Recovery and the NDIS Picture of green tree branch with leaves START MODULETABLE OF CONTENTS logo Description This training is designed for all recovery-oriented service providers that are operating in the NDIS environment. The information in this module is general in nature. Every organisation does things differently and has different policies and procedures, so please interpret the content in this module with your organisation in mind and discuss any discrepancies with your line manager. Duration: Approximately 30-40 minutes (note: you can close the training and pick up where you left off at a later date). Last updated: 2 July 2020. Content and links in this training were correct at the time of publication. We check these regularly; however, if you find broken links or errors, please contact transitionsupport@flinders.edu.auTraining objectives Topic 1 of 7 Picture of light bulb Training objectives This training is for all recovery-oriented service providers that are operating in the NDIS environment. It will help you to: • Understand what recovery-oriented practice is and your responsibilities as a provider • Understand how the NDIS aligns with a recovery-oriented approach • Know what you need to do to provide recovery-oriented services in the NDIS Picture of open book Assumed knowledge This module assumes a basic understanding of the principles of the NDIS and how the scheme operates. The following training modules on our website should be completed before this one: • Understanding the NDIS • Accessing the NDISWhat is personal recovery? Topic 2 of 7 Image of feet “passion led us here) What is personal recovery? The concept of recovery was conceived by, and for, people living with mental health conditions to describe their own experiences and journeys and to affirm personal identity beyond the constraints of their diagnoses. When we use the term 'recovery' in the mental health setting we are referring to the idea of 'personal recovery' rather than 'clinical recovery'. Click on the images below to learn more about the differences between the two approaches. Click to flip Picture of stethoscope Clinical recovery focuses on alleviating or controlling symptoms of mental health conditions. It is: • Based on the medical model of health and well being • Focused on “getting rid of” symptoms and restoring social function • Focused on “getting back to normal”. Click to flip Picture of person looking up at sky Personal recovery is about creating and living a meaningful and contributing life whilst living with, or recovering from, the impact of mental health conditions. It acknowledges that recovery is: • A unique and personal journey • A normal human process • An ongoing experience and not the same as an end point or cure • A journey rarely taken alone • Nonlinear - frequently interspersed with both achievements and setbacks. Recovery principles The principles of recovery-oriented mental health practice ensure that mental health services are delivered in a way that supports the recovery of mental health consumers. These principles are: Uniqueness Everyone's recovery journey is different Recovery-oriented mental health practice: • Recognises that recovery is not necessarily about cure but is about having opportunities for choices and living a meaningful, satisfying and purposeful life, and being a valued member of the community • Accepts that recovery outcomes are personal and unique for each individual and go beyond an exclusive health focus to include an emphasis on social inclusion and quality of life • Empowers individuals so they recognise that they are at the centre of the care they receive. Real choices People are the experts in their own lives Recovery-oriented mental health practice: • Supports and empowers individuals to make their own choices about how they want to lead their lives and acknowledges choices need to be meaningful and creatively explored • Supports individuals to build on their strengths and take as much responsibility for their lives as they can • Ensures that there is a balance between duty of care and support for individuals to take positive risks and make the most of new opportunities. Attitudes and rights Attitudes and rights Everyone has the right to live a meaningful and connected life Recovery-oriented mental health practice: • Involves listening to, learning from and acting upon communications from the individual and their carers about what is important to the individual • Promotes and protects an individual’s legal, citizenship and human rights • Supports individuals to maintain and develop social, recreational, occupational and vocational activities which are meaningful to them • Instils hope in an individual about their future and ability to live a meaningful life. Dignity and respect Communities must be accessible to, and respectful of, people from all backgrounds Recovery-oriented mental health practice: • Involves being courteous, respectful and honest in all interactions • Involves sensitivity and respect for each individual, especially for their values, beliefs and culture • Challenges discrimination wherever it exists within our own services or the broader community. Partnership and communication People should be involved in all aspects of their recovery journey and care Recovery-oriented mental health practice: • Acknowledges that each individual is an expert on their own life and that recovery involves working in partnership with individuals and their carers to provide support in a way that makes sense to them • Values the importance of sharing relevant information and the need to communicate clearly • Involves working in positive and realistic ways with individuals and their carers to help them realise their own hopes, goals, and aspirations. Evaluating recovery The outcomes of recovery practices can be seen in many ways including through improved social connections and participation in daily life Recovery-oriented mental health practice ensures and enables continuous evaluation at several levels: • Individuals and their carers can track their own progress. • Services demonstrate that they use the individual’s experiences of care to inform quality improvement activities. • The mental health system reports on key outcomes that indicate recovery. These outcomes include housing, employment, education, social and family relationships, health and well-being. Recovery language Recovery-oriented language guide The Mental Health Coordinating Council have developed a guide for using recovery-oriented language. You can download this guide from their website. VISIT MHCC WEBSITE According to the guidelines, recovery oriented language needs to be: 1 Respectful 2 Non-judgemental 3 Clear and understandable 4 Free of jargon, confusing data, and speculative comment 5 Consistent with our body language 6 Sincere in carrying a sense of commitment, hope and presenting the potential for opportunity 7 Strengths-based Recovery-oriented language should convey acceptance, hope, respect and uniqueness whilst avoiding 'worn-out' words. Click below to see examples of recovery language versus 'worn-out' expressions. Click to flip Large green tick • Kim has a mental health condition • Kim is having a rough time • Kim is experiencing difficulty with her medication • Kim has a tough time learning new things • Kim often (describe actions) when upset Click to flip Large red cross • Kim is mentally ill • Kim is uncooperative • Kim is treatment resistant • Kim is low functioning • Kim is dangerous, abusive, angry Source: Examples are from the Recovery Oriented Language Guide developed by MHCC As you will see, many of the recovery-oriented examples provided above describe challenges that the person is facing (it isn't about pretending challenges don't exist). The key difference between recovery language and 'worn out' phrases is that the recovery phrases describe the behaviours and experiences of the person, rather than describing the person themselves. More tips for using recovery language can be found in the guide. (saying below is in box with white flower) Recovery is not the same thing as being cured. Recovery is a process not an end point or a destination. Recovery is an attitude, a way of approaching the day and facing the challenges. Being in recovery means recognising limitations in order to see the limitless possibilities. Recovery means being in control. Recovery is the urge, the wrestle, and the resurrection... Pat Deegan, disability-rights advocate, psychologist and researcher (1996)Recovery-oriented services Topic 3 of 7 Recovery-oriented service delivery Recovery-oriented services acknowledge that people with lived experience are the experts in their lives, while recovery practitioners are the experts on available services and supports. Recovery practice is therefore a partnership which focuses on: • Supporting people to embrace their strengths, resilience and inherent capacity for living a full and meaningful life of their choosing • Adapting to people's needs and aspirations, rather than people having to adapt to the requirements of the service • Being trauma-informed, culturally aware and culturally safe • Being person-first and person-centred by maximising self-determination and self-management of mental health and wellbeing • Being aware of and addressing the broader factors that impact well-being and social inclusion of people experiencing mental health issues such as the social determinants of health • Supporting families and carers to understand people's experiences and how they can assist with recovery • Supporting local communities to accept, welcome and include people living with mental health conditions. In short, providing recovery-oriented services is about respecting individual choices and supporting people to make decisions. It focuses on doing things with people, not for them. So how does this align with the NDIS? Let's find out.Topic 4 of 7 Aligning recovery and the NDIS Here we will explore some of the key principles of the NDIS and how these align with a recovery approach. This activity assumes a basic understanding of the NDIS and its purpose. If you are new to the NDIS we recommend completing our 'NDIS explained' training module before doing this module. This is a learning exercise, so don't worry if you don't get everything right. There will be feedback after every question and we will have a look at the topic in more detail in the next lesson.Being a recovery practitioner in the NDIS Topic 5 of 7 How does the NDIS align with recovery approaches? This table summarises what you just learned about how the principles of the NDIS align with recovery practice. It also describes how you, as a recovery practitioner, can ensure you are providing services in line with these principles. Table summary of how the NDIS principles align with recovery practice. Table columns: Recovery principles, NDIS principles, Be a recovery practitioner in the NDIS Begin table contents Recovery principles column Uniqueness Everyone's recovery journey is different NDIS principles column People will have choice and control over the services they receive and from whom. Goals and aspirations as identified by the person will guide recovery and service outcomes. Be a recovery practitioner in the NDIS column Use supported decision making to ensure people are excercising choice and control Manage all potential conflicts of interest Develop service agreements in partnership with people to ensure their goals and service needs are met Be flexible and adaptive Recovery principles column Real choices People are experts in their own lives NDIS principles column Choice and control A flexible funding approach to develop a new disability services market - services will develop based on what people want, not what is available Be a recovery practitioner in the NDIS column Think creatively about your service and the services you refer to - how can the flexibility of the NDIS lead to new and innovative services? Recovery principles column Attitues and rights Everyone has the right to live a meaningful and connected life NDIS principles column The NDIS puts people in charge of their plan and their funding Carers and trusted others are included in the NDIS journey Social and economic participation for people with a disability is the main aim of the NDIS Be a recovery practitioner in the NDIS column Support people to participate in social, recreation and/or work activities that are meaningful to them Listen to people and their carers about what is important to them Recovery principles column Dignity and respect Communities must be accessible to, and respectful of, people from all backgrounds. NDIS principles column Respecting people's values, beliefs and culture through: Person centred planning Goals and aspirations Choice and control Challenging discrimination with services and the broader community through community inclusion grant funding and an emphasis on social and economic participation for NDIS participants. Be a recovery practitioner in the NDIS column Listen to people about what they want Be courteous, respectful and honest in all interactions Allow dignity of risk Recovery principles column Partnership and communication People should be involved in all aspects of their recovery journey and care NDIS principles column Person centred planning and goal driven service delivery Be a recovery practitioner in the NDIS column Recognise that service delivery is a partnership and communicate regularly to make sure everyone is on the same page Recovery principles column Evaluating Recovery The outcomes of recovery practices can be seen in many ways including through improved social connections and participation in daily life. NDIS principles column NDIS outcomes framework which measures progress toward goals across important life domains (eg. relationships, work) Be a recovery practitioner in the NDIS column Be mindful of the person's goals and what your service is doing to help the person achieve those goals Always build skills and capacity - do things with people and not for them. End table contents Exciting steps forward From a recovery perspective, there is a lot to be excited about when it comes to the NDIS. Here are some of the ways that the NDIS is changing service delivery to support individual recovery. Social and economic inclusion Supporting people to be active and contributing members of society is the main aim of the NDIS. This inclusive framework empowers people to live the life they choose and recognises the value of diversity and inclusivity. You can read about the NDIS focus on economic and social inclusion, how the scheme is going and their focus areas for improvement in the quarterly reports available on the NDIS website. Innovative service delivery NDIS services don't have to 'fit the mould' of traditional mental health and disability services. People can now use their NDIS funding to access personalised and innovative services, or those that aren't traditionally aimed at people with a disability. NDIS funding can help people to do things that they never dreamed of doing before. Some real-life examples include: • Attending a football game and taking part in a the guard of honour (read all about it in the Katherine Times) • Writing a play!! • Getting support from local providers and community members - as opposed to fly in fly out services in rural areas. Read more participant stories on the NDIS website. Building community capacity The NDIS is about more than individual support funding - it also recognises how important it is that communities, businesses, and mainstream services are inclusive of people with a disability and have the knowledge to appropriately support people to engage in the broader community. The national ILC grant rounds provide funding to organisations to work with the broader community and break down the barriers that stop people with a disability from living an everyday life of their choosing. While the NDIS is new and sometimes challenging, there are good reasons to be excited about it in terms of its capacity to support individual recovery.Challenges and strategies Topic 6 of 7 Addressing challenges – text in box with the work Change in neon The NDIS is a big change, both for people accessing services and for service providers. Your support and continued recovery focus as people learn about the scheme is really important. It ensures that people who are experiencing the change can do so with a trusted, recovery-oriented practitioner by their side. Picture of a yellow door and a green door side by side – doors numbered 31 and 33 See our 'NDIS access and psychosocial disability' training module for the details about how to support NDIS access for the people you work with. Recovery and the access process To access the NDIS people will need to show that they have a likely permanent disability and that they have substantial difficulties in at least one domain of daily life. Some people may find this challenging and feel like it is contradictory to the recovery principles. Your recovery-oriented skills and knowledge are crucial here. You may want to keep the following messages in mind when working with people during the access phase: • The NDIA needs evidence that the impairment caused by the mental health condition is likely to remain across the person’s lifetime. Confirming that the person’s impairment is likely to remain across their lifetime has no reflection on whether the person has achieved their best possible version of personal and emotional wellbeing. • The NDIS supports recovery by funding services and supports, as chosen by the individual, to meet their needs. It may feel confronting to identify areas of need - but doing so will empower people to live the life they choose and get the services they need. Using recovery-oriented language in an access request “When writing requests using recovery language make sure you talk about the support that someone receives to help them to get to where they are now. It's ok to write the application in a positive way, but make sure that you're still painting that really clear picture that demonstrates what the person's life looks like without the support in place. Some people that come into NDIS are functioning really well because they've been very well supported prior to their access request. It's fine to say that, but you need to demonstrate the supports that they require to keep them at that level of function - so the assessor can see the level of support that they're likely to continue to need in the future.” interview with NDIA mental health team representative pic of guy in hoodie standing in front of chalk board that has a picture of arms flexed showing muscles Incorporating strength and optimism The purpose of an access request is to provide evidence that the person needs the level of support provided by the NDIS. This document should be concise, accurate and designed to address the access criteria. Including information about a person's strengths in the access request may or may not be relevant to the application - it will depend on the individual. However, it is important not to include information that might make it more difficult for an access assessor to make an accurate assessment of a person's needs. Instead of adding statements about strengths (if not required for the purpose of the application) then have this conversation in person. Still not sure on how to tackle language in NDIS applications? Check out our 'NDIS access and psychosocial disability' training module.Certificate of completion Topic 7 of 7 Complete our feedback survey and download a certificate of completion for your records. Button: go to survey