The Recovery INSPIRER
Welcome to
Peer Voice NC's
Monthly Newsletter!
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North Carolina has joined 26 other states that have received federal funding from the Substance Abuse Mental Health Services Administration (SAMHSA) to build a unified, vocal, and influential statewide peer and "consumer" movement, Peer Voice NC (PVNC)!
This monthly update, along with weekly updates on PVNC's facebook page, will share progress, challenges and opportunities as PVNC evolves.
In this edition:
National Consumer TA Centers
The Origins of the Peer Role
Has Peer Support Become Co-Opted?
Peer Support: Reclaiming Lived Experience
PVNC Coalition Updates
Peer Wellness Center Pilot
Recovery Alternatives to Forced Tx
Peer Justice Initiative
Peer Support Standards
Let's Talk About Suicide
What's Next for PVNC?
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Peer Voice NC Is....
A Grassroots
MOVEMENT
that is
by Us, for Us
to challenge illness based systems and services
and have a valued voice and leadership
to impact social justice issues
and advance recovery and peer support policy, standards and practices
Guided by the
WISDOM
that can
only
be gained from being directly impacted
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National Consumer
Technical Assistance Centers
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In addition to statewide peer and "consumer" organizations, there are 5 National Consumer and Consumer Supported Technical Assistance Centers (NCTAC) funded by SAMHSA.
NCTAC's have played a critical role in advancing "consumer"-operated organizations, establishing peer-led approaches to healing, wellness and recovery, providing national training and education to strengthen leadership skills of people with lived experience, supporting the sustainability of peer-operated organizations and providing technical assistance on recovery-based practices such as shared decision making, crisis alternatives and peer support.
NCTAC's are an excellent source of information and offer free webinars, national trends and research! Click on each logo to learn more about each of the National TA Centers
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The Origins of the Peer Role
While peer support in NC is currently in the context of mental health and substance use services, the origins of peer support date back to the 18th Century when a mental health patient, Jean Baptiste Pussin, began supporting other patients in an "insane asylum."
Dr. Phillip Pinel observed the impact of Pussin's support and used it as the foundation of a reform effort called the Moral Movement.
A similar movement in the "addictions" community started in the 1840's with Temperance Missionaries and Inebriate Homes.
Contemporary peer support owes its success in large part to the
mental health consumer movement
of the 1970s. This movement marked the first time that former mental health patients began uniting, providing support to one another, and, borrowing from the Civil, Women's, Gay and Disability Rights movements, began demanding equality and opportunity. Uniquely, however, the Consumer/Survivor/Ex-Patient (C/S/X) movement also shared how they recovered in spite of the belief that recovery was not possible for people with psychiatric diagnoses. Together they began fighting against oppressive and inhumane treatments while raising the expectation of recovery.
The tools they used to do so are the same that PVNC is using today to build the NC peer and "consumer" movement:
Organizing and Mobilizing
Consciousness Raising
Self-Help and Empowerment
Advocacy and Self-Advocacy
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Goal 1:
Establish an independent, statewide mental health peer and "consumer" organization through coalition building and investing in peer leadership
Goal 2
: Develop and operate a NC Peer and Recovery Technical Assistance Center to incubate, launch and disseminate innovative recovery and peer support related tools, resources, models and training
Goal 3:
Enhance NCCPSS skills, knowledge and competencies by providing peer and recovery related continuing education and advanced education
Goal 4:
Enhance peer support supervisor skills, knowledge and competencies by providing peer and recovery related continuing education
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Has Peer Support Become
Co-Opted?
The use of Peer Support Specialists in the mental health systems began to rise in the 1980's. When it became a Medicaid billable service in the 1990's, dilemmas emerged about ensuring that the peer support role does not get "co-opted" by services and systems, relegated to tasks that contradict the values, ethics and integrity of peer support, and inequity of pay and exploitation as workers.
Concerns about the co-optation of peer support has been shared for many years by recovery and peer support pioneers. In 2018, it was written "as peer support emerges as a discipline.. there is a growing concern that it risks being co-opted by the very systems it was meant to change... Peer supporters, because of the environment, culture, relationships with co-workers, they often, unfortunately too often, tend to perform and practice more like traditional clinicians than they do peer supporters"
(
Evans, I., 2018, https://psychcentral.com/blog/peer-support-peer-problems/
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Co-Optation of Peer Support? You Decide...
- CPSS uses terms such as "client, consumer or patient" when referring to people
- Peer Support Specialist is monitoring, managing, or ensuring treatment compliance
- Peer Worker is using labels such as "frequent flyer, non-compliant, manipulative, unmotivated, cutter, attention seeker..."
- CPSS is being used as the "mole" to gather information from a person supported solely to share with the treatment team
- A CPSS does not have mutual lived experience with the other person... they can't truly say "I understand, I've been there and done that"
- CPSS role is to "transport" and drop off medications
- A CPSS is being utilized as a Case Manager or Paraprofessional
- CPSS's being involved in involuntary hospital commitment (IVC)
- CPSS's required to have clinical supervision
- CPSS giving advice rather than support
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Peer Support: Reclaiming Lived Recovery Experience
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"Peer Support" is a concept that is often confused, misused and misunderstood. It appears really simple at first; one person with "lived experience" providing support to another person that is "struggling" with mental health, substance use and related life challenges. Well, not so fast...upon further examination, its actually quite complex.
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We ALL Have a Story to Tell... Don't We?
The notion that "
we all have a story to tell... we're all in recovery from something
," has become a mantra that is used to qualify every person as having "lived experience." From divorce to cigarette cessation, these experiences are being cited as qualifications for participation and certification as a NC Peer Support Specialist. So what?!?
While it is likely true that most people have overcome life hurdles, difficult days, and events that made getting out of bed difficult at times, this is not the same as the experience of being a psychiatric survivor, returning citizen, recovering from a substance use disorder, surviving a suicide attempt, experiencing homelessness, and other extreme life circumstances.
Most people can relate to feeling different, sad, and fearful. However, most people cannot relate to the disruptions in employment, school, losing ones freedom, and overcoming the messages that relegate a person to being nothing more than a "client, consumer, member, resident or patient."
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Been There, Done That...
When people say they are in recovery, what does that actually mean? In recovery from what? Of course, a part of the recovery experience includes living ones life despite "diagnoses and symptoms." But recovery is more than that.
The history of the Consumer/Survivor/Ex-patient movement is deeply rooted in Civil, Human and Disability Rights. Pioneers of the recovery community worked tirelessly to uncover how people diagnosed with mental health and substance use issues are also in recovery from the labels, oppression, low expectations, stigma, and marginalization that occur in treatment settings.
Recovering from the identities of "mental patient," "felon," "addict," or "the homeless," also means defying these labels and claiming a wellness identity. As Peer Support Specialists, when we say lived recovery experience, we are therefore describing resilience, survival and thriving from all of the experiences that have disrupted our lives. This shared experience is critical in peer relationships.
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Shared Experience
Is shared experience important in a peer relationship? Let's use an example from the medical community to examine this. Imagine you are in the hospital and received a diagnosis of cancer, say lung cancer specifically. You have a doctor, social worker, discharge coordinator and a peer mentor. Each have their specific role to help you in the process. The peer mentor comes to see you and you ask questions, "What was it like for you? How did you tell your family? Why did you choose the treatments you did? How long was your recovery? How did you deal with depression? What is chemo and radiation like? How did you pay for it? Any resources you found helpful or not?" and the person says, I can help you find that information but I've never been through it myself, I was here as a cardiac patient." You get the point? Part of what makes peer support effective is the shared experience... someone that you can look to as a mentor, to share tips and be an example of hope. If the person can't offer you that, they can serve many other roles in your life, but they are not a peer supporter.
As PVNC travels throughout NC, we hear from Peer Support Specialists, "I'm working with someone that hears voices, but I'm in recovery from substance use issues and can't relate," or "I work with people that are using substances and I've never had this issue myself, I've lived with depression though." The title Peer Support Specialist does not quality us to work in every setting with every person. Success in a peer relationship lies in the "
Been There, Done That
and while I don't know what will work for you, I'd be happy to share some of my lessons learned for you to consider."
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Meet the Strategic
Planning
Council
Dana Cea
Toya Hooper
Damie Jackson-Diop
Karen Gross
Ed Rothstein
Faith Rhyne
Melissa Lewis
Elliot Palmer Jr.
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Currently, PVNC is organizing through topic based coalitions. These coalitions are led by people directly impacted by the issue(s) being addressed and are
OPEN
to anyone with expressed interest, including allies and family members. If you are interested in joining a PVNC coalition, make a request on the PVNC facebook page. Be sure check in weekly for updates from each coalition at:
www.facebook.com/pvncprn/
Current PVNC Coalitions:
- Peer Justice Initiative (PJI)
- Peer Wellness Centers Pilot
- Recovery Alternatives to Forced Treatment (RAFT)
- Peer Support Standards
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Peer Wellness Center Pilot
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In its effort to create peer-run alternatives and enhancements to traditional treatments, the Peer Wellness Center
workgroup reviewed national standards for peer and "consumer"-operated organizations, fidelity tools, and examples of peer wellness centers and research. A written report and recommendation was submitted to NC DHHS to fund two (2) Peer Wellness Centers in a rural and urban area, networked and supported by an existing NC peer/"consumer"-run organization that can provide mentoring, training/TA, and administrative support to build capacity.
Update:
NC DHHS has informed PVNC that they are developing a funding announcement to solicit applications for Peer Wellness Center pilots. Once released, it will be posted on PVNC facebook site: www.facebook.com/pvncprn/
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Recovery Alternatives to Forced Treatment (RAFT) Coalition
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PVNC's RAFT coalition is comprised of people impacted by involuntary hospitalization, family members, clinicians and lawyers that are gathering data and examining the use of involuntary commitment (IVC) in NC including:
- Volume of IVC across each region
- Reasons for IVC (policies, legal, beliefs, liability, community gaps)
- Alternatives to IVC (national and international models and policies)
- Impact of IVC (trauma, cost, service engagement, human rights, etc.)
- Strategies to expand community-based recovery alternatives
Understanding Trauma and Resilience
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The Future of Healing: Shifting From Trauma Informed...
Shawn Ginwright Ph.D. From time to time, researchers, policy makers, philanthropy and practitioners all join together in a coordinated response to address the most pressing issues facing America's youth. I've been involved with this process for...
Read more
medium.com
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Let's Talk About Suicide
Suicide is the 10th leading cause of death in the United States. This monthly column will offer information, resources, and research dedicated to the topic.
Survivors of suicide have an
expertise that cannot be replicated
and they are using their voices to dispel myths, examine the complexity of suicide, and create alternatives to traditional treatments.
The S Word: Stories from Survivors
The S Word
is a film for and by survivors to inspire people to find reasons to live, reclaim the survivors experience and demand change by changing the conversation.
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Our Story
A suicide attempt survivor is on a mission to find fellow survivors and document their stories of unguarded courage, insight and humor. She discovers a national community rising to transform personal struggles into action. Suicide has affected...
Read more
theswordmovie.com
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Peer Justice Initiative (PJI)
PJI is comprised of NCCPSS with lived criminal justice experience that are organizing to 1) establish a NC "Forensic Peer Support" (FPS) credential, 2) utilize nationally recognized FPS training to build the NC FPS workforce, 3) impact criminal justice reform efforts, and 4) advocate for FPS integrated into diversion, re-entry, and jail/prison efforts.
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Forensic Peer Support Training
Forensic Peer Support Training
PJI has engaged the Pennsylvania Mental Health Consumer Association (PMHA) and Drexel University to provide the 3-Day Forensic Peer Support Training in NC.
The first training will occur December 9-11th in Charlotte, NC for 25 CPSS from Western to Central NC. Applications are currently being reviewed.
The second training will occur in March in Durham, NC for 25 CPSS from Eastern to Central NC. The link to the application will be posted in January.
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Pennsylvania Mental Health Consumers' Association -...
In October of 2015, a three-year Statewide Consumer Network grant was awarded to PMHCA by the Substance Abuse and Mental Health Services Administration (SAMHSA). This grant enabled further development of the training curriculum completed under...
Read more
pmhca.org
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Suicide and Overdose in NC Jails:
A Call for Reform
In its recent report, Suicide in North Carolina Jails, Disability Rights NC has detailed the rise of overdose deaths and the continued rate of death by suicide in NC jails. NC jail rules have not been updated in 25 years.
In response, DRNC has detailed recommended reform efforts to include:
- Adoption of active suicide prevention programs in all NC jails and detention facilities
- Implementation of specific jail rules to improve intake screening and policies to improve observation
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NC jail suicides and fatal ODs on the rise- North...
Advocates want to update old jail rules to help keep inmates safe, but sheriffs' objections are slowing down the process. By Taylor Knopf Suicide and drug overdose deaths are on the rise in North Carolina jails, according to a recent report...
Read more
www.northcarolinahealthnews...
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Peer Support Standards
Peer Support Standards are inclusive of statewide training and continuing education, specialty credentialing, certification and re-certification, supervision, rates, service definitions/clinical coverage policies, selection, training and oversight of providers, opportunities for peer-run programs and organizations, development of a PSS trade association, and salary, employment and equity issues for the NCCPSS workforce.
New PSS Service Definition
Despite questions and concerns regarding the new PSS service definition and Clinical Coverage policy, the following Communication Bulletin has been released:
The Peer Support Standards Coalition did submit the following two documents/requests to NCDHHS, however has not received responses:
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PVNC is currently working on the following:
- PVNC Website (coming soon!)
- NC Peer Support White Paper
- Development of formal recommendations for the future of peer support
- 2-Day Peer Leadership Forum for current and emerging leaders to learn about policy, legislative change, grassroots organizing and to develop a shared statewide agenda for peer support
- Training of trainers for forensic peer support
- Peer support and supervisor CEU's
- Housing First Trainer training for NCCPSS that have experienced homelessness or have lived in congregate care
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