1 Peer Support 101: Principles, Values and Practices Simon Messmer, MSW, CPS Behavioral Health Systems Specialist Center for Behavioral Health Initiatives December 30, 2015

2 2 What is Peer Support?

3 Some definitions SAMHSA (2014): “….services delivered by individuals who have common life experiences with the people they are serving…. In self-help and mutual support, people offer this support, strength, and hope to their peers, which allows for personal growth, wellness promotion, and recovery.” Kansas Medicaid Service Definition: “….consumer centered services with a rehabilitation and recovery focus designed to promote skills for...managing psychiatric symptoms….emphasizes the opportunity for consumers to support each…to move forward in recovery.”

4 General principles Peer support is based in recovery and person- centered. It emphasizes mutuality and assumes that all are capable of moving beyond perceived limitations, old ways of thinking and achieving wellness in their own way.

5 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. SAMHSA (2013)

6 What does Peer Support look like? Human experience language Strengths Model Self-determination Trauma-informed Recovery-oriented Five Stages of Recovery

7 The Fives Stages of Recovery Model Origins Applicability Utility: Not a diagnostic tool

8 Disabling aspects of diagnoses Symptoms Side-effects Situation Self-image System Stigma

9 The Fives Stages of Recovery Model Impact of Illness The person is overwhelmed by the disabling power of the diagnosis The role of services is to decrease the emotional distress by reducing symptoms and communicating that there is life after diagnosis The danger is that the person will re-define herself in mental illness terminology that will automatically limit her future Life is Limited The person has given in to the disabling power of the diagnosis The role of services is to instill hope and a sense of possibility and to rebuild a positive self-image. The danger is that the person will have identified so strongly with the negative stigma of the illness that he can not see any possibility Change is Possible The person is questioning the disabling power of the diagnosis The role of services is to help that person see that she is not so limited by the illness and in order to move on she will need to take some risks. The danger is that the person will be afraid to or discouraged from taking the necessary risks and remain in the "life is limited" stage. Commitment to Change The person is challenging the disabling power of the diagnosis. the role of services is to help the person identify his strengths and needs in terms of skills, resources and supports. The danger is that the person will not get the necessary skills, resources and supports he needs to do what he wants to do and will not succeed in moving forward. Actions for Change The person is moving beyond the disabling power of the diagnosis. The role of services is to help the person trust in her own decision making ability and to take more and more responsibility for her own life. The danger is that the person will begin to doubt her own ability to function on her own and revert back to a life lived in the system.

10 Practical Matters

11 Settings and Application Community Mental Health Centers VA Medical Centers State hospitals Other social service providers –Supportive housing programs –Homeless outreach –Advocacy organizations –Employment services –Consumer-run organizations –Drop-in centers Health Homes

12 KS Certified Peer Specialists Qualifications Must self-identify as a current or former consumer of mental health services Must be at least 18 years old and have a high school diploma or equivalent Must complete state approved certification training program Training/Certification Requirements Must complete both Level 1 (L1) and Level 2 (L2) peer support trainings Must pass state approved examination after both L1 and L2 trainings

13 Peer Specialist Roles and Responsibilities Use lived experience of recovery to: Develop and access resources and supports in the community Assist in developing (re-developing) natural supports (e.g. family and friends) Assist in making independent choices and taking a proactive role in treatment Assist in developing uniquely personal wellness strategies

14 Peer Support Activities Face-to-face interactions with individual clients or in group settings (group size is limited to 8) Coaching or educating clients on how to communicate needs/wants with other providers Identifying and accessing other services Advocating with and on behalf of clients Participating in treatment teams (or similar) Developing program/organization initiatives

15 Peer Support Tools Recovery story Wellness Recovery Action Plans (WRAP), Pathways to Recovery or similar personal wellness tools – FYI: There is a version for IDD folks Problem-solving “Dissatisfaction as an Avenue for Change” “Facing One’s Fears” “Creating the Life You Want” (intentional decision- making)

16 Five Stages of Recovery

17 Common challenges (real and imagined) Recruitment and hiring How do I as ask a prospective employee whether he/she has a mental illness without getting sued? How do I know if someone is “recovered enough” to do the job? How do I support an employee or co-worker in recovery?

18 Peer Support in Health Homes

19 Peer Support in Health Homes Requirements Who has to have peer support available? Who can provide peer support? What do they do? When do we have to have peer support?

20 Peer Support in Health Homes Qualifications Certified Peer Specialist or Peer Mentor Services Member and family support Referral to community supports and services

21 Peer support in Health Homes “Member and family support” includes/requires: Identifying supports needed and strengths Identifying barriers to member’s highest level of health Locating resources to eliminate barriers Advocating on behalf of member Effective communication with member, family/support persons or caregivers Making accommodations related to culture, disability, etc. Promoting self-management capabilities Assisting in making informed choices

22 Peer support in Health Homes “Referral to Community Supports” includes/requires: Assisting member(s) to advocate for care, complete paperwork, and/or identifying natural supports Knowledge of the medical and non-medical service delivery system within and outside of the member’s area Engagement with community and social supports Establishing/maintaining relationships with community services providers Fostering communication and collaborating with social supports Knowledge of the eligibility criteria for services Identifying or developing for comprehensive resource guides

23 Peer Support in Health Homes Kansas Certified Peer Mentor (KCPM) Must be a KPMT Must complete additional KCPM education Kansas Peer Mentor In Training (KPMT) At least 18 years old A minimum of one year in stable recovery Completion of BHS approved KPMT education Agree to abide by Peer Mentor Code of Ethics Signed Merit of Public Trust

24 The Life and Times of a Peer Specialist in Health Homes Close collaboration with treatment team Implementing/facilitating “Health Action Plan” Coordination with community health providers –Often point-of-contact –Follow-up with providers and client –Transportation Advocacy for and with clients –Attend medical, dental, etc. appointments –Sometimes must act as “voice” of client

25 Peer Support in Health Homes What seems to be working: Key ingredients Peer specialist with broad personal and professional experience Full partnership with treatment team Clearly defined role – Transparency with members and colleagues – Solid job description Use of “communication logs”

26 Questions

27 Contact Info Bailey Blair, LMSW, CPS Center for Community Support & Research (CCSR) Simon Messmer, MSW, CPS CCSR William Welch, CPS, KCPM Member & Family Support Bert Nash Community Mental Health Center Lawrence, KS