Thought Leader Track Peers in the Workforce: Invasion or Innovation? - PDF document

PRA Recovery Workforce Summit, Thought June 25, 2014 Leader Session, Baltimore, MD Thought Leader Track Peers in the Workforce: Invasion or Innovation? June 25, 2014 1 T HOUGHT L EADER S ESSION : 2 B ALTIMORE , MD. J UNE 25, 2014 Welcome ome to a Veterans s Ad Administra istratio ion Medica cal l Center er Anywhere ere USA 3 Peers in the Workforce: Invasion or Innovation? 1

PRA Recovery Workforce Summit, Thought June 25, 2014 Leader Session, Baltimore, MD Current t Op Openings Certified Peer Specialist Peer Support Apprentice Certified Peer Specialist Peer Support Apprentice Certified Peer Specialist Peer Support Apprentice Certified Peer Specialist Peer Support Apprentice Certified Peer Specialist Peer Support Apprentice Certified Peer Specialist Peer Support Apprentice Certified Peer Specialist Peer Support Apprentice Certified Peer Specialist Peer Support Apprentice INVASION 4 Current Op Cu Openings Certified Peer Specialist Peer Support Apprentice Certified Peer Specialist Peer Support Apprentice Certified Peer Specialist Peer Support Apprentice Certified Peer Specialist Peer Support Apprentice Certified Peer Specialist Peer Support Apprentice Certified Peer Specialist Peer Support Apprentice Certified Peer Specialist Peer Support Apprentice Certified Peer Specialist Peer Support Apprentice 5 6 Peers in the Workforce: Invasion or Innovation? 2

PRA Recovery Workforce Summit, Thought June 25, 2014 Leader Session, Baltimore, MD Panel Presenters Reneé Kopache, MS, CPRP Rita Cronise, MS Coordinator of Wellness Management Instructional Design Consultant for the Hamilton County Mental Health iNAPS; Adjunct Faculty, Rutgers and Recovery Services Board University June 25, 2014 7 Panel Presenters (cont.) Kathleen O’Donnell, Liz Smithhart, LPC, CPRP MS, CPRP, Volunteer Regional Director, Recovery Innovations June 25, 2014 8 L EARNIN NING O BJECT ECTIVES Participants will be able to describe: • The role and value of peers in the behavioral health workforce • Authentic peer support • Key factors to effectively integrate peer services • The difference between “invasion” and “innovation” when employing peers in psychiatric rehabilitation and behavioral health workforce. Peers in the Workforce: Invasion or Innovation? 3

PRA Recovery Workforce Summit, Thought June 25, 2014 Leader Session, Baltimore, MD Question on 1 What at is the purpos ose, e, ro role, e, and value ue of peers in the workfor orce? ce? 10 Question 1: What is the purpose, role, and value of peers in the workforce? Purpose • Hope, connection, encouragement, communication, empowerment (AEB) • Disruptive innovators (Deegan) Role • Peers support is intentionally different from conventional care. (Mead, Davidson) • Peers draw upon lived experience to share ‘been there’ empathy, insights, and engage people along the spectrum of support needs. (Mazza, Salzer) Value • Peers offer something no one else can (lived experience of recovery). • If successful, peers break down stigma and transform the mental health system (Ragins) June 25, 2014 11 Question on 2 What at is authent entic ic peer suppor ort? 12 Peers in the Workforce: Invasion or Innovation? 4

PRA Recovery Workforce Summit, Thought June 25, 2014 Leader Session, Baltimore, MD Question 2 What is Authentic Peer Support? Basic Criteria Lived experience + desire to support others + specialized training + supervision June 25, 2014 13 Authentic Peer Support is… • Not Clinical • Not a “junior” position • Not a token • Not hierarchical, forced, mandated, or coerced • Not driven by funding, policy, or program structure • Not a low cost substitute for conventional treatment (Davidson) • Not well-researched (Cochrane Collaboration report) June 25, 2014 14 Authentic Peer Support is… Not a service If support is “ the service …” …then peers are just one of many (family, friends, neighbors, community, etc..) who can provide “the service” of support -- each from a unique yet valuable perspective. June 25, 2014 15 Peers in the Workforce: Invasion or Innovation? 5

PRA Recovery Workforce Summit, Thought June 25, 2014 Leader Session, Baltimore, MD Core values Peer support is Peer supporters are • Voluntary • Hopeful • Honest and direct • Open-minded • Mutual and reciprocal (non-judgmental) • Equally shared power • Empathetic • Strengths-focused • Respectful • Transparent • Agents of change • Person-driven (National Practice Guidelines for Peer Supporters, iNAPS) June 25, 2014 16 Authentic ic Peer Support: A Comparis rison Chart SOURCE: Equipping Behavioral Health Systems & Authorities to Promote Peer Specialists/Peer Recovery Coaching Services. (2012). Expert Panel Meeting Report. BRSS-TACS. Peer Identity ity and Peer er Drif ift in the VA (SOURCE: VA Peer Specialist Toolkit. (2014). Implementing Peer Support Services in VHA. A Collaboration between VISN 1 New England MIRECC Peer Education Center and the VISN 4 MIRECC Peer Resource Center.) Peers in the Workforce: Invasion or Innovation? 6

PRA Recovery Workforce Summit, Thought June 25, 2014 Leader Session, Baltimore, MD Question on 3 What at are the key y factor ors that must be addres essed ed for the e integr egratio ation n of peers? 19 KEY FACTORS • Environment/culture • Programs/services • Staffing • Evaluation/outcomes • Research • Advancement of discipline 20 Environment / Culture • Recovery driven philosophy – From the top down (mission, vision, values, policies) – Peer involvement in all aspects (from administration to program development to service delivery, evaluation, and outcomes) June 25, 2014 21 Peers in the Workforce: Invasion or Innovation? 7

PRA Recovery Workforce Summit, Thought June 25, 2014 Leader Session, Baltimore, MD Environment / Culture • Avoid ‘false philosophy’ of recovery – Changing the words but not the deeds – Recovery-oriented approaches are not ‘business as usual’ under the medical model June 25, 2014 22 Environment / Culture • Address/eliminate stigma – Toward people with mental illness – Toward peer providers – From peers and peer providers toward professionals June 25, 2014 23 Programs/Services • Unique role peers can play in service delivery • Peer involvement in service design • Services based on peer to peer support • Not provide services offered by other professions unless with equal salary/benefits • Eliminate role confusion (UPENN study) June 25, 2014 24 Peers in the Workforce: Invasion or Innovation? 8

PRA Recovery Workforce Summit, Thought June 25, 2014 Leader Session, Baltimore, MD Staffing • Training (for peers and non-peers) • Job descriptions (not one-size-fits-all) • Boundaries • Supervision • Salaries/hours June 25, 2014 25 Evaluation/outcomes • Person-centered (not system-centered) • Dimensions of wellness/quality of life • Community inclusion June 25, 2014 26 Research • Peer support services not well researched • Research needs to be more rigorous • Research needs to be more setting-specific • Research that explores qualitative as well as quantitative questions June 25, 2014 27 Peers in the Workforce: Invasion or Innovation? 9

PRA Recovery Workforce Summit, Thought June 25, 2014 Leader Session, Baltimore, MD Advancement of discipline • Define services peer workers can/should provide • Guard against ‘infection’ • Avoid co-optation and mission drift • Pace number of certified peer graduates to the number of available job openings June 25, 2014 28 Advocate against inappropriate use of peers “ Peer staff should not be low cost substitutes for treatment as usual, but are being used that way across the country” – Larry Davidson – “I often sit in on clients’ appointments when the case manager can’t. I help fill medication boxes…I file paper work, do encounter notes when I see a client, and make myself available to the case managers for ‘other’ jobs.” – “I take clients to doctors’ appointments, shopping for groceries, and out to lunch. I bring clients into the ACT office for injections. I help fill pill boxes with medication .” – “Most of our work is transporting clients.” – “I counsel patients with mental health issues. I also act as support staff for doctors, nurses and the social workers .” June 25, 2014 29 Advocate against inappropriate use of peers – “ I am involved with crisis management, and do paperwork, lots of it .” – “I collaborate with clients to develop plans best suited to their needs according to the objectives assigned by the case managers .” – “I get together with my clients once a week. My main goal is to help keep people out of the hospital .” – “I help people fill out their paperwork…I talk to people who won’t help themselves and let them hear my story.” – “Unfortunately, I am a glorified bus driver and check writer .” June 25, 2014 30 Peers in the Workforce: Invasion or Innovation? 10