BRATTLEBORO — Eighteen years ago, Mary Ellen Copeland began drawing up a new method for dealing with mental illness.
She was looking for a way to reclaim her own life after years of battling anxiety, depression, and mood swings, and Copeland decided “personal empowerment” - allowing a person to take charge of one's own treatment - would be key.
The Dummerston resident's WRAP strategy, standing for Wellness Recovery Action Plan, was the result, and it appears to have worked on a large scale.
The Brattleboro-based Copeland Center for Wellness and Recovery is a decade old, and its administrators say WRAP is in use in all 50 states and worldwide.
On Sept. 3, more good news came in the form of federal support totaling $330,000 annually for five years, money that will be used to spread WRAP even farther, develop more peer counselors, and reach out to a younger generation.
“It's really exhilarating to me to be able to share with the nation how strong Vermont has been in leading the way in recovery,” said Matthew Federici, the Copeland Center's executive director.
Holes in the system
It's no secret that Vermont has had trouble providing adequate mental-health care in recent years.
Tropical Storm Irene dealt a severe blow to the system by knocking out the Vermont State Hospital, and the Brattleboro Retreat - having stepped in and expanded after that disaster - has faced regulatory issues of its own.
Though the state is working to expand mental-health offerings, it's still common to hear about a lack of available facilities for those needing mental-health care.
But even under the best of circumstances, the system has holes.
U.S. Rep. Peter Welch, D-Vt., mentioned a few during a visit to Brattleboro on Sept. 3 to discuss new funding for the Copeland Center.
“Mental illness is such a tough thing to address,” Welch said. “The reliance on medication - which has its place, obviously - [and] the reliance on institutional treatment - the hospital - was a way not so much of treating but putting out of sight, out of mind what the problem was.”
Welch recalled his days working as a public defender.
“So many of the people I represented were not criminals,” he said. “They were folks who had significant mental illness, and we didn't know as a society how to help them, and they ended up in the criminal justice system. And that's not good.”
Neither Welch nor Federici is claiming that the Copeland Center's flagship program - WRAP - can or should replace traditional mental-health treatment. However, Welch sees it as part of a “comprehensive system,” and one that can decrease reliance on the treatment system.
“What I so admire about the Copeland Center is that it incorporates a very simple proposition of personal responsibility and self-help into a treatment plan,” Welch said. “It's not just a frustrated and overburdened provider giving medication, or a frustrated criminal-justice system putting somebody in an institution.”
The basic principle, Welch said, is that “they're going to get better if they are actively involved in their own treatment. And that's true for physical health, just as it is for mental health.”
“It's such a simple insight, but so essential,” Welch added. “It's harder to do, probably, than just give a pill. But on the other hand, it has the potential for much-more-effective outcomes. And that's the pioneering work that the Copeland Center has done.”
'Figuring out how to navigate life'
WRAP is billed as a “personalized recovery system” that is supposed to give people the tools they need to get through daily life. Users learn the system via a series of group meetings led by “peers who use WRAP for their own recovery.”
People often find their way to WRAP via the mental-heath system. But Federici believes that, “where largely the mental health system asks, 'What are your symptoms?' and 'What is wrong with you?' our program asks, 'What does wellness look like to you?'”
“We realize where they want to start is not with what a doctor may say is their mental-health symptom,” he said. “Where they may want to start is, 'I want to quit smoking,' 'I want a better relationship with my girlfriend,' or 'I want to lose weight.' And then, from there, we take a whole-health approach. And I think that's why this program has evolved to be so effective for so many different people.”
For many, Federici said, “it's life that's the problem, and figuring out how to navigate life. It's not this kind of predefined thing.”
The center tries to reach a “diverse group of people,” Federici said. He mentioned examples including those coping with addiction and illness; veterans; and prisoners via a program called “Mentoring for Re-entering.”
Welch said the Copeland Center's programs are “not just some theory. This is something that, in practice, has been tested, looked at, and found to actually be quite effective.”
Copeland administrators say WRAP has been recognized by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) and has been listed in the National Registry of Evidence-Based Programs and Practices.
The grant announced on Sept. 3 is a new form of federal recognition via SAMHSA. It totals $1.65 million over the five-year period - though Federici noted that the annual renewal is based on performance - and the grant also includes additional money to organize a national conference.
The grant will allow the Copeland Center to set up, as of Oct. 1, a new program called Doors to Wellbeing, one of three National Consumer Technical Assistance Centers funded by SAMHSA.
The center will work to expand the reach of the WRAP program; reach out to a younger audience; and boost the training and use of peer specialists - people who have had “significant mental-health challenges” but who now are involved with helping others work through those issues in their own lives.
“One of the greatest challenges is shifting the paradigm - the perspective - that people with these challenges need to be helped more than they can help,” Federici said.
Federici said center administrators want to focus on “reaching populations that are underserved right now. In particular, we talk a lot about being able to reach the veterans of the Afghan and Iraq wars.”
The grant is no small thing for a nonprofit with an annual budget in the $500,000-to-$600,000 range. Federici said the center can hire a full-time program director and a technical assistance director, and the money also will help support existing staff while providing overall financial stability.
“Where otherwise we had been going from partnership to partnership and contract to contract to fund trainers to go out and run our programs, it will give us that sustainability.
“We'll know that we can do that,” Federici said. “And we can also then serve agencies and communities that have traditionally not had the resources to pay for the trainers and the time.”