Presented by

The Temple University Collaborative on Community Inclusion for Individuals with Psychiatric Disabilities

And

The National Mental Health Consumers’ Self-Help Clearinghouse

Into the Thick of Things: Promoting Community Inclusion in Peer-Run

Services

The contents of this presentation were developed under a grant from the Department of Education, NIDRR grant number H133B100037 (Salzer, PI). However, those contents do not necessarily represent the policy of the Department of Education, and you should not assume endorsement by the Federal Government.

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Our PresentersJoseph Rogers is executive director of the National Mental Health

Consumers’ Self-Help Clearinghouse (funded in part by the Substance Abuse and Mental Health Services Administration) and chief advocacy officer of the Mental Health Association of Southeastern Pennsylvania. He is an internationally known advocate and a leader of the consumer movement, with particular expertise in the design and implementation of peer-run programs as well as in behavioral health policy.

Christa Burkett is the technical assistance coordinator at the National Mental Health Consumers’ Self-Help Clearinghouse and Co-Chair of The Temple University Collaborative on Community Inclusion’s National Leadership Committee.

Bryce Hewlett presently serves as the executive director of the Delaware Consumer Recovery Coalition - the statewide, c/s/x network of Delaware. Bryce is a community organizer and activist at heart. His involvement in the c/s/x movement began in Philadelphia in 2007. Since that time he has helped organize several Alternatives conference and presented at many national conferences. Part of his current work includes facilitating placement of peer specialists in Delaware’s emerging community mental health programs as well as providing oversight and support of peer specialists in the statewide coalition.

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Peer Advocacy Movement Grew out of Struggle for Rights & Empowerment

International Conference on Human Rights and Against Psychiatric Oppression, Vermont, 1985

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Ex-patients’ Rights Groups Form in 1970s and Early 1980s

Judi Chamberlin

Sally Zinman

Ed KnightJay Mahler

George EbertSally Clay Dan Fisher David Oaks

Leonard Roy Frank

Joseph Rogers

…in Massachusetts, California, New York, Pennsylvania, Florida, Oregon

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On Our Own: Patient Controlled Alternatives to the Mental Health System

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“We want as full as possible control over our own lives. Is that too much to ask?” –Howie the Harp

Howie the Harp

(1953-1995)

•Control•Choice•Self-determination•Empowerment•Recovery

Decades Spent Convincing Establishment of Peer Support’s Value

• Presenting at conferences• Attending meetings of professionals and administrators• Serving on boards and committees• Writing and publishing articles

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1993 sit-in in then-CMHS director Dr. Bernard Arons’ office led to more funding for peer-run programs.

Former SAMHSA administrator Charles Curie supported recovery movement, fought use of S&R

Paradigm shift: Establishment believes in recovery and accepts value of peer support

• “Mental Health: A Report of the Surgeon General” (1999)

• Report of the President’s

New Freedom Commission

on Mental Health (2003)

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Then-U.S. Surgeon

General David Satcher

Michael F. Hogan, Chair, President’s New Freedom Commission

Powers-that-be” realize that recovery-oriented, peer-run

services are key to recovery

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SAMHSA Administrator Pamela S. Hyde (top); CMHS Director Paolo del Vecchio (bottom)

SAMHSA recognizes Peer Support as one of the 10 fundamental components of recovery. The 10 are:•Self-Direction

•Individualized and Person-Centered

•Empowerment

•Holistic

•Non-Linear

•Strengths-Based

•Peer Support

•Respect

•Responsibility

•Hope

Peer Specialists in Pennsylvania

● CMS approved Medicaid reimbursement for peer specialist services in PA in 2007.

● It is going well in PA.

● Every county must provide peer specialists to any Medicaid recipients who meet the “medical necessity” criteria.

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“The National Association of Peer Specialists, Inc. (NAPS), is a private, non-profit organization dedicated to peer support in mental health systems.

www.naops.org

Founded in November 2004 by a group of peer specialists, the organization has quickly grown with members from every state.”

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Genesis of Study of Consumer-Operated Service Providers

and Community Integration

• Little indication that consumer-operated service providers are helping with community integration

• Temple Collaborative and Clearinghouse brainstorm a grant proposal to NIDRR

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Procedures• Creating survey

questionnaire• Sending online request-

for-Information• Sifting through responses• Contacting respondents

for more information• Compiling a compendium

of results• Identification of

community integration strategies

• Developing a one-day training

Sample Responses:

Housing● Dodge City Peaceful Tribe (Kansas)

• Integrated peers into existing patterns of small-town social networks.

• Tribe developed relationships with a core group of 20 small local landlords who advertise by word-of-mouth and rent to people based on the landlord’s comfort with the person recommending the renter.

• If peers are hospitalized, their home can be held for them and the Tribe can mediate if there are problems.14

Employment

● Office of Consumer Advocates, (Hagerstown, Maryland)

∙ Built relationship with Martin’s Supermarkets (branch of Giant Foods, which hires individuals with disabilities and provides sensitivity training to staff who do not have disabilities)

∙ Refers peers to potential employment opportunities in five local Martin’s stores.

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Education

● Howie the Harp (New York City)

∙ Collaborates with the SUNY Manhattan Educational Opportunities Center for adult learners to help peers get GEDs

∙ Participates in free PACE University computer literacy skills training program

∙ Continues to seek mainstream training-provider to help train peers in basic office skills.

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Education:● Amarillo (Texas) Area Mental Health Consumers

∙ Helps peers get scholarships at regional institutions of higher education.

∙ Refers others to:

◦student loan offices for Pell Grants and student loans.

◦ Handicapped Student Services at Amarillo College

◦ Panhandle Independent Living Center for computer training

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Religion and Spiritual Life:

● Saint Louis Empowerment Center (Missouri)

◦ Developed an informal network with African American churches near the Empowerment Center.

◦ Peers attend church-based social activities as well as church services.

◦ New opportunities for housing through this network have opened up.

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Leisure & Recreational Activity

● Vermont Psychiatric Survivors

• Links peers to community organizations according to the peer’s interests – e.g., bowling, knitting – rather than providing activities in the Center.

• Peer mentors introduce a peer to a new community group, provide help until the peer is better integrated, at which point the peer participates more independently.

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Civic Life

•DBSA-Southern Nevada

◦ Sponsors monthly speaker series on mental health issues in partnership with local library.

◦ Speaker series is open to the public, rather than just being for peers in the peer center.

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Civic Life

● HOPE Impact (Wahiawa, Oahu, Hawaii)

• Peers attend local neighborhood meetings to advocate for other peers, individuals who are homeless, and veterans with such challenges.

• Group founder has a TV show entitled “Hope in Recovery.”

◦ Highlights individuals in recovery.

◦ Plans to interview local officials about mental health policy.

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Health Care

● Amarillo Area Mental Health Consumers

• Refers peers to smoking cessation classes and diabetic care group in the community rather than in-house classes.

• Refers peers to grieving group and hospice education group at a regional hospital.

• Encourages senior peers to go to a community senior center rather than identifying only as a peer. 22

Health Care

● DBSA-Southern Nevada

• Participate in large public health fairs in the local area, setting up booths, making contacts, handing out literature.

• Sponsor their own outdoor health fair attended by other health care providers.

◦ The fairs have art displays, a car wash, and sometimes basic health screenings.

• These activities are based on reciprocity between DBSA and community organizations.

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Community Inclusion StrategiesUsed By

Respondents…

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Community Integration Strategies Uncovered:

• Peer mentoring• Referrals• Partnerships• Directing peers to

membership-based groups

• Do-It-Yourself (DIY)• Using community

networks

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Practical Strategies Assess Needs & Priorities.

Explore Community Resources.

Identify Environmental Barriers.

Offer Individualized Supports.

Update the Plan.

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Practical Strategies: Assess Needs &

Priorities• Counselor/client assessment of current levels of community integration

• Expression of interest in progress in varied domains

• Setting priorities: ◦ Feasibility◦ Importance◦ Opportunity◦ Overcoming counselor/client anxiety

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Practical Strategies: Explore Community

Resources• What already exists for citizens

without disabilities?

• What entry requirements exist?

• What demands does participation make?

• Sharing information-gathering responsibility

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Practical Strategies: Identify Environmental

Barriers• Consumer/staff/

community attitudes• Regulations and

legislation• Financial resources• Community

discrimination

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Practical Strategies: Offer Individualized

Supports• Staff training

• Accompaniment

• Community mentors

• Financial assistance

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Practical Strategies: Update the Plan

An initial plan: Who What Where When How

A plan to reviewA plan to revise

Peer Specialists in Delaware

Bryce Hewlett

Executive Director

Delaware Consumer Recovery Coalition

(302) 689-DCRC

www.delawarerecovery.org

Peer Specialists in Delaware• Delaware is presently going through a process to develop

a credential for peer support specialists• This process will yield peer support as a Medicaid

reimbursable expense in Delaware• Our first training toward certification will begin at the end

of this month (November)

Peer Specialists in Delaware• Since we do not have a certification program we call peer

specialists those who work in peer support roles and have received training to do so

• The lack of a certification program has made for a great deal of confusion by the state, services providers, and volunteer organizations

Delaware Consumer Recovery Coalition and Peer Specialists• All peer-operated services that are a part of the DCRC

primarily use peer specialists as employees• All peer resource centers use community mental health

providers as fiscal agents• The directors of these services are peer specialists who

serve on the DCRC board of directors

Peer Operated Services• Delaware Consumer Recovery Coalition (Statewide –

Delaware)• The Creative Vision Factory (Wilmington)• Rick Van Story Resource Center (Wilmington)• Dover Hopes and Dreams (Dover)• ACE Center (Seaford)

Delaware Consumer Recovery Coalition

http://delawarerecovery.org/

Delaware Consumer Recovery Coalition

• Approx. 130 individual members• Statewide (urban and rural)• 4 member organizations• Peers Roles:

• Facilitate mutual-support, self-helps groups in each county in Delaware (4 monthly meetings right now

• Serve on boards and committees• Legislative/systems advocacy efforts

The Creative Vision Factory

http://thecreativevisionfactory.org/

Creative Vision Factory• Approx. 80 members• Urban setting (Wilmington, New Castle County)• Peer resource center focused on the arts• Peer Specialist Roles:

• all staff at CVF are peers• members of CVF engage the community around them and use the

center for community events

Rick Van Story Resource Center

http://rickvanstorycenters.org/

Rick Van Story Resource Center• Approx. 130 members• Urban setting (Wilmington, New Castle County)• Peer resource center focused on recovery activities and

homelessness• Peer Specialist Roles:

• all staff at RVRC are peers• Peers facilitate recovery groups (AA, NA, Hearing Voices,

spirituality, etc.)• RVRC received a contract through their fiscal agent to be a

homeless respite during the winter months

Dover Hopes and Dreams

http://www.delaware211.org/Resource?r=3629783

Dover Hopes and Dreams Resource Center

• Approx. 20 members• Sub-urban setting (Dover, Kent County)• Peer resource center focused on recovery activities• Peer Specialist Roles:

• all staff at DHD are peers• Peers facilitate recovery groups and activities

A.C.E. Peer Resource Center

http://www.facebook.com/pages/The-ACE-Peer-Resource-Center/369719023102241

A.C.E. Peer Resource Center

• Approx. 20 members• Urban setting (Seaford, Sussex County)• Peer resource center focused on recovery activities• Peer Specialist Roles:

• all staff at DHD are peers• Peers facilitate recovery groups and activities

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• Into the Thick of Things: Connecting Consumers to Community Life: A Compendium of Community Inclusion Initiatives for People with Psychiatric Disabilities at Consumer-Run Programs

http://www.tucollaborative.org/pdfs/COMPENDIUM_of_Innovative_CI_Projects_11-29_10.pdf

Resources

● Temple University Collaborative on Community Inclusion: http://www.tucollaborative.org

● National Mental Health Consumers’ Self-Help Clearinghouse: http://www.mhselfhelp.org

● Consumer-driven Services Directory: http://www.cdsdirectory.org

● Institute for Recovery and Community Integration: http://www.mhrecovery.org

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Resources