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Mental Health Promotion through

Community Development: How to


Employ Community-Campus
Partnerships to Integrate Practice,
Education, and Research

• Elicia Cruz, PhD, OTR/L • Sam Gannon, EdD • Hillary Johns, OTS
• Joe Olmstead, MS, OTR/L • Sara Shuster, OTS
• Jami Flick, MS, OTR/L • Brittney Cobble, OTS
Course Objectives

At the conclusion of this session, participants will be able to:


▰ describe a community development model through which
OT serves community organizations through service,
education, and research, in order to enhance the lives
of local citizens.
▰ use strategies to apply the community development
model, including how to gain entry, assess the
organizations’ and communities’ needs, and create
consultative and direct service delivery plans that OT
students and interns carry out.
Organization of this
Presentation
1. What it is: Community
Mental Health
Partnership
Development
2. What we did: The NOTTC
3. How we did it: Our
Process
3
Community Mental
Health Partnership
Development

What it is
4
Health

Individual Health Community Health


▰ Absence of disease ▰ Private &public efforts to:
▰ Social &mental well ▻ promote,
being ▻ protect, and
▰ Life satisfaction ▻ preserve
... the health of community
members
World Health Organization (2018). Constitution of WHO: Principles. Retrieved from:
http://www.who.int/about/mission/en/
Community Health Promotion

▰ Health of community - not individuals


▰ Community drives the process
▻ We “lose the lab coat!”
▰ May or may not involve interventions
▰ Targets of focus:
▻ Macro level
Development In vs. Of Community
Building the economic or
physical infrastructure of a
IN community (bricks & mortar
approach)

Building the human capacity to


address local issues and concerns;
alter the structure of the community OF
in terms of engagement
Beaulieu, B. & Welborn, R. (2013) Community Development 101. Purdue Center for Regional Development.
Retrieved from: https://www.pcrd.purdue.edu/files/media/Community-Development-101.pptx
Asset-Based Community
Development: Four Key Arenas

People

Physical
Resources Voluntary
Associations

Kretzmann, J.P., Mcknight, J.L. (1993).


Local Formal Building Communities from the Inside Out: A

Institutions Path Toward Finding and Mobilizing a


Community's Assets. ACTA Publications:
Chicago.
Community Development
Community-Based MH OT
- Networking
Health & Professional
- Relationship - Needs Assessment Outcomes
Building - Goal Development - Enhanced
- Appreciating - Intervention Community
Common Ground Planning Health & Quality
- Collaboration - Implementation of Life
- Program - Prepared
Evaluation professionals
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Recovery Model

Our work incorporates


the components of the
recovery model.

Leamy, t al., 2011


Stoffell, 2011
A Participatory Approach

▰ Partnerships form to serve a specific purpose.


▰ Partners have an agreed upon strategic plan.
▰ The relationship is characterized by mutual trust, respect,
genuineness, and commitment.
▰ The partnership builds upon strengths and assets.

Community-Campus Partnerships for Health (n.d.). Position Statement on Authentic


Partnerships. Retrieved from https://www.ccphealth.org/principles-of-partnership/ 11
12
Blundo, R. (nd). Participatory research and service-learning: a natural match for the community and campus. Retrieved from: https://www.mesacc.edu/community-civic-
engagement/journals/participatory-research-and-service-learning-natural-match
Community
Driven

13
Major Macrosystem
Stakeholders in Exosystem

Health Care Mesosystem

Microsystem
central focus of
influence (family)

interrelations between family &


other settings

systems that are fully separate


Bronfenbrenner’s from the family

Social Ecology overarching system of influence

Model
Chronosystem changes over time 14
Community-Campus Partnerships
▰ CCPs “enable communities and academic institutions to engage
each other in partnerships that balance power, share resources,
and work towards systems change.” -
https://ccph.memberclicks.net/community-academic-
partnerships
▻ For expansion of service-learning opportunities
▻ For expansion of community agencies’ capacity to meet
their missions.
▰ Enable faculty to nest scholarship demands into service and
teaching. Community-Campus Partnerships for Health (n.d.). Overview.
https://www.ccphealth.org/about-us/
Principles of Community-Campus
Partnerships

▰ Power
▰ Open communication
▰ Collaborative
▰ Continuous feedback
▰ Shared benefits

Community-Campus Partnerships for Health (n.d.). Guiding Principles of Partnerships.


Retrieved from https://www.ccphealth.org/guiding-principles-of-partnerships/
Considerations in Participatory
Research

▰ Collaboration ▰ Research process


▰ Knowledge ▰ Action
▰ Power ▰ Emotions and
▰ Ethics well-being

Kindon S, Pain R and Kesby M (2007) Participatory action research approaches and 18
methods: connecting people, participation and place. Routledge.
A National OT Training
Center Community
Mental Health Practice,
Education, and Research

What We Did
19
The Backbone of The Participatory
Approach in the NOTTC

▰ University ▰ Service Learning


partnerships ▰ Level I & II FW
▰ Academic-Based ▰ Clinical Doctoral
Research Internships
▰ Prepare ▰ Postdocs
practitioners to
develop & provide
CMH services
The NOTTC
Our Vision
Occupational Therapy is to be recognized as the
preeminent profession within the area of Mental and
Behavioral Healthcare

Our Mission
The NOTTC will develop leaders and further empower
leadership within the Occupational Therapy profession in
the area of Community Mental and Behavioral Health
through promotion of practice, education, research,
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collaboration, and viability.
22
Major Goals of The NOTTC
The NOTTC
24
Current Initiatives

Service Provision 25
Current NOTTC
Community Mental
Health Programs 26
27
Faith-based Partners

Our initial work with FBP


▰ As a starting point
▰ Lessons
▻ Benefit of transparency
▻ May need extra prep-time for practitioner
/ student fit with FBP

28
Faith-Based Community Partnerships

Benefits of partnering:
▰ Strengthening of ties improved neighborhood safety
▰ Connecting communities and congregations to support the
health and well-being through trusted relationships
Through the process:
▰ Setting a foundation of inclusion
▰ Increased knowledge and conversations about social
problems
▰ New perspectives of community
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Faith-Based Community Partnerships
Local politicians and positive partnerships:
▰ Able to articulate concept of partnership across the
community
▰ Sanctioning of program ideas
▰ Establishment of civic switchboard for connecting
resources and people
Faith-Based Community Initiatives: SAMHSA- Supports
organizations at the national, state, and local levels
▰ Mental health services, Substance Abuse, Addiction
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Existing Murfreesboro
Partners
The Greenhouse Learning Center

Drawing Microsoft Word, Excel, Exercise


Parenting and PowerPoint Choosing Health
Budgeting Reading and Literacy Insurance
Computer Music Couponing
Crock Pot Cooking Sewing Marriage Mentoring
GED
Veterans For Volunteers

• Integrates veterans with mental


and behavioral health
challenges into supportive
volunteer roles
• Goal: To build self-efficacy, job,
social, and interpersonal skills
Barnabas Vision

▰ Facilitates financial independence &


permanent housing
▰ Provide spiritual guidance
▰ Facilitates transition from a life of
survival to one of productivity
Hand Up For New Hope

Empowers for independence and quality of life

OT The Church Greenhouse Clients


Assists with Assists clients with Offers education Maintain employment,
community financial needs and and counseling Attend OT sessions,
integration and life provides ongoing Participate in classes &
skills as well as support system counseling
meaningful roles
Meet with church
directors
Wellspring Program

• For chronically homeless


• To obtain self sufficiency
• Volunteer & employment requirements
• Education requirements
• Exit with personal goals & direction
• Enhance job and life skills
Pathways to Success

Facilitate
▰ Work readiness
▰ Relationships with the community
▰ Explore personal interests through volunteering
Amelia’s Closet

▰ Empowers women
▰ Provides
▻ Professional apparel to women as
they find gainful employment
▻ Hope
▻ Volunteer opportunities
Possibility Place

Learning program for


adults with intellectual and
developmental disabilities
who cannot live
independently
Last Call 4 Grace

Promote recovery in survivors of human


trafficking
▰ Ministry to at-risk individuals
▰ Freedom Center for survivors
▰ Reprieve Program
▰ Coming soon: New housing
Break Free Program

▰ Developed for survivors of human trafficking


▰ Consists of:
▻ “Accompanier” education regarding effects of trauma
▻ TIP techniques
▻ Assessing participants (Recidivism Risk Screening
Tool)
▻ Implementation process of 18 group sessions

Developed by Brittney Cobble, 2018 41


Recognizing the Community Need

▰ Scant research on EBP for trafficking


▻ Only 3 RCTs in literature
▰ Only 4 articles that mention OT:
▻ No research on effective intervention
▻ No research on effects of trafficking on
occupational performance
▰ No theory for practice

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Recognizing the Community Need: FREE-2-Be-
ME Model

Elaborate
Maintenance
Believe
Excel
Educate/Explore
Reverse Thoughts Cobble, 2018

Form a Foundation 43
Process of Developing Break Free Program

▰ Literature Review
▰ Needs Assessment to ID gaps:
▰ Concept map of needs
▰ Logic model
▰ Program Development (on micro and meso levels)
▰ Education on implementation process
▰ Analyzed outcomes through Diffusion of
Innovations model Cobble, 2018
▰ Advocacy 44
Layout of Program

Intro: Form a Foundation Part 2: Changing My Doing


Phase 1: Relationship Formation TIPs Educate/Explore tier of F2BM
Phase 2: Assessment Part 3: Changing My Future
Part 1: Changing My Thinking Excel tier of F2BM
Reverse Thoughts tier of F2BM Mentorship Guidance
Elaborate tier of F2BM

Cobble, 2018

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* Reassessment guidance after completion of each Part
Murfreesboro, TN

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Affordable Housing Futures
Background: 501(c)3 Founded in 2017

Mission: “To lead local efforts to provide comprehensive credit


and housing-related education, outreach, advocacy, counseling
and coaching”.
▰ Education and Outreach ▰ Affordable Rental Mgmt & Devt
▰ Housing and Credit Counseling ▰ Current projects
▰ Fair Housing ▻ Power Avenue Project
▻ Victory Village 47
Victory Village

Problem Population Solution


> 50%of residents At-risk individuals: ▰ SRO Microhousing
are financially ▰ 24 month program
▰ Previously incarcerated
burdened by home ▰ On-site OT
▰ Veterans
costs in Rutherford ▰ Service opportunities
▰ Youths aging out of
County. ▰ Close to transportation,
system
jobs, local community
▰ Human trafficking
▰ Community partnerships
survivors
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OT Influence &Project Development

▰ Indoor space: 80 studio apartments


▻ On-site management
▻ Design: Universal, visitable, accessible,
sustainable.
▻ Specialized suites: Sensory design
▰ Outdoor space: Xeriscape
▰ Reduced monthly costs
▰ Community-based OT programming:
Person-Environment-Occupation
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Chattanooga: Frequent User Initiative

CSH: FUSE
▰ To “use housing as a platform for services to
improve the lives of the most vulnerable
people, maximize public resources and build
healthy communities.”
▰ To include:
▻ Housing  Counseling
▻ Transition planning &education  Recovery Support
▻ Supportive employment
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Mission 360 – Jackson, TN
Faith-based community OT program aimed at
strengthening rural communities through
▰ Strategic partnerships
▰ Service-delivery improvement
▰ Improved resource utilization
All toward improved health and well-being

51
How We Did It

The Community Mental


Health Program
Development Process 52
Identifying Community Agencies

The Environmental Scan


▰ Informal
▻ Your local world
▻ Word of mouth
▻ Assess the community
▰ Formal
▻ Search Engines
▻ Local Department of Health
54
Gaining Entry

▰ Build on
▻ informal networks
▻ natural gathering points
▻ traditions related to social gatherings.
▰ Gain entry and credibility through
traditional leadership structures.
▰ Take advantage of ethnic neighborhoods.”
https://ctb.ku.edu/en/table-of-contents/culture/cultural-competence/understand- 55
culture-social-organization/powerpoint
Challenges to Gaining Entry

▰ Expectations of community leaders


▰ Misperceptions in the community
▰ Linguistic skills
▰ Tensions between subgroups

https://ctb.ku.edu/en/table-of-contents/culture/cultural-competence/understand-
culture-social-organization/powerpoint 56
A Community Development Process

1. Identify common ground with community organization.


2. Invest time in relationship building to gain trust, insiders’
perspective, mutual understanding of strengths and needs.
3. Identify conceptual foundations that fit for OT and the
agency.
4. Build OT into current infrastructure.
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Student
Education &
Preparation of
OT Practitioners
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Forms of OT Student Education

▰ Service Learning
▰ Level I Fieldwork
▰ Level II Fieldwork
▰ Experiential Component of OTD
Program
▰ Research Projects

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Service Learning

What is service learning? Purpose


▰ Experience ▰ Learning objectives
▰ Reflection ▰ Sustainable
▰ Engagement ▰ Community-driven
▰ Semi- to fully ▰ Purposeful challenges
structured
▰ Partnerships
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▰ Community needs
Considerations in Service Learning

▰ Prioritize community needs


▰ Address health disparities
▰ Resources & knowledge
▰ Curriculum
▰ Logistics & Time
▰ Liability & Accountability

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Level I Fieldwork

Short-term fieldwork experiences that are designed to


complement and enrich the didactic portion of the curriculum.

Purpose & Objectives:


▰ Introduction to fieldwork and OT practice
▰ Build an understanding of client, group, and population
needs
▰ Skilled observation and selective participation
AOTA, 2016 63
Level I Fieldwork Opportunities

▰ Collaboration with a multi-disciplinary and/or


trans-disciplinary team through a shared
supervision model
▰ Potential for Level II Fieldwork students to
participate in supervision of Level I FW students
▰ Meets the need for either a Level I or II in a setting
that focuses on psychosocial factors

AOTA, 2016 64
Level II Fieldwork

What is Level II Fieldwork?


▰ Long-term placements (typically 12-weeks)
▰ Preparing to practice - moving from student to
clinician

AOTA COE, 2012 65


Level II Fieldwork

Purpose &Objectives:
▰ Focus on professional and critical reasoning
▰ Demonstrating ethical, professional practice
▰ For students to become competent, entry-level,
generalist occupational therapists and occupational
therapy assistants

AOTA COE, 2012 66


Level II Fieldwork

Opportunities:
▰ Assisting with supervision of Level I
Fieldwork students
▰ Unique opportunities to articulate the
role of OT
▰ High level management of OT services

AOTA COE, 2012 67


Level II Fieldwork

▰ Networking ▰ Advocacy
▰ Building relationships ▰ Education
▰ Consultation
▻ Assessment
▻ Build current program
▻ Add new aspect of the
program

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Research
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Survey Development

Examination
of the
Global Life
Skills
Assessment

UTC OTD70
Grounded Theory
How is an OT community
mental health program
created and sustained
using a community
development framework?

UTC OTD71
Student Research: Human Trafficking

▰ What does the victimizer look like and does OT play a


role here
▰ Examine the literature and paint a portrait of this
population, how that fits in with OT's scope of practice,
and how quality of life is affected by trafficking

TSU OT 72
Faculty Development

▰ CCP offer unique ways to nest service,


research, and teaching

73
Program Evaluation

Student
Community Client Professional
Learning

Process

Outcome

74
Program Evaluation

Process Outcome
▰ Student learning ▰ Community health
▰ Service provision ▰ Community infrastructure
▰ Community ▰ Housing
partnerships ▰ Quality of life
▰ Dissemination ▰ # of OTs working in
▰ Faculty scholarship community

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Funding &
Grants

76
Professional Presentations

▰ AOTA 2016
▰ AOTA Mental Health Specialty
Conference
▰ TN OT Association Annual Conference

▰ Need to emphasize dissemination in OT


and non-OT publications
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References

▰ American Occupational Therapy Association, Commission on Education. (2012). COE guidelines for an occupational
therapy fieldwork experience - Level II. Retrieved
from https://www.aota.org/~/media/Corporate/Files/EducationCareers/Educators/Fieldwork/LevelII/COE%20Guidelines
%20for%20an%20Occupational%20Therapy%20Fieldwork%20Experience%20--%20Level%20II--Final.pdf
▰ American Occupational Therapy Association, Commission on Education. (2012). COE guidelines for an occupational
therapy fieldwork experience - Level II. Retrieved
from https://www.aota.org/~/media/Corporate/Files/EducationCareers/Educators/Fieldwork/LevelII/COE%20Guidelines
%20for%20an%20Occupational%20Therapy%20Fieldwork%20Experience%20--%20Level%20II--Final.pdf
▰ Baum, C. M. (2007). Commentary. Occupational Therapy in Health Care, 21(1/2), 277-280.
▰ Beaulieu, B. & Welborn, R. (2013) Community Development 101. Purdue Center for Regional Development. Retrieved
from: https://www.pcrd.purdue.edu/files/media/Community-Development-101.pptx
▰ Beck, A. J., & Barnes, K. J. (2007). Reciprocal service-learning: Texas border head start and master of occupational
therapy students. Occupational Therapy in Health Care, 21(1/2), 7-23.

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References

▰ Blundo, R. (nd). Participatory research and service-learning: a natural match for the community and campus.
Retrieved from: https://www.mesacc.edu/community-civic-engagement/journals/participatory-research-and-
service-learning-natural-match
▰ Community-Campus Partnerships for Health (n.d.). Position Statement on Authentic Partnerships. Retrieved from
https://www.ccphealth.org/principles-of-partnership/
▰ Community-Campus Partnerships for Health (n.d.). Overview. Retrieved from https://www.ccphealth.org/about-
us/
▰ Community-Campus Partnerships for Health (n.d.). Guiding Principles of Partnerships. Retrieved from
https://www.ccphealth.org/guiding-principles-of-partnerships/
▰ Flecky, K., & Gitllow, L. (2010). Service-learning in occupational therapy education. Jones and Bartlett Publishers.
▰ Hoppes, S., Bender, D., & Beth, W. D. (2005). Service learning is a perfect fit for occupational and physical therapy
education. Journal of Allied Health, 34(1), 47-50.
▰ Kindon S, Pain R and Kesby M (2007) Participatory action research approaches and methods: connecting people,
participation and place. New York: Routledge.

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References

▰ Kretzmann, J.P., Mcknight, J.L. (1993). Building Communities from the Inside Out: A Path toward Finding and Mobilizing a
Community's Assets. ACTA Publications: Chicago.
▰ Leamy, M., Bird, V., Le Boutillier, C., Williams, J., and Slade, M. (2011). Conceptual framework for personal recovery in
mental health: systematic re and narrative synthesis. The British Journal of Psychiatry 199, 445–452. doi:
10.1192/bjp.bp.110.083733
▰ Lee, K. (n.d.). Understanding culture, social organization, and leadership to enhance engagement. In the Community
Toolbox, retrieved from: https://ctb.ku.edu/en/table-of-contents/culture/cultural-competence/understand-culture-social-
organization/main
▰ Stoffell, V. (2011). Recovery. In C. Brown & V. Stoffell (Eds.), Occupational Therapy for Mental Health: A Vision for
Participation (pp. 3-16). Philadelphia: F.A. Davis.
▰ Witchger Hansen, A. M., Munoz, J., Crist, P.A., Gupta, J., Ideishi, R. I., Primeau, L. A., & Tupe, D. (2007). Service learning:
Meaningful, community-centered professional skill development for occupational therapy students. Occupational Therapy
in Health Care, 21(1/2), 25-49
▰ World Health Organization (2018). Constitution of WHO: Principles. Retrieved from:
http://www.who.int/about/mission/en/
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