Brain Science and Updates From the Field

Recovery Project Seeks Family Involvement

Monday, June 29, 2015

Lloyd Wertz, center, with Stairways staff during Family Inclusion standards Project training.

When Lloyd Wertz was 8 years old, his father was hospitalized with an ulcer. After medical treatment and after-care, the ulcer was cured and his father was back to normal. “
Normal,” for the Wertz family, however, included the symptomology of mental illness.

“Back then they called it manic depressive illness,” said Wertz, following a recent workshop with Stairways staff. “After his manic phases, my father would sink into a deep, deep depression. He’d be like this for months, and it would get bad.”

At the ripe young age of 14, Wertz found himself the petitioner for his father’s involuntary commitment to a mental hospital – ample motivation for what became a life-long journey toward family awareness and inclusion in the mental health treatment of loved ones.

Wertz first visited Stairways in April of 2012 and returned for the final time in June, 2015, as part of a related research project and to train staff on his organization’s Family Inclusion Standards Project. The project is both professional and personal for him.

“I didn’t understand what was happening with my dad,” Wertz explained. “For his ulcer, he went to the hospital and the doctors fixed him. Shouldn’t it be the same for his depression?” The bipolar disorder eventually claimed Wertz’s father’s life.

What would he do differently then, given what Wertz knows now? The heartbreaking answer to this question comes quickly. “I wouldn’t have blamed my dad for his symptoms for the rest of his life. I thought he should be able to control it. I thought he wasn’t trying. I thought he was a drunk. Now I know he was self-medicating because he was really hurting.”

Wertz would have liked the opportunity to approach his father’s illness in an entirely different way. With greater awareness and information, he could have made things better at home – more comfortable – to assist in his father’s recovery.

This experience is “shared history” for millions of families, says Dr. William Beardslee of Harvard Medical School. In his book, Out of the Darkened Room (Little, Brown, 2002), Beardslee writes, “In far too many families, depression is neither recognized as a serious illness nor understood, and many of the misunderstandings are compounded by guilt and blame, by trying to make sense of the sufferer’s behavior and not knowing how to.”

Wertz, along with mental health providers like Stairways, are determined to change this shared history. Through workshops and trainings, professionals learn to expand their definition of “family” to include all significant persons (friends, roommates, clergy, etc.), and to enhance mental health recovery plans by actively enlisting the support and assistance of all who can affect the life of a recovering person.

Data collection, from routine audits Wertz performs on Stairways’ records, validates research findings and sought-after recovery outcomes. These include more accurate diagnosis, improved protection against relapse or re-hospitalization, lower risk for arrests or homelessness; and improved vocational goals. For families, benefits include a better understanding of their loved one’s recovery process, more realistic expectations, and opportunities to become leaders in advocacy – with health care providers and with the community.

During his training, Wertz reminded staff of more global benefits of deliberately enlisting the help of family or significant persons. “The reality is, the mental health work force is shrinking, even as the number of individuals seeking treatment increases.” With fewer psychiatrists, therapists and social workers entering the field, “We need to expand our resources. This means we need to look to peers. We need to look to family for help.”

Stairways staff attending Wertz’s workshop underscored the benefits of family inclusion with stories from their own experience.

Lisa Peters, mental health worker with Stairways’ new long term structured residence program, recalled a family she formerly worked with as a blended case manager. A daughter found her unresponsive mother, who had attempted suicide. Said Peters, “The daughter and her father stepped in, helped to coordinate coverage, and advocated with available social services.” The result was a strong partnership between family and Stairways staff which promoted all the supports needed for recovery.

Sharon Sandberg, while a therapist through Stairways’ personal care home, credits one resident’s sister with providing crucial information to staff when faced with a medication dilemma. “Our resident required a medication that was very expensive. Through normal coverage and the insurance information we were given, we couldn’t figure out how she could afford them, much less how we could continue to provide them.” The sister gave information about a pension fund the personal care home staff didn’t know about. It was a missing piece of information only her sister could provide.

Such stories are common, said Wertz. “Whether it’s notifying care workers that Johnny only wears sneakers. Ever. Or that Jimmy once lost a girlfriend on July 3rd and struggles with the memory at the same time every year, successful inclusion in recovery always comes down to family members who truly understand their loved one’s needs.”

How does Stairways as an organization measure up with its inclusion efforts? Favorably, according to Wertz’s professional assessment as a researcher and trainer of Family Inclusion Standards. “There are a few agencies in Philadelphia – then Stairways Behavioral Health – who stand out across the whole state for family inclusion,” Wertz said. “Stairways has intentionally made family engagement part of its operational effort. Institutionally, Stairways stands out in the field.”

While Wertz’s assessment is gratifying, the bar only rises as increasing need meets a diminishing workforce. Diminishing funding also means that workforce must continually do more with less. Families and significant others provide an essential part of the equation, said Wertz. “In the end, we are all ‘merchants of hope’ to individuals and their families. ‘Hope’ is the key word, and recovery specialists and family members alike share those same hope-full desires for the future.”

Learn more about the Family Training & Advocacy Center (FTAC) and the PA Psychiatric Leadership Council (PPLC) here: www.pmhcc.org

Out of the Darkened Room: When a Parent is Depressed; Protecting the Children and Strengthening the Family, by William R. Beardslee, M.D., is available through Amazon.com.


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