Certified Peer Specialist Services and the Peer Empowerment Programs of the Mental Health Association of Southeastern Pennsylvania
For nearly three decades, the Mental Health Association of Southeastern Pennsylvania (MHASP) http://www.mhasp.org has been a leader in the creation, implementation, development, and promotion of services run by and for individuals with mental health conditions, also called consumers or peers. In 1984, MHASP – founded in 1951 as a regional advocacy agency serving individuals with mental health conditions and their families – launched an initiative to create consumer self-help/advocacy groups, to help these individual empower themselves and work toward recovery. Today, MHASP has earned an international reputation for designing and implementing dozens of peer-to-peer services, for participating in rigorous research to demonstrate the effectiveness of peer-run services, for providing technical assistance and training to enable others to replicate these model peer-run programs around the U.S., and for leadership in promoting the burgeoning profession of Certified Peer Specialist (CPS), whose practitioners, in recovery themselves, help their peers on their own recovery journeys.
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MHASP created the first peer-run drop-in center in Pennsylvania, where individuals with mental health conditions could overcome their isolation, get involved in advocacy, or perhaps get assistance in finding employment. Then MHASP created other models, such as Outreach, Advocacy and Training Services (OATS), which served individuals with mental health conditions who were homeless (and which evolved into ACCESS-West Philly, a federally funded demonstration project); residential programs for individuals with mental health conditions who were homeless; employment projects; a project “without walls” for individuals with co-occurring mental health and substance use conditions, and others. Some MHASP projects have been studied to add to the evidence base for the effectiveness of peer-run services. In addition, MHASP’s Institute for Recovery and Community Integration http://www.mhrecovery.org , which trains and certifies peer specialists, and MHASP’s participation in gaining CMS approval to make peer specialist services Medicaid-reimbursable, have led to a burgeoning of the peer specialist profession.
Since 1984, MHASP has led others in creating and implementing peer-run services through numerous trainings and publications. Significantly, after creating several model consumer-run programs, in 1986 MHASP’s Joseph Rogers, a national leader of the consumer movement, saw the need for a consumer-run national technical assistance center to help the consumer movement grow, and established the National Mental Health Consumers’ Self-Help Clearinghouse http://www.mhselfhelp.org . (The federal government took notice and SAMHSA now funds three such centers – plus two more run by consumer supporters – through a competitive grant process.) MHASP has also led through participation in several federally funded research projects (including the Consumer-Operated Services Program Multi-site Research Initiative http://www.psych.uic.edu/uicnrtc/nrtc4.webcast1.jcampbell.transcript.pdf and demonstration projects (including the ACCESS demonstration program, serving homeless individuals with mental health conditions, which MHASP still operates). MHASP’s curriculum for training peer specialists has influenced the field, as has MHASP’s success in helping achieve CMS approval for Medicaid-reimbursed peer specialist services.
In 2007, MHASP’s work with Pennsylvania’s mental health authority to obtain CMS approval for Medicaid-reimbursed peer support services paid off. Now, Pennsylvania’s 67 counties must provide peer specialists to Medicaid recipients who meet the “medical necessity” criteria. MHASP has joined with Philadelphia government to promote CPS services, with the Office of Vocational Rehabilitation to increase CPS positions, and with Community College of Philadelphia to provide college credits for CPS training. With three partners, MHASP created a sustainable research project: a self-directed care program http://www.nyaprs.org/e-news-bulletins/2011/2011-04-29-Self-Directed-Care-Pilot-Puts-Consumers-in-Drivers-Seat.cfm employing CPSs to help peers create their own budgets for recovery-supporting goods and services. MHASP operates three other Medicaid fee-for-service peer teams and has SAMHSA support for two additional teams. MHASP also operates five peer-to-peer Recovery and Education Centers, offering CPS services onsite and in the field. County governments are poised to offer additional fee-for-service opportunities from these centers, along with the support they currently provide.
Peer specialist services are very replicable, and are being replicated nationally and internationally. One way that MHASP is furthering that outcome is through its Institute for Recovery and Community Integration http://www.mhrecovery.org , which promotes communities’ understanding of recovery and community integration as the catalyst for transforming individual lives, communities, and all levels of behavioral health systems in a culturally competent manner. The Institute does this through providing workshops on recovery, on-site Recovery Education groups, and Wellness Recovery Action Plan (WRAP) groups; training WRAP facilitators; operating a Peer Specialist Certificate Program and Online Forum for peer specialists; and providing technical assistance to agencies, service providers, and municipalities. In addition, most recently, MHASP’s Clearinghouse partnered in organizing Wellness Solutions 1.0: Uncensored Innovation http://www.thehopeconcept.com/wellness-solutions-1-0/ , a pre-conference institute to the annual conference of the National Association of Peer Specialists. Wellness Solutions 1.0 provided participants with information about how they could create and promote peer support.
MHASP participates in research proving the effectiveness of peer support services. These include a study http://rsw.sagepub.com/content/6/2/193.full.pdf comparing the effectiveness of peer case managers with professional case managers and a study of MHASP’s The Friends Connection, a “program without walls” that provides peer support for individuals with co-occurring mental health and substance use disorders (pp. 159-176 at http://books.google.com/books?hl=en&lr=&id=l4UqA8wObaQC&oi=fnd&pg=PR9&dq=cosp+multisite+study+clay&ots=6Ok7pYQ-ig&sig=Wuy-JEGYqKx-eosJynS_staNOxI#v=onepage&q=cosp%20multisite%20study%20clay&f=false ). The latter was studied by the Consumer-Operated Services Program Multi-site Research Initiative http://www.psych.uic.edu/uicnrtc/nrtc4.webcast1.jcampbell.slides.pdf, which demonstrated the effectiveness of peer support services. Currently, MHASP is participating in a study of its self-directed care project http://www.nyaprs.org/e-news-bulletins/2011/2011-04-29-Self-Directed-Care-Pilot-Puts-Consumers-in-Drivers-Seat.cfm, described above. These studies confirm that both providers and recipients of peer support services have increased community participation and “life satisfaction” and decreased use of such costly services as crisis and inpatient services; and that many of those utilizing peer services go on to become peer support specialists themselves or engage in other valuable endeavors such as school, employment, and positive social relationships.
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