The Roles of PeersYouth & Family

Stephanie Orlando, Director of YOUTH POWER!, Families Together in NYS

HistoryHistory• Much about the history of “peer support” is

still being uncovered through research currently being done on the national level.

• We know that in the 1850’s people in NY’s Utica State Lunatic Asylum wrote about the support of “fellow feeling” people in The Opal, a “Patient” edited newsletter.   

• In recent decades there has been a movement of consumers and survivors that have worked to ensure there are peer roles in mental health services and supports.

Family Peer SupportFamily Peer Support• In the 1980’s a movement for increased

family involvement on all levels of service began to gain momentum. Family support groups were developing all over the country and the state.

• In 1991 the NYS Office of Mental Health hired 5 regional parent advisors

• In 1995 a grassroots NY statewide parent support network incorporated as Families Together in New York State.

Youth Peer Support & Involvement in New York• In the early 1990’s the “first youth peer support

and advocacy groups” known to this generation. The experiences and accomplishments of those groups blazed the trail to a larger youth movement.

• In the late 1990’s the Office of Mental health began statewide youth involvement initiatives including the Youth Advisory Council (YAC).

• Youth Peer support groups and Systems Advocacy exists all over the state and are networked through YOUTH POWER! a statewide Network of young people with disabilities and/or social-emotional challenges

• In 2010 Regional Youth Partners will be hired by YP! to assist in supporting and networking youth peer advocacy groups

The President’s New Freedom Commission Calls for Inclusion

• In 2003, The President’s New Freedom Commission on Mental Health called for the complete inclusion of consumers and family members as providers, advocates, policymakers, and full partners in creating their own plans of care.

Develop a better understanding of the needs and issues of the youth population they serve

Develop systems that are more creative and better meet the needs of children and families

Generate fresh and innovative ideas of young people Bring clarity to the mission of an organization or agency Enhance the commitment and energy of adults Gain a different perspective of youth experiences with

multisystem involvement Increase its understanding of how young people view the

world Know what works and does not work based on real world

youth experience Interact with youth to overcome youth culture stereotypes See the positive things youth have to offer

Youth Involvement:Benefits to Others

Adapted From: Technical Assistance Partnership “Youth Involvement in Systems of Care: A guide to

Empowerment”, January 2005

Develop confidence through completing empowering tasks and feeling heard

Make friends and have a peer support network

Create a better system that will help themselves and others

Understand the community and government in a different way

Develop leadership experience and various other skills that will be useful throughout life

Build connections and professional resources

Youth Involvement: Benefits for Youth

Adapted From: Technical Assistance Partnership “Youth Involvement in Systems of Care: A guide to

Empowerment”, January 2005

Optimizing Youth Optimizing Youth LeadershipLeadership

From: Technical Assistance Partnership “Youth Involvement in Systems of Care: A guide to

Empowerment”, January 2005

Optimizing Youth Optimizing Youth LeadershipLeadership

From: Technical Assistance Partnership “Youth Involvement in Systems of Care: A guide to

Empowerment”, January 2005

Foundations: Foundations: CASSP CASSP PrinciplesPrinciples

• 1983 for the Child and Adolescent Service System Program (CASSP), envisioned as a comprehensive mental health system designed for children, adolescents and their families.

• CASSP is based on a well-defined set of principles for mental health services for children and adolescents with or at risk of developing severe emotional disorders and their families. These principles are summarized in six core statements.

CASSP PrinciplesCASSP Principles• Child-centered: Services meet the

individual needs of the child, consider the child’s family and community contexts, and are developmentally appropriate, strength-based and child specific.

• Family-focused: Services recognize that the family is the primary support system for the child and participates as a full partner in all stages of the decision-making and treatment planning process.

• Community-based: Whenever possible, services are delivered in the child’s home community, drawing on formal and informal resources to promote the child’s successful participation in the community.

CASSP PrincipalsCASSP Principals• Multi-system: Services are planned in

collaboration with all the child-serving systems involved in the child’s life.

• Culturally competent: Services recognize and respect the behavior, ideas, attitude, beliefs, customs, language, rituals, ceremonies and practices characteristic of the family’s ethnic group.

• Least restrictive/least intrusive: Services take place in settings that are the most appropriate and natural for the child and family and are the least restrictive and intrusive available to meet the needs of the child and family.

The Engine of ChangeThe Engine of Change

Families and YouthFamilies and Youth

Family driven and youth directed care

Provider and system driven

From Shifting Gears to Family-Driven Care – Federation of Families 2006

PARADIGM SHIFT: The Changing Role PARADIGM SHIFT: The Changing Role for Families and Youthfor Families and Youth

Provider Driven Family Driven

Source Of Solutions

Professionals and agencies

Child, family, and their support team

Relationship Child and family viewed as a dependent client expected to carry out instructions

Partner/collaborator in decision making, service provision, and accountability

Orientation Isolating and “fixing” a problem viewed as residing in the child or family

Environmental approach enabling the child and family to do better in the community

Assessment Deficit oriented Strengths based

From Shifting Gears to Family-Driven Care – Federation of Families 2006

Provider Driven Family Driven

Planning Agency resource based

Individualized for each child and family

Access To Services

Limited by agencies menus, funding streams, and staffing schedules

Comprehensive and provided when and where the child and family require

Expectations Low to modest High

Outcomes Based on agency function and symptom relief

Based on quality of life and desires of child and family

PARADIGM SHIFT: The Changing Role PARADIGM SHIFT: The Changing Role for Families and Youthfor Families and Youth

From Shifting Gears to Family-Driven Care – Federation of Families 2006

Youth Involvement in Youth Involvement in OrganizationsOrganizations

Quality and Satisfaction Hiring Practices & Staff Evaluations Environmental Design Social Marketing Outreach and Engagement Program Design, Implementation and Oversight Evaluation Youth Trainers Youth Employees Youth Peer Advocates & Educators Youth Advisory Committees Youth on Standing Workgroups, Committees,

Taskforces, etc. Youth/Young Adults Serving on Board of Directors

• Schedule meetings at a time youth can attend• Provide information • Help prepare youth before the meeting and

follow up to answer questions after• Provide feedback and information on next steps• Support during the meeting• Create clarity on role and expectations of

everyone• Address possible transportation issues• Consider/offer stipends & incentives• Recognize contribution

Making Meetings Accessible to Youth

Youth Advocacy & Youth Advocacy & EngagementEngagement

• Youth Advocates can be change agents that educate & inform to improve the environment and culture of a hospital.

• Their experience is a valuable asset.

• They are a partner to ensure quality of care.

• They provide a unique perspective that is crucial in a person centered approach to care.

• Peers can serve as role models, communicators, mediators, advocates, teachers and legal protectors

• Peers provide support from a perspective of experiential rather than professional authority

(Borkman, 1975)

• First hand experiences provide unique insights and analyses

The Important Roles Peers Have The Important Roles Peers Have in Inpatient Settings:in Inpatient Settings:

Adapted from “Peer Roles in Inpatient Settings A Core Strategy ©” Module originally created by Bluebird, Jorgenson, Lane; revised by Bluebird, 2008

• Self-help, peer support, and self-advocacy are recognized internationally as components of wellness, recovery, and treatment

• Peers understand the need for reform and often have the initiative to begin the task of creating new approaches to care

• Peers involved in a meaningful way at all levels of service promotes a positive organizational culture shift.

The Important Roles Peers have The Important Roles Peers have in Inpatient Settings Cont’din Inpatient Settings Cont’d

Adapted from “Peer Roles in Inpatient Settings A Core Strategy ©” Module originally created by Bluebird, Jorgenson, Lane; revised by Bluebird, 2008

• First hand experiences dealing with psychiatric disabilities equip peers with extensive practical knowledge and information in a way professional training cannot.

(Solomon, 2004)

• Peer relationships often incorporate friendship and encouragement; hope for recovery!

Peer Roles in Inpatient Peer Roles in Inpatient Settings:Settings:Delivering Services Delivering Services DifferentlyDifferently

From “Peer Roles in Inpatient Settings A Core Strategy ©” Module originally created by Bluebird, Jorgenson, Lane; revised by Bluebird, 2008

Peers Have Helped to Peers Have Helped to Create…Create…

• Alternative Dispute Resolution/Mediation• Communication Strategies• WRAP Wellness Recovery Action Plan

(Develop Daily maintenance plan, identify triggers, crisis plan)

• Recovery through the Arts (a vehicle for creative self expression, and personal empowerment)

• Comfort Rooms (Creating a home like comforting environment)

(Adapted from the Roadmap to Seclusion and Restraint Free Mental Health Services SAMHSA 2005)

Peers Have Helped to Peers Have Helped to Create…Create…• Drop In Centers (a central place for peer

support/self help, advocacy, information and resources, building on peers capabilities, talents and promoting wellness. Peers run and peers develop and provide alternatives to treatment including making friends and socializing)

• Services Animals - Use of animals for emotional support and healing of trauma

• Prime Directive/Choice Thru Voice• Meditation – Grounding Techniques (can

assist with dealing with feelings from trauma i.e. flashbacks)

(Adapted from the Roadmap to Seclusion and Restraint Free Mental Health Services SAMHSA 2005)

Independent VoiceIndependent Voice

• There has been a continuing request to increase independent peer & family advocates in Mental Health Services.

• Independent means that the advocate works for a peer run organization and is contracted with the hospital or mental health service.

• There are models to utilize for independent Peer Advocates in inpatient settings.

Why Independent?Why Independent?

• Builds trust with the young person and family members.

• Continuous training, supervision and support from experienced Peer Advocates

• Peer support that is needed Advocate to Advocate

• Cross-systems & community based

TrainingTraining

• All advocates must be trained in a variety of skills so that they can best assist the people they are working with.

• Training for Hospital staff and administrators is important so that everyone understands and values the role of the advocate

• Some questions to ask are:– What is it going to mean to your

organization/community?– What is the level of commitment? Is

everyone on board?– How comfortable is the organization

with youth speaking up? Would adults feel comfortable serving on committees, workgroups, etc. with youth as equal partners at the table?

– What will the organization do with the input you receive? Will you take action?

Evaluate Your ReadinessEvaluate Your Readiness

Building places of hope, Building places of hope, resiliency, and recoveryresiliency, and recovery

Together we can help families to get the support the need with the dignity and respect they deserve.

For more information on Youth and Family

Peer Support & Involvement Contact

Families Together In New York State&

YOUTH POWER!518-432-0333 Toll free: 888-326-8644

www.ftnys.org