ShainaRae Harvey

1. ShainaRae Harvey

2. Your Experience Matters!

3. YOUTH SUPPORT SPECIALISTS ( YSS’s) • Are young adults (18-29) that have received or are currently receiving behavioral health services. • Are here to provide direct SUPPORT to youth that are currently on their journey to recovery. Notice I said SUPPORT and NOT HELP! • Will understand that they are NOT experts in their roles, but this is simply a growing and learning experience for both the YSS and the peer. • YSS’s will encourage youth voice and choice within their treatment plan as well as empower youth to become their idea of successful. • Will understand that recovery looks different for each peer, and will provide individualized support.

4. What is Youth Peer Support?

5. National Definitions ? • Medicaid Definition – Refer to Handout • Efforts (Youth Move National video) YMN youthmovenational.orghas webinars you can download. • Youth Peer Support is a mutual connection among two people who establish a relationship based on lived experience ( World View). • Peer support services are delivered by individuals who have common life experiences with the people they are serving. People with mental and/or substance use disorders have a unique capacity to help each other based on a shared affiliation and a deep understanding of this experience. Youth support specialists offer strength, and hope to their peers, which allows for personal growth, wellness promotion, and recovery.

6. What is youth peer support in Arkansas • A Youth Peer Support Specialist is a person who uses their lived experience within the child service systems and skills learned in trainings, to provide peer support services in the behavioral health settings to promote recovery, hope, and healing for young adults. • They support youth in the recovery process and empower their peer to reach their fullest potential. • A YSS is allowed to provide Peer Support under the Outpatient Behavioral Health Services (OBHS) program reimbursed by Arkansas Medicaid.

7. Who can provide Peer Support A Certified Youth Support Specialist (YSS) is a peer that promotes recovery and resiliency for youth that are currently receiving mental health/behavioral health services. YSS’s use their lived experience, training, and knowledge to support and empower youth with behavioral health care needs. They understand the importance of building connections and working toward fostering relationships with youth transitioning to adulthood. They support youth in the recovery process and empower their peer to reach their fullest potential.

8. Helping When you think your role is to be the “ Helper” • What do you think your purpose is in the relationship? • How might you feel in this role? • How might you start to think of yourself if you’re always in this role? • In what ways would you measure your success in the relationship? If you are in the “ Helpee” role, • What might you think your role is in the relationship? • How might you feel in this role? • How might you start to think of yourself if you’re always in this role? • How may you measure your success in the relationship? If you are in the “LEARNER” role, • What might you think your role is in the relationship? • How might you feel in this role? • How might you start to think of yourself if you’re always in this role? • How may you measure your success in the relationship?

9. 5 Core Compacities • Connection • Chances • Choices • Communication • Commitment

10. H.E.A.R. • Help: The youth being supported to feel comfortable. It is important to remember that the responsibility for confront and communication is the work of the YSS not the youth being supported • Encourage: Your peer to tell you what they think. One of the reasons why peers are hired to support other youth is to find way to connect on an equal level. • Accept: Whatever your peer share with you. Even if you disagree with their perspective, it is important to communicating a sense of openness and authentic acceptance to assure youth that they are being supported. • Respond: In a way that communicates connection.

11. Recidivism Rate with Peer Support (SAMSA 2016) • • 36 percent reduction in the use of seclusion • • 48 percent reduction in the use of restraints • • 56 percent reduction in hospital readmission rates Participants who receive peer-based services feel that their providers communicate in ways that are more validating and report more positive provider relationship qualities compared with participants in control conditions (Sells et al, 2008). Peer support helps individuals have a sense of hope about recovery. Individuals receiving peer support are more likely to have employment (Repper & Carter, 2011). Individuals receiving peer support report overall increases in their quality of life (SAMHSA, 2016).

12. Cost Saving With Peer Support • Peer support is generally cost-effective and cost -saving. Optum Health, a managed care company, has shown substantial reductions in average inpatient days for people receiving peer support. In two of their managed care contracts, Optum saw an average 80.5 percent reduction of inpatient days, and a 32 percent reduction of involuntary hospitalizations for people receiving peer run respite services (Bergeson, 2013). Additionally, peer support increases the length of time that individuals spend in the community before their first psychiatric hospitalization (Repper & Carter, 2011). • Based on the evidence above and more, peer support is an effective and evidence-based practice. It is cost-saving and improves outcomes for individuals with mental health conditions. As the mental health system becomes more recovery-oriented, peer support is a practice that should become available around the country. Ron Manderscheid, Ph.D., the Executive Director of the National Association of County Behavioral Health Directors estimates that within the next five years peers will make up more than of 20 percent of the behavioral health workforce.

13. Integrating Peer Support Within a Company • After consulting with mental health organizations on how a YSS can function as a helpful member of the client’s treatment team, I have come up with two very different systems. However, both systems have proven to be effective within the organizations that implemented them.

14. Large Companies, Larger Case Loads, High Need Clients • The first model is a simple case load split with the case manager and YSS. This works at larger companies with a large pool of case managers and YSS to choose from. Each client that meets the necessary Medicaid guidelines to deem it necessary is assigned a: Therapist, Psychiatrist, Case Manager, and Peer Support/YSS. • Each member of the team has access to the chart and is able to access updates on the client. Both the Case Manager and YSS meet with the client more regularly and can work on skills to help clients meet their needs. The Case Manager and YSS participate in staff meetings, attend school meetings, court dates, and are available be an additional person in the clients life. • This model is extremely effective with high needs clients, and is a proven system for managing large case loads so clients do not get lost. Teams have reported that since there are 3-4 people seeing the client they have more hands on work with the clients and better success with clients completing care.

15. Small Companies, Small Case Loads, Lower Need Clients • The second system merges the case manager role and YSS/Peer Support role into a single position performed by one person. • The in-office process is still mostly the same. The YSS will participate in treatment team meetings and goal setting with other staff members. The YSS will update the team on the client’s progress and advocate for the client’s wishes. They will also usually be responsible for documentation per the company’s rules.

16. Case Management and Peer Support • Empathy vs Sympathy • Lived Experience vs Formal Learning • Evidenced Based Practices • Recidivism Rates • Proof in other areas of treatment; substance abuse ect.

17. Personal Attributes of YSS • Believes in, and models the importance of youth driven care. • Accepts the youth “where they are and have been” without judgment. • Able to share experience with an appropriate level of emotion. • Able to model positive behaviors. • Able to conduct oneself with honesty, respectfulness, and compassion.

18. Advocacy • Able to assist the youth in asserting their “voice”. • Knows how to find and use resources for youth rights. • Able to teach youth how to advocate for themselves.

19. Empowerment Ability to: • Recognize youth’s strengths and how to use them in a positive way. • Give youth space when needed to help themselves. • Support the youth through the consequences, whether positive or negative, of the choices they have made. • Assist youth in finding more support. • Inspire the youth through community engagement. Understands: • The definition of youth driven and youth guided, and how it relates to youth. • Stigma, and is able to identify how to approach the issue with youth.

20. Wellness • Model self-care for youth. • Understand the needs of the youth: physical, mental, social, and spiritual. • Able to identify the strengths of the youth. • Understands resiliency and recovery principles. • Assists youth in strength identification.

21. Knowledge • Knows how and where to find information about mental health, substance abuse systems, state and community resources, treatments available, services, supports, and youth and family rights. • Understands that youth support services are unique, and how they differ from other services provided. • Understands and recognizes their roles and responsibility as a mandated reporter. • Knows how to find information on child welfare, juvenile justice, developmental disabilities, and healthcare systems in Arkansas. • Knows what resources, rules, and regulations surround children and youth behavioral health services.

22. Knowledge • Knows and understands the “wraparound” principles and how they are beneficial to the youth and their family. • Able to communicate and express insight gained as the job progresses and to work side by side with other team members identified in the wraparound plan. • Knows how the public education system and higher education system relate to youth with mental health and/ or substance use issues and how to effectively communicate within the system. • Knows how the Department of Vocational Rehabilitation relates to youth with mental health/ or substance use issues and how to effectively communicate within the system.

23. Ethics and Confidentiality • Understands and is able to maintain confidentiality as required by state and federal law. • Understands and adheres to the Code of Ethics for YSS. • Treat everyone with the respect. • Understand personal and professional limits, and personal biases. • Able to recognize when to report ethical and safety issues and to whom. • Mandated Reporting

24. Crisis Prevention Planning • Understands the purpose of a crisis prevention plan, how to use the plan, and assist youth in understanding and utilization of the crisis prevention plan. • Able to help youth identify and access crisis resources in the community. • Knowledgeable about safeguarding and relapse prevention strategies for issues such as self-harm and substance abuse. • Knowledgeable about the issue of suicide and research-based prevention strategies. • Able to assist youth in identifying situations that may trigger a crisis.

25. Final Notes • Be tailored and personalized • Use active listening • Passion over Paycheck! • Life experiences give us different abilities to support youth than skills from traditional learning. • Everyone has a voice • Everyone deserves a chance

26. Interested in YSS Training ? Please contact: Michael Wyatt, LSW, MSW | Programmatic Lead University of Arkansas at Little Rock | MidSOUTH | School of Social Work O: 501-859-0361 | mawyatt@midsouth.ualr.edu |midsouth.ualr.edu -OR - ShainaRae Harvey, | YSS Trainer C: 909-971-7532 | srharvey10@gmail.com