Mabe says. The founding principles of the program have been integrated into every aspect of the department - from training medical and nursing students before graduation to training residents before they enter practice. Department faculty and the peer support specialists also work with faculty across the enterprise to educate them on the concepts of recovery.
"There is a clear need to extend ideas about recovery in mental illness to other disciplines in medicine including non-mental health providers. Often, other medical disciplines provide more psychiatric care than psychiatrists do," says Dr. Anthony Ahmed, Assistant Professor of Psychiatry and Health Behavior and the psychologist on the Project GREAT team. "People with mental illness don't just present in psychiatry clinics. They are often seen by primary care physicians and emergency room doctors. We must ask ourselves if we are having an impact on the way those providers provide care for people dealing with the challenge of psychiatric illness. "
"This program has inspired a lot of hope around the state," Buckley adds. "Not only are we broadening the perspectives and sensitivities of our doctors, but people in recovery see the state's medical school stepping up and being a team player and recognizing that recovery is not only a philosophy, but a potential treatment modality. "
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