There is often a sense of resignation that comes with being a patient, particularly when dealing with a serious condition. You can become acquiescent, and surrender an active role in being responsible for your care and improving your health. Ultimately, this surrender compromises your ability to get better.
For individuals living with serious mental illness, the resignation can be even more pronounced – as well as the loss of “self-efficacy,” which is defined as the confidence a person feels to learn a new skill or improve one’s own situation.
Helping to rebuild self-efficacy must be an essential part of an effective treatment plan.
The Healthy Solutions Program aims to do just that – cultivate the sense of self-efficacy among individuals with serious mental illness who come to our Waterman outpatient clinic.
“The success of Healthy Solutions has been remarkable,” says Monica Echeverri, who runs the program, which already has a client list of 70 people since it began in early February. “It can be tricky to get people to join, because it asks you to make changes and commitments. But once people get involved, they find that the positive, action-based curriculum makes a real difference in their quality of life.”
Irene Heard, 59, enrolled in Healthy Solutions after her psychiatrist at Waterman asked her to consider the program to raise her spirits. Irene often spent her counseling sessions in tears, lamenting how her life had turned upside down. She had worked most of her life in the human services profession, helping others in desperate need.
“Never did I imagine that it would happen to me, but three years ago everything came crashing down, and I became homeless and severely depressed,” Irene says. “I am a very proud woman, but this devastated my belief in myself.”
Irene lives alone in an apartment in southwest Detroit, and had retreated into a realm of isolation and passivity. Participating in Healthy Solutions has drawn her out again and motivated her to take initiative.
“It has definitely helped me with my social confidence,” Irene says. “The laughter that we share in class has been good for me. In fact, the days that I go to class are the best days that I have. They give me reason to get up and do something positive with my life.”
The Healthy Solutions curriculum has three different modules. For each module, classes meet once a week for two hours over the course of six weeks. The classes are interactive and uplifting, and they encourage participants to support each other to meet goals.
The Personal Action Toward Health (PATH) module is designed to enhance self-confidence in managing one’s illness and maintaining an active, self-directed life. PATH facilitators teach about informed treatment decisions, communication and problem-solving skills, strategies to manage difficult emotions and situations, and the importance of a healthy lifestyle.
The Physical Wellness module teaches about exercise, relaxation techniques, stress management, yoga and breathing exercises, and hygiene. Participants take things at their own pace and make gradual improvements.
The Cooking Matters for Adults module covers nutrition and healthy eating, food preparation, budgeting, and shopping.
The Healthy Solutions curriculum is based on rigorous research. Studies show that every dollar invested in this kind of program returns at least $4 in savings on healthcare and other costs. In addition, the positive effects of the program last at least three years.
Irene has completed the wellness and cooking modules, and is starting the PATH classes.
“We learn to take control of our lives and deal with our problems,” Irene says. “I have decided to be good to myself and not let my depression define me. I want to eat better. Try new recipes. Exercise more. Live healthier. I know I have many things in my life that I need to repair, but I want to repair them and move forward.”
Robert Campbell, 40, graduated from the PATH module and started the wellness classes. He receives treatment at Waterman for depression, anxiety disorder, and congenital brain damage.
“Just a few years ago, I would spend my days holed up in my room at a three-quarter house, watching movies all day long, not wanting anything to do with anyone,” Robert says.
Mental health treatment stabilized Robert’s life, and then he fell in love with Debbie. They share a house in southwest Detroit.
“I am different person today because I understand the value of therapy and I have reason to be a better man,” Robert says. “I have also learned through Healthy Solutions that I must try to keep myself at a level where I can endure the bad things that life can bring.”
Robert’s perseverance was severely tested this Easter Sunday when Debbie’s 17-year-old grandson was killed by a hit and run driver near their home.
“It was so senseless, and I was heading down a path of self-destructive self-pity,” Robert says. “After the funeral, I wanted to drown myself in alcohol, but I found the strength to stop.”
Robert set three personal goals for himself in his PATH class that he is determined to achieve. He wants to lose weight. He wants to pursue martial arts training. And he wants to quit smoking. Robert started smoking when he was eight years old.
To help with this last goal, Robert intends to join the smoking cessation classes offered through Healthy Solutions. Smoking addiction is a significant problem among persons living with mental illness. Studies show that mentally ill individuals are four times more likely to smoke than the general public. Almost half of all cigarettes consumed by Americans are consumed by persons with serious mental illness. This high rate of cigarette use is a major factor why persons with serious mental illness live on average 25 years less than others.
“I didn’t seem to care about myself before, but I do now,” Robert says. “I want to see what life has in store. Even if it knocks me down, I feel I can pick myself back up and stand tall.”