Workforce Development

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This is Workforce Development, advocating for peer support specialist positions. This mini e-learning is brought to you by the Café TA Center.

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Today, we're going to have a brief discussion that we hope will enhance your capacity and provide you with many ideas that will spark change and promote action and follow-up around peer specialist positions.

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Today's discussion objectives are to develop an understanding of the evolution and use of peer specialist, to recognize the impact of peer specialist, and acquire resources and information for advocating for the position, and finally, to develop a pathway for use in the advocacy in the process.

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First, we would appreciate it if you would take this little pre-test so we can find out more about what you already know.

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Thank you and welcome back. What is a peer specialist? The Georgia Certified Peer Specialist Program defines it as a consumer advocate who provides consumer information and peer support for consumers in a variety of settings. The Wisconsin Certified Peer Specialist define it as persons who have lived experience of mental illness, have formal training in the peer specialist model of mental health supports for adults, who use their unique set of recovery experiences in combination with solid skills training to support peers who have mental illness and actively incorporate peer support into their work while working within an agency's team support structure.

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This is definitely an emerging and growing profession. Some states or programs have a certification program where they insist that people who claim to be peer support specialist meet eligibility criteria. Most of them have to take an exam and some of them even require performance reviews. Then in other places, states and programs do not have a certification program, but many still have eligibility criteria and performance reviews.

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There are many types of payment for these positions. Some of the positions are volunteer. Some agencies and programs hire the individual as an employee while others use them as a contracted provider. Then finally, some of them pay a stipend.

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There's a great history of peer support specialist. Peer to peer support began in the late 18th century in France. Past patients of a mental hospital were used as workers to eliminate abuse within the program.

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D. Banks McKenzie in 1875 said of this group, "They fully understand each other's language, thoughts, feelings, sorrows, signs, gripes, and passwords, therefore yield to the influence of their reformed brethren much sooner than to the theorists who speak in order that they may receive applause."

 

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Exactly what is it that peer support specialists are doing? They do peer-to-peer support, outreach to others within the population, follow-up, information and referral, help them navigate the system, provide them with coaching, and planning processes.

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Some of the specific sample duties include providing peer-directed outreach, motivating peers to utilize available services and resources, identifying mental health and recovery resources for the individuals that they work with, to serve as an ally and a confidante, provide feedback on the recovery process, and serve as a role model and a mentor.

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They facilitate the transition from a professionally directed treatment plan to a client developed and directed personal recovery plan. They also assist in preventing and solving problems, and they serve as an experienced broker of necessary services. They can be a monitor or a companion for their peers and they can serve as a lifestyle consultant or coach.

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In addition, they can introduce new commerce to the culture of recovery and orient them to recovery roles, rules, rituals, language, and etiquette, and open doors of opportunity for them for community participation. They can advocate for individuals in need of services as well as for systems change. They can educate their peers, providers, systems in communities, and help develop and expand recovery support resources.

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There are many settings for peer specialist. They can serve in emergency rooms, within crisis services, in-patient and outpatient care, independent living centers, veteran's hospitals, supported living arrangements, prison and forensic areas, community resource centers, drop-in centers and clubhouses, community support programs, comprehensive community services, aging and disability resource centers, within family care settings, and a homeless shelter, or even a community recovery service.

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Peer specialists have the potential to impact themselves, other consumers, their community, as well as the system.

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Some of the general points of impact include that first generation studies showed that it is feasible to hire people in recovery and peers as behavioral staff. Second generation studies indicate that peer staff can generate equivalent outcomes as non-peer staff. Third generation studies are investigating whether or not these contributions are unique.

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The recovery impact includes an increase in understanding of symptoms, an increase in social functioning for those they work with, increase engagement with the staff, increase in hope, self-care and well-being, as well as an increase in quality of all of the life domains.

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Further research on peer support programs has shown that participation in these services yield improvement in psychiatric symptoms and decrease hospitalizations. Larger social support networks enhance self-esteem and social functioning as well as decrease lengths of hospital stays and lower service cost overall.

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By increasing trained peer personnel, an agency can increase the number of people served and their own cost-effectiveness due to the flexibility in scheduling and organizational commitment that is often inherent in the employment of peers. It appears to be more effective, allows staff spread, offers targeted response with a lower cost.

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There are challenges as well. Certified peer specialists are an established vehicle for empowering consumers, but many service providers are unclear of how to include certified peer specialists in their organization and even maybe skeptical as to their value.

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There are barriers that exist regarding the confusion between consumer involvement and the role of peer specialist. The potential cost, stigma, the professional attitude towards the profession, turf guarding, and experiences and history with certified peer specialist programs.

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Well then, how do we advocate for more positions across the country? The Merriam-Webster Dictionary defines an advocate as one that pleads the cause of another, specifically one that pleads the cause of another before a tribunal or judicial court, or one that defends or maintains a cause or proposal, or one that supports or promotes the interest of another. It's that last one that we want to focus on.

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There's many ways to advocate for these positions. I mean one informal way would be speaking out at meetings and conferences, writing letters, or person-to-person education. More formal ways might be to become a part of a group or organization that's promoting peer specialist programs, to be very strategically driven, or to propose problem solving within a program and its services.

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Informal promotion requires that you recognize intended goals. Is your goal for systems change? Do you want to get a job? Or maybe it's both. You have to develop the message and take advantage of all opportunities including those impromptu times where you run into someone and you begin engaging with them and telling them about your ideas regarding a peer specialist. This might be with the service provider that you use, someone within the community, or maybe just a chance encounter at a program office.

 

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Here's a simple sample message that you might use. You could say to them, "Did you know that peer specialists have been making an impact on mental health recover for over a century? They have effectively increased the capacity, independence and outcomes for others with mental health issues based upon their own personal experiences and specialized training. They save money and lives, and are critical components of transforming the mental health system of care."

 

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Some formal approaches that you could use would be developing goals and objectives; figuring out exactly what it is that you want and how you're going to get there; creating a strategic plan; looking at the direction that you've got to go, who you need to speak to, when you're going to do it, and how you're going to know that you did a good job; developing ideas, resources and tools; and identifying and engaging partners. Let's talk a little bit more about this.

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Goals and objectives should be simple and very easy to follow. An example might be, "Enhance the recovery potential for persons in the ABC mental health program." Your objectives would be, "To develop a peer specialist position, develop a job description, recruit and hire for the position, train peer specialists and their supervisors, and sustain and improve the position for maximum outcomes."

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I know strategic planning sometimes seems like tedious and long way to get things done. Strategic planning can help you coordinate and organize your direction such a identifying your goals, setting the direction that you want to go, identifying every step and the action that it's going to take to get there, assigning the work to individuals to help you get it done, measuring and monitoring your outcomes, and adjusting your methods so that you know that you're moving forward in the way that you intended.

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Here's a sample strategic planning template. You would write the area at the top and then each activity that you were going to do to get you where you wanted to go. The start date, the end date, who the lead person would be that was going to take responsibility to make sure that it was going to get done, and then you could put notes and updates on how you were doing in the last column. This would allow you an opportunity to plan, assign, and track what you were doing.

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You really need to get some snapshots of what it is that you're going to do, what do you want, what do you have to get it done with, what don't you have, and what will you need to meet your goals and objectives. How do you get where you're going?

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Then some ideas, resources, and tools that you could use to help you promote a peer specialist position would be sample programs that other people are using, maybe some trainings that you found for peer specialist, job descriptions, some of the core competencies that are emerging throughout the country, and maybe some standards. You could locate these things and use them as tools for influencing others about how they could incorporate a peer support specialist into their program.

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One of the tools that you might locate would be sample job description. There's many on the Internet and there's a link below for some of them, the one that's shown. You might want to take the job description and customize it to the program and the ideas that you have before you show it to anyone.

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Find some partners, partners who believe in a peer support specialist position and the direction that you would like to see the program go. These might be service providers, other advocates, maybe community leaders, certainly state national leaders that have implemented and advocated for the position for years, program administrators, and even legislators.

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Make sure that you know the program, understand the program's mission and vision, know their history regarding peer involvement and understand their program policies and impact their influence. Know the decision makers. Generally, you want to make sure that the ideas that you're giving them will fit well within their mission, that they have a history of understanding the importance of peer involvement. It helps you know better exactly where you need to start and what you need to do to get them to understand the importance of the program.

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Do your research. Find the latest information regarding peer specialist. Locate data regarding the impact on the target populations. Understand better and share the cost and potential savings for programs by using peer support specialist. Find recommendations of national and international authorities who can talk about the research behind using peer specialist within a program.

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Definitely create a plan. Develop a plan that could be personal or as a group and identify those partners and other peers and professionals who could help you get the job done. Work that plan. Work it. Adjust it. Do what you need to do in order to meet your goals and objectives.

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The process is not always natural when you're trying to develop a plan and advocate for peer support specialist positions. Maybe you're not used to going out and advocating for a group of people. You're used to going out and advocating for your own needs. It's definitely evolutionary and you learn as you go. Your needs have to be planned and they will determine the outcome. How careful you work that process will determine exactly where you end up in the end.

 

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Definitely get organized. Gather the facts and if you are asked about a question that you don't know the answer to, tell them you'll get back to them and go back and gather more facts. Collect information and data so you have it in your hands and be familiar with that. Listen more than you talk. You would be amazed at what you can learn by listening to people as they talk about things and as they ask you questions.

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Determine the desired outcomes that you want to have. Is it the program? Know exactly what it is that you want. Are you advocating for a position or are you advocating for a job? Or maybe both? There's noting wrong with going out and feeling that you have something to offer to a program in advocating for a position for yourself within that program.

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Recognize that the issue always has multiple sides. List each issue and the potential impact on your efforts and always acknowledge differing views in your own thought process. For example, you might have to think about the fact that they may say to you, "Oh, that's a good idea but we can't afford it." What are you going to say? What if they say to you, "We already have consumer involvement. We really don't need a peer support specialist position." Now, what are you going to say? Or maybe they're going to say to you, "Well, you know what, we're not really sure that that actually works." You need to think about each of the issues as they might present them and think about what it is that you need to say to them to counter that.

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Gather those tools. Get some sample job descriptions for people to look at. Give them some sample contract so they have a pretty good idea of how this could be done within their own program. Provide them with some policies in utilizing peers from other programs. Provide them with some ideas on how they could train peers and their supervisors, and give them some certification applications and processes so that they can see that nationally, this is an idea that has come forward as a new profession.

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Develop a short elevator speech, one minute or less, that describes the position, its importance, and your interest. This will give you an opportunity to present very briefly and very quickly an introduction into the idea that you have and then you follow-up that one minute speech with, "I'd like to speak with you further on this. Could we setup a meeting?" Practice your elevator speech on family and friends so that you have it down because it doesn't always come natural. You could also develop a standard 15 or 20 minute presentation, maybe PowerPoint, and have a whitepaper with it that describes your ideas and gives the people an opportunity to see some of the other things that are going on across the country. Then you call up the program. Let them know that you have a brief presentation that you would like to do with them and go through it. Allow them an opportunity to process what it is that you said and answer any questions.

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Create those opportunities for yourself. Look for opportunities at conferences. Volunteer to do a presentation in workgroups or committees. Ask if you can have a few minutes on the agenda. Work with legislators and other policy makers to get them to understand the idea that peer support specialist can save the state and program money. Work with program administrators. Get them on your side. Sign up to speak. Setup appointments where you can come in and talk to folks about what you're thinking.

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Develop relationships with others. Work with others who have the same goals and develop a partnership with like-minded organizations maybe within your community, within your state, or national organizations that are promoting the idea of peer support specialist. Meet others in a position of influence such as administrators, policy makers, and service providers. Get to know them a little bit before you start introducing new ideas to them.

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Know when and how to use data. Make sure that that data is relevant, that it's new. I like to think about using data that's no more than three to five years old. Be prepared to explain the data and how it impacts the targeted population. Have written resources on hand and develop a file of create a resource list. You could carry research articles that have data in them and hand them out. You don't have to read the entire research article to the individual that you're meeting with, but you can hand them the research article and say, "Here's some data that you might want to read about to better understand exactly what it is that I'm saying."

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Apply a little bit of peer pressure. Locate other programs that are doing something similar. Develop a list of programs with peer specialist positions or share brochures from other programs to show that this is an authentic form of professional job, and that there's other places doing the same things very successfully and share some of the bragging ideas that other programs are doing when they're talking about how effective their peer support specialist program is.

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Work as a volunteer to get your foot in the door. Volunteerism is a good way for you to introduce yourself and your ideas to others. You could use this to meet people in positions of influence. Reduce the barriers related to the unknown regarding the position by helping them get used to you. Make people more comfortable with the idea of involving consumers and peer support specialist positions. Identify program areas where the position can make a difference and then share those ideas with your supervisors or other people that are in charge of the program.

 

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Listen to all the challenges to introducing the position into a program and treat each of them as a real threat to the success of your ideas. Research and locate resources to reduce those objections. Hold community forums and program focus groups to discuss the differences. Take notes. Share those notes and those ideas with persons of influence or administrators in charge of the program so that they can see that this is more than just a good idea. This is idea that other people like yourself want to see happen within the community.

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Never do everything by yourself. Build your file and your knowledge of the position, the potential impact, and the tools necessary to make it successful. Share these with others. Be a walking encyclopedia. When someone asks you a question, you should be able to either answer it or say to them, "You know, I read something about that. Let me get that information and send it to you."

 

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There are a few advocacies do's and don'ts. Whenever you're trying to advocate for change, do make sure that you listen to others and that you respond with the facts. When they ask questions, give them the answers, or be willing to find answers for them. Be very inclusive. Don't exclude other ideas because other ideas may be something that you want to try as well. It may help you reach your goal. Follow through. When you're asked to give them something or you promised them something, make sure that you do it because that way, you're indicating that not only are you invested in the program, but you're invested in their ability to understand it better. Do not threaten them with anything. Don't whine or dramatize the things that are going on that are negative. Don't quit because you do not get your own way. Figure out another way. If you have a strategic plan and you've been developing a process to track how far you're getting with what it is that you're doing, you should be able to make some adjustments along the way that won't force you into quitting.

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Some of the next steps that we see happening is the evolution of national standards. That's on the horizon as we speak. There's potential to nationalize many of the successful models that are already in place. Pretty soon, everyone in the country will have heard about peer support specialist. Pretty soon, everyone will know what the term is, what the profession is, and where it's been going. There is certification and you can further the professional image of the position by becoming certified. In creating a marketable image so that everyone will be able to see exactly what it is that a certified peer support specialist can do.

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We appreciate you spending this time with us today. We hope that you will spend a few minutes and take our post-test. We'd like to find out a little bit more about what you have learned.

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In conclusion, there are thousands of peer specialists across the nation. This is not a new concept. Not all programs are using their fill ready for peer support specialist. It will take an informed and targeted advocacy to reduce some of those barriers. Progress is in the hands of those who believe.

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I'd like to leave you with this quote. "Never believe that a few caring people can't change the world. For, indeed, that's all whoever have."

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Thank you so much for staying with us today in learning more about how to advocate for peer support specialist positions. This was brought to you by the Café TA Center. The Café TA Center is supported by SAMHSA to operate one of its five national technical assistance centers providing technical assistance, training, and resources that facilitate the restructuring of the mental health system through effective consumer-directed approaches for adults with serious mental illness across the country. You can visit our website and find other trainings, information, resources, and things that you might be able to use in your everyday work. Thank you very much and we appreciate your time. Thank you.