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South EIP Peer & Carer Peer Worker Open Forum - PIER, Portland, Maine (USA)
This document outlines a workshop focused on peer support for early intervention in psychosis, held by the South EIP Programme and the Portland Identification and Early Referral (PIER) Service. It covers the history and integration of peer services in Maine, emphasizing the importance of peer support in mental health care, and discusses strategies for team cohesion and communication. The workshop also addresses ongoing challenges in peer involvement and the necessary frameworks for effective peer support within clinical settings.
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South EIP Peer & Carer Peer Worker Open Forum - PIER, Portland, Maine (USA)
- 1. South of EnglandEarly 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 • Thisis 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 13Sustainability & 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 andEarly Referral (PIER) Service in Maine, Portland (USA) Welcome
- 5. Statewide Peer Supportin 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 (andpronouns) • Role at MaineHealth • Length of time in the role 6 Who are we?
- 7. ❖ Peer SupportHistory 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 PeerServices 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 viaCIPS 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 isIntentional Peer Support different than traditional helper roles? Me You
- 13.
- 14. Foundational Model acrossall 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 ServicesOrganizational 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 urgeto plug and play • Supervision • Understanding the role • Team Meeting • Communication 17 Thinking through integration….
- 18. Collaborative Supervision Model 18 Peersupport 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 spacesthat 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 teammeeting 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 amongstteam 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 tobe 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 andEarly 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 Careat the PIER Program
- 26. 26 CSC and IPSare 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 • AllTeam: 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 Meetingtwice 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 multipleMaine 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 AdvisoryGroups 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 situationswhere 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 attemptsbeen 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 FORHAVING US! Questions?
- 34.
- 35. www.england.nhs.uk For more informationabout 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