Person-centered treatment planning and persons with psychiatric disabilities

Contributed By:  Robert Rousseau, MDiv., MA, ACPS, MHRE

A paradigm shift has taken place within the past fifteen years concerning the way that treatment planning takes place for persons with psychiatric disabilities. In the past, State departments charged with the responsibility of providing services for citizens with mental illness were obligated to implement regulatory standards from Medicaid or other federal agencies. These requirements governed the process of creating treatment plans. A series of assessments conducted by medical personnel, clinicians, and case managers provided the overarching framework or infrastructure upon or out of which the treatment plan was fashioned. This method is standards-driven and designed by benign health care professionals who determine the kinds of services that will be offered to “consumers.”

Person-centered planning (PCP) represents a radical departure from the above method. The process does not begin with standards, assessments, and offered services that are derived from outside the milieu of the person served, but rather begins with the stated needs and desires that originate from within the person served.

In addition, the person served identifies other persons whom they would like to be part of the conversations that contribute to the formation of the treatment plan. In other words, the person served can create their own circle of support including a family member, spouse, friend, co-worker, mentor, employer, teacher, and preferred mental health professional. The PCP process returns self-determination and desired outcomes (goals) to the person served. It is truly an individualized plan.

Essential PCP Elements

1. Internal locus of control - PCP understands that the person served is the primary agent in creating his or her future.  Like any citizen, persons with psychiatric disabilities have the legal right to life, liberty and the pursuit of happiness.
2. Respect - PCP understands the stigma and discrimination that persons served have and continue to encounter.  Respect, active listening, and being open-minded characterize the planning environment.
3. Personal Gifts and Strengths - The person served has strengths and unique personal gifts. These, and not assumed or perceived limitations inherently imposed by specific mental illnesses, shape desired outcomes.
4. Community Integration - PCP maximizes independence, creates community connections, and works toward achieving the individual’s dreams, goals, and desires.
5. Circle of Support - In PCP, the person served selects and invites who she or he wants to be present in pre-planning and planning meetings.

Editor’s Note:  Bob Rousseau pictured speaking at the 2010 MA Department of Mental Health Metro Southeast Legislative Breakfast.  Bob is currently a Director of Peer Recovery Services for Fellowship Health Resources.  He is an advanced certified peer specialist and a certified WRAP group facilitator.