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Project Magic of Peer Voice 2013 10

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October 2013 presentation on Magic of Peer Supports (YouTube) - http://bit.ly/PeerDrivenSystems …

October 2013 presentation on Magic of Peer Supports (YouTube) - http://bit.ly/PeerDrivenSystems

In 2012, Magellan was directed by the Arizona Department of Health Services to reinvest $27 million in enhanced services for individuals with serious mental illness but who lacked Medicaid (AHCCCS). In partnership with the state and community, hundreds of peer and family roles were hired to work alongside case managers, clinicians and medical staff to create something truly different. The decade of recovery in the 1990s must now yield recovery and peer supports being adopted by systems.

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  • The answer depends on the culture of an agency, but the target is a peer driven system of care, Level 5.
  • http://www.narconon-news.org/drug-facts/history-of-alcohol-treatment.html
  • http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=1284563
  • Following an involuntary confinement in the 1960s, Judi Chamberlin authored “On Our Own: Patient-Controlled Alternatives to the Mental Health System.” She was a political activist who in 1971 joined the Mental Patients Liberation Front and partnered with the Center for Psychiatric Rehabilitation at Boston University.
  • advocate against forced treatment, abuse etc.  but also to provide resources for each other and for self-help
  • http://www.bu.edu/cpr/products/multimedia/sample-tvr2.pdf
  • The answer is True.
  • http://www.npr.org/2010/12/03/131786390/a-new-civil-right-lacks-enforcement
  • SAMHSA recognized peer support services and Consumer operated programs as evidence based practices in 2002 and 2009 respectivelyhttp://profiles.nlm.nih.gov/ps/access/NNBBHS.pdf
  • Not without controversy,many people still believe they should not be beholden to the medical necessity criteria of Medicaid
  • http://downloads.cms.gov/cmsgov/archived-downloads/SMDL/downloads/SMD081507A.pdf“Peer Support services are an evidence based model of mental health care which consists of a qualified peer support provider who assists individuals with their recovery from mental illness and substance use disorders. CMS recognizes that the experiences of peer support providers, as consumers of mental health and substance use services, can be an effective component of the State’s delivery of effective treatment.”
  • http://content.healthaffairs.org/content/28/4/w555.long
  • http://www.integration.samhsa.gov/health-wellness/wham/wham-training
  • The answer is B & C. See next slide.
  • http://blogs.plos.org/mindthebrain/2013/06/27/hiring-peer-support-counselors-a-bold-innovation-to-enhance-access-to-mental-healthcare-in-rural-america/ & http://www.apa.org/pubs/journals/features/prj-35-2-87.pdf
  • “Remember back in MPLF? You put up a sign on the office wall that said, 'End Psychiatric Oppression by Tuesday.' That's what I want. End psychiatric oppression by Tuesday,” Judi Chamberlin in conversation with David W. Oaks, October 2009
  • http://www.youtube.com/watch?v=G_GvUvrJgOw
  • http://www.azdhs.gov/bhs/documents/title19/FY13-NT19SMI-Magellan-funding.pdf
  • CHOICES Network believesthe answer is A & C only.
  • Transcript

    • 1. The Magic of Peer Voice: From Token to Core System DAVID COVINGTON, LPC, MBA— CRISIS ACCESS, LLC crisisaccess.com
    • 2. It All Starts With Peer Voice Acknowledgements: Larry Fricks Gene Johnson & Lori Ashcraft Eduardo Vega
    • 3. Polling Question #1 Which of the following best characterizes your agency approach to peers? Level 1 - We do services to people Level 2 - We do services for people Level 3 - We do services with people Level 4 - We have peer-driven care & leaders Level 5 - We have a peer driven system of care
    • 4. What Have We Learned
    • 5. A Mind That Found Itself Clifford Beers Galvanized the mental hygiene reform movement and founded the organization that would later become Mental Health America, which led to systematic reforms and continuous advocacy presence
    • 6. The First Support Groups The 12-Step program of substance recovery founded in the early ‗30s provided a demonstration of the power of self-help and support from a ―peer‖ although the ―peer‖ was called a ―sponsor.‖ There is evidence Native Americans were Alcoholics Anonymous doing something of the same as early as 1772.
    • 7. First Clubhouse Model John Beard (Fountain House) in New York revolutionized the old ―day treatment‖ programs to a new approach where those served were ―members‖ and not ―patients,‖ and given meaningful roles in the clubhouse and community.
    • 8. ―On Our Own‖ Published Judi Chamberlin
    • 9. Judi Chamberlin ―There are real indignities and real problems when all facets of life are controlled—when to get up, to eat, to shower—and chemicals are put inside our bodies against our will‖
    • 10. From Privileges to Rights National Council on Disabilities Report Judi Chamberlin ―Patient privileges, such as the ability to wear their own clothes, leave the confines of psychiatric facility, or receive visitors, should instead be regarded as basic rights‖
    • 11. Center for Psychiatric Rehab William Anthony & Boston University ―There is a revolution brewing in the field of severe mental illness… It is a revolution in vision – in what is believed to be possible… It will be up to consumers and family members to lead this [recovery].‖ In 1973, 13 leaders formed Psychiatric Rehabilitation Association (PRA)
    • 12. WRAP Mary Ellen Copeland First structured tool for self-help for individuals with mental health challenges. The key concepts of WRAP (hope, personal responsibility, education, self-advocacy, and support) laid the foundation for self-help recovery.
    • 13. Polling Question #2 The Americans with Disabilities Act gives civil rights protections and guarantees equal opportunity in public accommodations, employment, transportation, government services, and telecommunications. The ADA also applies to Mental Health. A. True B. False
    • 14. Olmstead Decision Lois Curtis On June 22, 1999, the US Supreme Court held that unjustified segregation of persons with disabilities constitutes discrimination in violation of the Americans with Disabilities Act and stated that people with psychiatric disabilities are legally entitled to live in communities of their choosing
    • 15. Cemetery Projects
    • 16. Peer Support as Science Surgeon General‘s Report on Mental Health Introduced ―self-help groups‖ and peer supports as an emerging evidence based practice and chronicled the history of the recovery movement
    • 17. Medicaid-billable Service Georgia‘s Wendy Tiegreen & Larry Fricks Georgia was the first state to have peer supports approved by CMS (Arizona followed the next year) and laid the ground work for a national sea change with more than 20 states following suit. Recovery Innovations began using the phrase ―Peer Support Specialist‖ in 1999.
    • 18. CMS Guidelines
    • 19. Don Berwick What ‗PatientCentered‘ Should Mean: Confessions Of An Extremist
    • 20. Courtesy of Appalachian Consulting Group, Ike Powell and Larry Fricks
    • 21. WELL & WHAM In 2001, Recovery Innovations married peer support with education by creating WELL (Wellness and Empowerment in Life and Living) as a new self-help approach to the former case management approach of compliance and monitoring of “activities of daily living.” In 2012, the Center for Integrated Health Solutions (SAMHSA/HRSA) created WHAM (Whole Health Action Management)  2-day, in person peer support training  Set whole health and resiliency goals  10 Health and Resiliency Factors
    • 22. Suicide Attempt Survivors Policy decisions related to the suicide prevention field have historically been made by three groups: researchers, clinicians and family members of those who died by suicide. There have been hundreds of support groups nationally for those bereaved by suicide but few examples of similar peer opportunities for those struggling with suicide. Eduardo Vega & John Draper In 2014, a National Action Alliance for Suicide Prevention Task Force will publish “Activating Hope” (provisional title) that will challenge these norms.
    • 23. The Gift of Peer Support
    • 24. Polling Question #3 Which of the following best characterizes research surrounding peer services? A. Peer supports found less effective than non-peer professional counterparts B. Equally effective C. More effective D. There have not been credible studies
    • 25. Focus of Research
    • 26. ABIL‘s Phil Pangrazio
    • 27. Phil Pangrazio ―[In our movement] we don‘t have a token seat at the table. We lead the table.‖
    • 28. John McKnight ―Revolutions begin when people who are defined as problems achieve the power to redefine the problem‖
    • 29. The Gift of Peer Support There is a sense of gratitude that is manifested in compassion and commitment. Courtesy of Appalachian Consulting Group, Ike Powell and Larry Fricks
    • 30. The Gift of Peer Support There is insight into the experience of internalized stigma. Courtesy of Appalachian Consulting Group, Ike Powell and Larry Fricks
    • 31. The Gift of Peer Support Peer specialists take away the “you do not know what it’s like” excuse. Courtesy of Appalachian Consulting Group, Ike Powell and Larry Fricks
    • 32. The Gift of Peer Support They have had the experience of moving from hopelessness to hope. Courtesy of Appalachian Consulting Group, Ike Powell and Larry Fricks
    • 33. The Gift of Peer Support They are in a unique position to develop a relationship of trust with their peers. Courtesy of Appalachian Consulting Group, Ike Powell and Larry Fricks
    • 34. The Gift of Peer Support The gift is circular and fosters recovery by affirming the ability of peers to play meaningfully roles in other people's live and society. Courtesy of Eduardo Vega (MHA of San Francisco)
    • 35. Peer Driven Systems by Next Tuesday
    • 36. Peer-Driven System
    • 37. Recovery Empowerment Continuum Characteristics Perspective Level 1 Level 2 Level 3 Traditional Psychosocial Rehabilitation Philosophy/Continuum Done to Done for Done with Motto Level 4 Level 5 Peer-Driven Peer-Driven Care System Done by Clinical team Strong dependence Genuine voice and Many roles in the Self-directed care is identifies goals and on system & participation with system are filled a core value with develops service artificial (paid) some support for by peers, including Characteristi peers holding some plans. Compliance supports with no individual risk workforce, leadership and cs with directives is individual risk taking & governance, etc. advocacy positions focal point taking or family engagement in Not a token within the system. activities. engagement. natural supports. gesture. Culture change Clinically sound Safety and security Personal recovery Personal recovery through peer professional with a goal of through through selfCore Value leaders and services & stability stability collaboration directed care staffing Compliant Dependent Respected (Voice) Leader Empowered Person(s) Subservient Institutionalized Involved Advocate Leaders Prescriptive Caretaker Partner Consultant Peers Staff Directive Protector Guide Support Advocate Member Clinically driven Protective Collaborative Recovery driven Peer-driven Organization Provider is expert Risk Averse Engaging Person is expert Peer-staffed Discouraged Blocked Supported Encouraged Expected Risk Taking 1950 1980 2010 Compliance/ Present Directive Dependent/ Care Taker Voice & Participation Action & Leadership Peer-Driven
    • 38. Polling Question #4 Which of the following are reasons a CBHC peer staff member should be terminated? A. B. C. D. E. Sleeping with a client Not showing up to work the first day Stealing from the organization Being re-hospitalized for mental health Reporting hearing active hallucinatory voices
    • 39. Recovery Innovations‘ Education Center Lori Ashcraft 1. Organizational commitment 2. Quality training prior to employment 3. Recovery training for all staff Supervisor and leadership training 4. Job-specific peer support roles 5. ―Tipping point‖ with critical mass of peer support workers Courtesy of Recovery Innovations & Gene Johnson
    • 40. Recovery Innovations‘ Education Center Gene Johnson 6. Develop career ladder to the peer support discipline 7. Parity for peer support workers; supervision and support, performance expectations, pay, promotion, ethics 8. Remember, it‘s real work, not sheltered work or therapy Courtesy of Recovery Innovations & Gene Johnson
    • 41. Peers Make a Difference. If she can do it, then so can I!
    • 42. Contact Us Email david.covington@crisisaccess-co.com gene@recoveryinnovations.org Social Networking http://www.linkedin.com/in/davidwcovington https://twitter.com/davidwcovington https://www.facebook.com/david.covington http://www.youtube.com/davidcovington crisisaccess.com