Mark Salzer, Ph.D.

Professor and Chair Department of Rehabilitation Sciences Temple University Director, TU Collaborative on Community Inclusion

GROW Residence Kankakee, IL.

Federal Recognition of Peer Support…Increasingly Viewed As A “Medical Necessity”

1978: President Carter’s Commission on Mental Health offered early federal recognition that “groups composed of individuals with mental or emotional problems” were being formed around the country 1987: Surgeon General’s Report recommended strategies for promoting self-help groups 1999: Surgeon General’s Report promotes self-help groups and consumer run services Pre-2001: Peer support services funded by states and counties 2001: CMS Funding of Peer Support in GA and AZ 2003: The President's New Freedom Commission on Mental Health promotes consumer-operated services 2004: VA strategic plan agenda recommendation “Hire veterans as Peer/Mental Health Para Professionals.” (Commission Rec. 2-3.18 &19, Appendix 1).

2007: CMS guidance letter to states on peer support services 2008: Handbook on Uniform Mental Health Services in VA Medical Centers and Clinics states that “all veterans with SMI [serious mental illnesses] must have access to Peer Support (2, pg. 28)”.

http://www.pewtrusts.org/~/media/legacy/uploadedima ges/pcs_assets/stateline_photos/2013/09/0911topstoryviz png.png

Daniels, A., Grant, E., Filson, B., Powell, I., Fricks, L., Goodale, L. (Ed), Pillars of Peer Support: Transforming Mental Health Systems of Care Through Peer Support Services, www.pillarsofpeersupport.org; January, 2010.

What Are Peer Specialists Doing?

Program % Time Groups % Time Individuals Average Across All Programs 25% 48% Case Management Partial Hospital/Day Program, Inpatient, or CRISIS VR or Clubhouse 15% 38% 61% 43% 32% 47% Therapeutic Recreation or Psych. Rehab.

36% 44% Residential Drop-In Center Education/Advocacy Independent Peer Support Program 4% 41% 27% 22% Other/Could not be Coded 22%

Salzer, M.S.

, Schwenk, E., & Brusilovskiy, E. (2010). Certified Peer Specialist Roles and Activities: Results from a National Survey. Psychiatric Services, 61, 520-523.

75% 37% 26% 51% 38%

Whole Health Action Management (WHAM)

 Promote resiliency, wellness, and self-management of health and behavioral health  Basic Elements  Teach skills to enhance self-management  WHAM peer support groups  Weekly action plans to create new health habits

Recovery Coaching to Promote “Personal Medicine”

 “Personal medicine”: self-taught, nonpharmaceutical strategies that persons with mental illnesses use, often in combination with psychiatric medication, to advance their recovery and improve their lives.

 Example: a man with bipolar disorder who used math problems to help himself get to sleep and thus avoid a manic episode  “There seem to be as many types of personal medicine as there are individuals: fishing, parenting, repairing airplanes, walking, diet, caring for pets, friendship, driving...” (Deegan, 2007, p. 65).

Deegan, P. E. (2007). The lived experience of using psychiatric medication in the recovery process and a shared decision-making program to support it. Psychiatric Rehabilitation Journal, 31(1): 62-69.

Pennsylvania SDC Demonstration

 Magellan Health Services  Office of Behavioral Health, Delaware County, Pennsylvania (In coordination with PA OMHSAS)  Temple University Collaborative on Community Inclusion of People with Psychiatric Disabilities  Mental Health Association of Southeastern Pennsylvania

Recovery Coach Activities

 Budget coaching  Exploring dreams to develop life goals  Setting budget from goal activities  Obtaining authorization for purchases   A total of 507 asks from 35 people Examples      Gym memberships Items for weight loss Computer Work clothes Attending leisure events

Engagement Specialist

 Strongest evidence showing peer support benefits  Peers can…  Combat demoralization by offering hope  Decrease self-stigma  Enhance self-advocacy and choice