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May 3, 2012 Volume 3, Issue 16
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The second quarterly Webinar for 2012, "Understanding and Building on Culture and Spirituality in Recovery-Oriented Practice," was held April 4, 2012. Download the slides and handout.

Wellness Programs Target More Than Weight Loss
by Stephanie Yamkovenko
When a 2006 study found people with schizophrenia die an average of 25 years younger than the general population,1 it was a "huge wake-up call for mental health providers," said Catana Brown, Ph.D., OTR/L. "We were seeing people in their 30s die of heart disease. It was just really shocking."

People with mental health conditions are at risk of premature death from untreated chronic illnesses like obesity, diabetes, and cardiovascular disease. Additionally, forty-two percent of adults with mental health disorders are obese.2

Dr. Brown's wellness initiative for people with mental health conditions was one of the 20-plus programs reviewed by SAMHSA last February. The programs used lifestyle interventions to reduce obesity and improve overall fitness.

SAMHSA's review found lifestyle modifications could help people with mental illness lose weight, but not all efforts were successful. They identified programs that had better results, including those that lasted more than 3 months, combined education and activity, and incorporated nutrition and exercise.

An Occupational Therapy-Based Health Promotion Program
Occupational therapy (OT) can assist people with weight loss and promote healthy, rewarding activities. "We help people engage in [their] everyday lives, and really encourage them to explore all of the things they might do on a regular basis to improve their overall state of wellness," said Virginia Stoffel, Ph.D., O.T., BCMH, FAOTA, Vice President of the American Occupational Therapy Association.

Dr. Brown's 2006 study had all of the components for success. "Some of the things we thought made it unique were that it addressed both exercise and nutrition," she said. "It was also one of the few research studies that targeted people who were living in the community." Despite the difficulties of not being able to control diet and activity, Dr. Brown and her colleagues felt it would be more realistic to help people within their communities.

The program encouraged goal setting and accounted for more than just social support. For example, consideration was given to the tools people with mental health conditions and limited resources might need, like low-cost cooking supplies and healthy, affordable groceries.

Participants attended weekly group meetings and set nutrition and physical activity goals. During each session, they discussed new objectives and participated in activities to help them stick to their plans. For example, when group members learned how to use a fast food nutrition guide, they practiced ordering and eating healthy meals at a fast food restaurant. At the end of the program, participants had lost an average of six pounds and had a significant reduction in waist circumference.3

The Wellness Model
OT practitioners are guided by the wellness model, which supports positive choices for a more satisfying lifestyle, said Margaret Swarbrick, Ph.D., OTR, CPRP.

The U.S. health care system has a wellness model and a medical model. The medical model focuses on "fixing people" by reducing symptoms, but the wellness model is more comprehensive. It embraces eight fundamental dimensions for achieving a higher quality of life: physical, spiritual, social, intellectual, emotional, occupational, environmental, and financial.4 "The medical model is the prevailing model," said Dr. Swarbrick, "but an important role for OT is to keep them both in balance."

Occupational Therapy in the Wellness Model
OT practitioners use the wellness model to focus on prevention, advance recovery, and create health promotion programs. But because OT is not as well recognized in mental health services as it could be, some practitioners still face challenges. "This is why we're sponsoring a bill in Congress and held a congressional briefing about the role of OT in mental health," said Dr. Stoffel. "My hope is that the bill and advocacy will open doors."

Despite the challenges, Dr. Brown said the obesity epidemic for people with mental health disorders has created enough widespread concern to shake up treatment centers throughout the U.S. As a result, many organizations are developing and administering new weight loss and wellness programs.

Stephanie Yamkovenko is a staff writer at the American Occupational Therapy Association. Contact her at

  1. Colton, C. W., and R. W. Manderscheid. 2006. Congruencies in Increased Mortality Rates, Years of Potential Life Lost, and Causes of Death Among Public Mental Health Clients in Eight States. Preventing Chronic Disease, 3(2), 1–14.
  2. SAMHSA–HRSA Center for Integrated Health Solutions. 2012. Research Review of Health Promotion Programs for People with Serious Mental Illness. Retrieved from
  3. Brown, C., J. Goetz, A. Van Sciver, D. Sullivan, and E. Hamera. 2006. A Psychiatric Rehabilitation Approach to Weight Loss. Psychiatric Rehabilitation Journal, 29(4), 267–273.
  4. Margaret Swarbrick. 2012. Wellness and aging. Words of Wellness Newsletter, 5(9), 3–4.

Conference Will Promote Mental Health Recovery
Mental health advocates will convene in South Florida this month at "Mental Health Transformation in Action," a conference hosted by the Eleventh Judicial Circuit, Florida Partners in Crisis, Florida Department of Children and Families, and Consumer Statewide Network. The conference was designed to heighten awareness about mental illness, crime, and the justice system.

Training sessions and motivational speakers have been scheduled for the May 15 event, which by and large aims to keep those suffering from mental illness out of jail by providing proper care and community support.

The Crisis Intervention Training session will focus on suicide prevention—a pressing issue for law enforcement officers, who have more reported deaths from suicide than those killed in the line of duty. The session will help officers recognize and address signs of mental illness.

The event will be held at the Jungle Island Treetop Ballroom in Miami, Florida. Learn more and see the meeting program.

APA Offers Scholarship for Graduate Program
The University of Maryland Counseling Psychology program has introduced a graduate certificate to help practitioners work with survivors of violence, torture, and trauma (VTT). The 12-credit, four-course program was designed for advanced graduate students and seasoned professionals alike. Because courses are offered online, the program is accessible to working and training psychologists, counselors, family therapists, social workers, and international students.

To support enrollment, the American Psychological Association (APA) will provide a 50 percent scholarship towards the programís tuition to the first 20 students who apply and are accepted for the fall 2012 term.*

Applicants must have a master's or doctoral degree from an accredited institution in psychology, counseling, social work, psychiatry, or a related field. To learn more about the VTT program, visit

*Students must complete the program to receive the scholarship.

May Is Mental Health Month
With more than 240 affiliates nationwide, Mental Health America (MHA) represents growing interest in the U.S. to help people live mentally healthier lives every day and in times of crisis.

MHA began celebrating "Mental Health Month" more than 60 years ago to raise awareness about certain conditions, treatment services, and recovery. This May, two important themes have emerged in their outreach efforts:

Do More for 1 in 4 is a call to arms to support Americans who live with a diagnosable, treatable mental health condition.

Healing Trauma's Invisible Wounds focuses on the impact and aftermath of trauma and the recovery process for trauma victims.

The RTP Resource Center Wants to Hear From
Recovery-Oriented Practitioners!
We invite practitioners to submit personal stories that describe how they became involved in
recovery-oriented work and how it has changed the way they practice.
The RTP Resource Center Wants to Hear From You, Too!
We invite you to submit personal stories that describe recovery experiences. To submit stories or other recovery resources, please contact Cheryl Tutt, MSW, at 877.584.8535,
or email All stories are reviewed by Carrie Nathans, RTP Editor.

We welcome your views, comments, suggestions, and inquiries.
For more information on this topic or any other recovery topic,
please contact the RTP Resource Center at
877.584.8535, or email

The views, opinions, and content of this Weekly Highlight are those of the authors, and do not necessarily reflect
the views, opinions, or policies of SAMHSA or the U.S. Department of Health and Human Services.