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MAKING THE
CASE FOR PEER
TO PEER
SUPPORTS AND A
US PEER
WORKFORCE
DAPHNE KLEIN, CEO
ON OUR OF
MONTGOMERY
COUNTY
GAITHERSBURG
MARYLAND
K | P + ASSOCIATES |
MARYLAND
12/2/2017 Jennifer M. Padron (c) 2017. All Rights Reserved. 1
ASYLUM photo, artist unknown
12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved.2
HOW THE NUMBERS STACK UP
• December 7, 2016, the 21st Century Cures Act passed 94-5 out of the
House of Representatives with turgid fanfare and horror.
12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved.
3
LACK OF CONTROL (THE PATIENT’S PERSPECTIVE)
• A medically, clinically necessary diagnosis substantiating the use of psychotropic
medication dosing is geared to control and manage exhibited DSM-5
symptomology popularized and normalized by the American Psychiatric
Association, the American Medical Association, National Association of Social
Work and the American Psychological Association.
12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved.
4
THE DSM-V AND SPMI
SERIOUS PERSISTENT MENTAL
ILLNESS
• Diagnostic Statistical Manual’s (DSM-5,
2016) symptomology of “Serious
Persistent Mental Illness” (SMI) includes
anxiety or panic disorder(s), behavioral
and mood disorder(s) with the more
complex or complicated issues being
major depression and the bipolar or
schizophrenia spectrum disorders.
12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved.
5
HOW THE
NUMBERS
CONTINUE TO
FALL
35.5% percent of all US Social
Security Disability Insurance (SSDI)
beneficiaries live with such a
diagnosis. The SSA 2012 numbers
of 10,088,739 SSDI beneficiaries
nearly doubled from 5,044,388
since 1995.
National Association of State
Mental Health Program Directors
Research Institute, Inc. (NRI), (2013)
http://www.nri-incdata.org/
Annual Statistical Report on the
Social Security Disability Insurance
Program
12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved.
6
45% OF ALL PEOPLE
WITH MENTAL
ILLNESS, HAVE 2+
PHYSICAL
DISORDERS (CO-
MORBIDITIES)
Nearly half (45%) of all individuals
living with any mental disorder have
two or more debilitating physical
disorders further lowering their
quality of life and leading to a
significantly high rate of comorbid
physical issues.
01
Average age of death is now 52
years old for an individual living with
an SPMI diagnosis.
Harvard Mental Health Letter, (2003);
NASMHPD, (2006); Parks, Svendsen,
Singer, Foti, (2006).
02
12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved.
7
MORBIDITY AND MORTALITY EQUATES TO PHYSICAL
DEATH <25 YEARS EARLIER THAN OTHERS
Physical comorbidities is the leading
reason why people with SMI are dying
25 years earlier than the general
population. There is a higher frequency
of multiple general medical conditions
that more than double the rate of
premature deaths from these
conditions.
01
Fricks, (2012); Mental Health America,
(2010); National Alliance on Mental
Illness, (2011).
02
Kelly, Boggs, and Conley, 2007; Mauer,
2006; Parks et al., 2006; Sokal et al.,
2004; Saha, Chant, and McGrath, 2007;
Laursen et al., 2013).
03
12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved.
8
MEDS, MEDS
AND MORE
MEDICATIONS
12/2/2017
Jennifer M. Padron (c) 2017. All Rights Reserved.9
MORE NUMBERS
• Forty-six (46) years ago, in 1967, 1:3
American adults filled a prescription
for a “psychoactive” medication, with
total sales of such drugs reaching
$692 million. In its’ June 2008 report
the GAO determined that one in
every sixteen young adults in the
United States is now diagnosed with
an SPMI (Whitaker, R., 2010).
• In 2010, $16.1 billion was spent on
antipsychotics in the US, to treat
depression, bipolar disorder and
schizophrenia. $11.6 billion was spent
on antidepressants, while $7.2 billion
for the treatment for ADHD
12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved.
10
SUICIDE AND
COMPLETION Suicide completion numbers
worldwide today tragically occur
every 40 seconds and injury
accounts for 30-40% of excess
mortality, where 60% of premature
deaths in persons with a diagnosis of
schizophrenia are due to medical
conditions such as cardiovascular,
pulmonary and infectious diseases.
World Health Organization (2016).
Retrieved April 11, 2016
http://www.befrienders.org/suicide-
statistics
01
National Association of State Mental
Health Program Directors
(NASMHPD) Medical Directors
Council Report, 2006
02
12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved.
11
SOLUTIONS
12/2/2017 Jennifer M. Padron (c) 2017. All Rights Reserved. 12
A NATIONAL US PEER WORKFORCE STEPS UP
Peer roles in mental health, substance abuse
and community health are evolving, as people
with lived experience offer a potent resource
to help other peers who are facing these
health concerns through education, support,
and coaching.
01
Peer roles are evolving within the context of
emerging “recovery-oriented” integrated
health systems (Tucker, S. J., Tiegreen, W.,
Toole, J., Banathy, J., Mulloy, D., Swarbrick, M.,
2013).
02
12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved.
13
CERTIFIED PEER SPECIALIST CERTIFICATION (AND
ENDORSEMENTS)
The CPS and Endorsements (Transition Age Youth,
Certified Peer Specialist, Forensic Peer Recovery
Specialist, Vet to Vet, Family to Family, Aged &
Across the Life Span, Crisis First Responder,
Recovery Coach and Community Health Worker
Promotora)
01
Offers a workforce of professionals whose shared
life experience opens the door creating a recovery
based workforce who have empowered
themselves using the principles of Recovery Based
Practices
02
12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved.
14
SEAMLESS • Peer Supports & Services function as seamless
efficient teams that are triage based (MD,
PhD, RN, LCSW, LPC, CPS, FPS, RC, TAY)Technical, training and
assistance services
12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved.
15
PEER SUPPORTS & SERVICE
12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved.
16
• As of July 2017, 46 States, two Territories (Guam and
Puerto Rico), the District of Columbia and the Veterans
Administration system have established programs to
train and certify peer specialists.
NEXT STEPS
HIGHER QUALITY OF
LIFE (QOL)
INCREASED PHYSICAL
HEALTH QUALITY OF
LIFE (PHQOL)
LOWERED INPATIENT
INCREASED
OUTPATIENT
LONGEVITY, HEALTH &
WELLNESS
SUSTAINABLE
INNOVATIVE
EMERGENT
12/2/2017 Jennifer M. Padron (c) 2017. All Rights Reserved. 17
TODAY’S
POLITICAL
CLIMATE:
CHALLENGES
AND
OPPORTUNITIES
PRESERVATION
12/2/2017 Jennifer M. Padron (c) 2017. All Rights Reserved. 18
COMMUNICATION
TOOLS
STRUCTURAL AND INSTITUTIONAL
PUBLIC HEALTH WELLNESS AND
RECOVERY MODELS
12/2/2017 Jennifer M. Padron (c) 2017. All Rights Reserved. 19
ENGAGE
TARGET
COMMUNITIES
12/2/2017 Jennifer M. Padron (c) 2017. All Rights Reserved. 20
IMPLEMENTATIO
N & EVALUATION
12/2/2017 Jennifer M. Padron (c) 2017. All Rights Reserved. 21
IMAGINEA WORLD WITHOUT
FORCED MENTAL
HEALTH DIVERSITY
12/2/2017 Jennifer M. Padron (c) 2017. All Rights Reserved. 22
K | P + ASSOCIATES FOR MORE INFORMATION
12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved.
23

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Making the Case for Peer to Peer Supports and A US Peer Workforce

  • 1. MAKING THE CASE FOR PEER TO PEER SUPPORTS AND A US PEER WORKFORCE DAPHNE KLEIN, CEO ON OUR OF MONTGOMERY COUNTY GAITHERSBURG MARYLAND K | P + ASSOCIATES | MARYLAND 12/2/2017 Jennifer M. Padron (c) 2017. All Rights Reserved. 1
  • 2. ASYLUM photo, artist unknown 12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved.2
  • 3. HOW THE NUMBERS STACK UP • December 7, 2016, the 21st Century Cures Act passed 94-5 out of the House of Representatives with turgid fanfare and horror. 12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved. 3
  • 4. LACK OF CONTROL (THE PATIENT’S PERSPECTIVE) • A medically, clinically necessary diagnosis substantiating the use of psychotropic medication dosing is geared to control and manage exhibited DSM-5 symptomology popularized and normalized by the American Psychiatric Association, the American Medical Association, National Association of Social Work and the American Psychological Association. 12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved. 4
  • 5. THE DSM-V AND SPMI SERIOUS PERSISTENT MENTAL ILLNESS • Diagnostic Statistical Manual’s (DSM-5, 2016) symptomology of “Serious Persistent Mental Illness” (SMI) includes anxiety or panic disorder(s), behavioral and mood disorder(s) with the more complex or complicated issues being major depression and the bipolar or schizophrenia spectrum disorders. 12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved. 5
  • 6. HOW THE NUMBERS CONTINUE TO FALL 35.5% percent of all US Social Security Disability Insurance (SSDI) beneficiaries live with such a diagnosis. The SSA 2012 numbers of 10,088,739 SSDI beneficiaries nearly doubled from 5,044,388 since 1995. National Association of State Mental Health Program Directors Research Institute, Inc. (NRI), (2013) http://www.nri-incdata.org/ Annual Statistical Report on the Social Security Disability Insurance Program 12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved. 6
  • 7. 45% OF ALL PEOPLE WITH MENTAL ILLNESS, HAVE 2+ PHYSICAL DISORDERS (CO- MORBIDITIES) Nearly half (45%) of all individuals living with any mental disorder have two or more debilitating physical disorders further lowering their quality of life and leading to a significantly high rate of comorbid physical issues. 01 Average age of death is now 52 years old for an individual living with an SPMI diagnosis. Harvard Mental Health Letter, (2003); NASMHPD, (2006); Parks, Svendsen, Singer, Foti, (2006). 02 12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved. 7
  • 8. MORBIDITY AND MORTALITY EQUATES TO PHYSICAL DEATH <25 YEARS EARLIER THAN OTHERS Physical comorbidities is the leading reason why people with SMI are dying 25 years earlier than the general population. There is a higher frequency of multiple general medical conditions that more than double the rate of premature deaths from these conditions. 01 Fricks, (2012); Mental Health America, (2010); National Alliance on Mental Illness, (2011). 02 Kelly, Boggs, and Conley, 2007; Mauer, 2006; Parks et al., 2006; Sokal et al., 2004; Saha, Chant, and McGrath, 2007; Laursen et al., 2013). 03 12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved. 8
  • 9. MEDS, MEDS AND MORE MEDICATIONS 12/2/2017 Jennifer M. Padron (c) 2017. All Rights Reserved.9
  • 10. MORE NUMBERS • Forty-six (46) years ago, in 1967, 1:3 American adults filled a prescription for a “psychoactive” medication, with total sales of such drugs reaching $692 million. In its’ June 2008 report the GAO determined that one in every sixteen young adults in the United States is now diagnosed with an SPMI (Whitaker, R., 2010). • In 2010, $16.1 billion was spent on antipsychotics in the US, to treat depression, bipolar disorder and schizophrenia. $11.6 billion was spent on antidepressants, while $7.2 billion for the treatment for ADHD 12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved. 10
  • 11. SUICIDE AND COMPLETION Suicide completion numbers worldwide today tragically occur every 40 seconds and injury accounts for 30-40% of excess mortality, where 60% of premature deaths in persons with a diagnosis of schizophrenia are due to medical conditions such as cardiovascular, pulmonary and infectious diseases. World Health Organization (2016). Retrieved April 11, 2016 http://www.befrienders.org/suicide- statistics 01 National Association of State Mental Health Program Directors (NASMHPD) Medical Directors Council Report, 2006 02 12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved. 11
  • 12. SOLUTIONS 12/2/2017 Jennifer M. Padron (c) 2017. All Rights Reserved. 12
  • 13. A NATIONAL US PEER WORKFORCE STEPS UP Peer roles in mental health, substance abuse and community health are evolving, as people with lived experience offer a potent resource to help other peers who are facing these health concerns through education, support, and coaching. 01 Peer roles are evolving within the context of emerging “recovery-oriented” integrated health systems (Tucker, S. J., Tiegreen, W., Toole, J., Banathy, J., Mulloy, D., Swarbrick, M., 2013). 02 12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved. 13
  • 14. CERTIFIED PEER SPECIALIST CERTIFICATION (AND ENDORSEMENTS) The CPS and Endorsements (Transition Age Youth, Certified Peer Specialist, Forensic Peer Recovery Specialist, Vet to Vet, Family to Family, Aged & Across the Life Span, Crisis First Responder, Recovery Coach and Community Health Worker Promotora) 01 Offers a workforce of professionals whose shared life experience opens the door creating a recovery based workforce who have empowered themselves using the principles of Recovery Based Practices 02 12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved. 14
  • 15. SEAMLESS • Peer Supports & Services function as seamless efficient teams that are triage based (MD, PhD, RN, LCSW, LPC, CPS, FPS, RC, TAY)Technical, training and assistance services 12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved. 15
  • 16. PEER SUPPORTS & SERVICE 12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved. 16 • As of July 2017, 46 States, two Territories (Guam and Puerto Rico), the District of Columbia and the Veterans Administration system have established programs to train and certify peer specialists.
  • 17. NEXT STEPS HIGHER QUALITY OF LIFE (QOL) INCREASED PHYSICAL HEALTH QUALITY OF LIFE (PHQOL) LOWERED INPATIENT INCREASED OUTPATIENT LONGEVITY, HEALTH & WELLNESS SUSTAINABLE INNOVATIVE EMERGENT 12/2/2017 Jennifer M. Padron (c) 2017. All Rights Reserved. 17
  • 19. COMMUNICATION TOOLS STRUCTURAL AND INSTITUTIONAL PUBLIC HEALTH WELLNESS AND RECOVERY MODELS 12/2/2017 Jennifer M. Padron (c) 2017. All Rights Reserved. 19
  • 20. ENGAGE TARGET COMMUNITIES 12/2/2017 Jennifer M. Padron (c) 2017. All Rights Reserved. 20
  • 21. IMPLEMENTATIO N & EVALUATION 12/2/2017 Jennifer M. Padron (c) 2017. All Rights Reserved. 21
  • 22. IMAGINEA WORLD WITHOUT FORCED MENTAL HEALTH DIVERSITY 12/2/2017 Jennifer M. Padron (c) 2017. All Rights Reserved. 22
  • 23. K | P + ASSOCIATES FOR MORE INFORMATION 12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved. 23