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The Power of Peers: The Effectiveness of Peer-Delivered Services. Joseph Rogers, Executive Director National Mental Health Consumers’ Self-Help Clearinghouse 1211 Chestnut St., 11th Floor Philadelphia, PA 19107 800-553-4539, ext. 3844 …jrogers@mhasp.org. Alternatives 2011
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The Power of Peers: The Effectiveness of Peer-Delivered Services Joseph Rogers, Executive Director National Mental Health Consumers’ Self-Help Clearinghouse 1211 Chestnut St., 11th Floor Philadelphia, PA 19107 800-553-4539, ext. 3844…jrogers@mhasp.org Alternatives 2011 Orlando . . . Oct. 26-30, 2011
A Glimpse at 20 Years of Research • Summarized from Boston University Center for Psychiatric Rehabilitation http://drrk.bu.edu/research-syntheses/psychiatric-disabilities/peer-delivered-services • Developed with NIDRR grant H133A050006
Purpose of the Review • Dramatic growth in peer-delivered services in recent years: 7500 peer programs or groups identified in a 2006 survey. • The review searched for an evidence base for peer-delivered services to give direction to program developers, decision makers, advocates and funders.
Types of Peer-Delivered Services Included in the Research Summary (1) • Peer-run programs: • drop-in centers • peer learning/ advocacy centers • crisis housing Peer Support and Wellness Center Decatur, GA
Types of Peer-Delivered Services Included in the Research Summary (2) • Peer-run groups, e.g.: • Double Trouble • Grow • Recovery
Types of Peer-Delivered Services Included in the Research Summary (3) • Peer specialists working with individuals, offering support, referrals, crisis, linking or other services • may be in peer-run programs or non-peer-run programs Gina Calhoun, CPS
Importance of Research • 1. Assure continuous quality improvement among peer-delivered services • 2. Educate and inform decisions made by and about peer-delivered services • 3. Help convince mental health professionals and funding agencies about the value of peer services.
Types of Research Available on Peer-Delivered Services (1) • 1. Research that compares the results of two or more groups. • 2. Research that compares one group of peers’ functioning at points in time (“before and after” the peer- run service)
Types of Research Available on Peer-Delivered Services (2) • 3. Research that uses questionnaires, phone calls or focus groups to determine satisfaction with services or opinions about services. • 4. Program evaluation: looking at results when peer-run groups/programs were added to a larger health care system.
Limitations of Peer Studies (1) • Some of the studies are fairly small and results are difficult to generalize. • The largest study (COSP Multisite Research Initiative) has not yet published all its results. (Some findings were published in 2009. See Slide 33 for URL.)
Limitations of Peer Studies (2) • Some of the results are conflicting, e.g., peer run-programs improve social functioning vs. do not improve social functioning. • Some of the studies were not very rigorous (no random selection, no control group etc.). • The definition of peer-run or peer-delivered programs varies across the country.
What Studies Were Included? 126 articles were initially included. 48 of these made it through the screening for quality and meaning.
Conclusions (1) • Several authors concluded that peer-delivered services resulted in similar out-comes to those of professionally delivered services. • Question: Should peers be expected to outperform professionals?
Conclusions (2) • Several studies suggested that peer- delivered services that are added to traditional services did not changeoutcomes, but… • There was some evidence that peers provideddistinctive skills and experiences that may behelpful in engagement and retention.
Conclusions (3) • There was some evidence that peer-delivered services provided in a group context can improve outcomes if members attend regularly and for a long enough time.
Conclusions (4) • Results from some of the peer-delivered group services,such as Vet-to-Vet, suggested that those who used the program regularly had better outcomes, e.g., both in empowerment and functioning. Vet-to-Vet http://vet2vetusa.org/
Questions for Discussion • Is it important for peer-delivered services to have a strong research base? Why or why not? • What might some of the barriers be to having good research on peer-delivered services? • What suggestions do you have to increase and improve the research base for these services?
“Powers-that-be” realize that recovery-oriented, peer-run services are key to recovery SAMHSA recognizes Peer Support as one of the 10 fundamental components of recovery. The 10 are: • Strengths-Based • Peer Support • Respect • Responsibility • Hope • Self-Direction • Individualized and Person-Centered • Empowerment • Holistic • Non-Linear SAMHSA Administrator Pamela S. Hyde (top); CMHS Director A. Kathryn Power (bottom) 18
Resources • “Federal Multi-site Study Finds Consumer-Operated Service Programs Are Evidence-Based Practices” http://www.hhs.state.ne.us/Behavioral_Health/BHcommission/8-Jun-22-09/F-Johnson-DrJeanCampbell-Study-ConsumerOperatedServices.pdf • “Peer-run Crisis Alternatives” http://www.power2u.org/peer-run-crisis-alternatives.html
Resources • National Mental Health Consumers’ Self-Help Clearinghouse: http://www.mhselfhelp.org • Consumer-driven Services Directory: http://www.cdsdirectory.org/ • Institute for Recovery and Community Integration: http://www.mhrecovery.org • Temple University Collaborative (formerly UPenn Collaborative) on Community Integration: http://www.tucollaborative.org • Boston University Center for Psychiatric Rehabilitation Disability Research Right to Know http://drrk.bu.edu