Peer Support Services: an Emerging Resource for Health Reform

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• Recovery Oriented Services

Enhanced Consumer Centric Directed Care

• Improve and enhance the existing Peer Specialist/Recovery Services– Data currently within Optum services demonstrate a nearly 40% reduction in in-patient hospital stays– Peer specialists also demonstrate consistently that the members they serve are more engaged in their

local community support activities

• Behavioral/Medical Integration Opportunities– As a result of a demonstration project in San Antonio, Texas we found that a Whole Health Peer

Coach can successfully engage members that are resistive and help them to address both their medical/physical issues as well as their mental health or substance use issues.

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Components of the Whole-Health Peer Specialist Program• Assessment of the need for this service

• Criteria for admission to the program– 60 years of age or older– Two hospitalizations in the prior year– Diagnosed with both a mental health issue and a general

health issue

• Willingness to develop a relationship with our Whole-Health Peer Specialist (WHPS)

• Contract established with an elder care provider to administer the program

– Provider in conjunction with Optum search and locate the Peer Specialist for this project

– Referrals were offered to provider by Optum

• A specially trained advocate who has actually experienced mental illness as well as having a physical health issue

• Training includes standard Peer Specialist Training as well as an additional component to deal with the physical health issues

• Understands the impact such illness can have on a person’s physical and emotional well-being

• Does not diagnose or treat any medical issues• Does help a mental health consumer who is dealing

with physical health conditions develop recovery goals• Offers support in following the care and wellness

treatment plan created by the consumer and the treating clinician

Peer Whole-Health Specialist

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Program Launch

• Project launched September 1, 2010

• WHPS starts to engage referrals

• WHPS works with between 18 and 22 individuals

• Both in-person and phone contact regularly established with program participants

• Relationships develop

• Some referrals easy to engage and willing to participate in the program

• Others required several phone conversations with WHPS prior to willingness to participate in the program

• Common finding with all participants the WHPS needs to share their experiences with both mental health issues as well as general health issues

Findings

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Case Study: Mrs. V

1. Initially, when the Whole Health Peer Specialist met with Mrs. V she had been in and out of the hospital several times for treatment of depression. 

2. Her self-esteem was very low, and she did not believe that her life could get better.  When the WHPS commented that it is possible for her to find recovery, Mrs. V cried. 

3. She said that she had never been told that "Recovery is Possible" and it was hard for her to believe, because she had no hope.

4. Midway through the program, Mrs. V was re-hospitalized again for depression. 5. With treatment and working with the WHPS, her life gradually began to improve and

she became able to manage her medication and make all doctor appointments.  6. Her husband Mr. V is very supportive of his wife, and they have a strong

relationship. 7. At Mrs. V’s request the WHPS was able to help her sort through her mail and coach

her on responding to correspondence by assisting her with writing letters or making phone calls.

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Outcomes

The program has assisted to decrease hospitalization rate by 70%

Length of stay prior to entry to program: 6 days

Length of stay after entry to program: 2.3 days

Participants engaged in their local communities

Participants willingly call WHPS as needed

Thank You and Questions?

Peter C. AshendenDirector of Consumer and Family Affairs1-708-749-7396peter.ashenden@optum.com