Into the Thick of Things:
Promoting Community
Inclusion in Peer-Run Services
Presented by
The Temple University Collaborative on Community Inclusion
for Individuals with Psychiatric Disabilities
And
The National Mental Health Consumers’ Self-Help
Clearinghouse
The contents of this presentation were developed under a grant from the Department of Education,
NIDRR grant number H133B100037 (Salzer, PI). However, those contents do not necessarily represent
the policy of the Department of Education, and you should not assume endorsement by the Federal
Government.
Our Presenters
Joseph Rogers is executive director of the National Mental Health
Consumers’ Self-Help Clearinghouse (funded in part by the Substance Abuse
and Mental Health Services Administration) and chief advocacy officer of the
Mental Health Association of Southeastern Pennsylvania. He is an
internationally known advocate and a leader of the consumer movement,
with particular expertise in the design and implementation of peer-run
programs as well as in behavioral health policy.
Christa Burkett is the technical assistance coordinator at the National
Mental Health Consumers’ Self-Help Clearinghouse and Co-Chair of The
Temple University Collaborative on Community Inclusion’s National
Leadership Committee.
Bryce Hewlett presently serves as the executive director of the Delaware
Consumer Recovery Coalition - the statewide, c/s/x network of Delaware.
Bryce is a community organizer and activist at heart. His involvement in
the c/s/x movement began in Philadelphia in 2007. Since that time he has
helped organize several Alternatives conference and presented at many
national conferences. Part of his current work includes facilitating
placement of peer specialists in Delaware’s emerging community mental
health programs as well as providing oversight and support of peer
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specialists in the statewide coalition.
Peer Advocacy Movement Grew out of Struggle
for Rights & Empowerment
International Conference on Human Rights and
Against Psychiatric Oppression, Vermont, 1985
3
Ex-patients’ Rights Groups Form in
1970s and Early 1980s
…in Massachusetts, California, New York, Pennsylvania, Florida, Oregon
Judi
Chamberlin
Sally Zinman
Sally Clay
Joseph Rogers
Jay Mahler
Dan Fisher
4
Ed Knight
David Oaks
Leonard
Roy Frank
George Ebert
4
4
On Our Own:
Patient Controlled
Alternatives to the
Mental Health
System
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•Control
•Choice
•Selfdetermination
•Empowerment
•Recovery
“We want as full
as possible
control over our
own lives. Is that
too much to ask?”
–Howie the Harp
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Howie the Harp
(1953-1995)
Decades Spent Convincing Establishment
of Peer Support’s Value
• Presenting at conferences
• Attending meetings of professionals and
administrators
• Serving on boards and committees
• Writing and publishing articles
1993 sit-in in
then-CMHS
director Dr.
Bernard Arons’
office led to
more funding
for peer-run
programs.
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Former
SAMHSA
administrator
Charles Curie
supported
recovery
movement,
fought use of
S&R
Paradigm shift:
Establishment believes in recovery and
accepts value of peer support
• “Mental Health: A Report of the Surgeon General” (1999)
• Report of the President’s
New Freedom Commission
on Mental Health (2003)
Michael F.
Hogan,
Chair,
President’s
New
Freedom
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Commission
Then-U.S.
Surgeon General
David Satcher
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:
•Self-Direction
•Strengths-Based
•Individualized and
Person-Centered
•Peer Support
•Empowerment
•Responsibility
•Holistic
•Hope
•Non-Linear
•Respect
SAMHSA Administrator Pamela S.
Hyde (top); CMHS Director Paolo del
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Vecchio (bottom)
Peer Specialists in
Pennsylvania
● CMS approved Medicaid
reimbursement for peer specialist
services in PA in 2007.
● It is going well in PA.
● Every county must provide peer
specialists to any Medicaid recipients
who meet the “medical necessity”
criteria.
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“The National Association of
Peer Specialists, Inc. (NAPS), is
a private, non-profit
organization dedicated to peer
support in mental health
www.naops.org
systems.
Founded in November 2004 by a group of peer
specialists, the organization has quickly grown
with members from every state.”
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Genesis of Study of ConsumerOperated Service Providers and
Community Integration
• Little indication that consumeroperated service providers are
helping with community
integration
• Temple Collaborative and
Clearinghouse brainstorm a
grant proposal to NIDRR
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Procedures
• Creating survey questionnaire
• Sending online request-forInformation
• Sifting through responses
• Contacting respondents for more
information
• Compiling a compendium of
results
• Identification of community
integration strategies
• Developing a one-day training
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Sample Responses:
Housing
● Dodge City Peaceful Tribe (Kansas)
• Integrated peers into existing patterns of small-town
social networks.
• Tribe developed relationships with a core group of 20
small local landlords who advertise by word-of-mouth
and rent to people based on the landlord’s comfort
with the person recommending the renter.
• If peers are hospitalized, their home can be held for
them and the Tribe can mediate if there are problems.
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Employment
● Office of Consumer Advocates, (Hagerstown,
Maryland)
∙ Built relationship with Martin’s Supermarkets
(branch of Giant Foods, which hires individuals with
disabilities and provides sensitivity training to staff
who do not have disabilities)
∙ Refers peers to potential employment
opportunities in five local Martin’s stores.
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Education
● Howie the Harp (New York City)
∙ Collaborates with the SUNY Manhattan Educational
Opportunities Center for adult learners to help peers get
GEDs
∙ Participates in free PACE University computer literacy
skills training program
∙ Continues to seek mainstream training-provider to help
train peers in basic office skills.
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Education:
● Amarillo (Texas) Area Mental Health
Consumers
∙ Helps peers get scholarships at
regional institutions of higher
education.
∙ Refers others to:
◦student loan offices for Pell
Grants and student loans.
◦ Handicapped Student Services
at Amarillo College
◦ Panhandle Independent Living
Center for computer training
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Religion and Spiritual Life:
● Saint Louis Empowerment Center
(Missouri)
◦ Developed an informal network with African
American churches near the Empowerment
Center.
◦ Peers attend church-based social activities
as well as church services.
◦ New opportunities for housing through this
network have opened up.
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Leisure & Recreational Activity
● Vermont Psychiatric Survivors
• Links peers to community organizations
according to the peer’s interests – e.g., bowling,
knitting – rather than providing activities in the
Center.
• Peer mentors introduce a peer to a new
community group, provide help until the peer is
better integrated, at which point the peer
participates more independently.
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Civic Life
•DBSA-Southern Nevada
◦ Sponsors monthly speaker
series on mental health issues
in partnership with local
library.
◦ Speaker series is open to the
public, rather than just being
for peers in the peer center.
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Civic Life
● HOPE Impact (Wahiawa, Oahu, Hawaii)
• Peers attend local neighborhood meetings to
advocate for other peers, individuals who are
homeless, and veterans with such challenges.
• Group founder has a TV show entitled “Hope in
Recovery.”
◦ Highlights individuals in recovery.
◦ Plans to interview local officials about mental health
policy.
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Health Care
● Amarillo Area Mental Health Consumers
• Refers peers to smoking cessation classes and diabetic care group
in the community rather than in-house classes.
• Refers peers to grieving group and hospice education group at a
regional hospital.
• Encourages senior peers to go to a community senior center
rather than identifying only as a peer.
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Health Care
● DBSA-Southern Nevada
• Participate in large public health fairs in the local area,
setting up booths, making contacts, handing out
literature.
• Sponsor their own outdoor health fair attended by
other health care providers.
◦ The fairs have art displays, a car wash, and sometimes basic
health screenings.
• These activities are based on reciprocity between DBSA
and community organizations.
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Community Inclusion
Strategies
Used By Respondents…
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Community Integration
Strategies Uncovered:
•
•
•
•
•
•
Peer mentoring
Referrals
Partnerships
Directing peers to
membership-based groups
Do-It-Yourself (DIY)
Using community networks
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Practical Strategies
 Assess Needs & Priorities.
Explore Community Resources.
Identify Environmental Barriers.
Offer Individualized Supports.
Update the Plan.
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Practical Strategies:
Assess Needs & Priorities
• Counselor/client assessment of current
levels of community integration
• Expression of interest in progress in
varied domains
• Setting priorities:
◦ Feasibility
◦ Importance
◦ Opportunity
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◦ Overcoming counselor/client anxiety
Practical Strategies:
Explore Community
Resources
• What already exists for citizens without
disabilities?
• What entry requirements exist?
• What demands does participation make?
• Sharing information-gathering
responsibility
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Practical Strategies:
Identify Environmental
Barriers
• Consumer/staff/
community attitudes
• Regulations and legislation
• Financial resources
• Community discrimination
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Practical Strategies:
Offer Individualized
Supports
• Staff training
• Accompaniment
• Community mentors
• Financial assistance
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Practical Strategies:
Update the Plan
 An initial plan:
 Who
 What
 Where
 When
 How
 A plan to review
 A plan to revise
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Peer Specialists in Delaware
Bryce Hewlett
Executive Director
Delaware Consumer Recovery Coalition
(302) 689-DCRC
www.delawarerecovery.org
Peer Specialists in Delaware
• Delaware is presently going through a process to develop
a credential for peer support specialists
• This process will yield peer support as a Medicaid
reimbursable expense in Delaware
• Our first training toward certification will begin at the end
of this month (November)
Peer Specialists in Delaware
• Since we do not have a certification program we call peer
specialists those who work in peer support roles and have
received training to do so
• The lack of a certification program has made for a great
deal of confusion by the state, services providers, and
volunteer organizations
Delaware Consumer Recovery Coalition
and Peer Specialists
• All peer-operated services that are a part of the DCRC
primarily use peer specialists as employees
• All peer resource centers use community mental health
providers as fiscal agents
• The directors of these services are peer specialists who
serve on the DCRC board of directors
Peer Operated Services
• Delaware Consumer Recovery Coalition (Statewide –
•
•
•
•
Delaware)
The Creative Vision Factory (Wilmington)
Rick Van Story Resource Center (Wilmington)
Dover Hopes and Dreams (Dover)
ACE Center (Seaford)
Delaware Consumer Recovery Coalition
http://delawarerecovery.org/
Delaware Consumer Recovery Coalition
• Approx. 130 individual members
• Statewide (urban and rural)
• 4 member organizations
• Peers Roles:
• Facilitate mutual-support, self-helps groups in each county in
Delaware (4 monthly meetings right now
• Serve on boards and committees
• Legislative/systems advocacy efforts
The Creative Vision Factory
http://thecreativevisionfactory.org/
Creative Vision Factory
• Approx. 80 members
• Urban setting (Wilmington, New Castle County)
• Peer resource center focused on the arts
• Peer Specialist Roles:
• all staff at CVF are peers
• members of CVF engage the community around them and use the
center for community events
Rick Van Story Resource Center
http://rickvanstorycenters.org/
Rick Van Story Resource Center
• Approx. 130 members
• Urban setting (Wilmington, New Castle County)
• Peer resource center focused on recovery activities and
homelessness
• Peer Specialist Roles:
• all staff at RVRC are peers
• Peers facilitate recovery groups (AA, NA, Hearing Voices,
spirituality, etc.)
• RVRC received a contract through their fiscal agent to be a
homeless respite during the winter months
Dover Hopes and Dreams
http://www.delaware211.org/Resource?r=3629783
Dover Hopes and Dreams
Resource Center
• Approx. 20 members
• Sub-urban setting (Dover, Kent County)
• Peer resource center focused on recovery activities
• Peer Specialist Roles:
• all staff at DHD are peers
• Peers facilitate recovery groups and activities
A.C.E. Peer Resource Center
http://www.facebook.com/pages/The-ACE-Peer-ResourceCenter/369719023102241
A.C.E. Peer Resource Center
• Approx. 20 members
• Urban setting (Seaford, Sussex County)
• Peer resource center focused on recovery activities
• Peer Specialist Roles:
• all staff at DHD are peers
• Peers facilitate recovery groups and activities
Resources
• Into the Thick of Things: Connecting
Consumers to Community Life: A
Compendium of Community Inclusion
Initiatives for People with Psychiatric
Disabilities at Consumer-Run Programs
http://www.tucollaborative.org/pdfs/CO
MPENDIUM_of_Innovative_CI_Projects_1
1-29_10.pdf
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Resources
● Temple University Collaborative on Community
Inclusion: http://www.tucollaborative.org
● 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
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