Peer Element of ODDESSI Corrine Hendy, Peer/OD Practitioner, Nottinghamshire Healthcare Foundation Trust Dr Sarah Carr, Middlesex University London

Our background: How we became involved Experience of mental health services, an absence of humane responses and communication. Desire to make a difference to our local and national communities. Promoting value and credibility of experiential and first-hand knowledge for practice and research. Training and accreditation in respective roles.

Programme Aims Programme Aims: To develop a protocol acceptable to clinicians, service users and carers for the delivery of Open Dialogue (OD) for the management of mental health crises. To assess the clinical and cost-effectiveness of OD. To understand the experiences of service users, carers, support network members and staff (including peer workers/peer co- therapists). To develop a model of OD that can be implemented in routine NHS care.

Overview of Peer Element in OD 1) Refine and establish OD teams start operating across all sites. Develop operational protocol with core and flexible OD model functions and staffing structure, including peer support. 2) Develop Peer Support element – ‘POD’ Integral members of OD team. Co-worker in network meetings attend, team meetings and supervision. Roles will evolve and develop… 1) Peer workers recruited by each Trust. 2) Peers receive OD training the same as healthcare professionals. 3) Each Open Dialogue trial team has trained peer workers. 4) Peers as co-practitioner/co-worker 5) Peers will receive regular supervision 6) Peer role supported to evolve Who defines Peer Support? 1970s, unstructured peer support, people met in homes, or public places. 1980s and 1990s, Authorities funded peer support roles defining “peer support” in their funding contract . independent, peer-run, non-profit organisations grew. 1990s, state mental health authorities created “peer speacalist” roles for people with lived experience based on peer support values working alongside clinicians and administrators in mental health provided services. 1993 Policy makers with people with lived experience aimed to bring peer values and principles into paid roles. Challenges working alongside clinicians who did not understand the role. In 2017, Mental Health America (MHA) launched a standardised national peer specialist certification through the Florida Certification Board. Paper: Defining ‘Peer Support’: Implications for Policy, Practice, and Research,

What do we already know about peer support? Peer support in OD draws on the ‘Intentional Peer Support’ approach developed by Sherry Mead in US. There are many approaches to peer support provision in England, from NHS peer delivered services to independent community-based mutual support groups. ‘making a connection based on shared lived experience, then using that relationship to elicit the particular challenges the service user was facing before role-modelling, through the peer worker role itself, hope in moving beyond challenges’ (Gillard et al, 2015). Lloyd-Evans et al 2014 – systematic review

What do we already know about peer support? The effects of complex interventions like peer support aren’t fully understood (Lloyd-Evans, 2014). But research into peer worker perceptions and experiences of working in mainstream mental health services is beginning to indicate some of the individual, organisational, structural and cultural challenges and complexities. ‘Mental health professionals and peer workers should enter into an alliance to address barriers in the integration of peer workers to enhance quality of service delivery’ (Vandewalle et al, 2016).

Study Phase 1 and 2 plans Phase 1 (2018) Identify existing service user and peer support groups and initiatives at each site. Scope activities and roles with peer support workers and other stakeholders. Establish peer supporter stakeholder groups in each site. Develop initial outline of peer support role, core principles and basic competency framework. Phase 2 (from 2019) Facilitate groups for OD peer workers/co-therapists using an Action Learning Set approach to enable group learning, development and support.

Assessing the development of peer support in ODDESSI: Action Learning Sets What is a Learning Set? A personal development tool to learn new ways of working, share experiences and help with problem solving. A group of about 5-8 people, meet together on a regular basis to discuss work-related issues or to develop skills in an area of common interest. What are the benefits ? Give individuals time to explore issues in an environment which is empowering and which helps the individual to find a solution – rather than be told what to do.

Evolving… ...Watch this space… A set of core principles and basic competency framework for quality and consistency, but not an imposed model. Supported to grow and evolve in context. The peer element of ODDESSI is peer or user-led. ...Watch this space…

Thank you Corrine Hendy, Peer/Open Dialogue Practitioner, Nottinghamshire Healthcare Foundation Trust: corrine.hendy@nottshc.nhs.uk Dr Sarah Carr, Associate Professor of Mental Health Research, Middlesex University London: s.carr@mdx.ac.uk