On August 14, 2001, a hot summer day for Buffalo, New York, I met with several members of the Recipient Associate Managers (RAMs) and a representative of the New York State Office of Mental Health. The current chair is Donald M. Langreck, the co-chair is Katharine Tussing. The other managers present were Michael Thompson and Jo Anne M. Babcock. Also present was Michael DiPirro a recipient affairs specialist and pharmacist from the New York State Office of Mental Health. All are consumers of mental health services. The mission statement of the RAM is: The customized mental health service system is one in which every provider has an in-house Recipient Associate Manager who acts as a customer service coach to executive staff and who applies tests of goodness of fit in the continuing processes of services improvement.

The Recipient Associate Managers are directly linked to Dr. James Warde, who is the Director of Managed Care and Recipient Initiatives. Dr. Warde reports directly to George Roets, the Executive Director of the Buffalo Psychiatric Center This program has been in operation for several years.

The Recipient Associate Managers are a cadre of recipients deployed throughout the Buffalo Psychiatric Center. Systematic training and experience in mental health administration is provided to recipients who are at a point of readiness in their recovery. At this point of readiness in their recovery, they can benefit from a personal experience while at the same time contributing to the management of the Buffalo Psychiatric Center. To be eligible, people must have a serious and persistent mental illness (SPMI) or have a mentally ill chemical abuser (MICA) diagnosis with at least 100 hours of organized recipient activities over the previous two years. Recipients are prepared for this associate manager role through formal instruction, take-home assignments, committees and task groups. Interested recipients may learn how to become focus group moderators and how to conduct satisfaction surveys. The recipients are offered a $125 monthly stipend. The Recipient Associates bring recipient perspectives to the management table, and they apply the tests of goodness of fit to the planning and review of programs and practices. The program promotes achievement and a high level of input by recipients. Participating recipients find a new sense of self-worth. They learn how to navigate the institution, how to contribute to performance improvement and promote customer satisfaction. The hospital management benefits by maintaining a consumer focus.

A task group was formed to address the complaints of a community group called Forever Elmwood. Forever Elmwood and the task group came together over concerns that the population of persons who have a mental illness in the community was increasing. Forever Elmwood was concerned that this was a detriment to the community. They were very much worried about property values, and other stigma issues. There were several meetings where Forever Elmwood would raise a topic and the Recipient Associate Task Group would provide information. One woman called for taking everyone in for an evaluation the minute anyone was reported to the police. It was explained by JoAnn Babcock that, " people who have a mental illness are more afraid of people than aggressive to people. You don’t have to run across the street when you see me. I’m not about to attack you. You can nod your head and smile. I’m not about to kill you. They surprised me because they said the mental health recipients are not the problem. They recognized they have a problem with crime and drug users."

Donald Langreck said that many people who have a mental illness live and move through the Elmwood Avenue Neighborhood. This task group was a way to reach out to the neighborhood and create a positive outlook toward people who have a mental health concern. The result of these meetings, held during Mental Health Month, was an event called "People First," held at a neighborhood church. It involved persons from all across the area reading poetry, singing, and playing music. The Recipient Associates asked businesses from the Elmwood Avenue Neighborhood to donate any kind of gift, product or service as door prizes. The neighborhood group called Forever Elmwood has a strong interest in the arts. Two or three hundred people from the neighborhood attended. The event showcased assets instead of deficits. Participants were very pleased with the response of the community. There are plans in place to make this an annual event.

Michael Thompson provided a discussion of the Quality Assurance Task Group. They were asked to assess the community sites of Buffalo Psychiatric Center throughout the four county region. At this meeting, discussions also included how the Recipient Associate Managers could use the recipient voice at the table and at every level within the Hospital. "We determined that the best way to do that would be to know the customers of the hospital. So this is how we started doing customer satisfaction surveys. Out of this the group was incubated a peer run business called RESPECT, Inc. The RAM was able to then talk about the policies, procedures and product. Now at the tables throughout the hospital, the RAMs have the same relevance as anyone else. It is fun to watch how things can move when we take an active role."

Michael DiPirro commented that this is the philosophy at the Office of Mental Health. "Consumers are to be at every table where major decisions are being made about their well being. The people of RAM are becoming professional consultants. They have lived recovery and have the experience. They have gone through every one of these products and can help deliver the product. It is very exciting to see what they have done and what they will do in the future."

Additionally, Michael Thompson said after a year of work and education, the RAM is almost ready to train professionals and consumers throughout the facilities of the four county region to initiate their self-help programs determined by the needs of the particular population.

Katharine Tussing said, "About a year ago we met with the head of the Small Business Development Center to discuss a collaborative training program. At the beginning of this year, we decided to write a grant proposal together that would have instructors from Buffalo Psychiatric Center and the State University of New York at Buffalo State College. We’re in the process of writing that grant. We’re going to include several mental health agencies from throughout the city of Buffalo. RAM will collaborate with the agencies for a practicum placement. Eventually they will develop their own RAM program with a tool kit that will be developed at the same time as the grant."

Please see boxes 1 and 2 for the training and practicum placements of the Recipient Associate Managers. Box 3 is areas of Best Practices proven through evidenced based research.

BOX 1

Cultural Diversity Training

Process Re-engineering

Yearly Buffalo Psychiatric Center Update

SSI and SSD

HUD Community Building

Starting a Small Business

Special Assertiveness and Listening Skills

Attitude, Motivation and Stress Management

Effective People Skills

Conflict Management

Policy and Procedures

Coaching

Leadership Skills

Team Building

BOX 2

RAM Task Groups

Marketing

Self-Help Policy and Training

Wellness

Operations Management

Trauma

Peer Initiative Group

Leadership

Institutional Review Board

Educational Committee

Delta Residential Project

BOX 3

Medication

Training and Illness Self-Management [sounds funny AP]]

Case Management

Family Education

Supportive Employment

Integrated Treatment of Co-occurring Disorders

Wellness

Self-Help