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An electronic circular of the Coalition's Center for Rehabilitation and Recovery
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No. 58, February 2010
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The Center for Rehabilitation and Recovery provides assistance
to the New York City mental health provider community through
expert trainings, focused technical assistance, evaluation,
information dissemination and special projects.
THE DIRECTOR’S NEW YORK MINUTE The Impact of Limited Literacy I was having lunch last year with the dynamic associate chair of our department of psychiatry in Boston. She was in charge of a very large inner city outpatient division and as we were gulping down our store-bought sandwiches and sodas, she made my jaw drop! She quite casually remarked that she kept running into people throughout her daily practice, who would confess after two to three years of working with her, that they were unable to read very much. Although she was a caring clinician and listened well to people, she had no idea that all those I asked her to give me a ballpark figure of how many people she thought might be in this group. She said “I believe it is almost 60 percent!” Well, I almost fell off my chair because Boston prides itself for its institutions of higher learning. After all, there are 17 colleges and universities and the town used to be called “the Athens of America” in ages past. Looking at the national statistics, I found that America is now considered to have about half of its population with limited literacy and Boston, surprisingly, was even higher (1,2). Furthermore, recent reports have calculated that not being able to read costs the U.S. economy between $106 to $238 billion a year in healthcare and other costs. (3) Literacy has been defined as: “using printed and written information to function in society, to achieve one’s goals, and to develop one’s knowledge and potential.” (4) Limited literacy makes ordinary challenges such as “filling out a job application, following directions on a prescription medicine bottle, balancing a check book, and consulting a bus schedule” seem almost insurmountable. (5) In the public sector work that we all do, the complex interactions between immigration and poverty often lead to poor reading skills and need be factored into our clinical approaches as well. I propose that we could increase our ability to help people, who come through our door seeking help and relief, if we provided a 3-5 minute screener of reading capacity as part of a standard assessment package. There is an easy-to-use instrument developed by the Harvard Center on Adult Learning and Literacy called the REALM - the Rapid Estimate of Adult Literacy in Medicine (6). It has been tested against more comprehensive standard reading skill tests and was found to be “correlated highly” (meaning that it could be used in a valid way as a screener in place of the much longer tools). All the words in the REALM are divided into three levels of difficulty and generate 4 categories of reading expertise or lack thereof. The bottom two reading categories are considered to be below the 3rd and 5th grades and therefore our handout materials should be gauged accordingly for each group. If people do poorly on the test, we could provide a class on reading skills acquisition. We might consider using the approach of Personalized Recovery Oriented Services – PROS. Agencies could develop a new CRS (Community Rehabilitation & Support) class, which is not labeled remedial reading, but perhaps something like “How to Cope with the Real World.” Such a curriculum might use the new reading acquisition immersion strategies which focus on day to day challenges of job classified ads, how to read prescription bottles, interpreting subway and train schedules, and filling out a post office receipt for certified mail to Medicaid. In fact, such students could work together to actually help the agency reinterpret existing handouts into more understandable formats as a learning task. A recent publication in 2008 by Ngwudike wrote “Literacy is an indispensable tool for effective participation in the 21st Century information age. It opens the minds of individuals to the realities and possibilities of life. Literacy is a condition for partaking in the American dream. It correlates with employment, earning power, and job security. Literacy is a vehicle for lifelong learning and self-actualization.” (5) I secretly suspect that becoming more literate will increase access to appropriate care, improve knowledge of active coping strategies, and elevate self esteem, all of which will decrease symptoms and odd behaviors. A literate person is able to be more involved in his or her own care and fully participate in the community. Reference (1) Irwin Kirsch et al. Adult Literacy in America: A First Look at the Results of the National Adult Literacy Survey. ERIC# ED358375. U.S. Government Printing Office, Superintendent of Documents, Washington, D.C.1993 (2) Stephen Reder. Adult Literacy Synthetic Database for Boston. 1990 Census http://www.alri.org/boslitstats.html (3) First Literacy Fund. Literacy is a Human Right. http://www.firstliteracy.org accessed 01/26/10 (4) National Center for Education Statistics. A First Look at the Literacy of America’s Adults in the 21st Century. U.S. Department of Education, Institute of Education Sciences. The 1992 and 2003 National Assessment of Adult Literacy, pg.2 (5) Benjamin Ngwudike, The 2003 National Assessment of Adult Literacy (NAAL): Performance of African Americans in a National Context, Jackson State University, 2008, pg. 1. (6) Terry C. Davis et al. Rapid Assessment of Literacy Levels of Adult Primary Care Patients. Family Medicine, 1991; 23:433-5. PROS Learning Collaborative and Google Groups On January 12, 2010, the Center held a learning collaborative for interested members and agencies who wanted to learn more about implementing Personalized Recovery Oriented Services (PROS) programs. The learning collaborative featured 37 representatives from a variety of organizations around New York City, including government partners, clubhouses, advocacy groups, and health agencies. Discussions centered on regulations and documentations concerning PROS. We are also pleased to announce that we have set up a Google Group in order to provide a forum for questions and discussions about PROS. If you wish to be added to the Google Group, please contact Eric Lu at elu@coalitionny.org. We look forward to seeing you at our next learning collaborative! Storytelling Exchange: Project on Young Adults The third Storytelling Exchange took place at the Coalition's Center for Rehabilitation and Recovery on January 25th. The purpose of the Exchange has been to provide a forum for therapists and other related staff, who work with young adults, to share ideas and experiences pertaining to storytelling and narrative therapy. This particular Exchange featured Jessica Zapotechne, Art Therapist at CASES, an alternative to incarceration program. She devised an original curriculum to elicit narrative from group participants through drawing, photography, and text. The quality and content of the art and Jessica's insights into the creative process inspired therapists to reflect on ways that they might implement a similar approach at their agencies and schools. Amy Smiley, who directs the Center's Storytelling Project, presented theoretical material related to trauma, memory, and narrative through two different case studies. One case shed light on a veteran's recovery process through his historical narrative related to racism in the military. The other emphasized the impact of childhood sexual abuse on a young adult's difficulty to assert herself in social and professional contexts. Dr. Smiley also facilitated an in-depth discussion on civic engagement in response to trauma, as a way to find meaning and purpose in the aftermath of shattering life circumstances. Center Welcomes New Staff, Eric Lu, Junior Fellow in Behavioral Health
Introduction to Benefits Management FREE half day training offered in various locations across the city designed for clinicians and other staff interested in learning the nuts and bolts of benefits management. The latest changes in SSA guidelines will also be discussed. Facilitator: Margie Staker and Patricia Feinberg, MS Recovering Together: Introduction to Group Work Intended Audience: Mental Health Practitioners (including those who may work in PROS programs) This FREE full-day training is designed for mental health practitioners who seek to harness the power of groups to support individuals in their recovery. The training may be of particular interest to providers of Personalized Recovery Oriented Services (PROS) since group work is the main service modality in PROS programs. Through didactic and experiential learning, participants will acquire the skills they need to plan and lead groups that are meaningful and alive. Facilitator: Aaron Vieira, LMSW To register for any Center training or presentation, please go to: www.coalitionny.org/the_center/training/ Note: If you are typing the URL in your browser, the space between “the” and “center” is in reality an underscore symbol “_”. Other Community Events & News International Advocate for People with Mental Illnesses Dies Judi Chamberlin was the mother, leader, and face of a movement that has inspired recovery, rights and community integration for people with psychiatric disabilities. Ironically Judi died on the eve of the national holiday honoring our great civil rights hero Dr. Martin Luther King Jr. Following in the footsteps of Dr. King’s civil rights movement, Chamberlin bravely started her own movement in uncharted territories of breaking down barriers which were discriminatory against and marginalizing people suffering from mental illnesses. Chamberlin published a book in 1978 called On Our Own, which was regarded as a manifesto of rights for mental health consumers, challenged the way that mental health consumers have been labeled and treated. She promoted a central theme that treatment was most effective when consumers became partners in the process. During the New York Association of Psychiatric Rehabilitation Services (NYAPRS) conference in September 2009, Chamberlin was awarded the Lifetime Achievement Award over the phone due to her failing health. During that phone call, over 700 people stood up and expressed their gratitude by chanting thank you. Chamberlin changed the landscape for mental health consumers. Her work lives on for the future as consumers learn to be active participants in their own recovery process. The PROS Overview Meeting Description: For agencies interested in converting eligible programs into PROS Caregiver Training at Kings Park Office Description: A Community Service to Help You Care for Your Aging, Ailing or Disabled Loved Ones Causes of Homelessness among VA Patients: The Role of Psychiatric and Addictive Illness, Service in the Middle East, and Receipt of VA Disability Compensation Description: Grand Rounds speaker Robert Rosenheck, MD, Department of Psychiatry, Yale University will be presenting his study on multiple factors, including income and age, in considering risk of homelessness among veterans. Annual Community Fair Description: The fair will highlight community services in East New York such as child care, mental health, after school, foster care, medical and other services. SSI and SSDI Benefits Training: “Myths, Tips, Tricks & How to Make It Work” Description: Presentation by John B. Allen, Jr., Special Assistant to the Commissioner New York State Office of Mental Health Drug Free Communities (DFC) Support Program Funding Description: Awarding $18.75 million for 150 new competing grants to support the efforts of community coalitions working to prevent and reduce substance use among youth. Boston University, Winter 2010 Psychiatric Rehabilitation Journal Executive Budget for the Office of Mental Health (OMH) Report of Health Development: A Summit on Young Children’s Mental Health The Americanization of Mental Illness The Cutting Edge: Non-Suicide Self Injury in Adolescence The State of Housing in America in the 21st Century: A Disability Perspective |
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educational materials she was handing out about illness, wellness, prescriptions, and side effects, were unintelligible to them. Such well intentioned efforts had been designed to help people become partners in care. She went on to say that the people, with whom she was trying to help, appeared more embarrassed about not being able to read than to tell her about odd symptoms and behaviors. 
The Coalition’s Center for Rehabilitation and Recovery would like to introduce our newest staff member, Eric Lu. Eric graduated in June 2009 from Harvard University with a Bachelor of Arts in Anthropology. He volunteered as a harm reduction street outreach worker in Boston, wrote his senior honors thesis on substance abuse recovery in Taiwan, and worked with the Bali Psychiatric Center in Taiwan with drug users in prison. Eric is planning to go to medical school, but for now he is working at the Center to help with the Youth Initiative website, promoting PROS, and putting together RECOVERe-works. Implementing a new idea for RECOVERe-works, he will travel to the agencies that plan to launch PROS programs and highlight their progress, challenges and recovery stories.The Coalition Home | Center for Rehabilitation and Recovery | Site Map
Tel: (212) 742-1600 Fax: (212) 742-2132