How to Build Peer Support for Incarcerated Persons with Mental Illness

1. Wednesday, September 3, 2014 3:00 – 4:30 p.m., EDT How to Build Peer Support for Incarcerated Persons with Mental Illness

2. Provide Conference ID 848 69 039 Welcome to the Webinar Please remember to dial-in to the phone # listed below: Dial In Information: Attendee Dial-In (toll-free):(877) 668-5013  Attendee Conference ID: 848 74 750 

3. AGENDA 3:00 p.m.- 3:05 p.m. Welcome and Overview 3:05 p.m.- 3:10 p.m. Introductions 3:10 p.m.- 3:35 p.m. Iowa Department of Corrections 3:45 p.m.- 4:10 p.m. Pennsylvania Department of Corrections Recovery Innovations 4:10 p.m.- 4:30 p.m. Questions and Answers

4. WELCOME

5. LarkeNahme Huang, Ph.D. Senior AdvisorAdministrator’s Office of Policy Planning and Innovation Substance Abuse and Mental Health Services Administration (SAMHSA) 

6. Joseph FentonSenior Associate Association of State Correctional Administrators

7. Association of State Correctional Administrators • ASCA Membership • Fifty State Administrators of Correction • Director, Federal Bureau of Prisons • Washington DC, Philadelphia, New York City, Los Angeles County • U.S. Territories

8. Association of State Correctional Administrators • 11 ASCA Committees Oversee the Work of the Association • Executive Committee • Program & Training Committee • Racial Disparity Committee • Substance Abuse and Mental Health Committee • Reentry and Community Corrections Committee • Policy: Resolutions, Legislation & Legal Issues Committee • PREA Committee • Research and Best Practices Committee • Information Sharing Committee • Past Presidents’ Committee • Nominating Committee

9. Association of State Correctional Administrators • The ASCA Substance Abuse and Mental Health Committee Coordinates this Webinar with SAMHSA • Committee Chair John Baldwin (Iowa) oversees the work of the Substance Abuse and Mental Health Committee • A special Sub-Committee was authorized by the ASCA Executive Committee earlier this month to develop guiding principles and explore best practices for dealing with the mental health population in prisons

10. Association of State Correctional Administrators • Survey of State Correctional Agencies Regarding Peer Support for Mentally Diagnosed Offenders • ASCA surveys • Survey on Peer Support for Mentally Diagnosed Offenders

11. Association of State Correctional Administrators • Survey of State Correctional Agencies Regarding Peer Support for Mentally Diagnosed Offenders • 34 Agencies Responded to the Survey • Thirteen responding agencies indicated they have a program in one or more of there institutions where peer mentors or peer specialists work in mental health units • (AZ, IN, IA, KS, LS, MD, MA, MI, MO, NH, OH, SC, WI)

12. Association of State Correctional Administrators • Survey of State Correctional Agencies Regarding Peer Support for Mentally Diagnosed Offenders • 2 – Mentor Co-Occurring Disorder Programs • 3 – Assist with Educational/Classroom Activities • 3 – Assist with Recovery Plans • 1 – Mentor Anger Management Programs • 2 – Assist in Suicide Prevention Initiatives • 8 – General Peer Mentor Support

13. Association of State Correctional Administrators • Survey of State Correctional Agencies Regarding Peer Support for Mentally Diagnosed Offenders • Eight responding agencies said they have a program in one or more of their institutions where peer mentors or peer specialists work to provide reentry services for offenders with mental health diagnoses • (AZ, IN, IA, KS, MA, OK, PA, WI)

14. Association of State Correctional Administrators • Survey of State Correctional Agencies Regarding Peer Support for Mentally Diagnosed Offenders • 1 – Mentor Co-Occurring Disorders Programs • 1 – Assist with Employment Opportunities • 1 – Assist with Financial Literacy • 1 – Assist with Recovery Plans • 4 – General Peer Mentor Support • 2 – Offer Classes about Reintegration

15. Association of State Correctional Administrators • Agency requests for information about establishing peer support programs for mentally diagnosed offenders: • Selection of peer supporters • Training of peer supporters • Information about starting peer support programs • Program protocols, policies and procedures • Pros and Cons of such programs • Identifying evidence based and best practices • Use of peer supporters for suicide watch

16. FacilitatorsDavid Morrissette, Ph.D., LCSW, CAPT, US Public Health Service, Center for Mental Health Services, SAMHSAJoseph Fenton Senior Associate, Association of State Correctional Administrators

17. PresentationsComments, Questions and Answers

18. IOWA John Baldwin, M.A. DirectorIowa Department of Corrections Bo Pourahmadi, M.A. PsychologistIowa Department of Corrections

19. Developing, Implementing and Sustaining the Iowa Department of Corrections Mentoring Program Presented by Bo Pourahmadi, M.A. Iowa Medical and ClassificationCenter Iowa Department of Corrections

20. Key Points to Get Started Must have strong support from administration and most operational staff Timing has to be right – now is the right time Association of State Correctional Administrators is committed to keeping the issue of mental health treatment in corrections as a point of emphasis.

21. What are the costs of getting started? Iowa spent less than $10,000 to get our mentor/peer program started The cost savings in reduced hospital trips alone paid for the program in a few months Offenders have a right or expectation to be housed/supervised in the least restrictive manner. Being able to supervise offenders in a lower status is cheaper.

22. How we first got started Offender Observers=peer support Desire on both sides NAMI assisted with training IMCC took it over from there Evolution leads to 18 mentors today

23. Training for Mentors Role model Teach/lead by example Provide active LISTENING (listen to problems) Builds confidence

24. Training for Staff Mental Health training for ALL staff Inmates with SMI are housed on all living units Ongoing Modeling/positive approach to dealing with inmates with SMI

25. Support for Peers Benefits of Mentoring Paid vacations Mentor Meals Support for Mentoring

26. Support for Peers Providing Hope Being part of a team Dual Asset

27. Thank you very much!Operational Questions: Bo.Pourahmadi@iowa.govSystems Questions:John.Baldwin@iowa.gov

28. PENNSYLVANIA Lori Ashcraft, Ph.D. Executive Director, Recovery Innovations Recovery Opportunity Center  Mary Finck Reentry Program Manager, Pennsylvania Department of Corrections  Marirosa Lamas, M.S. Superintendent, Pennsylvania Department of Corrections Robert J. Marsh, Jr., Psy.D. Psychologist, Pennsylvania Department of Corrections

29. How To Build Peer Support For Incarcerated Persons with Mental Illness

30. Building Institutional Support • Meeting with the Superintendents. • Selecting Certified Peer Specialist (CPS) Supervisory Committee. • Educating CPS Supervisors. • Program support and promotion by CPS Supervisors. • Department Of Corrections (DOC) Trainers meet with Institution staff during training. • Developed presentation for facilitation with security staff. • Staff observations.

31. Developing Policies and Procedures • Maintained standards and practices for peers that had already been established by the Office of Mental Health and Substance Abuse Services (OMHSAS). • Adaptation to the correctional environment was a learning process. • Developed specific items as we needed them. • Focused on needs of the institution. • Listened to the CPS’ ideas and suggestions. • CPS Supervisors network with each other and share information.

32. Training Design and Delivery • Recovery Innovations (RI) curriculum. • Tailored to correctional environment. • Training timeframes and content. • Experiences of the RI trainers. • DOC Certified Associate Facilitators

33. Recovery Pathwaysfrom our experience • Hope • Choice • Empowerment • Recovery Culture • Spirituality; meaning and purpose

34. Our Definition of Recovery Remembering who you are and using your strengths to become all you were meant to be.

35. Content of the Training • Peer Employment Workbook: Ashcraft, Johnson, Zeeb. META 2004 • Part I: Personal Development; Knowing Yourself • Recovery • The Power of Peer Support • Developing Self Esteem and Managing Self Talk • Community, Culture, Environment • Meaning and Purpose • Emotional Intelligence

36. Content of the Training Part II: Turning Point; Preparing Yourself for Work • Telling Your Personal Story • Employment as a Path to Recovery

37. Content of the Training • Part III; Skill Development • Communication Skills • Conflict Resolution • Recovery from Trauma and Developing Resilience • Recovery from Substance Abuse • Being with People in Challenging Situations • Peer Support in Action; Partnering with Professionals • Graduation

38. What Shows Up with Peers on the Team? • The Peer Support Specialist’s own recovery is strengthened through service. • Peer Support Specialists help others recover through engagement, hope, and mutual relationship/friendship • Helps the organization/system recover • As staff work alongside people in recovery, staff finds new hope • Confronts system and professional stigma • Moving from mental patient to colleague redefines rules and boundaries

39. Selection Criteria • Must undergo a vote sheet process • Custody Level 2 or 3 (min. to med. supervision) • Misconduct free for a minimum of one year. • No misconducts for assaultive behavior in the last two years. • Received recommendation from Licensed Psychology Manager (LPM) or Psychiatric Review Team (PRT) in regard to: • 12 months with no suicide attempts/gestures • 12 months with no injurious behavior • Stable adjustment with or without medication. • Behavior stability for12 months.

40. Selection Criteria • Has a high school diploma or GED. • Must have a history of having had mental health treatment services either while incarcerated or while in the community. • Be within no less than 2 years of minimum sentence and no more than 5 years of maximum sentence. • Must not be on the wait list for Alcohol and Other Drug (AOD) Therapeutic Community. • Long term offender/lifer with positive adjustment records can be considered when all other criteria is met.

41. Where Do CPS’ Work in the Institutions • Specialized Units • Housing Units • Activities • Library/Law Library • Infirmary • Hospice • Psychiatric Observation Areas • Education/Vocational • Standardized Groups • Transitional Housing Units • Reentry Services Offices • Veterans Service Units

42. Outcomes and Benefits • Significant reduction in misconducts from among the peer complement. • Decrease in placement in Psychiatric Observation • Increase in programming participation among the SMI population. • Decrease in self sabotaging behaviors for those offenders preparing for release. • Increased communication between staff and offenders. • Employment in the community upon release. • Internalized self transformation.

43. Outcomes of Peer Services in the Hospital • In the first year peers worked in the hospital • 56% reduction in re-hospitalizations • 48% reduction in restraints • 36%reduction in seclusion

44. Collaboration and Outreach • OMHSAS • PA. Commission on Crime and Delinquency (PCCD) • Mental Health Justice Advisory Committee (MHJAC) • PA Mental Health Consumers Assoc.(PMHCA) • Private Sector Employers • State Civil Service Position • CPS services billable to Medicaid/Medicare • Contacts in specific areas of the Commonwealth that reach out to CPS’ when released.

45. Questions

46. Recovery Opportunity Center Lori Ashcraft Lori@recoveryopportunity.com Websites: www.recoveryopportunitycenter.com www.recoveryinnovations.org Mary A Finck mfinck@pa.gov Website: www.cor.state.pa.us

47. Comments, Questions and Answers

48. Thank you! For additional information please visit: SAMSHA’S GAINS Center for Behavioral Health and Justice Transformation http://gainscenter.samhsa.gov/ Association of State Correctional Administrators http://www.asca.net/