Exemplary Models of Peer Support to Incarcerated Persons with Mental Illness

1. Wednesday, August 27, 2014 3:00–4:30 p.m., EDT Exemplary Models of Peer Support to 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 69 039

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 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. The State of Iowa Department of Corrections Mentoring Program Presented by Bo Pourahmadi, M.A. Iowa Medical and Classification Center Iowa Department of Corrections

20. Mentor, defined… The State of Iowa defines “Mentor” as: “An offender who is trained to work with inmates/patients (can be peer to peer) with their mental health care plans and in managing their serious mental illness (SMI).” Mentoring is supported by NAMI and we apply it to our prison setting.

21. Expectations of a Mentor Role model Teach/lead by example Share knowledge Provide active listening Builds confidence

22. Statistics of inmate A.B. since being assigned a mentor in January of 2013 Number of days on acute unit with goal of being in the least restrictive status From intake (May) of 2012 thru December of 2012==120 days From January 2013 thru June of 2013==94days From July 2013 thru December 2013==40days From January 2014 thru present==24 days

23. The Hiring Process On-site General Population (can use Peer to Peer mentors) background check Initially done by psychology and/or Treatment Services Director and Administrative Assistant It is then decided who needs a mentor based on compatibility Support Veterans—screen them and assist with re-entry including VA benefits

24. Positives of Mentoring for the Mentor Build relationships Utilize/Discover own positive traits Builds a trusting relationship Builds effective communication skills (communicating problems/symptoms) Learn how to problem solve with assistance and eventually on their own

25. Negatives of Mentoring for the Mentor Burnout Lack or mentee’s improvement/progression Subscription to an alternative style of learning Building rapport/trust can be difficult. Breaking rapport/trust can be easy

26. The Iowa Medical and Classification Center’s Component to Success We had 3 mentors two years ago and now we have 18. Results are consistent with inmate AB: Fewer placements on acute unit Fewer days on acute unit Fewer hospital trips

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

28. PENNSYLVANIA John E. Wetzel, B.A. Secretary, 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. Certified Peer Support Specialist Presented by PennsylvaniaDepartment of Corrections

30. Overview • Began in 2003 between the Pa. Dept. of Public Welfare Office of Mental Health and Substance Abuse Services. • Several years passed with several other regulatory and grant assuring steps in between • In 2008 OMHSAS partnered with University of Pennsylvania to develop a curriculum and training for CPS to specialize in working with older adults. • In 2010 PCCD, MHJAC began to address the utilization of CPS in the correctional systems.

31. Overview—contd. • Two critical components of the DOC CPS project: 1—existing work and activities established by OMHSAS 2—a collaborative relationship between PCCD, DOC and OMHSAS. • The DOC then secured monies specifically for training offenders in six pilot facilities. • Buy in from the Superintendents was important and achieved.

32. Overview—contd.

33. Areas Where Peers are Utilized • SNU (Special Needs Unit) • SRTU (Secure Residential Treatment Unit) • MHU (Mental Health Unit) • IRC/Orientation (Inmate Reception Committee) • Standardized Groups • Education/Library • Activities • Infirmary/POC (Psychiatric Observation Cell) • Re-Entry

34. Criteria • CL 2 or 3 • No misconducts for 1 year • No assaultive behavior in the past 2 years • No suicide attempts/gestures in the past year • No self injurious behavior in the past year • Stable adjustment (with or without medication) • Behavior stability in the past 12 months • Diploma/GED • Stability Rating B or C • Within 3 years of minimum

35. Criteria- cont. • May not be on AOD Therapeutic Community reserve list • Recommended by LPM (License Program Manager) • Administrative review required

36. Training • Recovery Innovations, Arizona • DOC Facilitators • 80 Hour University Level Course • Certification • Continuing Education hours

37. Peer Support Approach • Be fully present • Listen fully • Use reflective listening • Relate with empathy • Validate strengths • Ask permission and be mutual • Ask open ended questions • Honor Person as the Expert • Provide Choices • Use Recovery Language • Use Empowering Language • Use “I” Statements • Roll with Resistance

38. Certified Peer Specialist PEERS DO NOT… PEERS DO… Augment Staff Service Listen & Support Promote mutual relationships/treat as equals Live responsibly and in recovery Assist others in making their own decisions • Replace Staff • Provide Clinical Services • Supervise Inmates • Give Advice • Assume the Role of Expert • Model recovery only when working • Make decisions for others

39. Contact Information: Secretary John E. Wetzel | ra-contactdoc@pa.gov Dr. Robert Marsh | romarsh@pa.gov Marirosa Lamas, Supt. | mlamas@pa.gov

40. Comments, Questions and Answers

41. 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/