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Utilizing Peer Supports In Crisis Settings

Utilizing Peer Supports In Crisis Settings. Travis Atkinson, LLPC Lara Class, BSW Hope Network Behavioral Health Services. Defining Crisis.

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Utilizing Peer Supports In Crisis Settings

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  1. Utilizing Peer Supports In Crisis Settings Travis Atkinson, LLPC Lara Class, BSW Hope Network Behavioral Health Services

  2. Defining Crisis • A sudden attack of pain, distress, or disordered function, causing a state of disequilibrium; a decisive or crucial time, stage, or event (Webster’s Dictionary) • From the Greek word krisis, meaning “decision”

  3. The Relationship Between Trauma and Crisis • Relationship between childhood trauma and morbidity, mortality, and disability (Lanius, R., Vermetten, E., and Pain, C., 2010). • Individual’s perception of an experience defines the life event as crisis • Increased support and awareness for trauma-informed care needed in crisis

  4. Examples of Crises • Private • Death of a loved one • Bankruptcy • Loss of housing • End of a relationship • Diagnosis/emergence of an illness • Evicton/Moving • Loss of job/insurance • Public • Natural disasters • Man-made disasters • Terrorist attacks • Stock market collapse

  5. History of Peer Supports • International History • Richard Paternoster (1838) • Family tried to have him institutionalized • Captive for 41 days • Kept notes of treatment • Alleged Lunatics’ Friend Society

  6. History of Peer Supports • Harry Stack Sullivan • Directed inpatient hospital in 1920’s • Recruited young men with their own psychiatric disorders to work on his unit • Clifford Beers • Started the Mental Hygiene Movement around 1909 • Isaac Hunt • Elizabeth Stone

  7. History of Peer Supports • Jennie Fulgham • Diagnosed with paranoid schizophrenia in 1947 in Virginia • Worked at the phone company for 20 years • 1961- Began visiting people at mental institutions • 1978- Created Zuni Federation for Mental Health

  8. History of Peer Supports • National Level • De-institutionalization • Mental Health Consumer Movement • Community-based services focusing on community life • Olmsted Supreme Court decision 1999 • Alcoholics Anonymous (AA) • Founded by Bill Wilson in the 1930’s • Surgeon General’s report on Mental Health (1999) • Recovery

  9. History of Peer Supports • State Level • 2005-The first official Peer Support Certification course offered in MI • Currently 883 Certified Peer Supports in MI

  10. Supporting Evidence for Peer Supports • Consumers provided ACT had fewer people using hospitals and ER’s(Clarke et al. 2000). • Better engagement in services and more involvement in activities (Craig, Doherty, Jamieson-Craig, Boocock, and Attafua, 2004). • Significantly better crisis services, GAF, quality of life, substance abuse (Klein, Cnaan, and Whitecraft, 1998). • Veterans engaged in peer services reported significantly higher feelings of empowerment (Resnick, S., and Rosenheck, R., 2008).

  11. Why Peer Supports Work • Sharing similar life experiences with others canincrease a person’s understanding of his or her situation and reduce social isolation (Carpinello, Knight, & Janis, 1991). • People are no longer restricted to a passive role of “patient” relying on expert advice and can now serve as role models (Levy, in press; Maton, 1987; Roberts, et al., 1991). • Mutual support is an intentional process which includes standard procedures routines and prescriptions for addressing problems and issues of everyday life (Levine & Perkins, 1987). • Mutual support may offer worldviews and ideologies to assist persons in making sense of their experiences (Antze, 1976; Cain, 1991).

  12. What Makes a Peer Support Effective? • Utilizing Personal Experiences • Opportunities for a unique connection • Empathy is Gold

  13. Discussion Exercise • Pair up and share with one another your story of how you got into the mental health field • What things do you have in common?

  14. How Peers are Utilized in Crisis • Empathic listening • Sharing their experience • De-escalation

  15. Strategies Peers Can Use in Crisis Situations • WRAP • Motivational Interviewing • Mindfulness/Acceptance & Commitment Therapy • Personal Action Towards Health (PATH)

  16. How Can You Utilize a Peer Support Specialist? • Adjunct to your Role • As a Medicaid Billable Service • H0038 • Group facilitation • Liaison • Peer-run services

  17. Challenges & Solutions • Co-worker education/buy–in • Resistance to unfamiliar roles • Education • Keeping the Recovery Skills Alive • Time/Experience/Exposure • Peer involvement in leadership • Perceived threats to job security/job roles • Reminders about value of each person’s role • Stigma • Education/Awareness

  18. Challenges & Solutions • Co-worker education/buy–in (continued) • Lived experiences vs. degreed professionals • Opportunity for symbiotic relationship to provide a center conducive to recovery • Mandates • Opportunities to process change (staff meetings, private meetings, etc.) • Being open to change

  19. Challenges & Solutions • Mental Health Maintenance • Compassion fatigue/ countertransference/ vicarious re-traumatization • Debriefing • Supervision • Healthy outlets • Therapy • Working through disappointment • Peer support for peer support • Internal • External

  20. Challenges & Solutions • Mental Health Maintenance (continued) • Being effective amidst challenges/suffering “How can I be helpful when I can barely take care of myself?” • Understanding how to be helpful and “broken”/ imperfect • Being forthright with clients and treatment team • Perceived stigma of using sick time/vacation time • Regular communication with supervisor • Use of FMLA after 1st year of work • Education of peers on acceptable use of sick time/PTO

  21. Challenges & Solutions • Prioritizing • Triaging needs of the people being served • Supervision/consultation • Experience • Acknowledging limitations of the system • Identifying potential solutions

  22. Getting Started • Consult with supervisor/funding source • Identify the benefits to peer supports in the workplace • Appropriate Utilization • Create a job opportunity where peers are able to be successful and helpful • Maintenance • Consistent supervision and debriefing opportunities • External support • Identify peer group (internally or externally) where peers can share work experiences and support one another

  23. Discussion Exercise • Pair up with a new person and discuss how you use peers in your workplace or how your workplace might benefit from having peers.

  24. Discussion

  25. More Questions? Email: tatkinson@hopenetwork.org lclass@hopenetwork.org

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