Acmha Summit 3 Poster Handout


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Acmha Summit 3 Poster Handout

  1. 1. Supports: An Abridged History and Research of Peer1, CPS2, CSX3 Programs Supporting Outcomes Who then can so softly bind up the wound of another as he who has felt the same wound himself? --Thomas JeffersonBrief History of Peer Support It can be reasonably argued that peer support—the act of a person with the same or similar experiencehelping another—is as old as humanity itself. Indeed, early man learned to work co-operatively forfood gathering and shelter purposes. These early people had shared experiences and it was through thatco-operation they survived. Later, the early Greeks and Romans learned that peer support had avaluable role on the battlefield and soldiers were encouraged to form trusting, supportive bonds toenhance their fighting abilities and care for each other in battle.4In more contemporary times, peer support was recognized for mental health and substance usedisorders as early as 1838. At least three of the 13 original founders of the American PsychiatryAssociation expressed the need for asylum patients to socialize so as to discuss illnesses.5 “Patients areoften much interested in the delusions of their neighbors, and by their effort to relieve the affliction ofothers, frequently do much toward getting rid of their own.6Peer support and other social and environmental concerns languished after the moral treatment periodended around the turn of the 20th Century, although vestiges existed until the 1920s.7 In the 1960s, theCivil Rights Movement fostered basic human rights principles such as self-determination, dignity and1 “Peer” refers to a person with a psychiatric condition or a history of such a condition.2 “CPS” means “Certified Peer Specialist” and refers to a person who is trained and employed to use his/her recoveryexperience to help others similarly situation.3 “CSX” means a person or persons who are “consumers,” “survivors” and/or “ex-patients.”4 Peer support prevails in contemporary military organizations, especially in special forces units.5 Caplan, R.B. (1969). Psychiatry and the Community in Nineteenth-Century America: The Recurring Concern withEnvironment in the Prevention and Treatment of Mental Disorder. Basic Books, New York: NY.6 Kirkbride, T.S. (1854-55). In The American Journal of Insanity, XI, p. 143.7 Johnson, H. (2001). Angels in the Architecture: A Photographic Elegy to an American Asylum. Wayne State UniversityPress, Detroit, Mich. See also: Tomes, N. (1984). A Generous Confidence: Thomas Story Kirkbridge and the Art of Asylum-Keeping, 1840-1883. Cambridge University Press, Cambridge: Mass.Supports: An Abridged History and Research of Peer, CPS, CSX Programs Supporting Outcomes Page 1
  2. 2. choice. But, generally, that movement did not encompass the rights of those with psychiatric conditions and/or substance use disorders.8 During the 1970s and 80s, as mental health treatment shifted from long-term institutional care to community-based care, the peer voice emerged loud and clear. That voice advocated changes in the way in which mental health (and to some extent substance use disorder) services were delivered and by whom.9 Disparities between physical and mental health care in the 1990s to the present became more evident to more people as advocates from diverse backgrounds exposed inadequate care if not outright abuse.10 As the voice of peers grew louder and was persistently heard, peer support services emerged and became formalized with training requirements and government- sponsored certification. Self-help groups and a variety of peer-run mental health and substance use disorder services emerged by the end of the 1990s.11 At the same time, peers became recognized as change agents helping to transform “legacy” services to more progressive, recovery-oriented services.12Peer support is vital toLate in 2004, the National Association of Peer Specialists (NAPS) was formed inmy recovery journey. Michigan and quickly became a recognized membership-based organization for peer supporters across the U.S. Three years later, the first national peer specialist --Susan Meekhof conference was held in Denver, CO and brought together more than 225 peer supporters. The organization has sponsored annual conferences since their inception. The association has also published a quarterly newsletter, performed job satisfaction/compensation research and maintained a website. NAPS has also provided technical assistance to state officials establishing peer support programs and has promoted peer support throughout the U.S. and internationally.13,14 Outcomes Beginning in the later 1990s, a relative “handful” of social researchers performed diverse studies focusing on peer support. These initiative efforts focused primarily on implementation issues, such as the “why,” “where,” “when,” and “how” of peer support. In the last decade, other studies have 8 MaAdame, A.L. & Leitner, L.M. (2008). Breaking out of the mainstream: The evolution of peer support alternatives to the mental health system. Ethical Human Psychology and Psychiatry, Vol. 10, 3. 9 Ibid. 10 Boyle, P.J. & Callahan, D. (1993). Minds and hearts: Priorities in mental health services. The Hastings Center Report, Vol. 23, 5. See also: Davidson, L., Harding, C. & Spaniol, L. (2005). Recovery from Severe Mental Illnesses: Research Evidence and Implications for Practice. Center for Psychiatric Rehabilitation, Boston University, Boston, Mass. 11 Swarbrick, M., Schmidt, L.T. & Gill, K.J. [Eds.] People in Recovery as Providers of Psychiatric Rehabilitation: Building on the Wisdom of Experience. U.S. Psychiatric Rehabilitation Association, Linthicum, MD. 12 MaAdame & Leitner, (2008) and Boyle & Callahan, (1993). 13 National Association of Peer Specialists. (2010). Recovery to Practice: Situational Analysis for the National Association of Peer Specialists. (Author). Grand Rapids, Mich. 14 In 2012, the organization will officially change its name to “InterNational Association of Peer Specialists” to recognize members and conference attendees from the United Kingdom, Japan, Australia, Puerto Rico, Canada and other countries. Supports: An Abridged History and Research of Peer, CPS, CSX Programs Supporting Outcomes Page 2
  3. 3. examined outcomes, i.e. “Is peer support effective and, if so, why?” This second generation of researchhas been performed by dozens of highly respected social scientists.15What has been found? Evidence shows peer support:  Is often as effective as services provided by “traditional” mental health professionals16  Can significantly reduce rehospitalizations and associated costs17  Helps peers establish supports and relationships in their communities18  Increases personal empowerment19,20  Introduced beneficial treatment alternatives to traditional services21  Has become Medicaid reimbursable in a growing number of states22  Has resulted in peer-run service organizations in areas where legacy programs have been slow to change to a recovery orientation23  Has expanded to include diverse workforce niches.24In addition to serving mental health users, peer supporters Peer support is findingserve those with substance use disorders, the elderly, youth, places in mental health, substance abuse, prisonsand peers in forensic settings (courts, jails, prisons). Peer and jails and amongsupporters also act as educators in their communities and youth and the elderly. . --Antonio Lambert15 MaAdame, A.L. & Leitner, L.M. (2008).16 Bologna, M.J. & Pulice, R.T. (2011). Evaluation of a peer-run hospital diversion program: A descriptive study. AmericanJournal of Psychiatric Rehabilitation. 14: 272-286.17 Bergeson, S. (2011). New Report Reveals Mental Health Cost Savings Through Peer Support, NAPS Newsletter, Spring,2011, Vol. 7; 2.16 Ashenden, P. (2012). Personal communication, March 14, 2012.17 Chinman, M., Hamilton, A., Butler, B., Knight, E., Murray, S. & Young, A. (2008). Mental Health Consumer Providers: AGuide for Clinical Staff. Rand Health, Pittsburgh, PA. Downloadable from, search for publication: tr584.18 Townsend, W. & Griffin, G. (2006). Consumers in the Mental Health Workforce: A Handbook for Providers. NationalCouncil for Community Behavioral Healthcare, Rockville: MD.19 MaAdame & Leitner, (2008).20 Eiken, S. & Campbell, J. (2008). Medicaid Coverage of Peer Support for People with Mental Illness: Available Researchand State Examples. Healthcare, Thomson Reuter, Baltimore: MD.21 Ibid.22 Gill, K.J., Murphy, A.A., Burns-Lynch, W. & Swarbrick, M. (2009). Delineation of the job role.23 National Association of Peer Specialists, (2010).24 MaDame & Leitner, (2008).Supports: An Abridged History and Research of Peer, CPS, CSX Programs Supporting Outcomes Page 3
  4. 4. within service agencies and provide vocational and academic peer support. Peer support tasks are alsobecoming increasingly diverse as peers explore ways to exploit their strengths, talents and gifts for thebenefit of others. Those tasks include, but are not limited to: facilitating support groups, connectingothers with community resources, life enrichment, community and social inclusion activities, researchand administration.25More than two decades of contemporary use of peer support in mental health and substance usedisorder treatment services has proven the value of peer support in both settings. Despite an impressivebody of credible evidence and support by federal government agencies, issues remain regarding therecruitment, hiring, training and task assignment.NeedsAs peer support establishes itself as a profession, important needs have emerged. These needs areviewed as part of a natural process of the discipline’s development and include:  Greater use of peers as service providers in meaningful ways  Establishment of a national certification program instead of state-by-state control  Creation of a national database of peer supporters throughout the U.S.  Establishment of a “career ladder” through recognition and respect of one’s “lived experience” as opposed to heavy or sole reliance on academic credentials  Systematic continuing education process and system  Increased support of agency co-workers, administrators and government officials  Greater access to Medicaid reimbursement for peer support services  Funding stability for peer support services  Greater number of peers in leadership roles including policy making and organizational leadershipSerious questions remain as to who will lead the peer support movement and how. Incumbent peerleaders are already hard-pressed as they have taken on leadership duties for a variety of mental healthand substance use disorder organizations. In addition, these leaders are working diligently in local andstate venues to introduce or expand peer support in a variety of contexts. Withoutfocused attention—and quickly—on the peer leadership Lived experience is not“pipeline,” the movement risks the loss of incumbent enough. We must beleaders leaving lessons to be relearned. Feeding the peer recognized as theleadership pipeline falls heavily on peers but assistance professionals we are.from other disciplines and financial support for trainingare of increasing importance. --Lyn LegereThis document was drafted by Steve Harrington, Executive Director of the National Association of Peer Specialists and doesnot necessarily reflect the views of other persons or organizations.25 National Association of Peer Specialists. (2008). Compensation and Satisfaction Survey Report. NAPS Newsletter,Winter, 2008. Vol. 8, No. 1.Supports: An Abridged History and Research of Peer, CPS, CSX Programs Supporting Outcomes Page 4
  5. 5. To comment on this presentation or for more information, contact: Lead Presenter: Jen Padron, Office (817) 263-HOPE (4673); Mobile (512) 966-6830; jenpadron@me.comSupports: An Abridged History and Research of Peer, CPS, CSX Programs Supporting Outcomes Page 5