Joseph Rogers, Executive Director

1. The Power of Peers: The Effectiveness of Peer-Delivered Services Joseph Rogers, Executive Director National Mental Health Consumers’ Self-Help Clearinghouse 1211 Chestnut St., 11th Floor Philadelphia, PA 19107 800-553-4539, ext. 3844…jrogers@mhasp.org Alternatives 2011 Orlando . . . Oct. 26-30, 2011

2. A Glimpse at 20 Years of Research • Summarized from Boston University Center for Psychiatric Rehabilitation http://drrk.bu.edu/research-syntheses/psychiatric-disabilities/peer-delivered-services • Developed with NIDRR grant H133A050006

3. Purpose of the Review • Dramatic growth in peer-delivered services in recent years: 7500 peer programs or groups identified in a 2006 survey. • The review searched for an evidence base for peer-delivered services to give direction to program developers, decision makers, advocates and funders.

4. Types of Peer-Delivered Services Included in the Research Summary (1) • Peer-run programs: • drop-in centers • peer learning/ advocacy centers • crisis housing Peer Support and Wellness Center Decatur, GA

5. Types of Peer-Delivered Services Included in the Research Summary (2) • Peer-run groups, e.g.: • Double Trouble • Grow • Recovery

6. Types of Peer-Delivered Services Included in the Research Summary (3) • Peer specialists working with individuals, offering support, referrals, crisis, linking or other services • may be in peer-run programs or non-peer-run programs Gina Calhoun, CPS

7. Importance of Research • 1. Assure continuous quality improvement among peer-delivered services • 2. Educate and inform decisions made by and about peer-delivered services • 3. Help convince mental health professionals and funding agencies about the value of peer services.

8. Types of Research Available on Peer-Delivered Services (1) • 1. Research that compares the results of two or more groups. • 2. Research that compares one group of peers’ functioning at points in time (“before and after” the peer- run service)

9. Types of Research Available on Peer-Delivered Services (2) • 3. Research that uses questionnaires, phone calls or focus groups to determine satisfaction with services or opinions about services. • 4. Program evaluation: looking at results when peer-run groups/programs were added to a larger health care system.

10. Limitations of Peer Studies (1) • Some of the studies are fairly small and results are difficult to generalize. • The largest study (COSP Multisite Research Initiative) has not yet published all its results. (Some findings were published in 2009. See Slide 33 for URL.)

11. Limitations of Peer Studies (2) • Some of the results are conflicting, e.g., peer run-programs improve social functioning vs. do not improve social functioning. • Some of the studies were not very rigorous (no random selection, no control group etc.). • The definition of peer-run or peer-delivered programs varies across the country.

12. What Studies Were Included? 126 articles were initially included. 48 of these made it through the screening for quality and meaning.

13. Conclusions (1) • Several authors concluded that peer-delivered services resulted in similar out-comes to those of professionally delivered services. • Question: Should peers be expected to outperform professionals?

14. Conclusions (2) • Several studies suggested that peer- delivered services that are added to traditional services did not changeoutcomes, but… • There was some evidence that peers provideddistinctive skills and experiences that may behelpful in engagement and retention.

15. Conclusions (3) • There was some evidence that peer-delivered services provided in a group context can improve outcomes if members attend regularly and for a long enough time.

16. Conclusions (4) • Results from some of the peer-delivered group services,such as Vet-to-Vet, suggested that those who used the program regularly had better outcomes, e.g., both in empowerment and functioning. Vet-to-Vet http://vet2vetusa.org/

17. Questions for Discussion • Is it important for peer-delivered services to have a strong research base? Why or why not? • What might some of the barriers be to having good research on peer-delivered services? • What suggestions do you have to increase and improve the research base for these services?

18. “Powers-that-be” realize that recovery-oriented, peer-run services are key to recovery SAMHSA recognizes Peer Support as one of the 10 fundamental components of recovery. The 10 are: • Strengths-Based • Peer Support • Respect • Responsibility • Hope • Self-Direction • Individualized and Person-Centered • Empowerment • Holistic • Non-Linear SAMHSA Administrator Pamela S. Hyde (top); CMHS Director A. Kathryn Power (bottom) 18

19. Resources • “Federal Multi-site Study Finds Consumer-Operated Service Programs Are Evidence-Based Practices” http://www.hhs.state.ne.us/Behavioral_Health/BHcommission/8-Jun-22-09/F-Johnson-DrJeanCampbell-Study-ConsumerOperatedServices.pdf • “Peer-run Crisis Alternatives” http://www.power2u.org/peer-run-crisis-alternatives.html

20. Resources • National Mental Health Consumers’ Self-Help Clearinghouse: http://www.mhselfhelp.org • Consumer-driven Services Directory: http://www.cdsdirectory.org/ • Institute for Recovery and Community Integration: http://www.mhrecovery.org • Temple University Collaborative (formerly UPenn Collaborative) on Community Integration: http://www.tucollaborative.org • Boston University Center for Psychiatric Rehabilitation Disability Research Right to Know http://drrk.bu.edu