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Gayle Bluebird, RN Director, Peer Services Mental Health Association, MHA

Peers Contributing to Rapid Change: In and Out of the Hospital NAMI Advisory Committee on Restraint and Seclusion Monday, January 27 2014. Gayle Bluebird, RN Director, Peer Services Mental Health Association, MHA Delaware Substance Abuse and Mental Heath, DSAMH.

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Gayle Bluebird, RN Director, Peer Services Mental Health Association, MHA

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  1. Peers Contributing to Rapid Change:In and Out of the HospitalNAMI Advisory Committee on Restraint and SeclusionMonday, January 27 2014 Gayle Bluebird, RN Director, Peer Services Mental Health Association, MHA Delaware Substance Abuse and Mental Heath, DSAMH

  2. Delaware State Hospital in Crisis Delaware: (2007-2008) Sensational Accusations Front Page News Hospital called a “Warehouse” • Accused of…client negligence • Inadequate services • Inadequate housing: • Client death • Over 150 people ready for discharge (for years) Investigations by the US Department of Justice leads to a settlement agreement signed by the state in July 2011. • Hospital accused of warehousing people • Accusations of abuse in the Press. • Community Services inadequate. • Peer Support nonexistent. • Statewide Organization: Consumer Recovery Advocacy Coalition of Delaware (CRADC) • Penny Chelucci,Office of Consumer Affairs Director • 150 Patients ready for discharge from hospital.

  3. Moving Forward 2009 Kevin Huckshorn- Hired as State MH/SA Commissioner- recognized nationally for her work on seclusion and restraints reduction training 2010 Gayle Bluebird hired to develop and coordinate a team of Inpatient Peers 2010 Six Peers hired for work in the Inpatient setting • In 2011 Six additional peers hired as “Bridge” Peers • In 2012 11 Peers are on the team • By 2013 4 management Peers in place, 2 team leaders, and executive manager

  4. Peer Services Development • 2010: Management positions created and placed with the Mental Health Association to ensure adequate salaries • In 2012 a director was hired for our state organization, Delaware Community Resource Coalition • 2010-2013: Four Peer Operated Resource Centers • 2011-2012 Peers hired in the community for ACT teams, Community agencies, and Crisis Centers. • Community Peers in place • Three Peer Operated Resource Centers • 50 Peers working in community agencies • 6 Peers on all ACT teams • Approximately 75 Peers working

  5. Accomplishments • 2011 • Won new federal grant to implement Trauma Informed Care statewide and expand peer support specialists programming statewide. • Expansion of consumer-run Rick van Story Resource Center including an arts program. • Implemented new Peer Specialist Program in the Delaware Psychiatric Center. • 2012 • Over 1,400 peer support contacts this year. • Opening of the Drop Zone and Creative Vision Factory; 2 new peer run programs • Contract to jumpstart new Delaware Peer Coalition add to 2012 Community. • Delaware Psychiatric Center reduced operating capacity from 169 to 142.

  6. Delaware Psychiatric Center (DPC)Seclusion & Restraint Events 2008 - 2012 • Of the 39 total restraint events hospital -wide in 2010, client XX accounted for 34 of the 39 events. • Of the 50 total restraint events hospital-wide in 2011, client XX accounted for 41 of 50 events. • Client XX was an inappropriate admission for DPC and was discharged in 2011 to a facility that specialized in treating client XX’s disorder.

  7. Peer Services Management Team Peer Clinical Consultant Peer Services Director Peer Services Assistant Director Peer Services Educator Peer Team Leader Peer Team Leader Peer Services Administrative Specialist Trauma Peer Coordinator Drop Zone Coordinator Peer Services Department 2013

  8. It is important we know our history and honor the Consumer/Survivor Movement. • Early Movement Activists: • (Left to Right) • Howie the Harp • George and Mary Ann Ebert • Kinike Bermudez; Bluebird • Jay Mahler; Sally Zinman • Pat Risser; Judy Chamberlin • Jeannie Matulis • Sue Bud • Paul Engels

  9. How We Hire: • Requirements: • Prior work history and/or college experience • Self-Disclosure • Written Application • Resume • 2 or more interviews • Critical Thinking questions • Sparkling personality

  10. Orientation and Training: • Required hospital training-MANDT • Introductory Peer Training specific to hospital setting (by Peer Educator) • Shadowing • 6 week probation period • Ongoing weekly trainings • Ongoing on the job support from managers

  11. Peer Certification Training • We designed our own curriculum • Emphasis on creativity • All Peers must currently be working to be trained • Consists of 72 hours • Peers from community and hospital settings trained • To be integrated with State board • Three day entry level training by Training Educator

  12. We can change rapidly because of our focus on being unique.

  13. Why Delaware’s Peers are Unique: • Well excepted by staff and executives • Referred to clients in private facilities • Providing transitional Bridge services • Specialized Trauma Peers in community agencies. (SAMHSA Grant) • Eliminated Peers delivering medications on ACT teams • Positive relationships with psychiatrist • The Drop Zone resource center service inpatient clients. (community peers in progress) • The Creative Vision Factory with media attention • Medicaid reimbursable services on ACT teams (in progress)

  14. We Are Unique Because… We dress casually and make a statement about who we are as unique individuals. Dara Hagans Inpatient Peer Specialists

  15. We Are Unique Because… We prioritize finding out about a person's interests and strengths so that he/she can use their own individualized approaches to healing. Including alternative methods

  16. We Are Unique Because… We use a person’s full name whenever possible and with his/her consent. HIPPA laws are meant to protect confidentiality but often have an opposite effect. People often begin to think of themselves as non-persons. The key is to ask; the purpose is to honor.

  17. We Are Unique Because… We introduce wellness techniques creatively. • Examples: • Nail Painting • Employment • Searching on Internet • Healthy Snacks • Walking • Affirmation • Drop Zone “DIC Resource Center” • Creative Arts Projects • Restaurant Outings • Drum Circles • Hands and Heart Project Words have meanings. Charts give us a direction. But how we activate wellness is dependent on our approaching things in new and different ways.

  18. Comfort Room Western State Hospital Tacoma, WA Zen Room, Ft. Lauderdale Hospital, FL Definition: The Comfort Room, formerly called the “Quiet” or “Time-Out” room, is a room that provides sanctuary from stress. It can be a place where people can experience their feelings within acceptable boundaries.

  19. We move fast because we emphasize: Arts and Creativity By: Franzswa Watson “Hands Project”

  20. Arts and Creativity Examples: • “Creative Arts Factory”- Peer-Run Arts Center. • Art Exhibit in administration building lobby. • Comfort Rooms • Drumming Circle • Art Postcard Project • “Arts and Wellness” Carnivals “Henrietta”

  21. The Drop Zone

  22. Creative Vision Factory

  23. Art Post Cards Ken Segal Talented Peer Artist Segal’s postcard is one of 12 postcards that will be taken to the National Governor's Conference by Governor Markell. They will be used as a fundraiser for the arts center.

  24. Hope Totes • Admission Comfort Bags: • Given to all Peers on admission. • Contains rights information • Client Handbook • Peer Support information. • “All items selected with safety in mind.”

  25. Trauma Booklet • Created in 2011 • Written, and designed by Peer Support. • In easy-to-understand language. • Illustrated with national artists’ artwork. • Designed for persons receiving services… and others “Hugging Form” Meghan Caughey

  26. What has slowed us down… • Peers apply for jobs with no previous knowledge of Peer Support • Developing our hiring practices • Positions not a good fit • Taking on too much and over working • Inter-peer staff conflicts • Client Liaison used for counseling • Moving too fast

  27. What We’ve Learned: • To Establish an infrastructure first • To place importance on Peer supervision • Flexibility is very important • To communicate with each other effectively • To address conflicts directly • The importance of “always available” Administration • Collaboration is needed • To treat Peer Staff as any other employee

  28. Remember! Peer Support is a professional Job… Peers are treated like any other employee

  29. and not a Pampered Role! However, Taking care of yourself is the number one priority!

  30. Contact Information: Gayle Bluebird Office: (302)255-2701 E-Mail: Gayle.Bluebird@state.de.us Karen DiNardo Office: (302)255-2978 E-Mail: Karen.DiNardo@state.de.us Franzswa Watson Office: (302)255-9731 E-Mail: Franzswa.Watson@state.de.us

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