This week’s blog honours the work of Dr Mary Ellen Copeland, originator of the Wellness Recovery Action Plan (WRAP) ahead of World Mental Health Day on October 10th. The WRAP has brought hope to individuals with mental health conditions by promoting self advocacy, personal responsibility, education and the development of supportive strategies. The WRAP has not only been demonstrated to be an effective personal recovery plan, but also has encouraging applications in the workplace too.
The Wellness Recovery Action Plan was developed in 1997 by Dr Mary Ellen Copeland during a recovery skills seminar in Vermont and has, since then, gone on to become the most widely used evidence-based self management recovery plan in the world. The goal in the development of the WRAP was to help people stay well by constructing a self monitoring and structured response system of wellness tools that relieve and eliminate symptoms (Wilson, Hutson & Holston, 2013).
The WRAP is broken down into six sections:
- A daily maintenance plan
- Identify and respond to triggers
- Identify and respond to early warning signs
- Recognise and respond when things are breaking down
- A crisis plan or advanced directive
- A post crisis plan
A key benefit of this process is that it puts the individual in control of their personal wellness by documenting the lived experience of “who I am when I am well” in the daily maintenance plan, and then listing the tools which promote prompt recovery when personal triggers or crises are activated. You can view an example of how the WRAP is applied in person centred NHS care programmes here.
OK, but where do I start as an employer?
With person centred approaches now being favoured in the health and social care sectors, we are seeing a transition to greater personal advocacy in the workplace too. Business in the Community (BITC) in association with Public Health England have produced a Mental Health Toolkit for employers of 1 to 250+ employees which is packed with signposting to free resources and a step by guide to implementing good mental health support strategies in the workplace. There is also a concise and informative guide produce by Time to Change which outlines the most common mental health problems with signposting to further support resources.
What does research in the field show?
Slade et al (2014), point out that recovery is a highly subjective experience, and the definition is likely to change across the course of someone’s life. Strategies and programmes are about “recovering a life” and not changing an individual so that they “fit in” and become “normal” or independent of support services. The objective, they argue, should be to bring people to a place where they can participate equally in all aspects of a civil and economic life. In a study carried out by Wilson, Hutson & Holston, 2013), individuals using WRAP reported a substantial improvement in their quality of life after introducing the strategy, whilst acknowledging that recovery is a lifelong process. However, designing and promoting workplace support strategies for employee absence and return to work are just one dimension. Presenteeism or attending work with a health problem, can result in a reduction in job performance, impacting on overall company performance. Ammendolia et al (2016), found that when designing interventions to reduce presenteeism for mental health conditions, developing a culture which pro actively disengages with the stigma surrounding mental health conditions through HR and outside partner influence formed an actionable opportunity to bring about change.
World Mental Health Day takes place on October 10th, raising global awareness surrounding mental health, aware and advocacy against social stigma. You can find out more here.
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Ammendolia, C., Côté, P., Cancelliere, C., Cassidy, J. D., Hartvigsen, J., Boyle, E., … Amick, B. (2016). Healthy and productive workers: Using intervention mapping to design a workplace health promotion and wellness program to improve presenteeism. BMC Public Health, 16(1). https://doi.org/10.1186/s12889-016-3843-x
Business in the Community (BITC). (2018). Mental Health Toolkit for Employers. Retrieved from: https://wellbeing.bitc.org.uk/sites/default/files/business_in_the_community_mental_health_toolkit_for_employers.pdf
Copeland, M. E. (2018). What is WRAP. Retrieved from: http://mentalhealthrecovery.com/
NHS Foundation Trust, Cheshire and Wirral Partnership. (2018). Wellness Recovery Action Plan (WRAP). Retrieved from: http://www.cwp.nhs.uk/about-us/our-campaigns/person-centred-framework/recovery-toolbox/wellness-recovery-action-plan-wrap/
Slade, M., Amering, M., Farkas, M., Hamilton, B., O’Hagan, M., Panther, G., … Whitley, R. (2014). Uses and abuses of recovery: implementing recovery-orientated practices in mental health systems. World Psychiatry, 13(1), 12–20.
Time to Change. (2018). Types of Problems. Retrieved from: https://www.time-to-change.org.uk/about-mental-health/types-problems
Wilson, J. M., Hutson, S. P., & Holston, E. C. (2013). Participant satisfaction with wellness recovery action plan (WRAP). Issues in Mental Health Nursing, 34(12), 846–854. https://doi.org/10.3109/01612840.2013.831505