Foreign, state officials discuss behavioral health best practices

July 9, 2013

By Kim Walter

WINCHESTER – According to Andrea Coote, when it comes to the mental health and disability sector, Virginia isn’t all that different from Australia.

Coote, parliamentary secretary for Families and Community Services in Victoria, Australia, was able to draw the conclusion during her visit to Grafton Integrated Health Network headquarters on Monday.

She, along with Dr. Bill Hazel, Virginia’s Secretary for Health and Human Services, came to the area to learn more about Grafton’s best practices and how certain initiatives are “ahead of the game.”

Grafton is a private, nonprofit organization that provides services to people overcoming emotional, behavioral or developmental challenges.

Since 2009, Grafton has been providing consultation and training services in Australia related to “Ukeru” — the “least resistance” approach to crisis management — and “REBOOT” — a mobile application designed for clinical and organizational decision-making.

Coote said she wanted to see for herself how certain practices were taking shape, and hopefully gather ideas and information that could drive change within the disability sector in Australia.

“I think Victoria and Virginia share similarities in that they’re both looking at each individual that is treated in the disability sector,” she said. “Both places realize that patient’s needs are paramount, and if those things are looked after, the cost benefit is enormous.”

Coote said her community shares the belief that reducing restraint and eliminating seclusion is important, and was encouraged to hear data supporting that at Grafton. One presentation on Monday morning explained that lack of restraint is not only good for the individual, but also for staff and caregivers.

With less restraint comes lower cost because the numbers of injuries are decreased, Coote said. Turnover has been impacted from Grafton’s side, which also saves money.

“All these cost benefits are great,” Coote said. “But at the end of the day, it’s better for the client, and we’re very attracted to that way of thinking in Australia.”

Grafton’s results from reducing restraint and seclusion were highlighted by the Substance Abuse and Mental Health Services Administration in 2011. Hazel said SAMHSA and the federal government have continued to look at the topic and found that there is a definite advantage to “people being treated in a more accepting way.”

“If a person can’t behave properly, you teach them how to behave properly, as opposed to punishing them,” he said. “Grafton has actual data to show that it works.”

Coote was very excited to hear more about REBOOT. The mobile application, which should be ready for use this fall, will foster tracking skill attainment, communication in real time between the multidisciplinary treatment team and clinical decision-support.

REBOOT is being developed for use not only within Grafton’s service and programs, but also for wider use in many different settings, Hazel said.

Staff will be able to quickly update patient information, along with successes and setbacks to influence future decisions dealing with progress. Any doctor or specialist working with the patient also will have access to the information, all from their smartphone.

Hazel said being involved in politics means asking the taxpayers to fund a number of things, often without seeing the impact. With REBOOT, data can be brought to the clients.

Coote applauded the initiative for its “openness and transparency.”

“The numbers don’t lie, so if something isn’t working they’ll have a better chance of knowing why, and how to fix it,” she said. “It’s impressive to see Grafton doing constant self-analysis like this, welcoming criticism with the opportunity to make the system better.”

Coote also was interested in a presentation on Grafton’s history, and said she liked the overall mission of helping a client be a part of his or her respective community. She said certain methodologies were attractive in that patients get life skills and a better chance of getting out “into everyday life.”

Hazel said it was nice to get an international dialogue going about the current state of treating those with behavioral, physical and mental challenges.

“You know, we speak with different accents, have different political and economic backgrounds, but what’s interesting about people and relationships and mental illness and disabilities is that they’re pretty doggone similar,” he said. “We can certainly learn from each other.”