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Post by Admin on Jul 20, 2021 14:25:18 GMT
In a new article in Psychiatry Online, Dana Foglesong and colleagues report on a new set of guidelines laid out by the National Association of Peer Supporters (N.A.P.S) for supervisors of peer-support workers. Named the National Practice Guidelines for Peer-specialists and Supervisors (NPG-S), they were established to help supervisors with practical guidance on providing support and staying true to the core values of peer support. These guidelines respond to growing concerns that supervisors were often acting in ways that were contradictory to the peer-support values, sometimes causing further harm to the peer-supporters themselves. This required helping supervisors learn that peer support ethics are often different from those involved in clinical practice. The authors write: “The main purpose of the NPG-S is to assist supervisors and peer support specialists as they embark together on a mutual learning process about peer support values and how best to put them into practice.” www.madinamerica.com/2021/07/new-guidelines-supervisors-peer-support-workers/Lived Experience Inclusion & Leadership National Practice Guidelines for Peer Support Specialists and SupervisorsDana Foglesong, M.S.W., N.C.P.S., Kelsey Knowles, M.S.W., C.R.P.S., Rita Cronise, M.S., Jessica Wolf, Ph.D., Jonathan P. Edwards, Ph.D., N.Y.C.P.S. Published Online:13 Jul 2021https://doi.org/10.1176/appi.ps.202000901 ps.psychiatryonline.org/doi/full/10.1176/appi.ps.202000901Abstract In 2017, the National Association of Peer Supporters (N.A.P.S.) leadership became aware of growing member concerns about supervision contradicting or conflicting with core peer support values. In response, N.A.P.S. established a work group that revised the association’s 2013 National Practice Guidelines for Peer Supporters to include specific guidance to supervisors (i.e., the National Practice Guidelines for Peer Specialists and Supervisors). The new guidelines are not intended to address administrative or other basic functions of supervision; instead, they offer expertise and practical guidance to supervisors of peer support workers in understanding the core values of mutual support and managing the complexities of the nonclinical role in settings that may have different values and priorities.
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Post by Admin on Sept 8, 2021 19:21:23 GMT
Peers betraying Peers, and Relapse mentalhealthaffairs.blog/peers-betraying-peers-and-relapse/maxwellguttman/health-issues/I am an extremely disillusioned peer. I have spoken up about issues in the peer community on this platform and face to face with other peers. Since I first began identifying as someone with lived experience, and learning about the peer movement, this aspect of living and working as a peer continues to complicate anyone claiming to be a peer worker with unassailable ethics. The issue at hand is twofold: There is a lingering taboo question surrounding ‘relapse’ when living and practicing as a peer. How to best support a peer who is going through a crisis. During my time practicing in the peer world, I have observed that when peers get sick or decompensate, peer support stops, almost in its tracks. When a peer relapses, other peers turn their back. The second issue is that when there is suspicion or situation in which a peer may be relapsing, no protocols are put into place to ensure the intervention or investigation is completed without harming the peer further. Further, like any claim or investigation, in the human services, and mental health, any investigation and intervention cannot be taken just in the grounds of good faith of the person claiming someone needs help. Unwarranted and false claims with children protective services are a punishable crime, in issues of neglect and maltreatment. In the peer world, there is no such protections afforded to people corralling mutual peer support and interventions. Instead, people sometimes get harmed. In the case I will delve into later, I was personally harmed, and betrayed, by a false claim of relapse. This twofold issue is extremely complex, with implications on both ends, as we cross walk and troubleshoot why this is such an important area requiring more looking into by the thought leaders of the peer profession. Peers, by definition, have experienced the impact of a mental health ‘disorder’, and sometimes, severe ‘mental illness.’ While there is no rule written down by the Academy of Peer Services (APS) around how long a person should be in recovery or healed from their illness, there is a generally understood notion that this peer should be active in the recovery process, if not fully ‘recovered.’ If you are only just embarking on your recovery journey, you might experience a few more blips or issues while working as a peer than those who are fully recovered. Think about it. If you are still experiencing some ‘symptoms’ of a ‘disorder’ or haven’t learned how to enact the best possible self-care, it’s more likely you may need more time off or might be triggered more. You might need additional time to heal and recover as you continue your healing journey. More importantly, the concept of ‘peer support’ is a little unsettled when it comes to commonly accepted definitions when practicing in mental health. The definition of peer support even more than ‘relapse’ is what really belongs in the APS trainings. Here is the issue: peers carry their illness in their jobs and when they go home for the day. Now, when a hypothetical peer goes home after working in the agency, does the support he or she gives to her friends still considered ‘peer support’ because it is coming from a peer or just support because the peer is off duty? Since, at this point, the peer is no longer in his or her established role as a peer at an agency, and is in the community on his or her off time, what exactly is the protocol on how peers should help peers in crisis when there are so many boundaries and rules on how peers should do their jobs? Cooptation complicates establishing a definition that is truly non monotonized and commodified, doesn’t it? Since peer work is now an established practice, monetized and a discrete thing, we should really know if peer support is still truly mutual, and person centered when peers are on their off time or socializing out of work. The problem is peers are even more lost when outside the gates of the agency especially if a peer is in trouble and needs support outside of their work environment. Why? Because as few protocols there are on how to support peers relapsing in the agency should help there is even less guidance on what to do when a peer is in need outside of work on their off time. I suppose this shouldn’t be a shock I mean, other professions in mental health really aren’t given manuals on how to behave, in and out of the office. But peer work has a different caveat too it. Clinicians are not clinicians when they go home for the day. But, like I said earlier, peers always carry their diagnosis. So, should the fact that peers are still peers outside the office necessity them to provide their friends, or collogues in need support on their off time? I would hazard to say not required, and it certainly shouldn’t be encouraged for peers to work all the time. Self-care on a peer worker off time is critical to them continuing in their recovery. However, we need clearly defined protocols in place on how to respond to this very specific set of incidents: peers relapsing in and out of the workplace and how the agency should respond at different levels to make sure safety, decency and respect are all in place for everyone in involved. Either way, there is undoubtedly a vast spectrum to healing, recovery, and the level of rigor and performance of peers in the workplace. I’ll be brutally honest, when I first encountered another peer—introduced to her and a few others at my local mental health agency—my heart dropped, and I was highly concerned. I was concerned about myself, quite honestly, the status of the profession I was embarking on, and the quality of life and living and working as a peer in a mental health agency. I was also worried because I was shaking hands with glassy-eyed people who looked highly medicated. In some cases, tired looking, again, perhaps because of medication, or overmedication, and a general attitude I picked up from them as being overly grateful and happy just to be working in the same environment as their ‘professional’ counterparts. Seeing this was difficult for me because I was one of them. I was a peer myself. I wondered, do other folks see me in this light? Do others see me as healed or still ‘disordered? The answer to this question preoccupied me because if people still saw me as disordered, even just a little, I know they would be more likely to turn their back on me when they thought I was relapsing. It has happened to me. I have been marked as relapsing, even when I was quite well. I wasn’t even in distress. In this case, a colleague competing for the same position wanted me to resign and walk away from a promotion in our department in fear I would be promoted over her. This colleague went as far to suggest I was behaving out of my usual character and maligned me with a series of microaggressions when I was quite well. I sent her an email, but I inadvertently had a typo, or God forbid, two of them. When my coworker’s email responded with: “Max, are you OK??” my heart dropped. Because at that point, I knew this coworker wanted to mobilize her knowledge of my lived experience to make a case I was unwell or unfit and therefore not a good candidate for this position we were both competing. That is exactly what she did. I walked down to her office and started to apologetically explain away my typos, trying to make a joke about the email and how I could understand how it must have been extremely troubling and distressing to read an email with typos. That was when she said: “Max, I don’t like your tone. It is alarming…. please calm down!”. It seemed I was calmer than she was, and my interns surrounding me looked extremely puzzled at the interaction that just took place. I wasn’t puzzled or confused. The word ‘alarming’, just like ‘problematic’ and ‘distressing’ are often used to describe other folks when they are perceived as threatening. Since these words have so little clinical value, or much inherent meaning, I can understand why she used it. Words like ‘alarming’, ‘problematic’, ‘troubling’, are often used when no real language with real meaning or clinical value can be offered to describe a person’s behaviors. In this case, these behaviors were later the grounds used to make a negative false claim about my mental status. This was disturbing for me on several levels. When I first had my break due to schizophrenia, I did not know I was sick, a feature of the illness called anosognosia. Now, here I am, far into my recovery, ten years later, working in the field, and a coworker makes a false claim that I was sick when I wasn’t. This was also sad for my interns, who witnessed first-hand the type of heinous and deplorable behaviors people in their field are capable of enacting publicly. After the office incident, no one, not one other collogues at the agency or administrator stepped in to say this sort of transgressive way of handling inter office communication was frowned upon. Moreover, the void in the office left room left a gaping vacuum where other peers could have been supportive and intervened making it clear I had behaved appropriately and my collogues response was unwarranted. There was none of that, so, I left the agency shortly after. I am writing this so other peers aren’t left in the same shifty and lonely void I was left in where peer support would have been truly welcome and needed. My first peer supervisor, years before this betrayal, taught me how I was more powerful than lousy peers at our agency. My lived experience could one day be a model to others to be agents of change and a testament to the upper limits of success and career growth that a peer was truly capable of during their career. My supervisor also reminded me how important it was that I came out and stayed out as a peer and someone with lived experience. She also told me that my resolve and health would be under scrutiny from everyone around me in the agency. As I discussed earlier, and would sadly find out, again and again, this would be the case in the future too. I fully believe that in a profession based on living out and healing from a disorder, we should not just expect but be prepared for our fellow peers to relapse. There should be active protocols in place in every agency when this happens. From HR to agency-wide discussions and conversations around this very natural part of living with a mental health disorder. This can be handled several ways. I am recommending one possible approach given the issues I circled in the article. HR sets the agency tone of what is expected and frowned upon in terms of behavior. HR usually has books associated with the agency it is attached to and working for and can insert a working guidance on how agency members can handle a peer crisis or relapse both inside and outside of the agency. This can be reviewed during orientation to the agency and refreshers throughout the year at HR events. The direct service programs can trouble shoot these directives and reinsert new guidance into the HR books when there are substantive updates. Most importantly, if we are to gleam and further learning from my story, if an internal claim is made against another peer at an agency, there must be some sort of third-party review. All peers have the potential for relapse. We all can’t go around speculating on each other’s health during a time for promotions to knock another candidate back into the unemployment line. To be even more precise, we need to radically transform the way mental health agencies handle relapse. When I finally walked away and resigned from the situation I described above, I had a to send out emails to my interns, apologizing for the agency, and for the difficult interactions they observed. I can only imagine how difficult it must be for peers who really do relapse and and are too sick to follow up with the fall out within their agency. People struggling with relapse really shouldn’t have to hand hold their agency or coach them through this process. It needs to be manualized, and talked about at meetings, and embedded into the very culture of the agency, In my book, the most important item here is that we begin to fully prepare the ongoing conversation in agencies and the larger peer community around relapse and what it might mean for a program or a community of peers. I have often seen the taboo treatment of ‘relapse’ mean withdrawal or removal of support between the person relapsing and their fellow peers. This phenomenon is the very converse of what should happen between peers. We need to augment support in a crisis, not remove it, folks.
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Post by Admin on Nov 18, 2021 15:32:54 GMT
Lived Experience Leadership – Mapping the Lived Experience Landscape in Mental Health (2021)Posted on 17 November 2021 www.nsun.org.uk/resource/lived-experience-leadership/Commissioned by Mind and NSUN, this report collates the contributions provided by people with Lived Experience through 106 survey submissions, 32 interviews and 7 focus groups with 31 people. It was inspired by a desire to understand the complexities of the ‘Lived Experience Leadership’ field and determine any supportive role Mind, NSUN and other mental health organisations might play. Contributions were gathered from August 2020 until January 2021. This report is explicitly plural. Its intention is to honour and reflect the diversity in experiences and positions expressed by contributors rather than provide a neat narrative. As such, it includes many quotes – some of which may contradict one another, or offer another angle. About the report This report is the result of our Mapping Lived Experience Leadership project. Terminology The report uses the terms “Lived Experience”, “Lived Experience Leadership” and “LE-led” as broad umbrellas. They are imperfect and not intended to override the words we find for our own experiences and activities. Lived Experience (LE): Direct, first-hand substantive experience of mental distress, illness, diagnosis and/or mental health services. This can be associated with Lived Experience of poverty, trauma and other forms of prejudice and discrimination (e.g. racism and ableism). Lived Experience Leadership (LEL): A broad term used to describe what happens when people use their Lived Experience to change, shape or create something to benefit others in the broad field of mental health. LE-led: A term used to describe initiatives, projects, organisations that are run and controlled by people with Lived Experience (e.g. at least 75% of the trustees have LE) Key findings Lived Experience Leadership (LEL) is a contentious term that can evoke strong feelings. It can be validating and encourage a sense of hope. It can also divide, belittle and feel out of step with the more collective values inherent in the survivor movement. Whatever term we use, it is clear that people with LE are leading on a range of projects, initiatives and organisations. LEL can be found in activism, social media, involvement, research, freelance work, grants panels, creative arts, policy/think tanks, community organisations, statutory organisations and across allied sectors. Some of the challenges inherent in LEL include: Unrealistic or impossible expectations The fight for credibility Serving someone else’s agenda Not being valued Working in dangerous territories The heavy personal toll Attacks from others Things that have helped so far include: Connections Access to genuine and meaningful opportunities Ownership Finding a space to be me in all this Finding space to question things Creating cultures that care (and caring for ourselves) What more is needed? Nurturing lived experience – any supportive endeavour should be underpinned by principles of being LE-led, learning from the past, acknowledging inequalities and harm, and being visibly, genuinely diverse. Rather than creating a single offer of support, contributors highlighted the need for a range of options that people can choose from at different times, such as LE-specific leadership training and networking, investments in LEL, and having a specific and independent body or union. Creating supportive contexts for LEL – as so many challenges were linked to systemic problems, there is an urgent need to focus on contexts and organisations people with LE are trying to work in. This includes leading by example (in the case of mental health charities, ensuring LE is embedded at all levels), highlighting the value of LEL, supporting organisations to embed LEL, making a substantive commitment and investing resources, and having brave intra-organisational conversations.
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Post by Admin on Nov 18, 2021 15:34:48 GMT
Principled Ways of Working: Peer Support in Sussex Posted on 19 January 2021 www.nsun.org.uk/resource/principled-ways-of-working-peer-support-in-sussex/Alison Faulkner In 2017 Sussex Partnership Foundation NHS Trust hosted the “Principled Ways of Working” (PWoW) Conference in Portslade. Following on from this, a working group was established aiming to carry forward the learning from the event. The partnership formed subsequently to establish a Charter around principles of Peer peer support involved 13 groups and organisations across Sussex, both statutory and VCSE organisations, small and large, with the aim of getting more to sign up over time. In 2018 the Principled Ways of Working Peer Support Charter was produced. This has been used widely both locally and nationally. Following the publication of this charter the group temporarily disbanded due to a lack of resources. Following the award of further funding, the PWoW group reconvened in late 2019 and agreed that its next priority would be to identify the full range of peer support available across Sussex, with a view to creating a directory outlining the choices available for someone with mental health issues who is looking for peer support: they continue to meet and work together. This report is the result of a reflective exercise undertaken by the PWoW partners with NSUN, in order to enable them to review their work together and discuss their achievements, the benefits and the challenges of their work on film. Some of the funding for the partnership accessed during 2019/2020 came from National Mind via NSUN, both of whom were interested in making the learning from the partnership more widely available, as the model can be replicated in local areas across the country. A reflective blog piece by Anne Beales who remains part of the partnership and the final film where partners talk about the work to camera, edited by Flexible Films, accompany this report.
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Post by Admin on Nov 22, 2021 12:30:03 GMT
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Post by Admin on Nov 25, 2021 19:34:07 GMT
Peer Support Specialist Training Equipping you to meet the growing demand for high-quality peer-based counseling supports. www.labarberalearning.com/peer-support-specialist-trainingShare Your Experiences Empower the Lives of Others Whether you’re actively struggling with addiction or are working through the recovery process, you are not alone. Today, millions of people worldwide are facing similar addiction-related challenges. On the other hand, perhaps you’re someone who’s successfully recovered from addiction and is seeking to lend a helping hand to others. No matter where you are today, Pocket Rehab is here to facilitate a brighter tomorrow. By providing a community centered on care, offering Certified Peer Recovery Specialist credentialing, and bridging the gap between hope and tangible progress, we are helping over 150,000 members recover from addiction and behavior disorders. pocketrehab.teachable.com/WE LEARN. WE SHARE. WE THRIVE. Term 3, 2021 is now open for enrollment. www.academyofpeerservices.org/The Academy of Peer Services (APS) is an online, on-demand, self-directed training and testing website offering a wide range of interactive multimedia courses for those seeking certification in New York State as peer specialists in mental health settings. Courses on the supervision of peer specialists are also available. APS is a collaboration between Rutgers University, Dept. of Psychiatric Rehabilitation, The New York Association of Psychiatric Rehabilitation Services (NYAPRS), and a growing network of Community Collaborators. To learn more about our project team and Advisory Council, click here. The Academy is funded through the New York State Office of Mental Health (NYSOMH), Office of Consumer Affairs. Certification for peer specialists practicing in mental health settings is administered and authorized through a separate organization: the New York Peer Specialist Certification Board (NYPSCB). While designed for the certification of peer specialists providing services in mental health settings, anyone with an interest in learning more about peer support is welcome to take courses. Enrollment is free and open to all, but it is subject to our Terms of Use. Resources for Peer Supporters medium.com/forlikeminds/peer-supporters-abf070c4bf2eDefinition of Peer Supporters by NAPS — National Association of Peer Supporters “Peer support providers are people with a personal experience of recovery from mental health, substance use, or trauma conditions who receive specialized training and supervision to guide and support others who are experiencing similar mental health, substance use or trauma issues toward increased wellness. The term peer supporter is an umbrella for many different peer support titles and roles, such as peer advocate, peer counselor, peer coach, peer mentor, peer educator, peer support group leader, peer wellness coach, recovery coach, recovery support specialist, and many more…. In general, a peer supporter is an individual who has made a personal commitment to his or her own recovery, has maintained that recovery over a period of time, has taken special training to work with others, and is willing to share what he or she has learned about recovery in an inspirational way. In many states, there is an official certification process (training and test) to become a qualified “peer specialist.” Not all states certify peer support providers, but most organizations require peer support providers (who are employed) need to complete training that is specific to the expected responsibilities of the job (or volunteer work). Often, a peer supporter has extra incentive to stay well because he or she is a role model for others. Those who provide authentic peer support believe in recovery and work to promote the values that: recovery is a choice, is unique to the individual, and is a journey, not a destination. Also, self-directed recovery is possible for everyone, with or without professional help (including the help of peer specialists or peer providers).” Peer Specialists may also work under other job titles such as Peer Support Worker, Peer Support Specialist, Recovery Coach, Peer Navigator, Peer Bridger, Recovery Guide among other job titles. Get Support Today! We, who have been there, are bringing encouragement and hope to you one peer at a time on the phone, virtually, or in person! peerhopes.com/
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Post by Admin on Dec 20, 2021 18:31:43 GMT
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Post by Admin on Jan 3, 2022 19:01:38 GMT
Lived Experience Peer Cadet Program What is the Peer Cadet Program? The Lived Experience Peer Cadet Program is an employment opportunity for people with lived experience undertaking the Cert IV in Mental Health Peer Work, to enter paid employment across one of six participating Victorian non-government community mental health services. Beginning February 2022, the program offers a paid two day a week cadetship over 12 months at cohealth, EACH, Mind Australia, Neami National, Uniting Victoria Tasmania, or wellways. Peer Cadets will develop knowledge, skills, and confidence in a structured and supported environment. Throughout their employment cadets will receive supervision, training and reflective practice opportunities that are discipline specific. The Lived Experience Peer Cadet Program is funded by the Victorian Government. Applications open on 17 January 2021. Click here to register for updates. form.jotform.com/213408039002847www.mhvic.org.au/lived-experience-peer-cadet-program
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Post by Admin on Apr 4, 2022 14:27:05 GMT
‘Negotiating the swamp’: Struggles and ways forward in navigating our identities as experts ‘with’ experience in academic research contexts About this event An online dialogue with Dina Poursanidou, Veenu Gupta and Helen Spandler Dina and Veenu will reflect on being experts ‘with’ experience in UK academic research contexts, and on negotiating and navigating these roles that embody both personal and professional identities. Dina and Veenu will ask Helen to share, from their own academic position, their experience of working with experts ‘with’ experience in academia, and their own difficulties and struggles in understanding and supporting these individuals. Together they want to explore ways to make the landscape better for experts ‘with’ experience. Dina Poursanidou – Mental health service user researcher, member of the Asylum Magazine editorial group Veenu Gupta – PhD student, lived experience researcher Helen Spandler – Professor of mental health, editor of Asylum Magazine www.eventbrite.nl/e/negotiating-the-swamp-experts-with-experience-online-dialogue-series-registration-290264618287Lived Experience Workers We're developing our online communities for people across the UK who want to connect with similarly minded folk seeking to transform approaches to mental health and trauma in their community, workplace or public service. Our current communities are: www.peerhub.co.uk/online-communitiesMad Studies Xtra: State Of The Union Check out our availability and book the date and time that works for you www.pinkskythinking.com/booking-calendar/mad-studies-xtra-state-of-the-unionUnison to raise an LXP Motion at April Conference Posted byLXPRevolution4th Apr 2022Posted inUncategorized lxprevolution.co.uk/2022/04/04/unison-to-raise-an-lxp-motion-at-april-conference/From ‘they’ to ‘we’ Reflections on working as lived experience advisors media.samaritans.org/documents/Lived_experience_advisor_FINAL.pdf
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Post by Admin on Apr 21, 2022 13:40:47 GMT
Apples and Oranges in Peer Support Research By Ellen Dayan -April 14, 2022 www.madinamerica.com/2022/04/evidence-peer-support/Do you skip to the conclusions section at the end of research articles? We’re certainly at a crossroads now about the future of peer support, and everyone’s looking for evidence for or against it. But if you’re trying to decide whether to continue or to cut peer support in your organization, you’ll need a critical eye as you make your way through the literature. I recently came across a peer-reviewed journal article by White, Foster, and Marks, et al titled “The effectiveness of one-to-one peer support in mental health services: a systematic review and meta-analysis.” It seemed a smart choice for getting myself caught up on recent peer support outcomes quickly. But on closer inspection, I realized the conclusion is less than helpful for technical reasons, and I’d like to explain why. First, I should say that I’m a person living with a psychiatric diagnosis. I’m a “peer.” I’ve worked in the behavioral health field for several decades, and almost all my career positions have been related to peer support. I also specialized in research and evaluation in my graduate studies because I’m both excited by and confident in the dynamic question-and-answer process of the scientific method. There’s so much we can do with data if we collect, analyze, share, and discuss it responsibly. It’s critically important for us to understand what’s passing for “evidence” about peer support in research if we want it to have a future. So, let’s look at this meta-analysis closely. Meta-analysis is cool because it combines information from many very similar studies. Ideally, the more data and information you have in research, the more confident you can be about results. And, as long as we’re comparing apples to apples and oranges to oranges, reading one meta-analysis should be nearly as good as reading all 23 articles, in this case. White, Foster, and Marks, et al acknowledged a serious apples and oranges problem with their data, which we’ll look at, but the final two sentences of their conclusion read: “[We found] a modest, positive effect of peer support on self-reported recovery and an absence of effect, in the evidence to date, on clinical outcomes. Again, [the review] indicates that reporting bias—incomplete reporting of outcomes—continues to undermine the quality of the evidence base as a whole.” This damning conclusion was a shock to me, honestly. So, I resigned myself to spending the day with this study. What evidence warranted a description of peer support as only slightly useful (or fairly useless), and cast serious doubt on the entire evidence base on peer support? These are my thoughts about the meta-analysis and its conclusion through my magnifying glass. The term “reporting bias” in the conclusion suggests we’re cherry picking the data that’s reported. Is that because peer support outcome data don’t show what we’d like them to show? Or is it that the complaint is based on a gross misunderstanding of what peer support is and how it works? If clinical outcomes (apples) are not the same as recovery outcomes (oranges)—and they aren’t—the “missing” apples didn’t belong in the basket mixed up with oranges, anyway. William A. Anthony defined recovery as “having meaning and purpose in life despite symptoms of mental illness.” We measure recovery concepts in peer support in terms of hope, self-empowerment, self-determination, and engagement in meaningful activity, for example, not scores on clinical inventories. We know we’ll continue to experience symptoms and use mental health services, but also that the quality of our lives can improve dramatically at the same time. Peer support isn’t a clinical service provided by clinicians with clinical objectives. Measuring service use and symptoms of illness of people receiving peer support seems illogical, in my opinion. To be fair, the apples and oranges problem is a challenge that every meta-analysis grapples with, but the evidence for recovery from mental illness is not the absence of symptoms, and this single misunderstanding seems to account for an enormous amount of confusion for clinically oriented behavioral health professionals. Can we say that because these researchers found that “there was an absence of effect on clinical outcomes,” peer support doesn’t work? It wouldn’t be logical to come to that conclusion, but a quick glance at the last few sentences of the article might lead someone to think so. The next major apples and oranges problem has to do with the duties and relationships attributed to peer support specialists. This isn’t really just a simple apples and oranges problem for researchers, it’s an enormous and wildly exotic fruit salad. It doesn’t work to combine “peer support services” in one big basket when they’re not alike unless the differences are relatively unimportant. But these differences are particularly important. At a national conference about 15 years ago, I was a member of a Q & A panel on peer support. A woman who identified herself as a Peer Support Specialist stepped up to the mic and said, “I feel like a failure. My team asked me to try to get consumers to take their medication. They thought I could do it better because I’m a peer. I can’t do it better, though. I’m terrible at it.” The co-opting of peer support specialists into roles and duties that don’t fit with their training and purpose is a grave issue that plagues us to this day. A number of services in this meta-analysis were described as “paraprofessional case management” or “structured behavioural interventions.” These activities, by their very nature, seriously undermine a power-balanced peer support relationship, and they really should have been disqualified by the researchers as “too different” (apples, not oranges). Even “person-centered” case managers have perceived power over information and resources in the eyes of people receiving case management services. Case managers serve as the gateway to knowledge, benefits, resources, privileges, and opportunities. They perform inspections, write assessments, and document reports that directly impact our housing, employment, and rehabilitation prospects, and their evaluations of our progress often shape our treatment plans. But limiting the service of paraprofessionals, clinicians, and educators with lived experience of recovery from mental illness or addictions is not at all what I’m suggesting. It would be tragic to clamp down and discourage new ideas in the name of standardization. To correct the apples and oranges problems in research on peer support, we don’t need to disqualify, devalue, or eliminate any combination of peer status, job title, or job description from existence. But we must be able to describe and categorize who is doing what so that research outcomes for peer support are reliable, valid, and useful. For example, a “peer” who is hired and performs the job duties of a Case Manager is a Case Manager. The mere status of being a “peer” should never be used to recategorize the person’s job title or function as “Peer Support.” They may use their lived experience to develop more trust or empathy in the supportive relationship. But renaming or reclassifying this person’s title and/or function to “Peer Support” without correcting the job description and balancing power in the working relationship is misleading, inappropriate, and has muddied the water terribly. We could study new Case Manager job titles with new job descriptions that indicate the status of the Case Manager as a peer. Those hybrid entities are already out there and they’d be another excellent group to study. But the “Peer Support” category for peer workers, employers, funders, researchers, educators, and decision-makers should refer to a specific set of criteria so that Peer Support, as it is intended, has a future. Many others have written extensively on this topic, and their expert advice should shape a nationally recognized Peer Support job title and job description that employers and researchers follow very closely. My basic suggestion for defining “Peer Support” job titles and job descriptions is a 3-item checklist: The employee publicly identifies as a “peer” who has been certified as a Peer Support Specialist by a reputable organization. The job title uses exclusive “Peer Support” wording. The job description aligns with the philosophy, training, skills, and practical applications of solid peer support theory. There are well-known sources of accurate peer support outcome data, and we should hold researchers accountable for the quality of their data selections. I also understand that describing peer support roles and responsibilities feels like “codifying,” and that we’ve historically resisted labels of all kinds as a grass roots movement. But now researchers need our help, and we need theirs, too. In my opinion, peer support has been around long enough to stand the test of description and measurement. Our terms, functions, and even our philosophy will change over time because we’re a dynamic group of people. Let’s work together to improve the accuracy and quality of peer support outcome data. We have nothing to fear, and a great deal to learn. *** Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
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Post by Admin on Jun 16, 2022 20:24:09 GMT
Much like improvisation in music, IPS is a process of experimentation and co-creation, and assumes we play off each other to create ever more interesting and complex ways of understanding What is IPS? “As peer support in mental health proliferates, we must be mindful of our intention: social change. It is not about developing more effective services, but rather about creating dialogues that have influence on all of our understandings, conversations, and relationships.” – Shery Mead, Founder of IPS . Intentional Peer Support is a way of thinking about and inviting transformative relationships. Practitioners learn to use relationships to see things from new angles, develop greater awareness of personal and relational patterns, and support and challenge each other in trying new things. www.intentionalpeersupport.org/what-is-ips/?v=b8a74b2fbcbb
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Post by Admin on Jun 29, 2022 21:08:55 GMT
Peer Values Versus Violence: A View from Lived Experience By Meghan Caughey, MFA -June 21, 2022 www.madinamerica.com/2022/06/peer-values-versus-violence/Until recently, I lived in Portland, Oregon, working as Senior Director for a community mental health organization where I saw the employees giving everything to help struggling people. I witnessed great caring and sometimes great healing. And because it was human, there was a range of behaviors that included love and dedication but also anger and frustration. There rarely was violence, although it sometimes happened in the greater community. On May 16, I moved to Kerrville, Texas. Eight days after I moved, there was a horrendous mass killing in Uvalde at an elementary school seventy miles from my new Texas home. I clearly remember a day about ten years ago when the mass killing at the school called Sandy Hook took place. The peer support team I supervised didn’t know about it yet. I needed to share the awful information about it at that day’s team meeting. That meeting held many tears, and today, I find myself weeping again as I am writing about another mass killing of children and their teachers. Often when an individual takes a gun and shoots other people, we hear people say, “this murderer must have had a mental illness,” or “this individual was sick and evil.” But we know from statistics that persons with psychiatric diagnoses are more likely to be victims of violence rather than perpetrators. As peer support and peer wellness specialists, it’s our work to use our experience of healing from our mental health and addiction challenges to support and walk side by side with our peers who are also reclaiming their lives. Some of us have survived violent, coercive forms of socially condoned mental health treatments. I have personally been tied down in leather restraints for nearly 24 hours and forcibly drugged against my will. This was a response to my refusing to eat or get out of the psych ward bed. I’ve seen another of my peers in a mental health treatment program with their limbs covered with massive purple bruises from their “treatment.” But instead of becoming violent, many of us grow past the pain into poignant models of healing and compassion. Some years ago, a psychiatrist named Dr. Sandra Bloom visited where I was working in the community mental health program. She had developed a powerful, inspired concept called “The Sanctuary Model” (www.thesanctuaryinstitute.org). Briefly put, this model rejects the use or practice of violence in any form—no violent actions or speech. Instead, everyone, both patients and providers in mental health treatment, agrees to create a “sanctuary” and find other ways to communicate about and solve challenging and complex issues. No violence of any kind, including guns or other weapons, threats, or words. People non-violently connect with each other and community members instead of being isolated and shunned, as many with mental health diagnoses are. The Sanctuary Model involves humans agreeing to find different ways to resolve our difficulties rather than physical, verbal, or other manifestations of violence. Some people don’t believe that this non-violent model is even possible. Some of you might question if human beings can withhold violence and find non-violent means to resolve varying points of view and differing values. In our culture today, it is often an assumption that we must counter violence and anger with more violence and anger—that non-violence and the people who value and practice it will be crushed by violence. Indeed, old-school psychiatry was founded on the principle of justifying violence. This stereotypical psychiatric position is that at any time they may be called upon to use force or coercion to imprison and medicate—against their will—those with psychiatric diagnoses in order to protect them or their community from potential future harm. Countering the possibility of future violence with actual violence in the present. The lack of humanity and creativity is antithetical to healing and health for individuals and communities. But can you be healed from violence by having more violence done to you? It is the non-violent model that is truly healing and compassionate. Sometimes animals can be our teachers. We have seen examples of a threatening animal, such as a dog or cat, with a history of being beaten and starved. But then, when some loving person takes in the animal and is gentle, feeding it, treating it in a new way, the animal heals and becomes a source of love. This healing can be true with humans too. I recently heard a description of planet Earth that an astronaut reported. They looked out from their spacecraft, saw our small, alone planet, and were struck by how beautiful and fragile it is. There is no room for violence on our vulnerable planet. And we are all vulnerable living beings sharing it. The fragility of our planet communicates several truths: we cannot afford violence directed at each other, ourselves, or our environment. And we who live here on our fragile planet are all connected, even if we are unaware of it. There is no basis for the “othering” in which human individuals and groups sometimes engage. Persons with mental health challenges are often “othered.” Prejudice and discrimination are everyday experiences for many of us with psychiatric diagnoses. So here we are. It has been nearly two years since George Floyd was murdered in a culture that still demonstrates the violence of racism –and less than two weeks since a racially motivated mass murder in Buffalo, NY. Personal and systemic violence happens when we negate our common humanity and when the culture is not innovative or motivated to look honestly at itself, say no and instead create positive responses. I’ve been crying because of my sorrow for the little children and their teachers who were gunned down and killed in Uvalde. I find myself asking what I can do to keep this from happening—at a time when it is only more widespread than ever before. As a person with the lived experience of psychiatric issues who has had culturally endorsed violence inflicted upon me in response to my psychiatric problems, I ask, “What can I do to break the cycle of violence?” The governor of Texas and others say the answer to mass murder is more “mental health.” While we need expanded resources for mental health, if our culture continues to accept and feed an environment of more violence, we won’t be able to save innocent, vulnerable lives. The context of mental health treatment is as important as the treatment itself. If we perpetuate the acceptance of weapons of mass murder, there will still be more mass murders. Also, if mental health treatment utilizes forms of violence such as physical restraints and over-drugging, we will perpetuate more violence. People will not have the opportunities or expectations of creating change in their behavior or the hope that change is possible. Instead, those who give and receive behavioral health support can put our energy into creating individual and systemic kindness. In some ways, it can be easy to perceive our world and culture as frightening and dangerous. And yet, if we dare to model kindness and gentleness, there becomes an alternative to the violence. Despite the common stereotype that behavioral health issues frequently lead to violence, we can create something different that is commonly considered impossible or unlikely. And perhaps because it is not commonly expected, it can be surprising and help the rest of society question some common assumptions about violence. We know that there are countries outside the United States where violence is rare. They demonstrate that non-violence is possible. Perhaps those who have experience with psychiatric diagnosis and treatment can call attention to the emperor’s lack of clothes. The suffering person can reflect on what needs to be done to create peace. I don’t mean this in a romantic way—Emotional pain can fuel extreme behaviors. I am pointing to how a view from outside the everyday cultural norm can introduce valid new perceptions into the fabric of the culture. I don’t have any simple answers. I think that because of my lived experience of violent mental health treatments and the contrast of experience of treatments that are caring, perhaps I have gained heightened sensitivity to the issue of violence. My choice of non-violence and compassion are better examples of what my mental illness has encouraged in me—the opposite of the violence often ascribed to people with a psychiatric diagnosis. Those with a history of “mental illness” who have been given the non-violent support we need to recover can help lead our culture away from violence. I value sanctuary and non-violence and vow to dedicate my life to living it. We must reject worn, inaccurate stereotypes and build healing connections and non-violent options. It only creates prejudice and discrimination when persons with psychiatric issues are immediately blamed. Our culture suffers from egregious stereotypes and biases. And yet those of us with mental health challenges can be essential in helping to build a socially integrated, just, and compassionate culture. I hope that as we express gentleness and kindness towards our peers and others with whom we share this planet, we will create a world of sanctuary—a world with safety for all people and this very planet itself. We can help lead to the creation of healing from the sheer pain of our lives, creating a model of wholeness within our communities. It’s not easy, but every choice and action we make matters. *** Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
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Post by Admin on Jun 29, 2022 21:20:10 GMT
Peer Workers Aid in Suicide Safety Planning in Emergency Care Peer-based safety planning may be a feasible and acceptable service in Emergency Department care for patients experiencing suicidal thoughts. By Álvaro Gamio Cuervo -June 22, 2022 www.madinamerica.com/2022/06/peer-workers-aid-suicide-safety-planning-emergency-care/A new study published in Psychiatric Services examined how the provision of a peer-delivered safety planning intervention (SPI) may provide adequate clinical support for patients in the Emergency Department (ED). Findings show that peer-based SPI may result in fewer return ED visits, suggesting that safety planning with peers is an effective intervention. These results provide a new opportunity to include peer-support services in conjunction with clinical intervention to enhance suicide prevention efforts. “Unfortunately, general medical and mental health staff in the ED have limited time and training to maintain the fidelity of suicide interventions, and therefore brief, low-threshold evidence-based efforts are likely most feasible for implementation,” write the authors, led by Michael P. Wilson, a researcher at the University of Arkansas Medical Services Department of Emergency Medicine. The present article brings forth timely research given recent calls for randomized control trials to assess the effectiveness of peer support work. Furthermore, individuals seeking crisis services in an ED usually encounter added barriers to care. Those who seek mental health treatment in emergency departments tend to wait longer, especially if they are uninsured or have Medicaid. Although a promising intervention, peer support work brings unique challenges in supervision and professional development to meet the needs of service users. Therefore, Wilson and his team take the behavioral health field one step closer to learning how to adequately integrate a much-needed service in a high-need area for suicide treatment. EDs provide nearly half of all medical care in the United States, suggesting that many patients who experience suicidal thoughts will present to an ED during their lifetime. Yet, despite the urgent need to treat suicidality, medical and mental health staff have limited time and training, which contributes to the need for low-threshold evidence-based efforts in EDs. Safety planning interventions have been shown to reduce suicidal behavior after ED discharge through a personalized list of coping skills and social support. SPI is considered a best practice intervention that can be delivered in 20-45 minutes. While not a long-term solution, SPI is a readily available resource that allows for providing services in high-demand settings. SPI delivery may be improved through a peer-based connection that affords more time and compassion than general mental health and medical care. “Studies from both outpatient and inpatient settings have shown that the use of peers to deliver suicide prevention efforts has been associated with reductions in emergency services use, reduced numbers of readmissions to a psychiatric unit, and increased scores on various recovery assessment scales. However, no studies to date have prospectively evaluated peer-delivered SPI in the ED setting.” The research team conducted a pilot randomized controlled trial (RCT) in an urban ED with patients (n = 31) presenting with suicidal ideation or suicide attempt. Researchers assessed the feasibility, acceptability, and preliminary effects of peer-delivered SPI compared to provider-delivered SPI. Preliminary effects of interest were defined as the ability of safety planning to prevent ED return visits. Both sets of professionals (peer support and medical/mental health) received training in SPI as a part of the research protocol tailored to their roles. After arriving at the ED at scheduled study times, patients were randomly allocated to peer-delivered or provider-delivered services through online software. The Stanley and Brown Patient Safety Plan Template was used with patients before demographic and clinical data were collected through survey administration. The quantitative analyses did not find a significant difference in patients’ visits three months before or after enrollment. However, participants who engaged in SPI with peers had a significant decrease in ED return visits. Further research should assess whether this difference is due to more complete and higher-quality safety plans in the peer group, delivery of SPI by a peer, or a combination of both factors. “These findings are consistent with the rapidly growing popularity of using peers to deliver mental health and substance use interventions worldwide. Peer-delivered interventions are especially popular in the United Kingdom, where peers are used in many mental health facilities (47). In the United States, more than 30 states now have some level of Medicaid reimbursement for peer specialists,” the authors write. These findings contribute additional evidence to the effectiveness of peer support staff in mental health treatment which has increased tremendously in popularity during recent years. **** Wilson, M.P., Waliski, A., & Thompson R.G. (2022). Feasibility of peer-delivered suicide safety planning in the emergency department: Results from a pilot trial. DOI: 10.1176/appi.ps.202100561. (Link) ps.psychiatryonline.org/doi/10.1176/appi.ps.202100561
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Post by Admin on Aug 13, 2022 19:18:20 GMT
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Post by Admin on Oct 4, 2022 21:06:06 GMT
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