The Royal’s WRAP: A personalized plan for staying well outside of the hospital
Wellness Recovery Action Plan proven to be effective
For people with mental health issues, learning how to care for themselves, recognize triggers, identify strategies and maintain their mental health are keys to recovery.
That’s where Wellness Recovery Action Plan, or WRAP, comes in.
It is a 12-week facilitated group program during which people living with mental illness create a personalized plan for staying well outside of the hospital.
“It’s a structured approach for how to maintain mental wellness and what to do if things start to unravel,” said Leslie Bragg, a WRAP peer facilitator. “There are specific things you can do. People do get well in this program, we have seen it.”
The program helps clients take responsibility for their own well-being by identifying triggers and early-warning signs, building a personal tool kit of resources and strategies to stay healthy, engaging in crisis planning, and the particularly challenging process of developing a support network in a world that still sometimes stigmatizes mental health issues.
Created by Mary Ellen Copeland, an American educator who was diagnosed with bipolar disorder in her mid-30s, WRAP is not unique to The Royal, but the hospital and nurse Doreen Parker took a leadership role in bringing it to Ottawa.
WRAP groups are now common across The Royal, including within its Mood and Anxiety Program, the Schizophrenia and Recovery Program and the Women’s Mental Health Initiative, in which groups are open to women who are both patients and non-patients at The Royal. A WRAP group for families also recently started as part of The Royal’s Family Information and Support program.
“A lot of it has to do with relapse prevention and behavioural activation, so it’s doing something different than what people normally do,” said Parker, a nurse in The Royal’s Mood and Anxiety Program. “When people feel depressed they might isolate themselves, so we help them find other ways of getting out, even getting out of bed — doing something different.”
Parker was one of the first in Ottawa trained in WRAP, in 2005. Her program has since held 62 WRAP groups with more than 560 clients attending.
Parker has seen the effectiveness of WRAP proven through research but it’s the comments from clients that really drive home its impact. As one client wrote in a thank you card after her group, “Separating the person from the illness was the catalyst that has changed my focus and direction.”
“WRAP is a generic plan but it’s very structured and it’s individualized,” said Parker. “It’s all about people taking back control over their own health. We identify tools which are safe and free, and help them develop a daily plan to maintain wellness. The sharing in the group is also really valuable.”
Beset by setbacks in her lifelong battle with depression, Debbie McFarlane went through three WRAP programs before she finally absorbed the message. Now she’s one of its greatest champions.
“WRAP is all about ‘me,’” said McFarlane, 60, who first came to The Royal as a 12-year-old at risk for suicide. “Groups and programs are usually about how are we going to help each other, what are we going to do. And WRAP is about learning how to take care of yourself to keep yourself well out of the hospital, to keep yourself well in everything you do.
“So no matter what you do in life, you can take the WRAP program and put it to use in every situation in your life.”
The program embraces five key concepts to recovery: hope, personal responsibility, lifelong learning, self-advocacy and support.
McFarlane started as a client in 1972; she’s volunteered since 1995. She’s found purpose and inspiration in working on behalf of others. She operates a clothing store for hospital clients called Suits Me and she’s co-facilitated 36 WRAPs with Parker.
“The Royal saved my life,” she said. “I don’t think I would be here without the care that I got from the doctors and the social workers here at The Royal. So it’s my way of saying, I’ve got these skills and I can help clients and I want to give back.”