PeerRespite.net: Tools for Action & Evaluation in Peer Supported Crisis Response

Program Description

Peer respites are voluntary, short-term, overnight programs that provide community-based, non-clinical crisis support to help people find new understanding and ways to move forward. They operate 24 hours per day in a homelike environment. Peer respites are staffed and operated by people with psychiatric histories or who have experienced trauma and/or extreme states. A recovery-oriented mental health system – one in which crises are averted by providing adequate community-based care – has been the guiding vision for mental health systems since deinstitutionalization. For many, hospital-based psychiatric emergency services are undesirable and avoidable. Peer support can help facilitate the experience of a psychiatric crisis as an opportunity for inter- and intrapersonal growth. It is difficult for advocates, providers, and policymakers to “drink from the fire hydrant” of evidence when making decisions about local health systems. Amidst calls for more inpatient and emergency beds, there are innovations developed “bottom up” which have been successfully adopted and translated to other communities. PeerRespite.net is a comprehensive online resource dedicated to information dissemination and implementation efforts about peer supported crisis response. PeerRespite.net allows for information-sharing about promising practices developed by local communities, giving fresh perspectives a platform and easy-to-access support for data-driven values-oriented solutions.

Creativity

For communities that lack the resources to hire consultants, Internet-based tools efficiently disseminate technical assistance and evaluation assistance. Many peer support programs suffer from a lack of technical and financial support for their development and sustainability, and often have to fight upstream to compete with other mental health programs. PeerRespite.net helps ensure that there are trauma-informed alternatives to traditional crisis services for people when they need them. It supports local efforts to open new peer respites and establish sustainable resources for current programs by providing free public access to curated information about peer respites. The site features research reports, links to hands-on resources, and evaluation tools for non-researchers. PeerRespite.net has a nationwide program directory, which we are currently updating. It gives these innovative programs a platform to share the great work they do and allow others to incorporate that information into their local programming.

Leadership

PeerRespite.net was built in response to calls from stakeholders to organize and synthesize publicly-accessible information about peer-supported crisis response. It has been called a “definitive go-to resource on peer respites” by mental health system planning personnel, and has helped inform policy and practice developments across the U.S. Since the 2016 launch, PeerRespite.net has had nearly 7,000 unique visitors and 18,000 unique page views, representing every U.S. state and most of Europe. Visitors stay on the page an average of 2:13 and view two pages each session. There are 500 individuals on the mailing list, which has a 35% open-rate. Consumer/survivor advocates have referred to it as a source of useful information in articles in the Boston Globe and on PsychCentral. Live & Learn has had unique successes engaging the community of peer supporters, peer support program administrators and trainers, and the consumer/survivor community in appreciating and accessing research.

Sustainability

PeerRespite.net is operated by Live & Learn, Inc., a service user-run social enterprise that provides research, technical assistance, and knowledge translation services to behavioral health systems. Much of this is accomplished through long-term investments in relationship-building, co-collaboration on projects, and ensuring the meaningful representation of people with lived experience in all phases of projects. PeerRespite.net is a shining example of this kind of effort. We have been joined by friends at the National Empowerment Center, Intentional Peer Support, International Association of Peer Supporters, Copeland Center, Human Services Research Institute and the New York State Psychiatric Institute in our efforts to secure grant funding for the project. Approximately a quarter of visitors navigate to the site via social media. Approximately 15% of visitors are “referred” to the site by other advocacy organization websites.

Replicability

Since 2010, when the team conducted the first national survey of peer respites, the number of peer respite programs has more than doubled. As of 2016, there were 22 peer respites located in 11 states throughout the country. The data we collect and disseminate have been used by other programs and communities to design peer respites. While the data show some trends, variability between programs remains as peer respites continue to refine house policies through a process of discovery. While Live & Learn initially focused on peer respites, the approach of community-driven, Internet-based technical assistance and information dissemination could be expanded to other areas in mental health. It is important that people with psychiatric histories or who have experienced trauma and/or extreme states are meaningfully involved in such efforts. After all, learning from one another is peer support!

Results/Outcomes

The resources available on PeerRespite.net have proved useful for policy and practice. In 2015, the California Health Facilities Financing Authority reallocated funding to peer respites, based on the work of the Live & Learn team to document peer respites nationwide. There are always opportunities for learning when information is shared. For instance, California will soon have more peer respites than any other state, but currently lacks a peer specialist certification program. However, Georgia has 5 peer respites and is the first state to have a Medicaid reimbursable certified peer specialists. Improving the quality of publicly available resources can lead to greater engagement of patients, peer supporters, program administrators, and policymakers in understanding implementation and program design. We hope to increase the number and diversity of end-users who can use this type of information, and create a scalable process for reputable, real-world knowledge dissemination within this community.