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Text Box: Elizabeth Lavender Peer specialists approach a fellow peer who needs more intense help as an equal. They do not focus on diagnosis, prognosis, or disability. They focus on wellness and capability, and demonstrate respect. Peer specialists both empower their peers and are empowered by them. The peers are equals, growing and sharing. Both have experienced emotional and psychological pain; they have a natural connection. The peer specialist is person–centered; this means that their peer is the head of his/her own recovery team. Their peer decides what his/her recovery goals are and decides how she/he will obtain them. The peer specialist affirms and validates the newly recovering person and focuses on their strengths, mentioning these strengths to build self esteem, hope, and a focus on wellness. The person being helped becomes more mindful of the good parts of who they are. The peer specialist guides the person toward what he/she wants, not toward what the peer specialist wants. This is often done by using open-ended questions and listening carefully. Rather than identifying their peer as a patient, Peer specialists consider him/her a person. Why do we have peer specialists? The President’s New Freedom Report says, “Consumers who work as providers help expand the range and availability of service and supports that professionals offer. Studies show that consumer-run services and consumer-providers can broaden access to peer support, engage more individuals in traditional mental health services, and serve as a resource in the recovery of people with a psychiatric diagnosis. Because of their experiences, consumer-providers bring different attitudes, motivations, insights, and behavioral qualities to the treatment encounter.” State authorities say, “…consumers should be involved in a variety of appropriate service and support settings. In particular, consumer operated services for which an evidence base is emerging should be promoted. Use of peer specialists is found to decrease psychiatric hospitalizations, decrease the incidence of destabilization, and reduce substance abuse. Improved quality of life, higher self-esteem, increased community involvement and better symptom management were found.” Outcomes for consumers working with peer specialists included increased personal effectiveness, better quality of life, better illness management, and employability. (I have heard that 70% of people with mental illness are unemployed. Peer specialist and peer support positions can provide a career ladder for consumers to return to the workforce.) What is the difference between peer specialists and peer supports? To be a peer specialist, you should self-identify as a former or current consumer of mental health services. You should be well-grounded in your recovery, and normally have at least one year between diagnosis and application for training. You should have either a GED or a high school diploma. You also should have demonstrated leadership and advocacy experience. Peer specialists go through a class to be certified to assist other consumers, and participate in continuing education each year. A peer specialist is not meant to replace any professional psychological or social work staff person, and it is not good for peer specialists to become very familiar with the medical model: the medical model is pathology-based (focusing on what’s wrong with people), and peer specialists are strength-, person-, and wellness/recovery-based. Medical and psychological professionals are very valuable and needed; our approach is just very different. Peer specialists bring a particular set of gifts and experiences to the recovery system that people who have not experienced a mental illness and its medicines cannot bring. A person with a psychiatric disorder (let’s call that a psychiatric challenge) can understand the experiences of another person with that psychiatric challenge, and the process of going through the journey from diagnosis and very difficult days to wellness. A peer specialist, by her/his very presence, says, “Yes, recovery is possible; I am the evidence.” A peer support is a person who is a consumer who has come with staff permission to help. They don’t have peer specialist training. They could even have advanced degrees in psychology, etc. but they are trained to be experts, not equals. They are called peer supports. What is recovery? It’s a journey – not a destination. Recovery is a person taking control of his/her life, becoming more positive, integrated and skilled, and doing what they want to do to reintegrate into society. Recovery takes responsibility and working toward your wellness goals (often using Mary Ellen Copeland’s Wellness Recovery Action Plan, which is very helpful.) It doesn’t mean a cure, and it doesn’t mean return to a former state (nobody can really do that!). Hopefully, the recovering person will remember the greatness within them and will redesign their life based on their best strengths and skills. The Substance Abuse and Mental Health Services Administration (SAMHSA) says, “Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her own choice while striving to achieve his or her full potential.” The Peer Specialist models and provides education on the ten components SAMHSA has found which contribute to recovery: 1) Self-Direction, 2) Individualized and Person-Centered, 3) Empowerment, 4) Holistic (Body, Mind, Spirit), 5) Non-Linear (we all have setbacks in life), 6) Strengths-Based, 7) Peer Support, 8) Respect, 9) Responsibility, and 10) Hope. What is a very important issue for us? Health! In October 2006, the Medical Directors Council of the National Association of State Mental Health Program Directors (NASMHPD) reported: “People with serious mental illness served by the public mental health system die, on average, 25 years earlier than the general population.” USA Today put this as a front page story May 3, 2007, stating that this is a gap that has widened since the early 90’s when major mental disorders cut life spans by 10-15 years. The doctor’s report said that the reasons were largely due to preventable medical conditions: metabolic disorder (fat that collects in your central/belly area), cardiovascular disease, and diabetes. Also included as preventable were obesity, smoking, substance abuse and inadequate access to medical care. The report also mentioned that some psychiatric medications contribute to the risk. Depression and Bipolar Support Alliance (DBSA) has recently launched a 3 day peer specialist class on Peer-Led Health Self-Management to assist at-risk people. People with belly fat may be at risk for developing insulin resistance and diabetes. Peer specialists can play a role in supporting peers to live longer. The National Institute of Mental Health is funding a study which seeks to adapt an evidence-based medical self-management program. The program for adaptation is the Chronic Disease Self-Management Program that brings results in sustainable change in healthy behaviors and health in persons with a range of chronic conditions, says Dr. Benjamin Druss of Emory University who oversees the program. Emory has hired two peer specialists have been hired to adapt the CDSMP for consumers served by the public mental health system in the Atlanta area. Their program is called HARP (Health and Recovery Peer Project). Peer specialists can also go with consumers to visit their psychiatrists to support shared decision-making. Doctors are aware of which medicines are contributing to mortality and can also triage medicines. Consumers need more information about medicines and should only use very reputable websites (NAMI, NIMH, DBSA, and Mayo Clinic). A book by Dr. Herbert Benson, a Harvard Medical School trained cardiologist, The Relaxation Response, can be quite effective. Use your imagination to discover where peer specialists can work and what they can do!

Spring/Summer 2008

Grassroots Empowerment Project, Inc. (GEP) is Wisconsin’s only statewide non-profit organization that is controlled and directed by mental health consumers.

90% of the Board of Directors and 100% of the staff are people with mental illness.

We are funded by the State of Wisconsin Department of Health and Family Services, Bureau of Community Mental Health with federal Mental Health Block Grant dollars.

Facts about Mental Illness

FACT:

More than 54 million Americans have a mental disorder in any given year, although fewer than 8 million seek treatment.

FACT:

Depression and anxiety disorders — the two most common mental illnesses — each affect 19 million American adults annually.

FACT:

Approximately 12 million women in the United States experience depression every year. This is roughly twice the rate of depression in men.

FACT:

Depression greatly increases the risk of developing heart disease. People with depression are four times more likely to have a heart attack than those with no history of depression .

FACT:

One percent of the population (more than 2.5 million Americans) has schizophrenia.

FACT:

Bipolar disorder, also known as manic-depressive illness, affects more than 2 million Americans.

FACT:

The majority of people living with severe mental illness have incomes lower than $8,000 per year.

FACT:

People with mental illness can and do become empowered, begin a path toward recovery, and return to a productive life.

Consumer network news

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