National Peer Certification

Health disparities between the seriously persistent mentally ill (SPMI) population and general population exist which are alarming (MHA, 2008).  A report issued by the National Association of State Mental Health Program Directors (NASMHPD, 2006) stated that the rates of morbidity and mortality among people living with a chronic, episodic serious persistent mental illness are increasing (MHAT, 2008).  Individuals living with an SPMI are dying, on average, 25 years earlier than a person not experiencing SPMI (Elias, 2007).  While largely preventable, physical comorbidities (e.g., Respiratory disease, CDV, Diabetes), are deemed a side-effect of using long-term psychotropic medication prescription.

The National Association of State Mental Health Program Directors (NASMHPD) issued a position paper in 1989 recognizing that mental health consumers have a unique contribution to make to the improvement of the quality of mental health services in many arenas of the service delivery system. NASMHPD recommended utilizing consumers to assist with program development, policy formation, program evaluation, quality assurance, system designs, education of mental health service providers, and the provision of direct services (as employees of the provider system).

Within the context of a peer driven workforce, NASMHPD stated that consumers should be included in meaningful numbers in all of these activities. In order to maximize their potential contributions, their involvement should be supported in ways that promote dignity, respect, acceptance, integration, and choice. Support provided should include whatever financial, educational, or social assistance is required to enable their participation.  The terminology has changed to developing peer leaders and providing peer-to-peer support and treatment.  (NASMHPD, 1989)  In July of 2003 the President’s New Freedom Commission Report on Mental Health stated that mental health care should be consumer and family driven.

Consumers working as peer service providers help expand the range and availability of services and support which professionals offer. Consumer providers also bring different attitudes, motivations and insights to the treatment encounter and overall continuum of care.  Consumers are trained and hired as mental health peer whole health coaches to join a fostering human service workforce.  Peers are trained to share their own personal experiences of recovery from mental illness and open doors that otherwise would remain closed due to the stigma and shame associated with mental illnesses.  Integrating them into traditional behavioral health programs may result in professionals experiencing firsthand the valuable contributions peers have to offer.

Well-trained peers can be a valued and important component of a treatment team.  Peers create an environment that encourages and supports healthy futures and even helps individuals in the middle of mental health crises believe that they can and will experience a healthy future.  Creating healthy futures is critical for everyone and adults diagnosed with a serious mental illness should not be overlooked.  This provides an incredible economic opportunity for disadvantaged individuals.

A peer workforce that is trained, work-ready and skilled not only effectively changes life for the peers employed but for other potential Peer Whole Health Coaches and for the providers and provider agencies they work in.  Peer Whole Health Coaches develop skills and abilities in teaching life skills including: financial literacy, housing assistance, job training, and nutritional assistance.  Working helps these individuals overcome their disability and reach and maintain recovery by providing income and motivation.  The act of giving back to the community has additional long term and lasting rewards that provide access to the basics:  food, clothing, shelter, medical care, and a social support network.  The peer workforce coaches people about accessing health care, disease prevention, health promotion initiatives, and health literacy.

Peer specialists are an untapped workforce who create an atmosphere of hope and acceptance often times working side by side with medical professionals.  Peer Whole Health Coaches provide evidence and support, demonstrating that recovery is possible. Integrating peer specialists into the workforce can and does reduce the stigma of mental illness. Peer Whole Health Coaches often completely change clinical staffs’ perceptions of their clients because they see them as people first, rather than exclusively as a person with a mental health diagnosis.

Stamping out stigma, one person at a time, occurs when peer specialists are respected members any “treatment” team. The Substance Abuse and Mental Health Services Agency (SAMHSA) hallmark and innovative 10×10 Wellness Campaign was established in 2010.  The 10×10 Wellness Campaign established the  importance of improving the eight  dimensions of a person’s life (Swarbrick 2006) with a goal to increase life expectancy for persons with serious persistent mental illness  by 10 years over the next 10 years to 2020.  Currently, where I live in the State of Texas, mental health consumers living in community mental health programs are dying on average at the young age of 52 (SAMHSA, 2011).  The 10×10 can aggressively work to increase individuals’ lifespan by ten years to age 62 years of age.

According to UMDNJ and CSP-NJ’s Dr. Margaret (Peggy) Swarbrick (2006), eight dimensions make up a personal’s life.  The dimensions are social, physical, emotional, spiritual, occupational, intellectual, environmental and financial.  The social includes the development of a sense of connection and a well-developed support system.  The physical realm recognizes the need for physical activity, diet, nutrition, and sleep while discouraging the use of tobacco, drugs, and excessive alcohol consumption.  The emotional world includes developing skills and strategies to cope effectively with stress, challenges, and conflict.  The spiritual world includes searching for meaning and purpose in human existence in one’s life.  The occupational links the individual into deriving personal satisfaction and enrichment from one’s work.  The intellectual recognizes that there are creative abilities and the need to find ways to expand knowledge and skills.  The environmental is fostering good health by occupying a pleasant, stimulating environment that support well-being.  The financial domain includes feeling satisfied with a current fiscal climate and having a foreseeable positive future financial situation.

SAMHSA envisions a future in which people living with mental health issues pursue optimal physical and behavioral health, happiness, and recovery (SAMHSA 10×10, 2010) in their communities through integrated services, supports, and resources.  Earlier morbidity and mortality rates of individuals living with a serious, persistent mental illness urgently requires attention and programs which address largely chronic illnesses (e.g., cardiovascular disease, respiratory diseases).  Health disparities in the SPMI population is widespread. Whole health and wellness is an incorporation of mental, emotional, physical, occupational, intellectual, and spiritual areas of living (SAMHSA 10×10, 2010) which affects quality of life (Dunn, H.L., 1997). For the SPMI population, physical and behavioral whole health and an integrated wellness program(s) is directly related to the quality and longevity of life.

The Medical Directors Council (2010) of the National Association of State Mental Health Program Directors overall health findings support the SAMHSA 10×10 Wellness initiative as physical and behavioral educational interventions are essential for individuals living with an SPMI and for healthy living.  Mental health recovery includes wellness.  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, p. 25).  Recovery refers to the process in which people are able to live, work, learn, and participate fully integrated within their communities as opposed to living within a silo, or living isolated away and from supports.

Particular nationwide consumer provided services such as the Peer Whole Health Coach Project working jointly with the San Antonio Elder Care (SAEC) is a peer pilot project funded through OptumHealth as well as the outstanding City of New York and the New York Association of Psychiatric Rehabilitation Association (NYAPRS) OptumHealth Chronic Illness Demonstration Project (CIDP) Health Home.  Peers work as subject matter experts on the mind, body and spirit connection through actively engaging their matched consumer with whole health and wellness solutions (e.g., nutrition, exercise).

Larry Fricks, CEO and Director of Training at Appalachian Consulting Group, is the national innovator who introduced the Whole Health Training Module into the Depression & Bipolar Support Alliance’s national Certified Peer Specialist certification training.  This is one example of how COSP’s can offer the Peer Whole Health Coach Project at SAEC.  Fricks has partnered in his vision to provide a direct 1:1 peer to peer service focused on providing an integrated whole health model of wellness (Appalachian Consulting, 2011; DBSA, 2011).

The National Association of State Mental Health Program Directors  (NASHMPD) issued a position paper in 1989 recognizing that mental health consumers have a unique contribution to make to the improvement of the quality of mental health services in many areas of the service delivery system.  NASMHPD recommended utilizing consumers to assist with program development, education of mental health service providers, and the provision of direct services (as employees of the mental health provider system).

Currently, the model used for a peer workforce utilizing a Medicaid reimbursable funding mechanism with local mental health authorities, state hospitals and COSP’s demand collaborative efforts publically/privately.  National managed care organizations throughout the U.S. currently offer triage treatment units for a peer to perform psychosocial rehabilitation services.  Additional services and areas of subject matter expertise through a peer can be provided such as:

  • Physical fitness wellness action plans.
  • Wellness Recovery Action Plan (WRAP) ® Wellness Plans with Daily Maintenance Plan.
  • Assume the role of being a WRAP PAL ® with matched mentorship provided.
  • Perform whole health screenings.
  • Offer information & referral services.
  • Financial literacy training.
  • Housing assistance and referral services.
  • Job training.
  • Nutritional coaching.
  • Life skills training.
  • Enhancing sleep hygiene.
  • Personal life change agency.
  • Community integration.
  • Educational rehabilitation counseling and referral services.
  • Vocational rehabilitation counseling and referral services.
  • Trauma informed care resiliency skill building.
  • Treatment team capable.

 I support a national peer certification and peer registry to be built by peers, consumer/survivor/ex-patients (c/s/x), Certified Peer Specialists (CPS), advocates, MH/SA stakeholders, our leadership and other interested individuals.  A state by state Medicaid reimbursable peer workforce is often folded into the state mental health and/or public health social service system.  Imagine a peer workforce managed and operated via a cooperative c/s/x, peer, CPS driven and c/s/x, peer and CPS led organization?  To name a few, a national peer workforce would invigorate cause for action to implement public/private MH/SA CPS specializing in, and but not be limited to:

  • Psychosocial rehabilitation, recovery and integration.
  • Be hope based.
  • Whole health, wellness and resiliency.
  • Be trauma informed care recovery and resiliency based.
  • Substance abuse/Dual Diagnosis.
  • Housing.
  • Information referral & resource providers.
  • State and federal disability benefits service provision.
  • Independent living.
  •  Veteran Americans.

A national peer certification is supported broadly by national leadership, c/s/x, CPS, peers, advocates, and other MH/SA stakeholder individuals and organizations that are publically and privately funded.  I welcome an invitation to the 2012 Pillars of Peer Support in order to participate, offer programmatic options and support the peer, CPS, c/s/x voice.

 

Citations

Anthony, W. B. (1990, 1993, 2000). Psychiatric Rehabilitation, Center for Psychiatric Rehabilitation, Boston University, Boston, MA.

 Aquila, R., & Emanuel, M. (2000). Interventions for weight gain in adults treated with novel antipsychotics.  Journaln of clinical Pyschiatry, 2, 20-23.

Ball, M., Coons, V. & Buchanan, R.W. (2001). A program for treating olanzapine related weight gain.  Psychiatric Services, 52, 967-969.

Banham L. and Gilbody S. (2010). Smoking cessation in severe mental illness: What works? Addiction 2010; 105: doi:10.1111/j.1360-0443.2010.02946.x

Bazelon (2003). Criminalization of People with Mental Illnesses.  The Role of Mental Health Courts in System Reform.

Beebe, L.H., Tian, L., Morris, N., Goodwin, A., Allen, S.S., & Kuldau, K. (2005). Effects of mental and physical health parameters of persons with schizophrenia.  Issues in Mental Health Nursing, 26, 661-676.

Borkman, T. (1990). Experiential professional and lay frames of reference. In T. J. Powell (Ed.) Working with self-help groups, (pp.3–30), Silver Springs, MD: NASW Press.

Brar, J.S., Ganguli, R., Pandina, G., Turkoz, I., Berry, S., & Mahmoud, R. (2005). Effects of behavioral therapy on weight loss in overweight and obese patients with schizophrenia or schizoaffective disorder. . Journal of clinical Psychiatry, 66, 205-212.

Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, (2010). http://www.cdc.gov/brfss/.

Center for Disease Control National Center for Chronic Disease Prevention and Health Promotion Chronic Disease Indicators, Behavioral Risk Factor Surveillance System, (2010). Cigarette smoking among adults aged >=18 years category: tobacco and alcohol, Retrieved September 13, 2010, https://apps.nccd.cdc.gov/cdi?IndDefinition.aspx?IndicatorDefinition.

Centorrino, F., Wurtman, J.J., Duca, K.A.,  Fellman, V.H., Fogarty, K.V., Berry, J.M., Guay,

D.M., Romeling, M., Kidwell, J., Cincotta, S.L., & Baldessarini, R.J. (2006).  Weight loss in overweight patients maintained on atypical antipsychotic agents.  International Journal of Obesity, 30, 1011-1016.

Chafetz, L., White, M., Collins-Bride, G., Bruce, B.A., & Nickens, J. (20008). Clinical trial of wellness traininging: Health promotion for the mentally ill  Journal of Nervous and Mental Disease 196(6), 475-483.

Chinman, M., Rosenheck, R., Lam, J., & Davidson, L. (2000). Comparing consumer and nonconsumer provided case management services for homeless persons with serious mental illness. Journal of Nervous & Mental Disease, 188, 446–453.

Chinman, M., Weingarten, R., Stayner, D., & Davidson, L. (2001). Chronicity reconsidered: Improving person-environment fit through a consumer-run service. Community Mental Health Journal, 37, 215–229.

Christensen, A., & Jacobson, N. (1994). Who (or what) can do psychotherapy: The status and challenge of nonprofessional therapies. Psychological Science, 5, 8–14.

Clarke, G., Herinckx, H., Kinney, R., Paulson, R., Cutler, D., & Oxman, E. (2000). Psychiatric hospitalizations, arrests, emergency room visits, and homelessness of clients with serious and persistent mental illness: Findings from a randomized trial of two ACT programs vs. usual care. Mental Health Services Research, 2, 155–164.

Cook, J., Jonikas, J., & Razzano, L. (1995). A randomized evaluation of consumer versus nonconsumer training of state mental health service providers.  31, 220–238.

Copeland, M. E. (2002). Wellness Recovery Action Plan. West Dummerston, VT: Peach Press.

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.

Davidson, L., Chinman, M., Kloos, B., Weingarten, R., Stayner, D., & Tebes, J. (1999). Peer support among individuals with severe mental illness: A review of the evidence. Clinical Psychology: Science and Practice, 6, 165–187.

Davison, K., Pennebacker, J., & Dickerson, S. (2000). Who talks? Social psychology of illness support groups. American Psychologist, 55, 205–217.

Dixon, L., Hackmann, A., & Lehman, A. (1997). Consumer as staff in assertive community treatment programs. Administration and Policy in Mental Health, 25, 199–208.

Dixon, L., Krauss, N., & Lehman, A. (1994). Consumers as service providers: The promise and challenge. Community Mental Health Journal, 30, 615–625.

Dunn, H.L. (1977). What high level wellness means. Health Values 1(1), 9-16

Edmunson, E., Bedell, J., Archer, R., & Gordon, R. (1982). Integrating skill building and

peer support in mental health treatment: The early intervention and community network

development projects. In M. Jeger & R. Slotnick (Eds). Community Mental Health and Behavioral Ecology, 127–139. New York: Plenum Press.

Edmunson, E., Bedell, J., & Gordon, R. (1984). The Community Network Development

Project: Bridging the gap between professional aftercare and self-help. In A. Gartner & F. Riessman, (Eds.) The Self- Help Revolution, New York.

Elias, M. (2007, May 3). Mentally ill die 25 years earlier, on average. USA Today

Ell, K. (1996). Social networks, social support and coping with serious illness: The family connection. Social Science and Medicine, 42, 173–183.

Everly, G. (2002). Thoughts of peer (paraprofessional) support in the provision of mental health services. International Journal of Emergency Mental Health, 4, 89–90.

Felton, C., Stastny, P., et al., (1995) Consumers as Peer Specialists on Intensive Case Management Teams: Impact on Client Outcomes. Psychiatric Services Vol. 46 No. 10.

Fisher, D.B. (2010). The National Coalition for Consumer Advocacy, Boston, MA.

Frese, F., & Davis, W. (1997). The consumer-survivor movement, recovery, and consumer professional. Professional Psychology: Research and Practice, 28, 243–245.

Fricks, L., (2009) NASMHPD Sixth National Summit of State Psychiatric Hospital

Superintendents and the NASMHPD Summer 2009 Commissioner Meeting Powerpoint

Presentation, St. Louis, MO.

Galanter, M. (1988). Zealous self-help groups as adjuncts to psychiatric treatment: A

study of Recovery, Inc. American Journal of Psychiatry, 145, 1248–1253.

Galanter, M. (1988). Zealous self-help groups as adjuncts to psychiatric treatment:  A

study of Recovery, Inc. American Journal of Psychiatry, 145, 1248–1253.

Gartner, A., & Riessman, F. (1982). Self-help and mental health. Hospital & Community

Psychiatry, 33, 631–635.

George, L., Blazer, D., Hughes, D., & Fowler, N. (1989). Social support and the outcome of major depression. British Journal of Psychiatry, 154, 478–485.

Gottlieb, B. (Ed.) (1981). Social Networks and Social Support. Sage, Beverly Hills.

Gottlieb, B. (1982). Mutual-help groups: Members’ views of their benefits and of

roles for professionals. In L. Borman, L. Borck, R. Hess, & F. Pasquale (Eds.).

Helping People to Help Themselves: Self-Help and Prevention. New York. The Haworth Press, Inc.

Gould, R. A., & Clum, G. A. (1993). A metaanalysis of self-help treatment approaches.

Clinical Psychology Review, 13, 169–186.

Harvard Mental Health Letter. Mental illness and medical care. (2003). [Electronic Version].

Harvard University; Cambridge, MA.

Healthy People 2010 statistical notes, no. 20. Retrieved September 13, 2010, http://www.cdc.gov/nchs/data/statnt/statnt20.pdf.

Heiligenstein, E. & Stevens, S. (2006). Smoking and mental health problems in treatment seeking university students. Nicotine and Tobacco Research. 8:1-5.

Hodges, J., Markward, M., Keele, C., & Evans, C. (2003). Use of self-help services and

consumer satisfaction with professional mental health services. Psychiatric Services, 54, 1161–1163.

Humphreys, K. (1997). Individual and social benefits of mutual aid self-help groups.

Social Policy, Spring, 12–19.

Hutchinson, D.S., (1996) “Promoting Wellness in Rehabilitation and Recovery – A Call to Action”. Community Support Network News, Vol. 11, No. 2.

Hutchinson, D.S., Skrinar, G.S., & Cross, C. (1999).  The role of improved physical fitness in mental health and recovery. Psychiatric Rehabilitation Journal 2294), 355-359.

Jean-Baptiste, M., Tek, C., Liskov, E., Chakunta, U.R., Nicholls, S., Hassan, A.Q., Brownell, K.D., & Wexler, B.E. (2007).

Kalarchian, M.A., Marcus, M.D., Levine, M.D., Haas, G.L., Greeno, C.G., Weissfeld, L.>A., & Qin, L. (2005).  Behavioral treatment of obesity in patients taking antipsychotic medications. Journal of Clinical Psychiatry, 66, 1058-1063.

Katz A., & Bender, E. (Eds). (1976) The strength in us: Self-help groups in the modern

world. New York: Franklin Watts. Kaufman, C. (1995). The self-help employment center: Some outcomes from the first year. Psychosocial Rehabilitation Journal, 18, 145–162.

Kaufman, C., Schulberg, H., & Schooler, N. (1994). Self-help group participation among people with severe mental illness. Prevention in Human Services, 11, 315–331.

Littrell, K.H., Hilligoss, N.M., Kirshner, C.D., Richard, G.P., & Johnson, C.G. (2003). The effects of an educational intervention on antipsychotic induced weight gain. Journal of Nursing Scholarship, 35, 237-241.

McDevitt, J., & Weilbur, J. (2006).  Exercise and people with serious, persistent mental illness.  American Journal of Nursing, 106, 50-54.

McKibbin, C.L., Patterson, T.L., Norman, G., Patrick, K., Jin, H., Roesch, S., Mudaliar, S., Barrio, C., O-Hanlon, K., Griver, K., Sirkin, A., & Jeste, D.V. (2006). A lifestyle intervention for older schizophrenia patients with diabetes mellitus: A randomized controlled trial. Schizophrenia Research, 86, 36-44.

Mead, S., Hilton, D., Curtis, L., (2001) Peer Support: A Theoretical Perspective. Psychiatric Rehabilitation Journal. Vol. 25 No. 2

Mental Health America (2008). Publications. Retrieved, September 13, 2010, http://www.mentalhealthamerica.net.

Mental Health America of Texas (2003, 2004, 2008). Publications. Retrieved, September 13, 2010, http://www.mhatexas.org.

Menza, M., Vreeland, B., Minsky, S., M., Gara, M., Radler, D.R., & Sakowitz, m. (2004).  Managing atypical antipsychotic-associated weight gain: 12-month data on a multimodal weight control program.  Journal of Clinical Psychiatry, 65, 471-477.

Miller, L., & Miller, L. (1997). A.N.G.E.L.S., Inc. Consumer-run supported employment

agency. Psychiatric Rehabilitation Journal, 21, 160–163.

Mirza I, Phelan M. (2002). Managing physical illness in people with serious mental illness.

[Electronic Version] Hosp Med. 63(9):535–539.

National Institute on Mental Health (2010). Publications. Retrieved, September 13, 2010, http://www.nimh.hhs.gov.

New Freedom Commission on Mental Health, Achieving the Promise: Transforming Mental

Health Care in America. (2003). Final Report. DHHS Pub. No. SMA-03-3832. Rockville,

MD.

Nikkel, R., Smith, G., & Edwards, D. (1992). A consumer-operated case management project. Hospital & Community Psychiatry, 43, 577–579.

Oregon Health & Science University Smoking Cessation Center (2009).  Key Factors  in the treatment of smokers with mental illness. Portland, Oregon 97239. Retrieved September 13, 2010, www.tcln.org.

Parks, J., Svendsen, D., Singer, P., Foti, M. E., (Eds). (2006). Morbidity and Mortality in People with Serious Mental Illness. National Association of State Mental Health Program Directors (NASMHPD) Medical Directors Council. Alexandria, VA. Retrieved September 13, 2010, http://www.nasmhpd.org/general_files/publications/med_directors_pubs/technical%20report%20on%20morbidity%20and%20mortaility%20-%20final%2011-06.pdf.

Pelletier, J.R., Nguyen, M., Bradley, K., Johnsen, M., & McKay, C. (2005). A study of a structured exercise program with members of an ICCD Certified Clubhouse:  Program design, benefits, and implications for feasibility. Psychiatric Rehabilitation Journal, 29(2), 89-96.

Powell, T., Yeaton, W., Hill, E., & Silk, K. (2001). Predictors of psychosocial outcomes for patients with mood disorders: The effects of self-help group participation. Psychiatric Rehabilitation Journal, 25, 3–11.

Practice Guideline for the Treatment of Patients with Substance Use Disorders. American Psychiatric Association. 2006. Retrieved, September 13, 2010, http://www.psych.org/psych_pract/treatg/pg/SUD2ePG_04-28-06.pdf .

Raiff, N. (1984). Some health related outcomes of self-help participation: Recovery, Inc. as a case example of a self-help organization in mental health. In A. Gardner & F. Reissman (Eds.) The self-help revolution. New York, Human Sciences Press.

Rogers, E.L., Farkas, M., Anthony, W., Kash, M., Maru, M. (2010). Plain Language Summary, Systematic Review of Peer Delivered Services Literature 1989-2009, Conducted by The Center for Psychiatric Rehabilitation with support from the National Institute on Disability and Rehabilitation Research, Boston University (2010).

Richardson, C.R., Avripas, S.A., Neal, D.L., & Marcus, S.M. (2005). Incrasing lifestyle physical activity in patients with depression or other serious mental illness.  Journal of Pychiatric practice, 11, 379-388.

Rotatori, A.F., Fox, R., & Wicks, A. (1980). Weight loss with psychiatric residents in a behavioral self control program. Psychological Reports, 46, 483-486.

Salzer, M., Mental Health Association of Southeastern Pennsylvania Best Practices Team. (2002). Best practice guidelines for consumer-delivered services. Behavioral Health Recovery Management Project, Initiative of Fayette Companies, Peoria, IL and Chestnut Health Systems, Bloomington, IL.

Salzer, M. (1997). Consumer empowerment in mental health organizations: Concept,

benefits, and impediments. Administration and Policy in Mental Health, 24, 425–434.

Salzer, M., & Shear, S. L. (2002). Identifying consumer-provider benefits in evaluations

of consumer-delivered services. Psychiatric Rehabilitation Journal, 25, 281–288.

Sarason, I., Levine, H., Basham, R., & Sarason, B. (1983). Assessing social support: The social support questionnaire. Journal of Personality and Social Psychology, 44, 127–139.

Shubert, M., & Borkman, T. (1994). Identifying the experiential knowledge developed

within a self-help group. In T. Powell (Ed.) Understanding the self-help organization.

Thousand Oaks: Sage.

Skrinar, G.S., Huxley, N.A., Hutchinson, D.S., Menninger, E., & Glew, P. (2005). The role of a fitness intervention on people with serious psychiatric disabilities.  Psychiatric Rehabilitation Journal, 29(2), 122-127.

Solomon, P., & Draine, J. (1995a). The efficacy of consumer case management team: 2-year outcomes of a randomized trial. The Journal of Mental Health Administration, 22, 135–146.

Solomon, P., & Draine, J. (2001). The state of knowledge of the effectiveness of consumer provided services. Psychiatric Rehabilitation Journal, 25, 20–27.

Solomon, P., (2004). Peer Support/Peer Provided Services Underlying Processes, Benefits, And Critical Ingredients. Psychiatric Rehabilitation Journal Vol. 27. No 4.

State of New Mexico (2009). Retrieved September 13, 2010, www.state.nm.us/hsd/bhdwg/index/html, http://www.health.state.nm.us.

Stroul, B. A. (Ed.). (1993a). Children’s mental health: Creating systems of care in a changing society. Baltimore: Paul H. Brookes.

Stroul, B. A. (1993b). Systems of care for children and adolescents with severe emotional disturbances: What are the results? Washington, DC: CASSP Technical Assistance Center, Georgetown University Child Development Center.

Substance Abuse and Mental Health Services Administration (SAMHSA) (ND). Consumer/survivor-operated self-help programs: A technical report. SAMHSA, CMHS. Rockville, Maryland.

Swarbrick, M. (2006). A wellness approach. Psychiatric Rehabilitation Journal, 29, (4) 311- 314.

TAPA (2004) http://gainscenter.samhsa.gov/resources/presentation_materialSept4NetConf.ppt, Derived March 3, 2009.

Swarbrick, M. (1997, March). A wellness model for clients. Mental Health Special Interest Section Quarterly, 20, 1-4.

Swarbrick, M. (2011). Community Services Program-New Jersey (CSP-NJ) Whole Health & Wellness Newsletter.

Thorndike, A.N., Stafford, R.S., Rigotti, N.A. (2001). US physicians’ treatment of smoking in outpatients with psychiatric diagnoses. Nicotine Tob Res.3:85-91.

Vreeland, B., Minsky, S., Menza, M., Radler, D.R., Roemheld0-Hamm, B., & Stern, R. (2003). A program for managing weight gain associated with atypical antipsychotics. Psychiatric Services, 54, 1155-1157.

Walsh, J., & Connelly, P. (1996). Supportive behaviors in natural support networks of people with serious mental illness. Health & Social Work, 21, 296–303.

Weber, M., Colon, M., & Nelson, M. (2008).  Pilot study of a cignotive behavioral group intervention to prevent further weight gain in Hispanic individuals with schizophrenia. Journal of the American Psychiatric Nurses Association, 13, 353-359.

Weber, M., & Wyne, K. (2006). A cognitive/behavioral group intervention for weight loss in patients treated with atypical antipsychotics. Schizophrenia Research, 83, 95-101.

Weed, D. (1999). Health Lifestyle Workbook for Consumers of Mental health Services. Fall River Health and Human Services Coalition, Inc., Massachusetts Health Research Institute.

Wellness Recovery Action Plan ® (2009). Copeland Center, Vermont.

WHO (2008). The world health report 2008: Primary Health Care Now More Than Ever.

Geneva, World Health Organization.

Williams, J.M., Hughes, J.R. (2003). Pharmacotherapy treatments for tobacco dependence among smokers with mental illness or addiction. Psychiatric Annals. 33(7),457-466.

Wirshing, D.A., Smith, R.A., Erickson, Z.D., .Mena, S.J., & Wirsing, W.C., (2006). A wellness class for inpatients with psychotic disorders. Journal of Psychiatric Practice, 12, 24-32.

World Mental Health Day 2009 (2009). Mental Health In Primary Care: Enhancing Treatment And Promoting Mental Health, World Federation for Mental Health. Retrieved from http://www.wfmh.org/WMHD%2009%20Languages/ENGLISH%20WMHD09.pdf.

University of Texas at Austin Hogg Foundation for Mental Health (2011) Integrated health care, http://www.utexas.edu.

US PSYCHIATRIC REHABILITATION ASSOCIATION NATIONAL (2011) Cores and Principals of Psychiatric Rehabilitation, Retrieved August 3, 2011, http://www.uspra.org.

 

18 COMMENTS

    • Dear hogwash,

      Excellent analysis. This article made me literally sick in that it’s the same deadly stigmatizing and forcing lethal torture treatments of drugs or ECT involuntarily with the pretense of doing it in an egalitarian, healthy way. This is Orwellian doublespeak by the BIG PHARMA/PSYCHIATRY/GOVERNMENT totalitarian dictatorship trying to cover up their latest evil eugenics targeting of certain groups to justify robbing them of all human rights and plotting their latest euthanasia projects that are getting too obvious now, requiring a positive spin of “concern” about their health, which was the nightmare lie used in the first place about “mental health” to perpetrate this and other crimes against humanity.

      I have no doubt this blogger has good intentions, but I also have no doubt that any government agency has no good intentions when it comes to so called “mental health” due to their horrific actions and laws to date.” This type of program would just give would be victims a false sense of security to make them more willing sheep to the slaughter that is biological, mainstream psychiatry.

      George Bush, some experts have labeled a psychopath, and his father had huge family ties to Ely Lilly, which is why he created the Orwellian “NEW FREEDOM COMMITTEE” with psychiatrist Sally Satel bent on robbing all Americans of their civil and human rights with bogus labels and forced drugging. Bush colluded to push all the horrific “mental illness” screening from the cradle to the grave for the sole, souless purpose of pushing more toxic psych drugs on the majority if not all citizens with the pretense of the nobel aim of funding/promoting “mental health.” Along with starting the bogus IRAQ war to collude with the military industrial complex and power elite to rob more wealth from one more country preyed on by the U.S. for self serving reasons, George Bush also has the dubious honor of ensuring our children would be subjected to the worst medical catastrophe and betrayal ever with psychiatry’s fraud labels and poison drugs guaranteed to permanently disable them to make them the good, docile, apathetic sheep ready to do the bidding of the 1% power elite including the Bushes as they have been plotting for decades.

      SAMSHA is the agency the censored Bob Whitaker, making their true “mission” all too horribly clear.

      • Seems like they think they can develop a cheaply paid version of their own system using psychiatrized “Kapos” to run it without changing anything but the veneer.

        “Physical fitness wellness action plans” for those with practically irreversible weight gain and severe metabolic damage from the drugs.

        “Perform whole health screenings” in order to do absolutely too little too late or nothing at all once a “SPMI” starts to become chronically sick from the drugs and maybe even has diabetes going on.

        “Offer information & referral services” such as making crafts in the mental health center basement or going to NAMI and DBSA meetings to get brainwashed into complying with the early death regimen.

        “Financial literacy training”, so the “SPMI” know exactly how to spend their meager incomes of $700 a month that mostly gets turned over to the agencies running their lives.

        “Housing assistance and referral services” on how to find and rent a hovel from a slumlord.

        “Job training” to prepare the “SPMI” to work in sheltered wage-slavery workshops.

        “Nutritional coaching” so that the “SMPI” know how best to shop for food if they could afford anything other than pre-packaged, high-calorie, carb-laden garbage.

        “Life skills training” so the “SPMI” know how to do their laundry.

        “Enhancing sleep hygiene” for the “SPMI” who rarely get their own bedrooms and usually have to share with someone who is ranting or snoring in the group home or hospital. These are called “ear plugs”.

        “Personal life change agency” for the “SPMI” who have almost no control over their lives and have to get approval from someone else for just about everything, including when to pee.

        “Community integration” for those “SPMI” who have been drugged and quieted enough to live on the outside in the “community” but in settings that are worse than most people provide for their dogs.

        “Educational rehabilitation counseling and referral services” to provide jobs for state employees and newly graduated college students while crowding the “SPMI” into little “classrooms” and teaching them they they too can someday be a janitor at McDonalds if they can stay awake on the drugs.

        “Vocational rehabilitation counseling and referral services” where “SPMI” can go to get interviewed by people who don’t really believe that they can benefit from an education and instead would like to send them to a workshop to learn how to assemble and package junk for minimum wage.

        “Trauma informed care resiliency skill building” is a bone that SAMHSA is throwing out there to make this pig of theirs look nice.

        “Treatment team capable” “peers” are “peers” that promote the psychiatric agenda. Some call them “traitors”.

        • Dear Unimpressed,

          Again, superb analyis and exposure of the latest “veneer” promoted by the mental death profession otherwise known as dangerous BS!! Very witty but sad exposure of the truth behind their bogus pretense of improving health or the lives they destroy with impunity by a known eugenics demolition enterprise to profit all the more from the massive human suffering they create from their insatiable greed, lust for absolute power and control over every human on the face of the earth to inflict global slavery, pathological lying and lack of any conscience. Per Dr. Robert Hare, these are the traits of psychopathy, which may also be applied to corporations. See book and DVD, THE CORPORATION, in which the creator does make this claim with insights from Dr. Hare.

        • What you said is damn true it is actually horrifying. I have been there and done that and I damn well refuse to do it again. You forgot the clubhouse model where you either sit all day and do absolutely nothing or you attend life skills classes (which I did after even receiving a college degree and working) where the teacher believes in tough love and hollers at you and makes you stand up in class when you fall asleep from the side effects of your meds. She felt you were attacking her competency. I was forced into a sheltered workshop in the 1990s by vr because they wouldn’t send me out on a job without knowing how I worked! Then, at the workshop, they put me in with developmentally disabled on meaningless tasks at so much less than the regular rate of pay demoralizing both me and the developmentally disabled involved. As far as peer counselors; I will never trust them. They, unknowingly, are involved and brainwashed by the evil system, also. I saw one once and she was old as my mother; about eighty. I have nothing against those who are “elderly” They, too, have been much tortured and disregarded in America. She told me to get on some blood type which in addition to the withdrawal I was undergoing almost killed me. I am so sorry sometimes I get so filled with rage at what has been done to me in the name of false mean-spirited goodness to really keep me in little place as an allegedly sick person. This is a tragedy that needs to be righted soon. What more can I say?

      • Peer certification? Spare me the condescending garbage. ‘Consumer’? Are you kidding me?

        Interesting how she uses the unfortunate choice of words ‘certify’ when talking about people who in the past have been labeled as ‘certifiable’.

        So this is what psychiatry has come to? first they make people disabled and unemployable by creating learned helplessness and drug induced brain damage, and then they offer them a fake job palling around with psychiatrists and psych nurses in mental hospitals.

        I can’t wait to be locked on the ward and have one of these ‘peers’ point me in the direction of the suggestion box when I complain I have no human rights.

        What are the chances of a ‘peer’ network being allowed on psychiatry’s turf if they don’t take psychiatric drugs and believe in psychiatry’s lies?

        My peers are the people who believe I deserve rights, not some Uncle Tom ex mental patient who is still drugged to the nines and such a model of recovery that they are on disability for life, who have a part time ‘make work’ job handing out pamphlets full of empty rhetoric ready-made and pre-packaged from SAMHSA spin doctors.

        God grant me the serenity to comprehend how lucky I am that I can see through the lies. In another version of this life, I might actually be leaving comments of praise on this sad, sad ‘peer certification’ paper.

  1. I wholeheartedly agree with unimpressed, but want to specify: people supposedly suffering from “SPMI” die on average 25 years earlier than the general population. The 10 x 10 Wellness Campaign can potentially, according to this post, take 10 years off those 25 years lost. What’s wrong with the campaign that it can’t take 25 years off those 25 years???

    All that these campaigns, which we also see massively touted here in Denmark as THE solution to the problem of the drugs killing people, do is rearranging the deck chairs on the Titanic, while of course they can make those who label others with “SPMI”, and then tell them they can’t live without life-shortening drugs, feel better about their mistreatment of the labelled, and allow them to, continuedly, avoid having to face reality.

    • Also, claiming this should be family/consumer oriented means drug front funded groups like NAMI AND CHADD helping BIG PHARMA/PSYCHIATRY/GOVERNMENT push more life destroying stigmas and torture treatements that these horrible narcissistic groups falsely claim those unfortunate or ignorant enough to see a psychiatrist are a danger to the public and themselves to pass more totalitarian laws to rob more and more citizens of their civil and human rights. The fact that so called family members could do this to their so called families and society at at large shows most if not all are narcissists and/or sociopaths who drove their so called families crazy!! Beware of BIG BROHTER since 1984 has come with a vengeance!!

      • What good is it to gain 10 or 25 years back if psychiatry has destroyed your life and made it a living hell, which is their true purpose as instruments of social control in our growing police state. Many of these deaths are suicides caused by psychiatry’s demolition enterprise against their so called patients, which is maybe an additional number needing to be added to those who die due to their poisoning and deliberate brain/body damage. See article on the harm of DSM stigmas posted here today by Dr. Paula Caplan as an example of how psychiatry destroys constant lives by medicalizing normal life stressors for their own greed, profit, power and status. “What good is it to gain the whole world and lose your soul?”

  2. The words “support and acceptance” make me shiver because it means “brain-washing” into believing biop-sychiaty’s mental illness and broken-brain theories by already brainwashed peers. We were at the receiving end of that one in Britain

  3. I’d be interested in getting certified and participating as a peer counselor but, as posters above have noted, I would have a great deal of difficulty working in an environment where biopsychiatry reigned and medication regimens were regarded as having come down from God.

    (FYI, see http://onlinelibrary.wiley.com/doi/10.1002/hec.1737/abstract — they really don’t know what they’re doing! It’s not just a few bad apples.)

    Since my area of specialty is safe withdrawal from psychiatric medications, which in a rational world would be valuable expertise, I don’t expect to be very popular in conventional mental health settings.

    I imagine being a peer counselor would be in a similar situation to ethically conflicted doctors, but without the remuneration. I’d be very interested to hear of people’s experiences as peer counselors.

  4. I really don’t have the energy to write a treatise on all the reasons I find this article objectionable – although I agree with the critiques offered by several other posters, above. The only thing that I’ll add is that I find it reprehensible when a person who defines him or herself as a “peer” uses the system’s pathologizing language to refer to people with psychiatric histories. It’s dreadful enough to refer to people as “seriously and persistently mentally ill,” but to refer to them by the horrific acronym “SPMI” is just beyond comprehension.

  5. Many of the remarks of others replying here I agree with. The one point that strikes me is that the article seems to reflect the position of people who just don’t understand the word “recovery” in a helpful sense: the article states for example; “Peers are trained to share their own personal experiences of recovery from mental illness and open doors that otherwise would remain closed due to the stigma and shame associated with mental illnesses”.
    That is the definition used by those who buy the medical model. The “recovery” used by former psychiatric inmate’s means not recovery from “mental illness”, but recovery from the “treatment”.
    The existing drive for peer certification has become a strategic thrust on the part of those advocating the status quo to divide and conquer the current and former psychiatric inmate population and its efforts to restore their civil rights and lives.

  6. I just found this article. I agree with the comments here. Jen, were you being sarcastic? I am shocked. I would never ever want “training” to be a peer. I had over three decades of the best training ever. I spent time in institutions. I was inpatient over 50 times, used up my 190 Medicare days, and I guess they wanted to squeeze out all they could get. I think I need MORE training! Maybe I should rob a bank, no, I don’t mean to pay college tuition or to pay for said “training,” but so that I would get caught and spend time in a criminal prison. That would add stripes to my already overloaded uniform.

    When I first saw how the “peers” were being trained, I found that their training had no relevance to eating disorders, which were my problem. They failed especially to address the restrictive aspect. I was so put off that I told myself there was simply no point in attending their “retreat” since I’d have nothing in common with anyone there. Many, of course, defined “health” as “losing weight and exercise.” I would have dropped dead had I lost any more weight at the time. I was rather bewildered.

    I had state “services” which meant they sent this completely clueless person to visit me once a week. This proved to be a total nuisance. The state people knew nothing about what I was experiencing. This seems to be true for many people in my position who had these “state services.” A non-service for sure!

    One of these service people did know about ED. I only had her briefly. I liked her. She actually disappeared one day and then when she reappeared she was taken off my case. I can say in the long run she wasn’t that helpful, serving to urge me to stay in the same system that was killing me, not only killing my soul, but killing my body too.

    The best thing I ever did was to ditch these services. The coordinator of that team harassed me after that. I had to put blocks on my phone and email even. Finally, I received a snail mail. I threatened to take action since this was clearly uncalled for as I had already canceled the “service.” They kept calling me, trying to lure me back. I owe a lot to myself for making this smart decision. With no one to track me down, free of their babysitting, I was able to successfully walk out of the USA a free person and no one back there even noticed I was gone for two months.

    If anyone out there REALLY wants to ditch diagnosis and get free, ditch the “services” and you’ll be one giant step in the right direction. Show them you don’t need them. Dependent and needy no more! Who needs that?

    Julie Greene

  7. Oh my goodness that awful clubhouse. That was supposed to be the new great thing. Why the babyish name “clubhouse”? Well, it was just that. I remember being told to count about 500 pennies, then to count them again “because you might have made a mistake.” No more than anyone else might make a mistake, I should have said. Then, I mentioned to them that I’d like to go to school. They said, “Okay, we have sheltered classes.” I told them I had like 15/16ths of a bachelor’s degree which was most likely more than any “staff” had. They seemed to think I wasn’t very smart and wouldn’t let me near the computer. I finished my bachelor’s degree summa cum laude in 2003, went on to grad school (the shrinks objected) and then graduated without “accommodations” and no way did the school grant me a master’s degree out of tokenism for a “disabled” person. I am extremely lucky that I was born with high intelligence and I always enjoyed using it. I thrived in academic environments. That went over the clubhouse’s heads, apparently. When I had state “services” they couldn’t understand why I would write and study at the library all day. They assumed I was sitting at home watching the tube, wasting my life. The usual expectation, that we are useless, stupid, incapable, lazy…all the things that for sure I never was before I entered the MH system. Leaving the System entirely meant rekindling all that, using my REAL skills again, and feeling loved and wanted and happy and peaceful, and very much a rebel…the way I really was all along.