Peer Support and Peer Providers: Redefining Mental Health Recovery
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Peer support is a relationship and dialogue based on connection and trust. When we create this kind of relational environment, we can step back and see things from new angles, creating possibilities that couldn’t have previously existed.
Shery Mead, Founder and Managing Director, Shery Mead Consulting
In the early 1970s, during the era of deinstitutionalization, former psychiatric patients who had been discharged from hospitals and institutions began to meet in groups to discuss their experiences and provide mutual support. These groups modeled their approaches after many other groups at that time that formed to address discrimination and civil rights. Individuals in these groups discussed ways to counter the negative experiences they had in the mental health system and to advocate for positive change. As this process evolved, group members discovered that sharing stories, being heard, and being understood within respectful and trusting relationships with peers was transformative and had a positive impact on their recovery.
“Peer support has been defined by the fact that people who have like experiences can better relate and can consequently offer more authentic empathy and validation. It is also not uncommon for people with similar lived experiences to offer each other practical advice and suggestions for strategies that professionals may not offer or even know about. Maintaining its non-professional vantage point is crucial in helping people rebuild their sense of community when they’ve had a disconnecting kind of experience.” Shery Mead, M.S.W., and Cheryl MacNeil, Ph.D., defined peer support thus in their 2004 report, Peer Support: What Makes It Unique?
Since the early part of this decade, experts have come to realize and value peer-to-peer support in “the acquisition of real recovery.” According to the Georgia Peer Specialist Web site, Certified Peer Specialists work in a variety of mental health settings “to assist the peers they are partnered with in reaching the goals they wish to accomplish in their personal recovery journeys.”
In a groundbreaking letter to Medicaid directors in 2007, Dennis G. Smith, director of the Centers for Medicare and Medicaid Services, explained peer support service as an “evidence-based mental health model of care that consists of a qualified peer support provider who assists individuals with their recovery from mental illness and substance use disorders.” Most significant, the letter made it clear to recipients—State Medicaid directors—that peer support services could be provided under Medicaid as a “component of a comprehensive mental health and substance use service delivery system.”
A research base has been established that demonstrates that peer support services are an effective component of mental health care. (Davidson et al., 2003; Mead & MacNeil, 2006). A key differentiating factor in the certified peer specialist (CPS) role from other mental health positions is that, in addition to the traditional knowledge and competencies in providing support, the CPS operates out of a lived experience and experiential knowledge (Mead, Hilton, & Curtis, 2001). Information provided by peers is often seen to be more credible than that provided by mental health professionals (Woodhouse & Vincent, 2006). Peer support has demonstrated positive outcomes in the areas of substance abuse, parenting, loss and bereavement, cancer, and chronic illness (Kyrouz, Humphreys & Loomis, 2002; White, 2000), in addition to mental health. When peers are part of hospital-based care, the results indicate shortened lengths of stays, decreased frequency of admission, and a subsequent reduction in overall treatment costs (Chinman, Weingarten, Stayner & Davidson, 2001). Other studies also suggested that the use of peer support can help reduce the overall need and use for mental health services over time (Chinman, ibid.; Klein, Cnaan, & Whitecraft, 1998; Simpson & House, 2002).
The reciprocal giving and receiving as equals, often referred to as peer support, is life altering. More opportunities and choices become available, and as these strong bonds develop, they typically fuel one’s sense of meaning, purpose, and sense of belonging within a social context. The interdependent connections reveal a dynamic that is bigger than the individual—it is the formation of support networks and small communities. Peers carry hope for one another, and they always see some small light in the person they are supporting. Will Hall, co-founder of The Icarus Project, said, “Peer support is a common-sense solution to the emotional isolation at the heart of all mental health problems.”
To increase awareness of the value and effectiveness of peer support and demonstrate how peer support complements and improves the delivery of mental health services and supports.
This training will:
- Provide information about the history and evolution of peer support, clarify what is and what is not peer support, and give clear examples;
- Explain the role of certified peer specialists, Medicaid reimbursements, and certification;
- Review the research findings to date that show the effectiveness of peer support in the recovery from mental health problems;
- Discuss the dynamics of peers on the treatment team, the boundaries, and the impact of peer specialists on the role of traditional providers; and
- Explain how traditional providers are being educated in peer support, self-help, and recovery principles.
- People with disabilities, including consumer/survivors; family members of people with disabilities; current and past recipients of mental health services; and local, state and national mental health organizations
- Mental health advocates
- Mental health providers
- Health care providers
Jean Campbell, Ph.D.
A research associate professor in the Department of Psychiatry at the University of Missouri School of Medicine–Columbia, Dr. Campbell directs the Program in Consumer Studies and Training at the Missouri Institute of Mental Health. As an internationally known mental health consumer researcher, speaker, and consultant, she is a forerunner in the effort to define recovery and well-being of mental health service recipients in research and to promote multi-stakeholder approaches in evaluation and service delivery. Currently, she is working with the Missouri Department of Mental Health to promote consumer-operated service programs as an evidence-based practice and is a consultant to the new Missouri Heartland Consumer Network.
Dr. Campbell was part of the core working group that developed the COSP Evidence-Based Practices KIT for SAMHSA (now in clearance) and was principal investigator of the coordinating center for the large, multi-site federal research initiative that studied the cost effectiveness of consumer-operated programs as an adjunct to traditional mental health services. She was a consultant to the President’s New Freedom Commission on Mental Health and was a contributor to the Mental Health Report of the Surgeon General. She has written more than 40 articles and reports on the development and use of management information systems in service system improvement, shared decision making, privacy of health records, and peer-support programs.
Dr. Campbell is best known for her ground-breaking, consumer-directed research study of mental health consumer well-being in California, The Well-Being Project (1989), and the award-winning documentary, People Say I’m Crazy. For her work as a distinguished scholar and mental health consumer advocate, she received the NAMI Lionel Aldridge Award (2008), the Silver Key Award from the Mental Health Association of Greater St. Louis (2004), the New York Association of Psychiatric Rehabilitation Services Executive Directors Award (2003), the International Association of Psychosocial Rehabilitation Services Acknowledgement (2000), and the Human Rights Diversity Enhancement Award from the University of Missouri–Columbia (1995).
Steve Harrington, J.D., M.P.A.
Lawyer, mental health advocate, and mental health organizational and curriculum consultant, Harrington has worked as a senior policy consultant for a public policy think tank and is founder and current executive director of the National Association of Peer Specialists. As an educator, he has extensive experience as a public school teacher, a university instructor, and as an education administrator and curriculum evaluator for the Kellogg Foundation. Harrington has designed curricula for grades K through 12 and adults in continuing education settings and has taught classes to persons in recovery from psychiatric disorders, as well as mental health provider administrators, state mental health directors, case managers, and therapists. Harrington also has conducted grand round lectures at several medical schools and large medical facilities. Most recently, he was a delegate and lecturer at the World Mental Health Congress in Athens, Greece.
Harrington, who has been diagnosed with two psychiatric disorders and receives mental health services, is the author of 12 books on a variety of topics, including The Depression Handbook, You Can Recover! and his newest book, Trees of Hope, which has drawn critical acclaim from leaders in business, government, and health care. He is a contributing writer and spokesperson for two international mental health publications and was executive producer of Open Spaces, an award-winning documentary on mental health issues that has enjoyed international acclaim.
Harrington, who has extensive experience facilitating and conference planning, makes about 40 presentations—equally split between keynotes and workshops—at mental health conferences annually. He is also co-founder of Recover Resources, a consumer-owned-and-operated, Web site-based micro-enterprise that offers a variety of recovery materials. For more information, visit http://recoverresources.com/id31.html .
Shery Mead, M.S.W.
The past director of three New Hampshire peer support programs, including a peer-run hospital alternative, Shery Mead has done extensive speaking and training, nationally and internationally, on the topics of alternative approaches to crisis, trauma-informed peer services, systems change, and the development and implementation of peer-operated services. Her Intentional Peer Support, a trauma-informed approach that sees connections and relationship as the core of healing and growth, has been adopted by several states as “best practice.” Her publications include academic articles, training manuals, and books, including Wellness Recovery Action Plan & Peer Support, which was co-authored with Mary Ellen Copeland, and Peer Support: An Alternative Approach. Mead’s current interests include developing a theory and practice base for peer-operated programs, de-pathologizing the effects of trauma and abuse, and finding research and evaluation models that accurately reflect the work of peer programs. To read some of her writings, see www.mentalhealthpeers.com/booksarticles.html .
Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S. F., Urbanowski, F., Harrington, A., Bonus, K., and Sheridan, J. F. (2003). Alterations in Brain and Immune Function Produced by Mindfulness Meditation. Psychosomatic Medicine, 65: 564–570 (2003).
Georgia Certified Peer Specialist Project. March 2003. www.gacps.org/Home.html. Web. August 26. 2010
Mead, S. & MacNeil, C. (2006). Peer Support: What Makes It Unique?
International Journal of Psychosocial Rehabilitation, 10 (2), 29–37.
Mead, S., Hilton, D., and Curtis, L. (2001). Peer Support: A Theoretical Perspective. Psychiatric Rehabilitation Journal, 21,160–163.
Kyrouz, E. M., Humphreys, K., and Loomis, C. (2002). A review of research on the effectiveness of self-help mutual aid groups. In B.J. White and E.J. Madera (Eds.). American self-help clearinghouse self-help source book.7th ed., 71–85. Cedar Knolls, NJ; American Self-Help Group Clearing House.
White, W. (2000). The history of recovered people as wounded healers: from native America to the rise of the modern alcoholism movement. Alcoholism Treatment Quarterly. 18 (1) 1–22.
Chinman, M. J., Weingarten, R., Stayner, D., and Davidson, L. (2001). Chronicity reconsidered: Improving person-environment fit through a consumer run service. Community Mental Health Journal. 37 (3) 215–229.
Klein, A. R., Cnaan, R. A., and Whitecraft, J. (1998). Significance of peer social support with dually diagnosed clients: Findings from a pilot study. Research on Social Work Practice, 8 (5) 529–551.
Simpson, E. L., and House, A. O. (2002). Involving users in the delivery and evaluation of mental health services: systematic review. British Medical Journal, 325, 1–5.