The Group Home Employee Skills Training Project (GHEST)

The Group Home Employee Skills Training (GHEST) project is an ambitious collaborative effort of the Center aimed at improving care for people with severe mental illness. The concept for the project started with Louise Jordan, a board member for the National Alliance on Mental Illness (NAMI) Wake County.

Jordan's brother was hospitalized for 44 years after being diagnosed with schizophrenia. His experiences before and after his discharge are what sparked Jordan's passion to provide more intense training for direct care staff.

"The GHEST project will, I think, be a beginning. If it helps even one person to recover, it's worthwhile. Because there is hope for these people, even if our mental health system doesn't always reflect that hope." 
—LOUISE JORDAN According to Jordan, mental health group homes in North Carolina provide primarily custodial care, because employees typically receive only minimal training. Yet a person's home is the most important environment for promoting recovery — and the people who work in group homes are crucial to their clients' recovery.

"If we can make these homes more therapeutic," Jordan says, "the people living in them can recover some of who they were before their traumatic illness hit."

Early in 2010, Jordan and other members of NAMI Wake County approached the Center to discuss the urgent need for more intense staff training at adult mental health group homes. The result of collaborations among state, local, and academic mental health treatment experts, the GHEST project is designed to:

• Give direct care staff a clearer sense of purpose and job fulfillment by providing the knowledge and skills they need to impact the lives of the people in their care
• Give people with severe mental illness a better life and renewed hope for recovery
• Take away much of the burden — and cost — currently placed on law enforcement and hospital systems

Designed as an interactive, three-day program, GHEST teaches a variety of skills that direct care employees need to successfully support people with severe mental illness. Hours count towards training requirements for staff set by the State. The training topics cover:

• How to deal with certain behaviors that can be caused by mental illness
• Knowledge of client rights
• Understanding of medications used to treat mental illness — including how they should work, and how to recognize side effects
• How to spot signs that indicate a client's condition is declining, and how to prevent suicide
• Overall health and safety instruction
• How to recognize stigma, and how to overcome it
• How to help those with mental illness rebuild a meaningful life
• How to communicate more effectively as part of a treatment team

To develop the GHEST project, NAMI Wake and the Center formed a committee that included group home managers, employees of Central Regional Hospital, area Local Management Entities (LMEs), the Division of Health Services Regulation (DHSR), and various departments across UNC. During the spring and summer of 2010, the committee members worked together to clarify needs and to identify stakeholders with appropriate expertise to develop the training. Through this collaborative process, the GHEST project rolled out in September 2010, targeting 20 participants across three counties.

As the project expands, results at participating group homes will be tracked. Changes will be implemented based on these results, to ensure the training continues to accomplish its mission.