The behavioral healthcare industry is facing a monumental time of change. The mental health field in particular is faced with putting more responsibility on consumers to drive their own treatment. No longer, it seems, will a person with mental health challenges be cared for in a prescriptive, or “by-the-book,” kind of way. When an agency says its model of care is person-centered and individualized, that means that consumers are given the challenge of driving their own treatment, with the help and guidance of a knowledgeable workforce. Staff today are trained to understand that our work with individuals must come from the core belief that hope and healing are possible and that recovery has many pathways.
What does this new healthcare environment mean for staff? It means they must begin to think about the individuals they work with from multiple lenses, learning to understand their own feelings and reactions and how that might impact a consumer’s actions. It means that supervisors must help the workforce buy into new models of care, models that sometimes require staff to look inward. It means that supervisors must help staff look at outcomes – Are consumers getting better? Is the treatment provided effective? – and must make asking about outcomes part of the supervisory discourse. Supervisors must help staff be objective, introspective, and reflective. And it is through this active and collaborative supervision that both consumers and staff will learn to be more effective agents of change.
The new frontier of managed care requires a degree of collaboration not seen before. Care providers will be speaking with one another and working with the consumer to help him or her get the best outcomes possible. So, while this interaction may enhance a consumer’s future, staff must be willing to partner with collateral providers in a variety of new ways that may be quite unfamiliar at first. This interactivity may require more patience, a greater understanding of the system, and more accountability. Here is where supervision can offer its greatest reward. Staff can learn to listen more effectively to what consumers are saying as well as to what other care providers in the consumer’s network are saying. This coordination requires that staff be open, flexible, and honest with themselves and one another, as well as respectful of differing viewpoints. They must learn to accept feedback in a non-defensive manner and must be willing to integrate their supervisor’s consultation.
Supervision becomes even more important in this cooperative scenario because the supervisor wants to make sure that all staff members are effectively collaborating with one another. Supervision is where that care coordination can be discussed—working to make sure that everyone is looking to achieve the best possible outcomes for the consumer and understanding the pathways each member of the care team is taking to get there. Learning to update each team member’s activity with other providers is pivotal in making sure that the consumer’s goals are a priority.
In any field, an effective supervisor helps get the best out of his or her staff and motivates a worker to perform at an optimum level. Particularly in the behavioral health field, the best care is relationship-based—built on trust and mutual respect. This is true between staff and the consumer as well as between staff and his or her supervisor. The role of supervision must be one of respect, and it must be one of support. The supervisor is there for staff to bounce ideas off, to develop a plan for updating a consumer’s records, to help understand how to best inspire, and to entrust that staff members learn to trust themselves and their ideas.
Accountability is essential. Supervisors must help staff transition to this new healthcare environment, where we know that recovery is possible. Staff must learn to embrace their roles as helpers as consumers learn to advocate for themselves and their own goals. Supervisors must assess staff competencies and provide support in areas that need work while being encouraging in places where care meets the mark and beyond.
Supervisors must believe that the culture of their workplace is supportive of their efforts, that the road they lay out before staff and consumers is a road that works within an agency’s guidelines and ideology. Supervision is where the belief of success becomes part of an agency’s operational procedure. In addition to individual supervision provided to all staff, at ICL, we use such resources as Tip of the Week, which brings thoughtful suggestions on how to approach different consumer problems with compassion. Our nursing triage and internal mobile crisis teams work together to bring integrated care to the neighborhoods where consumers live. When new consumers are coming to an ICL facility, senior clinicians weigh in on high-risk behaviors, comorbidities, histories of aggression and violence, and more through our SARC (Special Admissions Review Committee) team. When staff feels it has exhausted all other interventions, a Clinical Risk Consultation Team (CRCT) can be gathered in which senior staff meets with the consumer and the entire treatment team to formulate a safe and effective care plan.
So we are learning that the best consumer outcomes come from a team approach that starts during individual supervision. It is the agency’s leadership that must support staff who, in turn, help consumers realize that their successes are within reach. People do get better and achieve meaningful lives and true community integration. Effective supervision is an essential component in helping this come to fruition.