We were very happy to hear that Health Education England has an ambition to double the number of Peer Support Workers in mental health as we believe that peer support is such an important part of early intervention in psychosis. EIP teams in the South of England have grown their peer support workforce from 5 to 26 in the last couple of years. To support further development, we have set up a monthly forum for peer support workers and this forum is open to other professionals every 3 months. For the next forum, we will be joined by Randy Morrison (Director of Peer Services), Sarah Lynch (PIER Programme Manager) Danny Kochanowski (Peer Services Supervisor) and Saras Yerlig (Youth Peer Support Worker from the Portland Identification and Early Referral (PIER) Service in Maine, Portland (USA) to hear about how they have embedded peer support work across all their services and how they support peer workers to develop within their role.

1. South of England Early
Intervention in Psychosis Peer
& Carer Peer Worker Forum
Open Forum with the Portland Identification and Early
Referral (PIER) Service in Maine, Portland (USA)
Wednesday 20th January 2021 | Zoom
#EpicMinds

2. Welcome &
Housekeeping
• This is an interactive workshop which will be recorded and cover:
• Brief background about the South EIP Programme Peer Support Network
• Peer Work at Portland Identification and Early Referral (PIER) Service
• Q & A
• To have a good virtual workshop please:
• Mute your microphone if not speaking to avoid distorted audio
• Use the ‘Raise Hand’ button to ask questions or comment
• Feel free to ask questions and comment via chat (there is no such thing as
a stupid question! ☺)
• Be respectful and do not share any patient identifiable information

3. South EIP Programme
13 Sustainability & Transformation Partnerships (STPs)
40 Clinical Commissioning Groups (CCGs)
15 Mental Health Providers
33 Early Intervention in Psychosis (EIP) Teams
~5,000 Patients with first episode psychosis or schizophrenia accessing EIP
610 EIP Practitioners Including 26 EIP Peer & Carer Peer Workers

4. Portland Identification and Early
Referral (PIER) Service in Maine,
Portland (USA)
Welcome

5. Statewide Peer Support in
Maine and Integration into
First Episode Programs
Randy Morrison, Director of Peer Services
Danny Kochanowski, Peer Services Supervisor
Saras Yerlig, Youth Peer Support Partner
Sarah Lynch, PIER Program Manager

6. • Name (and pronouns)
• Role at MaineHealth
• Length of time in the role
6
Who are we?

7. ❖ Peer Support History and Landscape in Maine
❖ Peer Support at Maine Behavioral Healthcare
❖ Integration of Peer Support into the Early Episode Program
7
Agenda for today

8. History of Peer Services in Maine
❖ Stakeholder group convened in 2003/04
❖ Worked with Shery Mead
❖ First Pilot in 2006
Result: State-funded Certification & Training Program
❖ No cost to participants
❖ IPSAC addresses challenges & reviews applications
8
State of Maine’s Landscape of Peer Services

9. • Apply via CIPS Application
• CIPS Peer 101 – Eventbrite
• Web Training
• Core Training (8 Days) – (Provisionally Certified)
• Co-reflections (4 per year)
• Continuing Educations (2 per year)
• CIPSS Skills Exam (one year later – full certification)
• Annually – continue with co-reflections and continuing eds
9
Maine’s Intentional Peer Support Certification Process

10. A Closer Look: Intentional Peer Support’s (IPS):
Three Principles
1. From helping to learning together
2. Individual to Relationship
3. Fear to Hope and Possibility
Intentional Peer Support. (n.d.). Retrieved April 23, 2020, from
http://www.intentionalpeersupport.org/

11. 1. Building Connection
2. Exploring Worldviews
3. Negotiating Mutuality
4. Moving Towards Together
11
Four Tasks of Intentional Peer Support

12. Traditional Help
12
How is Intentional Peer Support different than traditional
helper roles?
Me You

13. 13
Me You
Relationship
Shared
Responsibility
Intentional Peer Support

14. Foundational Model across all mental health services in Maine (statewide certification)
• Allows for community building and mutual learning across the state
• Consistency in the practice and definition of peer support
• Allows the work to remain grounded in the social/disability justice origins of the peer
movement
• Reinforces the fidelity of the peer role (resisting co-optation)
This has allowed us to create clarity in our operational structure throughout
multiple programs across MaineHealth.
14
How has Maine done this differently…..

15. 15
MaineHealth Peer Services Organizational Chart

16. Focus on learning & growth
Sharing challenges & growth openly, even when personal
Ongoing training & practice
• Weekly Role Play sessions
• Anti-Racism
• Gender Affirming Care
• Guest speakers at monthly all peer support staff meetings
Peer support staff bring these values into their respective services/teams
16
MBH Peer Services Culture

17. Resist the urge to plug and play
• Supervision
• Understanding the role
• Team Meeting
• Communication
17
Thinking through integration….

18. Collaborative Supervision Model
18
Peer support positions employ different practices
than traditional clinical providers.
• Every Peer Staff has a Peer Supervisor
• Collaborate with local program manager of
the service where peer staff works
Ongoing: One-on-One supervision (frequency needed)
Once a month group supervision with local Program Manager and Peer Manager
Once a month All Peer Staff Meeting
At times, weekly or monthly role specific peer staff meetings (e.g., ED, SUD)
Co-worker Mutual Support Partners

19. • Create spaces that welcome concerns, explore challenges, and address misconceptions
• Allocate time for the whole team to learn about the peer role (quarterly)
• Provide documents that clearly outline the role – functions and model
• Carve out time for the peer in larger agency trainings
What does it say to peer staff if the whole team takes the IPS training?
“You matter!”
19
Understanding the role…

20. • Redesigning team meeting is typically always needed
- Peer staff leaves during clinical discussions
- Peer staff has space on the agenda
- Peer staff discusses logistical information
• Team building exercises/check ins as humans (How is everyone?)
• Thematic discussions
- “Nothing about us without us” – why we don’t get specific
- We will talk more about what this looks like on PIER later!
20
Team Meetings

21. Sharing information amongst team members
• Good information to share
- Logistics, connections made & status of
connections, administrative topics, etc.
• Okay information to share
- If someone is struggling (mindful of details),
engagement with the team, etc.
• Avoid sharing
- Clinical details and discussions, test results,
medication, assessments, etc.
21
Communication

22. Taking time to be thoughtful about the necessary changes:
• Promotes role clarity
• Promotes increased communication
• Promotes team cohesion
• Promotes peer staff job satisfaction and retention
• Improves outcomes
22
What are the benefits….

23. 23
Portland Identification and Early Referral (PIER) Program
First Episode (FEP) and Clinical High Risk (CHRP)
Ages 14-26 within one year of a First Episode of Psychosis
Another FEP program in Adult Psychiatry – Ages 18-35 within 2 years of FEP
No catchment restrictions – offering care through telehealth and in person
-

24. • PIER Program (since 2000) – CHRP/early FEP – Research/Treatment to test community outreach/education about
early psychosis and multidisciplinary team based services including Multifamily Groups.
• Peer Support/ Family Partners emerged through multifamily groups where young people and family members share
their stories and support one another in an ongoing education and problem solving model. How do we formalize these
roles?
• Current PIER model (2015-Present) – FEP Program and CHRP.
• In 2015, partnered with an outside agency to provide Peer Support – challenges. Not enough integration or dedication
of staff time.
• In January 2019, added FT Peer Support through partnership/planning with Peer Services Director to work with
FEP/CHRP programs in Adolescent and Adult Clinics.
24
History - Adding Peer Support to the PIER Program

25. 25
Coordinated Specialty Care at the PIER Program

26. 26
CSC and IPS are Distinct Models with Overlap
CSC Clinical Team:
• Inclusion Criteria
• Case Review
• Family History
• Safety Plan
• Transdisciplinary
Treatment Planning
• Team based care
Peer Support:
• Leading with Curiosity
• Organic, mutual
relationship
• No preconception or
details given prior to
meeting
• Flexible out of office
meeting
• Voluntary, negotiated
Overlap:
• Engagement
• Education
• Multifamily
Group
• Staff team
building
• Shared Training

27. Team Meeting
• All Team: business, team building, scheduling, group planning and attendance,
engagement challenges, staff check-ins
• Peer Support does NOT attend: clinical discussion, family history and family treatment,
diagnosis, treatment goal setting and clinical care coordination
• Careful not to put peer staff into another role on the team
Peer Support Specialist
• Does not share information with the team about what is discussed with participant.
• Not given any background, clinical notes, diagnosis.
• Records time spent with participants and engagement of participants in Peer Support
Services
• Can suggest bridging information with the Clinician or other
27
Maintaining the Fidelity of both CSC and IPS models

28. • Team Meeting twice a week
• Groups
• One-on-one Meetings
• Multifamily Group
• Scheduling via text on work phone
• Prof. Development for CIPSS, internal/external supervision
• Monthly presentations, coaching young adult speakers
• Projects (i.e. website development)
• Consulting/collaborating with research projects
• Notes and administrative tasks
28
Peer Support Schedule at the PIER Program

29. Peers from multiple Maine Health programs co-facilitate weekly groups together
• Collaboration among peer staff
• Increasing access and opportunities across programs
• Allows for continuity in transitions between programs
Exploring Unique Experiences
• Adults
• Structure/philosophy from Hearing Voices Network and Alternatives to Suicide
Youth Group
• High school age
• Activities/games and check-ins
• Group norms co-created
29
Peer Support Groups

30. • Family Advisory Groups and Family/Participant Speakers Bureaus
• Dialogue between peer staff and participant about the peer staff’s involvement in
treatment.
• Clinical team and Peer Support welcome uncomfortable conversations.
• Direct communication among team members: checking in, being open to feedback,
expressing appreciation.
30
What’s Working Well for our Program

31. Challenges
• Navigating situations where it is hard to sit with discomfort and not pass along
information to the clinical team.
• Mutuality with adolescents, striving for transparency and openness about inherent power
dynamics.
Opportunities for growth
• Adding additional peer support staff
• Connecting to statewide network
31
Challenges and what’s next…

32. 1. Have attempts been made to include peers as early as possible in planning a new initiative or program?
2. Do peers have the power to make decisions and shape programs, or are they limited to “advisory” roles?
3. Are peers financially compensated in a manner equal to non-peers?
4. Is there a critical mass (or sufficient number) of peers involved to make a difference?
5. Have steps been taken to ensure that peer wellness is prioritized?
6. Has the program or organization invested in peer capacity building—e.g., paying peers to attend
conferences and workshops and to learn new skills?
7. Have program leaders or administrators taken explicit steps to ensure that peer perspectives are
valued, and that resistance to peer involvement is systematically addressed?
Jones, N. Phd. Peer Involvement and Leadership in Early Intervention in Psychosis Services: From Planning to Peer
Support and Evaluation. Peer Involvement and Leadership in Early Intervention in Psychosis Services: From Planning
to Peer Support and Evaluation. SAMHSA.
32
7 Peer Involvement Self-Assessment Questions

33. 33
THANK YOU FOR HAVING US!
Questions?

34. Q & A

35. www.england.nhs.uk
For more information about the South EIP programme,
please visit
www.time4recovery.com
To access EPIC MINDS resources developed with service
users and carers, please visit www.epicminds.co.uk
Commissioned by
Thank You