# Presentation: 425265

## Welcome to the TAPA Center for Jail Diversion’s Net Conference

- Integrating Consumers as Staff and Experts in Jail Diversion Programs

**A Branch of the National GAINS Center**

## TAPA Center for Jail Diversion

- Technical Assistance and Policy Analysis Center for Jail Diversion: A Branch of the National GAINS Center
- Funded by Substance Abuse and Mental Health Services Administration/Center for Mental Health Services
- Coordinating Center for 20 jail diversion programs
- National resource center for communities developing jail diversion programs
- Websites
- www.tapacenter.org
- Gainscenter.samhsa.gov

## Integrating Consumers as Staff and Experts in Jail Diversion Programs

- September 22, 2004

**Presenters:**
**LaVerne Miller, Esq. (Howie the Harp Peer Advocacy Center)**
**Ann-Marie Louison, MSW (CASES)**
**Albert Wilson (CASES)**

**Notes:**
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## Why Integrate Consumers as Staff and Experts in Jail Diversion Programs?

- Definition of ‘consumer’/’peer’ provider
- A consumer/peer provider is a person who is hired because s/he has a mental health condition and a history of involvement in the criminal justice system.  The primary tasks involve improving the client’s utilization of services to promote full community integration.
- Consumers offer a critical perspective
- ‘ People who have “been there” can offer the most relevant perspective on how systems fail and what meaningful alternative(s) should be in place.’
- 	(Bazelon Center for Mental Health Law (2003)

## Recovery

- Recovery is a personal process in which an individual gains insight into his or her psychiatric disabilities and chooses to utilize natural supports, self-help strategies,  and community resources for ‘*personal liberation and wellness.’ *(Curtis, 2000)
*Recovery *refers to the process in which people are able to live, work, learn, and participate fully in their communities.  For some individuals, recovery is the ability to live a fulfilling and productive life despite a disability.  For others, recovery implies the reduction or complete remission of symptoms.  Science has shown that having hope plays an integral role in an individual’s recovery. (New Freedom Commission, 2003)

## President’s New Freedom Commission Report on Mental Health (July 2003)

- Goal 2 Mental health care is consumer and family driven
- Consumers working as providers help expand the range and availability of services and supports that professionals offer
- Consumer providers bring different attitudes, motivations, insights, and behavioral qualities to the treatment encounter

## Types of Consumer-Provided Services

- Categories of peer support (Solomon, 2004)
- Self-help groups
- Internet support groups
- Peer-delivered services
- Peer-run or operated services
- Peer partnerships
- Peer employees

## Benefits of Consumer-Provided Services

- To individuals receiving them
- Improved social functioning
- Improved self-esteem and social support
- Improved quality of life
- Reduced use of hospitalization and/or crisis services (Solomon, 2004)
- Strengthening Self-Advocacy
- Wellness Recovery Action Plan (WRAP)
- Access to self help resources (Mead, et.al, 2001)

## Benefits of Consumer-Provided Services

- To service delivery system
- Cost-savings due to decreased hospitalization/shorter hospital stays
- Alteration of negative attitudes of service providers
- Provide mechanism for offering services to people in need of services who are alienated from the traditional mental health system (e.g. people who are homeless)
- Improve the effectiveness of the traditional mental health delivery system (Solomon, 2004)
- Greater optimism among professional staff about clients’ chances of recovery (Felton, et al, 1995)

## Other Roles for Consumers

- Jail diversion program planning
- Focus groups, members of planning committees, dialogue groups
- Jail diversion program oversight
- Participation in Boards of Directors and Advisory/Steering Committees
- Research and evaluation
- Hire peers as research assistants
- Consumer satisfaction surveys
- Hire as observers/monitors in court and jail setting to ensure clients’ rights are protected
- Advocacy

## Criminal Justice Mental Health Programs Need

- Staff who are invested in the recovery model
- Services that instill hope
- Relationships that facilitate communication and trust
- Mechanisms to inform participants of their rights
- Consumers to educate other staff about jail and prison culture
- Staff who are capable of acting as boundary spanners between the criminal justice and mental health systems

## Howie the Harp Forensic Peer Specialist Training Curriculum

- See http:// gainscenter.samhsa.gov /excel/Calendar2005.xls
- Orientation
- Introduction to Human Services, Professional Ethics and Responsibilities
- Self-Help/Recovery Skills
- Case Management Skills
- Work Readiness Skills
- Supervised Internship with Mental Health Care Provider (3 months)

## Howie the Harp  Forensic Peer Specialist Training Curriculum

- Phase 1: Professional ethics, self-help and recovery
- Phase 2: Working in the human services field
- Case management  skills
- Harm reduction model
- HIV and AIDS
- Cultural competency
- Conflict resolution
- Many others
- Phase 3: Intensive job readiness
- Resume writing
- Interviewing skills

## Howie the Harp  Forensic Peer Specialist Training Curriculum

- Internship assignments
- Staff develop sites for each class
- Trainees are matched for internship sites
- Trainees go on interviews
- Howie the Harp works with providers
- Supervisors are required to attend supervisor training at the Center
- Staff conduct site visits to internship site
- Supervisor prepares performance evaluation that is reviewed with trainee and staff

## Howie the Harp  Forensic Peer Specialist Training Curriculum

- Other services provided
- Support groups
- Double Trouble groups
- Men and women groups
- Individual counseling sessions
- Housing problems
- Entitlements
- Family issues
- Navigating the parole system
- Past legal problems
- Other

## Other Training for Consumer Employees

- Identify local organizations that may provide peer training, such as:
- Local or statewide peer-run organizations
- County or state mental health authority consumer affairs department
- Local or state mental health association
- Identify available training and conferences
- SAMHSA-funded Alternatives Conference
- National consumer-run organizations
- National Mental Health Consumers’ Self-Help Clearinghouse
- National Empowerment Center
- CONTAC
- Georgia Peer Specialist program
- Local and national peer consultants

## Finding Consumer Employees

- CASES Mental Health Programs developed relationship with the Howie T. Harp Advocacy Center to identify peer specialists—initially hired 2 part time peer specialists
- Hired consumer who had successfully completed the Nathaniel Project and Howie T. Harp’s peer training program as a full time case manager for the Parole Restoration Program
- Today, approximately one-third of program staff (5) are peers

## Hiring Consumers Who Have Completed Your Agency Programs

- Be aware that there are issues that may develop between staff and a potential consumer employee who formerly received services from an agency program
- e.g., How do you assure confidentiality when the former participant’s treatment records are in the agency’s database and therefore accessible to staff?
- Identify the particular issues and develop a mechanism for addressing them with the potential consumer employee and staff before hiring
- Develop mechanism to monitor consumer’s transition/integration as employee

## Consumer Employees

- Roles must be clearly defined as they are for any employee
- Job descriptions
- Peer specialist/educators can provide peer support services, case management services, and run groups
- Consumers are also advocates, lobbyists, and create and manage programs
- Create and review program policies and procedures

## Consumer Employees

- Educate participants about self-help techniques and processes
- Teach effective coping strategies based on personal experience and recovery goals
- Assist in the development of community support systems and networks
- Inform participants about their rights (Americans with Disabilities Act, Advance Directives)

## What Service Providers Can Do to Ensure Successful Consumer Involvement

- Create an organizational climate and culture that supports consumer employees.
- Reach an organizational consensus with key senior staff including, but not limited to, Program Managers, Human Resources, Union Rep, Employee Assistance Program (EAP), about the recruitment and hiring of consumer staff
- Identify organizational barriers to the recruitment, hiring and integration of consumer staff
- Train and familiarize staff about the role of consumer staff
- Seek out consumer-run agencies in your locality for technical assistance and support

## Make reasonable accommodations; flexible work schedule, part-time hours, co-worker buddy 

External supports: e.g., Howie T. Harp has a mandatory weekly support group for one year after completion of the training program

Ongoing, flexible, individualized support

Increased supervisory time

- External supports: e.g., Howie T. Harp has a mandatory weekly support group for one year after completion of the training program
- Ongoing, flexible, individualized support
- Increased supervisory time

- What Service Providers Can Do to Ensure Successful Consumer Involvement

## What Service Providers Can Do to Ensure Successful Consumer Involvement

- Create a clear job description
- Clearly define the degree of autonomy
- Create a comprehensive and supportive orientation phase
- Recruit supervisors who are committed to mentoring consumer staff
- Explore opportunities for consumer staff to have access to support from other employed peers, either internal or external to your agency
- Create opportunities for career advancement within the agency

## Challenges

- Not all consumers are prepared to serve in role of peer specialist/educator (consumers are a heterogeneous group)
- Give consumers time to establish proficiency in specific skills. Develop a supportive probationary period.
- Help consumers identify workplace supports, co-workers
- Allow time for increased tolerance for work demands
- Assist with personal disclosure strategies
- Respect boundaries: the consumer is an employee, not a client. Think about career advancement and promotion.

## Tips

- Pay competitive salary
- Build in supports
- Be prepared for the change in your agency culture
- Develop relationship with your local peer, advocacy, self-help agency
- Listen to what your peer specialists have to say about their employment experience
- Remember peer support is essential

## Available Resources

- National Mental Health Consumers Self-Help Clearinghouse _[www.mhselfhelp.org](http://www.mhselfhelp.org/)_
- National Empowerment Center _[www.power2u.org](http://www.power2u.org/)_
- Consumer Organization and Networking Technical Assistance Center _[www.contac.org](http://www.contac.org/)_
- Howie the Harp Transitions Training for providers—available Technical Assistance.  _[www.howietheharp.org](http://www.howietheharp.org/)_
- Mary Ellen Copeland _[www.mentalhealthrecovery.com](http://www.mentalhealthrecovery.com/)_
- Bazelon Center for Mental Health Law _[www.bazelon.org](http://www.bazelon.org/)_

## References

- Bazelon 2003, Criminalization of People with Mental Illnesses.  The Role of Mental Health Courts in System Reform.
- Curtis, L.C., 2000. Practice Guidance for Recovery-Oriented Behavioral Healthcare for Adults with Serious Mental Illness. _Personal Outcomes Measures in Consumer-Directed Behavioral Health._ Towson M.D., The Council on Quality and Leadership for Persons with Disabilities pp.25-42
- Felton, C., Stastny, P., et al., Consumers as Peer Specialists on Intensive Case Management Teams: Impact on Client Outcomes. Psychiatric Services Vol. 46 No. 10 1995
- Mead, S., Hilton, D., Curtis, L., Peer Support: A Theoretical Perspective. Psychiatric Rehabilitation Journal. Vol. 25 No. 2 2001
- New Freedom Commission on Mental Health, *Achieving the Promise: Transforming Mental Health Care in America. Final* *Report. *2003* *
- Solomon, P., Peer Support/Peer Provided Services Underlying Processes, Benefits, And Critical Ingredients. Psychiatric Rehabilitation Journal Vol. 27. No 4. 2004

## Contact Information:

- LaVerne Miller, Esq.
- Rhonda Stanford-Crews
- Howie the Harp Peer Advocacy Center
- 2090 Adam Clayton Powell Jr. BoulevardNew York, NY 10027
- Ph: (212) 865-0775FAX: (212) 865-1130
- _[www.howietheharp.org](http://www.howietheharp.org/)_
- Ann-Marie Louison
- Center for Alternative Sentencing & Employment Services
- 346 Broadway
- 3rd Floor
- New York, NY 10013
- Ph: (212) 553-6325
- _[alouison@cases.org](mailto:alouison@cases.org)_
- Albert Wilson
- Center for Alternative Sentencing & Employment Services
- 19 Beekman Street
- New York, NY 10038
- Ph: (212) 732-2060
- _[awilson@cases.org](mailto:awilson@cases.org)_

## Questions?