the expanding and evolving role of peers and peer support services laverne d. miller...
TRANSCRIPT
2
OUR COLLECTIVE CHALLENGE
Regain our momentum
Directly combat tendency to retreat in the face of media reporting of violent incidents
View challenges as opportunities
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WHO IS A PEER?
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KEY VALUES AND PRINCIPLES OF PEER SUPPORTMutuality
Choice
Self-determination
Strength based
Peers support services are not clinical but can complement clinical interventions
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SNAPSHOT OF PEER SUPPORT SERVICESNavigation
Discharge Planning
Education
Employment
Housing
Whole Health and Wellness
Advocacy
Community Integration
Crisis Services
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ROLES OF PEER STAFF
Peer Specialists
Recovery Coaches
Bridgers
Whole Health Counselors
Navigators
Warmline Operators
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SETTINGS
Community
Homes
In Patient
Outpatient
Prisons/Jails
Courts
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DELIVERY SYSTEMS FOR PEER SUPPORT SERVICES
Provided directly by peer operated programs(independent peer organizations)
Provided by peers in provider agencies
Peer operated programs contract with provider agencies
Self-Employment
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NEW INNOVATIONS IN EVIDENCE BASED PRACTICES SAMHSA funded Mental Health Transformation Projects
Supported Employment- Colorado, New Jersey, Oregon
Supportive Housing- Washington State, Connecticut
Critical Time Intervention- Idaho
Supported Education-Colorado, Michigan
Trauma Informed Care- Oklahoma, Michigan
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WHAT WE ARE SEEING
Improved recovery outcomes
Improved engagement
Increased satisfaction with services
Fidelity to EBP
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KEYS TO SUCCESSFUL IMPLEMENTATION Strong and visionary leadership
Meaningful involvement of peers
Training
Supervision
Mentoring
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EVIDENCE BASE FOR PEER
RECOVERY SERVICES
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COSP MULTI-SITE RESEARCH INITIATIVE 1998-2006
Largest and most rigorous study of COSPs to date
Studied several models of peer-operated services around the country
Jean Campbell, principal investigator
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DO COSPS REALLY HELP? WHAT IS THE EVIDENCE?Findings:Greater levels of independence, empowerment, and self-esteem
Improved sense that consumers could make their own decisions, solve problems, and help others
Quality of life improved Increases in social support, employment skills, education
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EVIDENCE IN SUPPORT OF PEER SERVICES
Services provided by consumer staff can be as effective or more effective than non-peer provided staff (Davidson, et al., Deegan, 2003; Clarke et al. 1995; Felton et al, 1995; Chinman, Rosenbheck, Lam, &Davidson et al. 2000).
Fewer hospitalizations, use fewer crisis services, reduce substance abuse, and experience improved employment outcomes, social functioning and quality of life (Armstrong et al. 1995; Besio & Mahler, 1993).
Consumer staff benefit from their helping roles (Anthony, 2000; Mowbray, 1997, Shiff, 2004, Solomon, 2004)
Consumers benefit from self-sufficiency due to increased income and sense of self-efficacy and purpose to life that work brings (Akabas & Kurzman, 2005)
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NEW DEVELOPMENTS
National competencies and standards
Increase in number of certified training programs
Medicaid Reimbursement
Private Insurance
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ONGOING CHALLENGES
Disparities in access (training and services)
Organizational culture
Stigma and discrimination against peer staff
Policies and practices consistent with American with Disabilities Act
Career advancement (“Prozac Ceiling”)
Compensation
Collateral consequences of any involvement with the criminal justice system
Understanding the impact that movement to state certification with emphasis on testing will have upon specific populations or communities