Culture of Wellness Initiative
Culture of Wellness: Promoting Smoking Cessation and Wellness Initiative - NEW! An initiative of the Vermont Department of Mental Health. Project Introduction Vermont community mental…
Culture of Wellness: Promoting Smoking Cessation and Wellness Initiative - NEW!
An initiative of the Vermont Department of Mental Health.
Vermont community mental health providers are challenged to provide care that addresses the mental health and overall health and wellness needs of people experiencing serious mental illness. We may ask ourselves, “Why should we focus on whole health when our expertise is in mental health?” National statistics indicate that about 50% of adults with serious mental illness are smokers, compared with 23% of the general population. People with mental health or substance use disorders experience reduced life expectancy, higher rates of disease and reduced quality of life. Specifically, smoking-related illnesses cause half of all deaths among people with serious mental illness. Recognizing the importance of addressing this need, the Vermont Department of Mental Health is partnering with the Vermont Cooperative for Practice Improvement and Innovation (VCPI; www.vtcpi.org), and an array of partners to improve the overall health and wellness supports and services offered, including smoking intervention and cessation for people experiencing serious mental illness.
The work of this initiative will be conducted within a voluntary practice improvement framework. Due to the nationally documented vulnerability of people with serious mental illness and limited resources available, initial efforts will focus on the Community Rehabilitation and Treatment (CRT) Programs within the designated mental health system of care.
Vermont Department of Mental Health (DMH)
Vermont Department of Health (VDH)
Vermont Cooperative for Practice Improvement and Innovation (VCPI)
Vermont Care Partners (VCP)
Goals of the Initiative
Long Term Goals:
1. Reduce life expectancy gap for people living with serious mental illness by 10% in the next five years
2. Reduce chronic disease burden for people living with serious mental illness as demonstrated by a reduction of 5% in the prevalence of each of the top five chronic disease within five years.
3. Improve quality of life for people living with serious mental illness as measured by the Health Related Quality of Life Measures by 10% over the next five years.
Short Term Goals and related Interventions:
1. Raise awareness of evidence-based prevention methods to delay or prevent chronic diseases
a. Create a statewide platform for education, awareness and dialogue to promote a whole health approach to supporting Vermonters with serious mental illness
b. Identify and evaluate health and wellness activities and programs being implemented statewide with the goal of broader dissemination and replication
2. Reduce smoking prevalence by 20% by December 2017 for people living with serious mental illness
a. Assure all Designated Agencies’ electronic health records are collecting information on smoking status, history (pack years), current quantity smoked and desire to quit
b. Elevate awareness statewide around the impact of smoking on rates of morbidity, disease and quality of life for people experiencing serious mental illness
c. Improve access to health and wellness, and smoking intervention and cessation support and programs for Vermonters experiencing serious mental illness
3. Improve nutrition by increase fruit and vegetable intake to standards recommended by Centers for Disease Control and reduce salt consumption to less than 2 grams per day
a. Educate CRT participants on the benefits on eating 2 cups of fruit and 3 cups of vegetable daily ( Moore & Thompson, 2015)
b. Educate CRT participants on the benefits on eating less than 2 grams of salt daily
4. Improve time spent doing exercise
a. Educate CRT participants on the benefits of exercising at least 210 minutes (3 ½ hours) each week or 30 minutes’ daily
AWARE Vermont – Vermont Care Partners & VCPI
AWARE Vermont - Youth Mental Health First Aid - AWARE-VT The AWARE-VT is 100% funded through a grant from the Substance Abuse & Mental Health…
AWARE Vermont - Youth Mental Health First Aid -
AWARE-VT The AWARE-VT is 100% funded through a grant from the Substance Abuse & Mental Health Services Administration (SAMHSA), and is contracted by Vermont Care Partners/Vermont Care Network. Visit the Vermont Care Partners site for more info! The AWARE Vermont / Youth Mental Health First Aid project will:
- Increase the mental health literacy of community members and professionals serving youth
- Reduce mental health stigma
- Support the early identification and referral of youth experiencing mental illness
VCPI is facilitating the data and evaluation of this initiative
Why Data Matters
The AWARE Vermont YMHFA initiative is being implemented to achieve a wider community impact by training a diverse group of adults, who in turn, will reach a broader spectrum of adolescents and transition aged youth within our Vermont communities. By training an increased number of YMHFA First Aiders, our communities can move toward wide-scale knowledge of behavioral health issues that affect youth and become more effective in addressing their needs and referring for support and services.
Within a performance improvement framework the goal of the AWARE Vermont effort is to create “improvement”. In order to measure this “improvement” in diverse systems we will need to develop simple ways to measure our current baseline. The data and evaluation of this work is critical to identify and measure the outcomes we are hoping to achieve. The key question that our data and evaluation efforts will help us answer is how we will know when we have achieved success through our efforts.
Data Tools and Strategies
- Informed Consent Form
- Course Evaluation
- Youth Mental Health First Aid Baseline Survey (Pre) Taken at beginning of training
- Youth Mental Health First Aid Follow up Survey (Post) Email follow-up
- Youth Surveys
- Community Surveys
- Participating Member Agency Data
Interested in attending a YMHFA Training? Contact your local coordinator.
Statewide Local YMHFA Coordinator Contact List by Designated Mental Health Agency:
Northeast Kingdom Human Services
Janet Hussey Monette
2225 Portland Street (P.O. Box 368)
St. Johnsbury, VT 05819
802-334-6744 ext 2135
802-748-3181 x 1164
Lamoille County Mental Health Services
72 Harrel Street
Morrisville, VT 05661
888- 5026 Ext. 171
Health Care and Rehabilitation Services of Southeastern VT
390 River Street
Springfield, VT 05156
802-886-4567 ext 2299
1138 Pine Street
Burlington, VT 05401
802-488-6000 ext. 6726
Northwestern Counseling and Support Services
130 Fisher Pond Rd
St. Albans, VT 05478
Clara Martin Center
11 Main St.
Randolph VT 05060
802-728-4466 ext 563
Washington County Mental Health Services
885 South Barre Rd
South Barre VT, 05670
802-229-1399 ext 702
Core Orientation & Clinical Skills for Direct Care Staff
Core Orientation for Direct Care Staff The goal of the Vermont Cooperative for Practice Improvement is to develop core orientation and competency materials for direct…
Core Orientation for Direct Care Staff
The goal of the Vermont Cooperative for Practice Improvement is to develop core orientation and competency materials for direct care staff of all kinds. This is one way of creating value for our members and developing a co-operative approach to helping all of our workforce understand value driven and recovery oriented practice. The Core Orientation & Clinical Skills Workgroup is advising the development of the orientation and competencies.
This project is exploring these critical questions:
What are the priorities and kinds of core orientation content and knowledge we want to direct care staff to receive upon hire?
How do we help people learn "value-driven" practice? Practice that is welcoming, helpful, strengths-based
What will be most helpful and have the most positive impact on quality of services?
What do our members see as the greatest value?
• Opportunities for staff to hear from consumers/families about their experiences
• Systems partnerships
• Resources that are available
• Tips & Tricks for avoiding burnout & compassion fatigue
• “Things I Wish I knew”
• Trauma Informed Care
• Strengths based
• Person-centered planning
• Learning from the lived experience
• Overview of our system of care
• Cultural Diversity
Vermont Cooperative for Practice Improvement and Innovation and consultants are working with the Core Orientation & Clinical Skills Workgroup and Advisory Committee to develop and disseminate a set of Core Orientation and Clinical Skills for direct care staff that are values-based and resiliency and recovery-oriented. VCPI established an Advisory Committee representative of statewide stakeholders to oversee the overall development of the Core Orientation materials and format. VCPI will facilitate the dissemination and implementation of the core orientation and skills materials to support the widespread adoption and utilization of these materials.
Development of the core orientation and skills materials will utilize existing research, programming and resources specific to community mental health and stakeholder input from Vermont providers, individuals with the lived experience, family members, and other stakeholders. A subcommittee has been established, expected to roll out Module I of the Core Orientation, focused around our Vermont System of Care's values, principles and beliefs, in 2018.
Collaborative Networks Approach (CNA)
VCPI is excited to announce the Vermont Training in Collaborative Networks Approach (CNA) Training Program! Collaborative Networks Approach (CNA) is a person-centered, recovery-oriented approach to treatment…
VCPI is excited to announce the Vermont Training in Collaborative Networks Approach (CNA) Training Program! Collaborative Networks Approach (CNA) is a person-centered, recovery-oriented approach to treatment that incorporates aspects of need-adapted approaches (Open Dialogue, reflecting therapies), peer support, and recovery-oriented care.
The goal of this training series will be to provide Vermont practitioners sufficient training to implement application of the Collaborative Networks Approach (CNA) within the Vermont System of Care. The curriculum will be organized with the guidance of Dr. Werner Schutze and will also involve other international practitioners from Norway where reflecting process originated and Tornio, Finland where Open Dialogue and needs adapted services originated. We aim to offer a pragmatic training that can be adapted within the existing system of care in Vermont. In addition, we will model the training to maximize its sustainability. We will train staff who will become trainers within their work settings. The training materials will be open access to supporting agencies within the state.
CNA Training Program:
Description: Comprehensive 16 days of training for 25 participants, over 5 sessions.
- Involvement of others from Europe so participants can get a spectrum of exposure to applications and different areas of expertise and emphasis. Pia Jessen and Rieulf Ruud will talk about reflecting process and its roots in Norway, and Mia Kurtti from the original Open Dialogue team will provide her perspective from Tornio.
• The trainings will include presentations from our Vermont based programs and other regional agencies who will share what they have learned about implementation in the US. This includes adaptions at Advocates in Framingham, MA and Parachute in NYC.
Description: Development and involvement of a trainer trainee cohort. This group could help provide continuity throughout the course of the training, could provide onsite consultation if requested.
Description: Continued TA, consultation and implementation support for all the participants. To allow access to expert faculty and to support implementation of the practices within a practice improvement framework. This can be done via teleconferences.
- Adobe conference video supervision/consultation with the European based trainers for participating programs.
• Consultation calls/video conferencing with training participants or Quarterly face to face meetings with in-state content experts
• Collaborative Network Approach Implementation
• Clinician needs and response to training
• Obstacles/barriers to implementation
• Special client issues related to CNA
VCPI administered funding provided from DMH to pilot the application of Open Dialogue in Vermont. Open Dialogue is a model of service delivery developed by a team in Western Lapland Finland over 20 years ago. The data indicates substantially lower rates of hospitalization and medication use, as well as other indications of a substantially altered, or entirely diverted, trajectory of schizophrenia. Pilot sites include CSAC/UCS and the Howard Center. Pilot programs are focused on clinical training, model implementation, evaluation of outcomes and recommendations on future implementation in Vermont.
VCPI’s ongoing efforts are focused on developing a sustainable training model and recommendations for future implementation in Vermont in coordination with champions of Open Dialogue across the state. In collaboration with the Open Dialogue workgroup, VCPI developed a proposal for continuation of activities surrounding the Open Dialogue model as well as a statewide survey to assess interest and readiness for people who have been involved with Open Dialogue in Vermont.
Vermont Care Partners (VCP) Results Based Accountability Pilot
VCPI is partnering with VCP to support Designated Agencies in implementing RBA to support investment in the RBA Software through establishing a training pilot and collaborative…
VCPI is partnering with VCP to support Designated Agencies in implementing RBA to support investment in the RBA Software through establishing a training pilot and collaborative mentoring and learning communities.
- Support the Designated Agencies (DA) and Specialized Service Agencies (SSA) in implementing scorecards at their individual agency based on the identified RBA outcomes.
- Vermont Care Partners (VCP) will implement system-wide scorecards using aggregated data from all the DAs and SSAs.
- The aggregated scorecards will be posted on the DAs, SSAs and VCP's websites.
- Move from a 5 site pilot to system-wide implementation.
Co-Occurring Competency E-Learning Community Project
Co-Occurring Competency E-Learning Community Project This is an exciting initiative and we are engaged in Phase 2 of the project (August 2017 - February, 2018), which is aimed at helping…
Co-Occurring Competency E-Learning Community Project
This is an exciting initiative and we are engaged in Phase 2 of the project (August 2017 - February, 2018), which is aimed at helping any program/agency to make further progress in the continuing improvement of co-occurring competent practice in order to provide better and more integrated co-occurring services for individuals and families in Vermont. Submit an Interest Form
The Pilot Project included:
- Access to E-Learning modules from the nationally recognized Focus on Integrated Treatment (FIT) Distance Learning Course developed by Hazelden and Dartmouth.
- Core Orientation and a virtual Learning Community combining online video training with continuing improvement and evaluation of staff competency in coordination with regular mentoring sessions for agency/program teams of staff participating in the pilot. Facilitated by Dr. Ken Minkoff, who is a national expert on integrated services and systems, and a founding partner of VCPI.
- 8 agencies throughout Vermont will be participating in the FIT curriculum and learning community in Phase 2: Howard Center, Northeast Kingdom Human Services; Lamoille Valley Collaborative; Washington County Mental Health Services; United Counseling Service of Bennington; and, Northwestern Counseling Support Services, Rutland Mental Health Services/Evergreen, and Health Care Rehabilitation Services of Vermont.
VCPI worked in partnership with the Vermont Department of Mental Health, the Vermont Department of Health, Division of Alcohol & Drug Abuse Programs, and other partners to launch an initiative aimed at helping any program/agency to make further progress in the continuing improvement of co-occurring competent practice in order to provide better and more integrated co-occurring services for individuals and families in Vermont. The initiative combined E-Learning Modules, as well as a Core Orientation and virtual Learning Community and TA. Phase 2 of the initiative launched in August of 2017 with 85 participants representing 8 agencies with an ongoing Learning Community that met in September, November and December. The initiative included the evaluation of online learning platforms and to evaluate their effectiveness as a modality to support workforce development, staff training and competency. VCPI has synthesized the data collected and is looking at ways to continue/ expand this innovative model. The Orientation and Supervisory modules are available on this site to VCPI members, along with supplemental materials including the Supervisory Workbook, developed by Kenneth Minkoff, MD.
Sponsored by the Vermont Cooperative for Practice Improvement and Innovation (VCPI) with support from the Vermont Department of Mental Health, the Vermont Department of Health, Division of Alcohol & Drug Abuse Programs and the Substance Abuse and Mental Health Services Administration (SAMHSA).
Promoting Recovery: Young Adult First Episode Psychosis Initiative
The Vermont Department of Mental Health is partnering with VCPI and consultants to launch a multi-year initiative to adopt evidence-based interventions and treatment approaches for…
The Vermont Department of Mental Health is partnering with VCPI and consultants to launch a multi-year initiative to adopt evidence-based interventions and treatment approaches for young adults experiencing first-episode psychosis. The first year of funding will be dedicated to planning, training, and infrastructure development while targeting program implementation and workforce development in the second year. During the initial year, the principals will work with a diverse group of stakeholders – including youth, families, a diverse array of youth-serving providers, and other state partners serving both youth and adults – to more clearly define the identification and prioritization of the target population and complete a review of current evidence-based and promising practices for that target population, as well as to identify best-practice system approaches for addressing the needs of a youth population that may transcend usual age boundaries for service eligibility. This will include a range of practices that are currently planned or have been piloted in Vermont. These include Recovery After Initial Schizophrenia Episode (RAISE) and Coordinated Specialty Care (CSC), as well as additional approaches (e.g., Open Dialogue, Wellness Recovery Action Planning, Soteria, TIPS, and others) that have demonstrated value in Vermont for engaging and helping youth and families who are experiencing early emergence of serious issues and may be hard to serve.
- To create a statewide platform for education, awareness and dialogue around young adults experiencing first-episode psychosis
- To identify evidence-based and promising practices and treatment approaches for young adults experiencing first-episode psychosis in Vermont
- To identify and define the target population and assessed need for services
- To develop a plan for implementation in Year Two including: identification of pilot sites, planned activities, future budget and data collection to support continuous improvement and dissemination and to evaluate program effectiveness
Vermont Family Based Approach (VFBA)
VCPI will be partnering with the Children Adolescent and Family Unit (CAFU) of DMH and Dr. James Hudziak of the Vermont Center for Children Youth…
VCPI will be partnering with the Children Adolescent and Family Unit (CAFU) of DMH and Dr. James Hudziak of the Vermont Center for Children Youth & Families to develop a contract and scope of work for implementation of the Vermont Family Based Approach. Funding is for 1 year with the potential for expansion.
Team Two Project
The philosophy behind Team Two training is one of collaboration, information sharing and resource management for law enforcement and mental health crisis teams when responding…
The philosophy behind Team Two training is one of collaboration, information sharing and resource management for law enforcement and mental health crisis teams when responding to a situation from the legal, clinical and safety perspectives. VCPI has supported the Team Two steering committee in linking outcomes based thinking to measurements of success.
VCPI has developed and implemented tools to evaluate the delivery of the training and its impact on service delivery in the field. VCPI collects, enters and evaluates pre and post data related to the Team Two effort to evaluate the training and impact of the training on services delivery and attitudes in the field.
DBT Institute & Learning Community
VCPI facilitated an 8-day intensive DBT Training Institute to over 30 participants from 7 agencies statewide in 2014. In an effort to sustain the implementation…
VCPI facilitated an 8-day intensive DBT Training Institute to over 30 participants from 7 agencies statewide in 2014. In an effort to sustain the implementation of this practice, VCPI facilitates an ongoing Learning Community consisting of current cohort members and content experts, Sue Swindell and Jodie Bisson. VCPI, in collaboration with the content experts developed Core Competencies for DBT to be utilized by participants and supervisors. VCPI is committed to expanding the DBT Institute, dissemination of content and implementation of the practice statewide.
In April of 2016, a DBT Leadership Symposium was held, which was developed as a follow up to the 8-Day Intensive DBT Training and Learning Community. The intent is to provide clinicians who have completed the training and are providing DBT an opportunity to enhance their knowledge and fine turn their skills.
In the Fall of 2016, VCPI held a second session of the 8-day intensive Institute, with 34 graduates.
In the Summer, Fall and Winter of 2017, VCPI held a learning community events where participants gathered to continue learning and sharing.
Dialectical Behavior Therapy (DBT) is a cognitive behavioral treatment that was originally developed to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD) and it is now recognized as the gold standard psychological treatment for this population. In addition, research has shown that it is effective in treating a wide range of other disorders such as substance dependence, depression, post-traumatic stress disorder (PTSD), and eating disorders. There is increasing evidence that DBT skills training alone is a promising intervention for a wide variety of both clinical and nonclinical populations and across settings.
What participants can expect from the DBT Training:
- Training in Dialectical Behavior Therapy provided by experts in the field
- 48 hours of Continuing Education credits divided into 4, 2-day training sessions
- Handouts, articles, and transcripts will be provided
- Participation in an ongoing Learning Community, which will include opportunities for clinical consultation and forums for discussion with other participants.
- On completion of the training, your email address will be added to the DBT state consultation list serve, which will allow you on-line support for clinical questions.
What we will expect of you:
- Attendance at all training sessions (CEU’s for partial attendance will not be awarded)
- Purchase of the text book and skills manual by Marsha Linehan
- Completion of homework assignments and evaluations
- Attendance and participation in your agency’s DBT Consultation team meeting
- Commitment to remain on a DBT team and participate in the virtual Learning Community for one year
Would you like to be added to Vermont DBT ListServe?
Six Core Strategies Initiative and Learning Community
VCPI is leading a major practice improvement initiative aimed at reducing Emergency Intervention Procedures (EIP) – such as seclusion and restraint - in Vermont hospitals,…
VCPI is leading a major practice improvement initiative aimed at reducing Emergency Intervention Procedures (EIP) – such as seclusion and restraint - in Vermont hospitals, specifically the three hospitals licensed as Level I facilities to replace the state hospital, (Brattleboro, Rutland, VPCH).The Vermont Department of Mental Health is partnering with VCPI and Consultants with expertise on the Six-Core Strategies©, Trauma-informed Care, and Recovery to support the implementation of a practice improvement project focused on prevention/reduction of coercive interventions, especially restraint and seclusion, as well as to promote trauma-informed care, recovery, consumer-driven care and resiliency.
The goals of the practice improvement project are:
- To identify agency strengths and needs specific to fully implementing the evidence-based Six Core Strategies© to prevent/reduce the use of coercive interventions, and specifically restraint/seclusion;
- To identify agency strengths and needs specific to achieving successful culture change and successfully implementing practices that optimize positive outcomes for those served
- To identify agency strengths and needs that support resiliency, trauma-informed, recovery-oriented and consumer-driven approaches.
VCPI has been working in partnership with the hospitals and stakeholders to provide implementation assistance and support on the ground in addition to the overall project management. Implementation of the initiative began in May with TA and initial consultation to hospitals with site visits scheduled for each hospital in August and September. A 2-day training took place in October of 2014, and November of 2015, with each participating hospital sending a team of 10-12 people. An ongoing post 12-month learning community commenced in November 2014.
VCPI is leading a major practice improvement initiative aimed at reducing Emergency Intervention Procedures (EIP) – such as seclusion and restraint (S/R) - in Vermont hospitals, specifically the three hospitals licensed as Level I facilities to replace the state hospital. (Brattleboro, Rutland, VPCH) as well as voluntary participants such UVMMC, Springfield Hospital and CVMC. VCPI is working in partnership with the hospitals and stakeholders to provide implementation assistance and support on the ground in addition to the overall project management. The reporting period for this initiative marks the second year of implementation of the Six Core Strategies and includes; ongoing consultation, a 2-day training and an ongoing Learning Community for participating hospitals. The Learning Community is set to launch in January of 2016.
The Learning Community provides continued TA, consultation and implementation support for all of the participating facilities, to allow access to expert faculty on being more effective in engaging clients with a lot of challenges, who are experiencing S/R or involuntary medications frequently. The Learning Community consists of monthly call with facility teams (4-5), led by Dr. Kevin Huckshorn, addressing:
- Six Core Strategies© Implementation
- Staff needs and response to training
- Obstacles/barriers to implementation
- Special issues related to S/R episodes
Funding for this project has been provided by the Vermont Department of Mental Health