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Presented by:Ann Jadin Ed.D
Community Engagement Director&
Tom JadinCertified Peer Specialist
Emerging Practice of Peer Recovery ServicesWisconsin Occupational Therapy Conference
Friday, October 7, 2016
MISSION:NAMI Fox Valley works to
empower and support everyone touched by
mental illness. We strive to eliminate stigma and
nurture recovery through education, support,
advocacy and outreach.VISION:
We envision a community, free of stigma, that
supports and promotes mental health and
recovery.
211. E. Franklin StreetAppleton, WI 54911
(920)954-1550www.namifoxvalley.org
Help. Hope.
Recovery.
NAMI Fox Valley Programs
• Support: People Helping People‐ A dozen support groups
• Education: Knowledge is Power‐ Family‐to‐Family, Peer‐to‐Peer, REAP, New Hope Peer Specialists
• Outreach: Changing Hearts and Minds‐ NAMI Talks Speakers Bureau, Ending the Silence
• Advocacy: Speaking Out Together‐ Community’s Voice on Mental Illness
New Hope Peer Specialist Training
Adapted from Consumers As Providers (CAP) Training Program
Nationally awarded, Kansas Certified Peer Specialist training program
NAMI Fox Valley’s Role in Workforce Development
New Hope Class
Graduates Pass State Cert. exam
Internship Placements
Offered Employment or
employed
Summer 2014 Class 1
11 10 11 11
Fall 2014Class 2
11 11 9 7
Fall 2015Class 3
12 11 8 8
Total 34 32 28 26
NAMI Fox Valley’s Role in Workforce Development
County # CPS 2014 # CPS 2015 # CPS 2016
Brown 5 7 12
Calumet 0 2 2
Door 0 0 1
Kewaunee 0 1 1
Langlade 0 0 2
Outagamie 4 11 18
Shawano 3 0 1
Waupaca 1 1 1
Winnebago 2 4 8
Counties with the highest numbers: Milwaukee, Dane, Waukesha, LaCrosse, Brown and Outagamie.
Defining Peer Support: ◦ A person in recovery and or a person with lived experience who offers services and supports to other people in recovery (Davidson, 2006). ◦
A system of giving and receiving help based on values of respect and mutual agreement…not based on “traditional” psychiatric models (Mead, 2001).
A person who has experienced similar
struggles and triumphs; someone with lived experience of the
mental health and or substance abuse
systems.
Peer Recovery Services
A person who, through their own recovery has gained the necessary skills to support others.
The Gifts of Peer Support• Insight• “Been There, Done That”• Compassion• Hope• Trust• Whole‐ Health Self‐Management
The History of Peer SupportAs much as possible, all servants chosen from the category of mental patients. They are at any rate better suited to this demanding work because they are usually more gentle, honest and humane.”
Letter from Jean Baptiste Pussin (1793) Pussin was the superintendent and chief physician of Bicetre Hospital in Paris, where he himself had been a patient.
The History of Peer Support•Peer movement over time…
–18th century: moral treatment era–1970’s: “ex‐patient,” independent living movement, civil rights perspective (deinstitutionalization)–1990’s: mental health service user movement–2000’s: integrating peer support into the traditional mental health service system
•More than 10,000 individuals in the US providing peer support (2012).
•Based on psychiatric models or diagnostic criteria (“What do you need vs. what do people with your diagnosis need.”)•Defined as an Expert/Patient Relationship•Effective/helpful when “required”•“Helping” vs. Facilitator Role
Shery Mead (Defining Peer Support, March 2003)
•Myth: Peer specialists will relapse.•Myth: Peer specialists are fragile.• Myth: Peer specialists are inappropriate additions to treatment teams. •Myth: Peer specialists cannot work due to benefits.•Myth: Peer specialists will not maintain appropriate boundaries.
•Connection through shared experience builds a mutual relationship of trust.
•This foundation allows peers to respectfully challenge one another.
•“Try out new behaviors” to move beyond previous “worldview”
•Creating meaning through relationships: illness to moving towards discovering personal and relational change.
Shery Mead (Defining Peer Support, March 2003)
Evidence to Support Peer Support • A that peer‐provided, recovery‐oriented behavioral
health services produce outcomes as good as—and in some cases superior to—services from non‐peer professionals (Solomon, 2004).
• The use of peer specialists as part of the treatment team, have favorable results (Davidson et al., 2006),
• “results indicate shortened lengths of stays, decreased frequency of admissions, and a subsequent reduction in overall treatment costs” (Chinman et al., 2001).
• Using peer recovery coaches can strengthen social supports and improve recovery outcomes (Kaplan, 2008).
Evidence for Peer Support Hiring
The Health and Recovery Peer (HARP) Program Druss et al. Schizophrenia Research (2010)
• Medical disease self‐management programs may increasingly be integrated into peer workforce to improve health and healthcare for mental health consumers.
• The recovery model may provide a useful approach for understanding how all persons with all chronic illnesses –both medical and mental health – can lead fuller and healthier lives.
Mental Health & Peer Recovery Services Peer support services are considered “evidenced based” by the Centers for Medicare and Medicaid Services and a “critical pathway” of increasing client involvement in behavioral healthcare by the New Freedom Commission on Mental Health.
• Being a recipient of mental health services
• Navigated his/her own course through recovery
• Transforming their own negative experiences often motivates
• “Living proof” that recovery is possible and inspire others
Substance Abuse &Mental Health Services Administration 2012
What is the Unique Role of Peer Support Relationship?
•Respect•Shared responsibility
•Mutual agreement of what is helpful (mutuality and mutual empowerment)•Understanding through empathy•Building connection
Shery Mead (Defining Peer Support, March 2003)
Giving & receiving help based on guiding principles:
What is a Certified Peer Specialist?• Peer with formal training and the peer specialist model of mental health supports who uses lived experience along with skills training to provide peer support
• Active participant on the individual’s recovery team.
• Two year certification with required continuing education
WI CPS Core Competencies• Values: Believes that…
– Recovery dimensions/principles– Empathy– Cultural awareness– Recovery as process
• In‐Depth Knowledge of Recovery– SAMHSA definition– Knowledge of neuroscience/impact of mental health & substance use disorders
– Person‐centered and strengths‐based planning– Stigma, shame, discrimination, oppression and marginalization
WI CPS Core Competencies• Roles & Responsibilities
– Consumer rights: state, federal laws, ADA, civil rights– Ethics & Boundaries, Confidentiality– Scope of practice of a CPS– Role of self‐disclosure– Cultural and trauma awareness
• Skills– Outlook for hope & recovery– Support: problem solve, exploring life choices, crisis de‐escalation/intervention, understanding perspective, recognizing strengths
– Facilitate & support utilization of resources– Self & Peer Advocacy
Recovery is a process of change through which individuals improve their health and wellness, live a self‐directed life, and strive to reach their full potential.
Resilience is the ability to adapt to life‐changing situations and stressful conditions. It is the ability to “bounce back” in the face of a challenge, which can guard against feelings of hopelessness or defeat.The DIMENSIONS: Peer Support Program Toolkit was developed by the University of Colorado Anschutz Medical Campus, School
of Medicine, Behavioral Health and Wellness Program June 2015
Recovery, Resiliency & Self‐management 1. Independent living 2. Engagement in meaningful relationships3. Effective management of health and mental
health conditions4. Maintenance of sobriety5. Participation in practices that support self‐
care, health, and overall well‐being
BENEFITS of PEER SUPPORT & COACHING . . .
• Reduces the number of admissions and days spent in hospitals and increased time in the community
• Reduces use of acute services (e.g., emergency rooms, detoxification centers)
• Increases engagement in outpatient treatment• Increases active involvement in care planning and self‐care
• Improves social functioningSubstance Abuse &Mental Health Services Administration; 2012
BENEFITS of PEER SUPPORT & COACHING . . .
• Increased hope, quality of life, and satisfaction with life
• Reduces substance use• Reduces depression and demoralization• Improves chances for long‐term recovery• Increases rates of family reunification• Reduces average service costs per person
Substance Abuse &Mental Health Services Administration; 2012
Emergency roomsCrisis ServicesIn and Outpatient carePrison and Forensic areasCommunity Resource CentersVeteran's HospitalsSupported Living
.
Scope of Practice for Certified Peer Specialists:
ADRC‐ Aging & Disability Resource CentersCSP‐ Community Support ProgramsCCS‐ Comprehensive Community ServicesCRS‐ Community Recovery ServicesTransitional Housing ProgramsPeer Run Respite Centers
.
Scope of Practice for Certified Peer Specialists :
Independent Living Agencies Domestic Abuse SheltersWarming SheltersHomeless SheltersCounseling CentersAddiction ProgramsDrop‐In CentersClubhouses
.
Scope of Practice for Certified Peer Specialists:
• Increased engagement and activation in treatment
• Increased empowerment and hope
• Increased satisfaction with and quality of life
• Decreased self‐stigma
• Reduced use of inpatient services
• Increased social functioning
• Increased community engagement
• Decreased hospitalization
Benefits of Working WITH a Peer Specialist
• Increased knowledge
• Increased sense of empowerment and self‐worth
• General improved quality of life
• Increased stabilization and resilience
• Increased financial independence and less reliance on benefits
Benefits of Working AS a Peer Specialist
• 1) What are the reasons your organization is considering a peer support program?
• 2) Pick the two most important reasons. List them here and describe why they’re important.
• 3) How does implementing a peer support program benefit your organization?
• 4) What makes the implementation of a peer support program personally relevant to you?
Implementing a Peer Support Program
1. To conduct program evaluations and research trials to gather evidence on the benefits for people in recovery.
2. To examine cost effectiveness of peer‐provided services for funders and policymakers.
3. To evaluate program structures, types and styles of supervision, mentoring, and supports that help peers experience job success and role satisfaction.
Future Considerations
• Descriptions/dates of program offerings: www.namifoxvalley.org
• Call us at (920)954‐1550• Join our mailing list! (Post and/or Electronic)
• Come for a visit – we are here to help!
QUESTIONS?
References …• Cook, et. al (2010). Developing the evidence base for peer‐led services: Changes among participants
following Wellness Recovery Action Planning (WRAP) education in two statewide initiatives. Psychiatric Rehabilitation Journal, 34, 113‐120.
• Davidson, L., Chinman, M., Sells, D. & Rowe, M. (2006) Peer Support Among Adults With Serious Mental Illness: A Report From the Field Schizophrenia Bulletin vol. 32 no. 3 pp. 443–450.
• Druss et al (2010). The Health and Recovery Peer (HARP) Program: A peer‐led intervention to improve medical self‐management for persons with serious mental illness. Schizophrenia Research, 118, 264‐270.
• DIMENSIONS: Peer Support Program Toolkit was developed by the University of Colorado Anschutz Medical Campus, School of Medicine, Behavioral Health and Wellness Program June 2015.
• Equipping behavioral health systems & authorities to promote peer specialist/peer recovery coaching services. Expert Panel Meeting Report, March 21 – 22, 2012; Prepared for the Substance Abuse &Mental Health Services Administration; August 17, 2012.
• Medicaid Coverage of Peer Support for People with Mental Illness: Available Research and State Examples (2008).
• National Practice Guidelines for Peer Supporters, SAMHSA Working Definition of Recovery (2011).
• Solomon, P. (2004). Peer support/peer provided services underlying processes, benefits, and critical ingredients. Psychiatric Rehabilitation Journal, 27(4), 392‐401.
• Wisconsin Peer Specialist Employment Initiative http://www.wicps.org/