Peer Support: A Critical Component in Supported Housing. Tom Hill Lyn Legere

Transcription

1

2 Peer Support: A Critical Component in Supported Housing Tom Hill Lyn Legere

3 Disclaimer Slide This webinar was developed [in part] under contract number HHSS I/HHS T from the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). The views, policies and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS. 3

4 Supported Housing Treatment Related/$$ SUD and MH Agency & Community Based Recovery Oriented SUD Sober Homes MH Recovery Combat Homelessness PSH model Transitional Housing

5 A Tale of Two Systems 25% Homeless Mental Health Challenges High percentage of co-occurring disorders. Systems create artificial division between SUD and MH. 38% Homeless Substance Use

6 Permanent Supportive Housing Study after study has shown that supportive housing not only resolves homelessness and increases housing stability, but also improves health and lowers public costs by reducing the use of publicly-funded crisis services, including shelters, hospitals, psychiatric centers, jails, and prisons.

7 Note: Intensive services include help finding housing, working with the landlord, physical and behavioral health care, assistance finding employment and others. Regardless of model, housing that has the supportive element is effective & efficient.

8 Potential Services Permanent Supportive Housing Toolkit 01 Tenant Support Services 04 Crisis Intervention 02 Service Planning & Case Management 05 Peer Mentoring & Peer Support 03 Counseling & Psychosocial Assessment 06 Recreational & Socialization Support

9 Partnership shared homologou s kindred equal Match Relationshi p same Similar PEER likeness Allianc e equivalent affinity Commonality alike akin reciprocal Comparable similitude connection parallel

10 The Basics Peer Support Case Management

11 Peer Support/Case Management PS & CM May Share Tasks Purpose & Approach different Examples Give a Ride Connect to Resources Engage Family

12 Been there, done that, got this t-shirt and I m not there now!

13

14 Complementary, NOT Duplicative

15 Peer Support Salzer, 2002

16 Self-Efficacy Can I do what I need to do to make a change? Belief in Outcome Do I believe the outcome will be positive? Engagement Need Do I have an internal or external need to make a change? Information Do I have the info I need to make a good choice? Desire Do I WANT to make a change in my life? *Vocational Peer Support, c Boston University Center for Psychiatric Rehabilitation

17

18 Tenants Say Specifically, participants reported preferring to do activities and feeling safer with other individuals who also experience mental health challenges. They also reported appreciating the higher level of transparency available when working with peers compared to traditional staff, as well as the general support and investment provided. Read more at CISRO (Housing) Portland

19 Tenants Say The personal approach, nonjudgemental approach, just made you feel like a human being, you know? [beneficiary 1] In comparison to someone who hasn t been there trying to understand, because the experience that they have helps, and it makes you feel that you re not the only one. [beneficiary 2]

20 Does Peer Support Make A Difference? Emerging research shows that peer support is effective for supporting recovery from behavioral health conditions. Increased selfesteem and confidence Increased sense of control and ability to bring about changes in their lives Raised empowerment scores Increased sense that treatment is responsive and inclusive of needs BRSS TACS, (2012) Equipping Behavioral Health Systems & Authorities to Promote Peer Specialist/Peer Recovery Coaching Services, SAMHSA Bringing Recovery Supports to Scale.

21 Does Peer Support Make A Difference? cont. Increased sense of hope and inspiration Increased empathy and acceptance (camaraderie) Increased engagement in self-care and wellness Increased social support and social functioning BRSS TACS, (2012) Equipping Behavioral Health Systems & Authorities to Promote Peer Specialist/Peer Recovery Coaching Services, SAMHSA Bringing Recovery Supports to Scale.

22 Does Peer Support Make A Difference? cont. Decreased psychotic symptoms Reduced hospital admission rates and longer community tenure Decreased substance use and depression BRSS TACS, (2012) Equipping Behavioral Health Systems & Authorities to Promote Peer Specialist/Peer Recovery Coaching Services, SAMHSA Bringing Recovery Supports to Scale.

23 Tenants Say I just feel that with the support worker, because they ve had their own issues and mental health issues, I feel they have a better understanding of where you re coming from.. I really think the sharing bit, and I think that helped to build up trust as well. It made me feel like a person rather than some sort of patient. [beneficiary 1]

24 When I saw that other people recovered, it gave me hope that I could too. Corinna

25 BRSS TACS, (2012) Equipping Behavioral Health Systems & Authorities to Promote Peer Specialist/Peer Recovery Coaching Services, SAMHSA Bringing Recovery Supports to Scale.

26 BRSS TACS, (2012) Equipping Behavioral Health Systems & Authorities to Promote Peer Specialist/Peer Recovery Coaching Services, SAMHSA Bringing Recovery Supports to Scale.

27 When PEER support is implemented & supported BRSS TACS, (2012) Equipping Behavioral Health Systems & Authorities to Promote Peer Specialist/Peer Recovery Coaching Services, SAMHSA Bringing Recovery Supports to Scale.

28 Peer Bridging Peer Bridger Project 71% decrease in hospitalization PeerLink Tennessee/Optum study 73% decrease in hospital days PeerLink Wisconsin Optum study 44% decrease in hospital days Hendry, P., Hill, T., Rosenthal, H. Peer Services Toolkit: A Guide to Advancing and Implementing Peer-run Behavioral Health Services. ACMHA: The College for Behavioral Health Leadership and Optum, 2014

29 Examples PeerNET, PA: mobile peer teams supporting people to acquire and maintain housing; Central City Concern, Portland Oregon Peer AHEAD (Access to Housing through peer-delivered Engagement, Assistance, and Direction), PA: Homeless outreach and housing support Shelter Plus Care Promise Resource Network, Charlotte, NC ReStart Recovery Innovations, AZ Temporary housing, peer run Sober Recovery Homes

30 Using Peer Support/Recovery Coaches in Housing Models: Getting Started What treatment agencies in your area are currently using peer support workers? What recovery supports and services are currently available in your community? Why reinvent the wheel when there are potential collaboration opportunities? Use of peer support workers in housing models Shared peer programs on- and off-site Training and evaluation tools

31 The peer specialist can help reduce the consumer s ambivalence because the peer specialist s lived experience brings a level of credibility. By modeling behaviors and showing that doing X will bring a particular benefit, they have legitimacy. The consumers that do well as peer support specialists are the stellar clients, the ones who have made enormous transformations in their own lives. Steacy, A. (2011). Tips for peer support specialist programs. Rockville, MD: Substance Abuse and Mental Health Services Administration. Retrieved from

32 Wraparound services and especially those delivered by peer recovery specialists are key to helping the newly housed person adjust, building a new community, and understanding how to live housed. Steve Samra

33 References Peer Specialists Bellamy, C. D., Rowe, M., Benedict, P., & Davidson, L. (2012). Giving back and getting something back: The role of mutual- aid groups for individuals in recovery from incarceration, addiction, and mental illness. Journal of Groups in Addiction & Recovery, 7, Bologna, M. J., & Pulice, R. T. (2011). Evaluation of a peer-run hospital diversion program: A descriptive study. American Journal of Psychiatric Rehabilitation, 14, Chinman, M., Oberman, R. S., Hanusa, B. H., Cohen, A. N., Salyers, M. P., Twamley, E. W., & Young, A. S. (2015). A cluster randomized trial of adding peer specialists to intensive case management teams in the Veterans Health Administration. Journal of Behavioral Health Services Research, 42, Chinman, M., George, P., Dougherty, R. H., Daniels, A. S., Ghose, S. S., Swift, A., & Delphin-Rittmon, M. E. (2014). Peer support services for individuals with serious mental illnesses: Assessing the evidence. Psychiatric Services, 65, Coatsworth-Puspoky, R., Forchuk, C., & Ward-Griffin, C. (2006). Peer support relationships: An unexplored interpersonal process in mental health. Journal of Psychiatric & Mental Health Nursing, 13(5),

34 References Peer Specialists Cook, J. A., Copeland, M. E., Corey, L., Buffington, E., Jonikas, J. A., Curtis, L. C., & Nichols, W. H. (2010). Developing the evidence base for peer-led services: Changes among participants following Wellness Recovery Action Planning (WRAP) education in two statewide initiatives. Psychiatric Rehabilitation Journal, 34, Corrigan, P. W., & Sokol, K. A. (2013). The impact of self- stigma and mutual help programs on the quality of life of people with serious mental illnesses. Community Mental Health Journal, 49, 1-6. Davidson, L., Bellamy, C., Guy, K., & Miller, R. (2012). Peer support among persons with severe mental illnesses: A review of evidence and experience. World Psychiatry, 11, Druss, B. G., Zhao, L., von Esenwein, S. A., Bona, J. R., Fricks, L., Jenkins-Tucker, S, Sterling, E., Diclemente, R., & Lorig, K. (2010). The Health and Recovery Peer (HARP) Program: A peer-led intervention to improve medical self-management for persons with serious mental illness. Schizophrenia Research, 118, Felton, C., Stastny, P., Shern, D., Blanch, A., Donahue, S., Knight, E., & Brown, C. (1995). Consumers as peer specialists on intensive case management teams: Impact on client outcomes. Psychiatric Services, 46,

35 References Peer Specialists Mead, S., & MacNeil, C. (2006). Peer support: What makes it unique? International Journal of Psychosocial Rehabilitation, 10, Min, S-Y., Whitecraft, J., Rothbard, A. B., & Salzer, M. S. (2007). Peer support for persons with co-occurring disorders and community tenure: A survival analysis. Psychiatric Rehabilitation Journal, 30, Short, R., Woods-Nyc, K., Cross. S. L., Hurst, M., Gordish, L., & Raia, J. (2012). The impact of forensic peer support specialists on risk reduction and discharge readiness in a psychiatric facility a five-year perspective. International Journal of Psychosocial Rehabilitation, 16, Sledge, W. H., Lawless, M., Sells, D., Wieland, M., O Connell, M. J., & Davidson, L. (2011). Effectiveness of peer support in reducing readmissions of persons with multiple psychiatric hospitalizations. Psychiatric Services, 62, Trachtenberg T, Parsonage M, Shepherd G, Boardman J. (2013) Peer Support in mental health: Is it good value for money? London: Centre for Mental Health Walker, G., & Bryant, W. (2013). Peer support in adult mental health services: A metasynthesis of qualitative findings. Psychiatric Rehabilitation Journal, 36, 28

36 References Recovery Coaching Bassuk, E. L., Hanson, J., Greene, R. N., Richard, M., & Laudet, A. (2016). Peerdelivered recovery support services for addictions in the United States: A systematic review. Journal of Substance Abuse Treatment, 63, 1 9. doi: /j.jsat Best, D., & Laudet, A. (2010). The potential of recovery capital. London: RSA Projects. Retrieved from the-potentialof-recovery-capital Center for Substance Abuse Treatment. (2009). What are peer recovery support services? HHS Publication No. (SMA) Rockville, MD: Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. Cloud, W., & Granfield, R. (2008). Conceptualizing recovery capital: Expansion of a theoretical construct. Substance Use & Misuse, 43(12 13), doi: / Reif, S., Braude, L., Lyman, D. R., Dougherty, R. H., Daniels, A. S., Ghose, S. S., Delphin Rittmon, M. E. (2014).. Peer recovery support for individuals with substance use disorders: Assessing the evidence. Psychiatric Services, 65(7), doi: / appi.ps White, W. (2009). Peer-based addiction recovery support: History, theory, practice, and scientific evaluation. Chicago, IL: Great Lakes Addiction Technology Transfer Center and Philadelphia Department of Behavioral H

37 References Peer Bridging Hendry, P., Hill, T., Rosenthal, H. Peer Services Toolkit: A Guide to Advancing and Implementing Peer-run Behavioral Health Services. ACMHA: The College for Behavioral Health Leadership and Optum, 2014

38 Toolkit References Adler, D., Bergeson, S., (2012) The Next Step to Sustainability: Guide for Family and Consumer Run Organizations Seeking to Expand Their Funding by Becoming a Part of a Managed Care Network, Optum Health, Public Sector, BRSS TACS, (2012) Equipping Behavioral Health Systems & Authorities to Promote Peer Specialist/Peer Recovery Coaching Services, SAMHSA Bringing Recovery Supports to Scale. Dickerson, G., Integrating Peer-support Services with Healthcare Reform, Homeless Resource Center. SAMHSA. (2014) Hendry, P., Hill, T., Rosenthal, H. Peer Services Toolkit: A Guide to Advancing and Implementing Peer-run Behavioral Health Services. ACMHA: The College for Behavioral Health Leadership and Optum, 2014

39

40