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Massachusetts
sets up peer support centers
(October
2007 Issue)
By Nan Shnitzler
The concept of peer support in behavioral health has taken many
guises from Alcoholics Anonymous to Vet Centers to any kind of group
therapy. Now the state of Massachusetts has adopted the model to
assist mental health consumers along the road to recovery.
The Department of Mental Health is setting up six state-funded
regional centers where mental health consumers, known after training
as "certified peer specialists" will provide services. Centers in
Worcester and Quincy are up and running. Centers in western and
southeastern Mass., metro Boston and the Lawrence/Lowell area are
in the pipeline, says DMH Assistant Commissioner Michael O'Neill.
"The centers are another way of helping people become more enlightened
as they become consumers of mental health services," O'Neill says.
The centers will have several functions. Enhanced information and
referral will help consumers who are testing the mental health care
waters find resources, services and access to benefits and entitlements.
Before engaging DMH or a community health plan, if people know what
to expect, they should feel less intimidated right from the start.
One-on-one support might include help with Wellness Recovery Action
Plans (WRAP) or dealing with real-life issues like trouble with
a neighbor or landlord.
"We think there's no better way of doing that than from someone
who's actually experienced the system directly," O'Neill says.
Peer specialists will also consult with DMH and traditional service
providers to incorporate a consumer voice in recovery and rehabilitation
activities.
Finally, the regional centers will support the peer specialists
as they embark on their new role on the other side of the mental
health care table. Such support can combat being re-traumatized
from hearing the stories of those they are now serving or stem feelings
of isolation in the clinical culture.
"It's important to be clear that peer specialists will not replace
but supplement traditional mental health care services," O'Neill
says.
They also collaborate. For example, the department is adding to
inpatient services "peer debriefers" to help patients who have been
restrained avoid it in the future. The state's 15 PACT teams (Program
of Assertive Community Treatment) have peer specialists on staff.
The Massachusetts Behavioral Health Partnership, an arm of MassHealth,
pays an enhanced rate for programs that incorporate peer support.
"My point is that peer support is starting to take hold in certain
settings," O'Neill says.
Elena Eisman, Ed.D., ABPP, executive director of the Massachusetts
Psychological Association, got her professional start in the self-help
arena so she sees real value to peers who have been through a particular
problem helping others deal with the same.
"The theory is they have a different appreciation for what the
struggles are and can see things in a different way from the professionals,"
Eisman says. "Both are valuable roles, but they're different."
She acknowledges that some professionals might find the concept
threatening and thinks more work could be done to define how the
interface with the professional treatment community works.
Deborah Delman is executive coordinator of mental health consumer
advocacy group M-Power, acting director of the Transformation Center,
which runs the peer support training and a certified peer specialist.
She emphasizes that peer specialists are not delivering therapy
but have been trained to use their own stories of illness and recovery
to keep others from remaining "self-identified mental patients."
"People in the mental health system still hear from treaters that
they will never work, that they are not expected to own a house,
that they must give up a satisfying life," Delman says. That flies
in the face of what peer specialists have been trained to communicate,
that work and a stable home life have value in recovery and that
recovery is possible for all.
The standardized 40-hour training is a requirement for Medicaid
funding, which Massachusetts has yet to seek, according to O'Neill.
Applicants must have a high school diploma or GED and a primary
diagnosis of mental illness (but not addictive disease) and pass
oral and written exams.
"What we [peer specialists] want is a place in the mental health
community and to welcome people with mental health conditions with
coverage rather than competition," Delman says about any friction
with the status quo. "Rather than fight over pieces of the pie,
make a bigger pie."
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