NYAPRS Note: The excellent interview below from our friends at The Coalition with Dr. Peggy Swarbrick highlights the theme on every policy maker’s mind: integration. How can we improve health outcomes through a person-centered approach in whatever setting we serve people? This is also an especially timely piece because Dr. Swarbrick will be joining us in three weeks at the NYAPRS Executive Seminar to discuss leading innovations in integrated care. There is still time to register for the Seminar with reduced rates; see the program and confirm your attendance today! https://rms.nyaprs.org/2014-executive-seminar/
Health as the Cornerstone of Recovery: An Interview with Peggy Swarbrick, PhD, OT, CPRP, FAOTA
The Coalition of Behavioral Health Agencies, Inc.; RECOVERe-works, March 2014
Not only is Peggy Swarbrick, PhD, OT, CPRP, FAOTA, the go-to expert on peer wellness in the metropolitan area, but as Director of the Institute for Wellness and Recovery Initiatives at Collaborative Support Programs of New Jersey (CSPNJ), and part-time assistant professor at Rutgers School of Health Related Professions, she exemplifies the spirit of CSPNJ because she “shares a vision of healing and hope that is promoted by choice, freedom, inclusion and destigmatization.” As a leader, author, academic, researcher, trainer, and advocate working in the interface between health and behavioral health, Dr. Swarbrick is the ideal expert to explain why health is often considered the cornerstone of recovery.
Question: The Substance Abuse and Mental Health Services Administration (SAMHSA) defines health as one of the four principles that are key to life in recovery. How and why did health become such a priority?
Dr. Swarbrick: I believe health, and thinking about health from a multidimensional aspect, became important for many reasons, but the big one was the health disparity between many people who had mental and substance use problems, and those who did not. People saw that good health is one of the goals of recovery, treatment, and prevention, and that wellness is not just physical, but social, emotional, and spiritual.
Question: Is health and wellness different for people in recovery versus people who aren’t?
Dr. Swarbrick: For people in recovery, health has often meant a crisis or a challenge mentally, emotionally, socially, or spiritually. Someone who identifies as being in recovery may take a run to deal with stress or triggers that often lead to emotional imbalance and negative reactions. Someone who is not in recovery may not think as clearly about the reasons for taking a run.
Question: What can behavioral health professionals do to help people in recovery with health issues?
Dr. Swarbrick: Behavioral health professionals can be aware of health as the goal. We get caught up in the signs, the symptoms, of mental illness, and do not focus on health as something to strive towards. Second, I think professionals need to become more comfortable understanding that the mind and the body work together. Many times behavioral health providers say, “You have diabetes, I can’t talk to you about that.” They don’t understand that not taking care of diabetes could cause a relapse. Sometimes it is supporting clients, and taking care of their physical health, that helps them reduce their depression or anxiety.
Question: I would imagine that behavioral health professionals might feel they don’t have the time to learn about physical health, and so pass responsibilities on to other professionals.
Dr. Swarbrick: I understand that, but I think that we can’t say then that we’re doing person-centered, individualized care. We’re never going to be experts in diabetes, but there are some very simple, practical things that most professionals could suggest to help a person with diabetes. We definitely have to have a better understanding of what we call “health literacy.”
Question: What do you find is the biggest problem behavioral health professionals have with the more global idea of health?
Dr. Swarbrick: The feeling, “Oh, I don’t want to say something wrong,” or, “I’m not a doctor.” Or, “I don’t want the liability.” Once we do a health literacy training, we get a very different reaction. Staff and others understand their boundaries and their limits, but they often become more empowered with tools to help people use resources; collaborate with others; or frame health from a self-care perspective. That may involve medical follow-up with routines that are indicated for their health issues.
So I think my message is: help people do things that are good for their health, particularly things they can do on a day-to-day basis to get their bodies moving. That’s a big thing, and if we can encourage people to do that, we can help relieve a lot of anxiety, depression, and isolation.
Read more about Dr. Swarbrick’s message in Wellness and Recovery: A Self-Defined Balance of Health Habits, in the September 2013 RECOVERe-works, and the more recent, scholarly, “Promoting the health of peer providers through wellness coaching.”
Other resources of interest include health literacy bibliographies and health literacy issues of Words of Wellness, a CSPNJ publication archived here. Particularly relevant are “10 Questions You Should Ask” (Volume 3, Number 8, February 22, 2010) and “Communicating & Collaborating for Wellness” (Volume 4, Number 11, June 3, 2011). A guide to running a health fair, and a related publication on peers’ perspectives on how health fairs motivate them are available elsewhere.
The new video, Culture, Language and Health Literacy, shows how culturally competent health communication is necessary to provide adequate care. A guide to the health literate organization, and other free material, are also available.
Health Passport forms allow people to assemble information about their preferences and needs, and have this data included in their charts. Passports come as PDFs in English and Spanish, which can be completed by hand or electronically.
http://www.coalitionny.org/the_center/recovere-works/RECOVERe-worksMarch2014-2.html#Health