Lamb Insurance Services
NextGen Healthcare

The Economics of Recovery – The Day the Patients Ran the Asylum

Joanne was smiling as her fellow students congratulated her for passing her Microsoft Word Certification Test. She had to put in eighteen months of class time at the Center in order to pass. Her goal now was to become certified in PowerPoint and Excel, while she held down her new part-time secretarial job.

Just two years earlier, Joanne was an inpatient at St. Joseph’s Medical Center in Yonkers, N.Y. where she was being treated for Schizophrenia. She was recalling her time there. She had felt lonely during her stay; there were no visitors or phone calls, she didn’t feel like socializing and there was little to do but watch TV, eat & sleep.

She thought, “If I could learn about the computer while I am an outpatient, then why couldn’t I learn when I was an inpatient? My diagnosis hasn’t changed. Why don’t we donate some computers to Saint Joseph’s Inpatient and Continuing Day Treatment Units?”

Dr. Barry Perlman, MD, St. Joseph’s Director of Psychiatry, and past President of the New York State Psychiatric Association, thought it was a program worth trying. He was “particularly delighted at the idea of one non-profit agency which serves persons with mental illness helping another.” We were thrilled at the thought of our small consumer-run agency being invited to help a two hundred plus bed hospital. But could we deliver?

While we did have twelve years of teaching experience with persons with a broad spectrum of diagnoses, many with cognitive deficits; Schizophrenia, Schizoaffective Disorder, Autism, Substance Abuse etc. and at other agencies; Jawonio, three OMH Rockland Psychiatric Centers, The Guidance Center, Open Arms Men’s Shelter and others, we had no experience teaching folks at an inpatient unit.

To guide our software selection, we searched the databases of OMH, VESID, APA, Columbia, Yale, NYU, etc. and found a number of studies, Centers and Labs involved in Cognitive Neuroscience Research (ccsn.vchicago.edu).

Their findings, combined with our personal and professional expertise helped us to arrive at four criteria:

1)    The software programs had to be able to engage a wide spectrum of diagnoses and skill sets.

2)    They had to be fun, as well as useful.

3)    They needed to include both the patient’s and staff’s interests.

4)    And the toughest; not require staff training, equipment maintenance or an out of pocket expense of more than $1,000 (We got our Board to donate the $).

We refurbished six Pentium Computers with Microsoft Office 2007. Four were placed in an empty office at the CDT site and two were placed in the Arts and Crafts Room of the Inpatient (ILS) Unit.

To ensure a successful launch, three of the Centers’ Microsoft Certified Peer Instructors (Peter, Steve & Maria) volunteered two hours a week for four weeks to teach the basics.

On the first day when we got to the ILS site, we had mixed feelings. While the project was an affirmation of how far we had come in our recovery and were now able to give back to our fellow consumers, we couldn’t help wondering, when the ILS door closed behind us; “would they let us out?”

Six of the thirteen ILS patients received individual one-hour instruction weekly, for four weeks. Following class, the patients had free time to play video games. Most of the patients were familiar with the computer probably because of their youth. Cyberphobia (fear of computers) was observed in only one case. Several patients were accomplished typists (25+ wpm) and enjoyed practicing on the Mavis Beacon Typing Program.

Lisa Sutton, LMSW ILS Staff said she thought “they felt more confident – it gave them hope for a successful recovery and self-sufficiency.”

At St. Joseph’s Outpatient CDT Program, nineteen of the twenty-five clients enrolled in the computer training course. The CDT students especially enjoyed creating their own business/personal and birthday cards, flyers and letters.

Dianne Rossi, LMSW, the CDT Director, observed, “The clients help one another to learn – the more skilled taking on the role of instructors. It’s a self-contained, win-win program. Even the JCAHO and OMH auditors were impressed.”

A year and a half later, we conducted four staff interviews to ascertain the programs long-term viability; “were the computers and Nintendo Wii still functioning? Were they an integral and valued part of the programs? Would they recommend them to other CDT and Inpatient Units?” The answer was “yes” to all our questions.

The staff reported the Wii game program was very popular for both the patients and staff with 30-minute blocks of game time given out as rewards. After program hours, the ILS staff played Wii games to relieve their stress!

Dozens of patients have utilized these computer programs in the past eighteen months and, no doubt, dozens more will enjoy and profit from them in the future.

Joanne planted a seed that a small consumer-run agency was able to turn into a permanent program enhancement at a major Community Hospital helping hundreds of fellow consumers in their recovery, for pennies.

There was no committee, no government oversight, no grant – just a handful of volunteers at Saint Josephs and the Center with a dream. Just because our budgets get cut does not mean we have to stop being effective providers.

Have a Comment?