The Mental Health Minute

Articles and news about mental health issues

A story about Peer Specialists

The use of Peer Specialists is controversial at best, but studies are finding that using peer specialists in patient  care gives hope and a message of possibilities.  The fact that there are real mental health consumers who have lives and are productive is a very powerful message.  Too often, the messages we send to our patients is that they are “broken” and cannot be fixed.  We don’t do that on purpose, but we still do that.  When you introduce a peer specialist into your program, you get someone who relates to your patients in a completely different way and who understands what they face daily.  You get  someone who inspires and brings hope back into their lives.

Peer Specialists must undergo significant training and certification to be allowed onto mental health units, but even that is not enough to prevent these wonderful people from “giving back” and staying healthy.

Please read this article entirely at the site, The New York Times.  You won’t regret reading it and you will learn quite a bit about who a peer specialist is.
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After Drugs and Dark Times, Helping Others to Stand Back Up

Dual Diagnosis: Antonio Lambert, diagnosed with a mood disorder and addiction, manages through faith, medication and companionship – leaning the same “peer specialist” skills he teaches.

By
Published: December 19, 2011

SMYRNA, Del. — The taste of cocaine and the slow-motion sensation of breaking the law were all too familiar, but the thrill was long gone.

Antonio Lambert was not a young hoodlum anymore but a family man with a career, and here he was last fall, high as any street user, sneaking into his workplace at 9 o’clock at night, looking for — what, exactly? He didn’t really know.

He left the building with a few cellphones (which he threw away) and a feeling that he was slipping, falling back down into a hole. He walked in the darkness, walked with no place to go, and then he began to do what he has taught others in similar circumstances to do: turn, face the problem, and stand back up.

“I started talking to myself, out loud; that’s one of my coping strategies, and one reason I relapsed is I had forgotten to use those,” said Mr. Lambert, 41, a mental health educator who has a combined diagnosis — mood disorder with drug addiction — that is among the scariest in psychiatry.

He texted a friend, someone who knew his history and could help talk him back down. And he checked himself into a hospital. “I know when it’s time to reach out for help.”

The mental health care system has long made use of former patients as counselors and the practice has been controversial, in part because doctors and caseworkers have questioned their effectiveness. But recent research suggests that peer support can reduce costs, and in 2007, federal health officials ruled that states could bill for the services under Medicaid — if the state had a system in place to train and certify peer providers.

In the years since, “peer support has just exploded; I have been in this field for 25 years, and I have never seen anything happen so quickly,” said Larry Davidson, a mental health researcher at Yale. “Peers are living, breathing proof that recovery is possible, that it is real.”

Exhibit A is Mr. Lambert, a self-taught ex-convict who is becoming a prominent peer trainer, giving classes in Delaware and across the country. He is one of a small number of people who have chosen to describe publicly how difficult it is to manage such a severe dual diagnosis, including the sudden setbacks that often come with it.

“He is an extreme example of how much difference passion and commitment can make, given where he’s come from,” said Steve Harrington, the chief executive of the National Association of Peer Specialists, a group devoted to promoting peer support in mental health care.

Mr. Lambert, who has climbed out of a deep hole with the help of religious faith, medication and his own forms of self-expression, puts it this way: “There are a lot of people dealing with mental illness, drugs, abandonment, abuse, and they don’t think there’s a way out. I didn’t. I didn’t.”

Bean Bean in Spider City

His grandmother was the first person to call him Bean Bean, and the boy was so skinny that he couldn’t shake it.

He couldn’t avoid the older toughs in the Brighton section of Portsmouth, Va., either, and he spent some of his school-age years taking beatings. That was Brighton back in the day, and at least those fights taught survival skills. Not everything did: He remembers being sexually abused at age 6, by an older boy in the neighborhood — brutally.

He had no one to tell, even if he had known what to say. His mother and father were split, living blocks apart, each a fixture in the neighborhood’s social swirl of house parties, moonshine “shot shops,” card games and other attractions. His mother, called Chucky, was often out, sometimes leaving the boy at a friend’s house for “a few hours” that turned into an entire weekend. For much of that time, he waited on the porch.

He idolized his father, a truck driver and warehouse worker who lived nearby but spent his free time out, too, drinking and playing cards.

“During that time I was an alcoholic, but I would go out and try to find him when I heard he was out,” said his father, Edward Lambert, in a recent interview at his house in Brighton. He gave up drinking years ago for God, and father and son would eventually become close…[read more]

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December 20, 2011 Posted by | Mental Health | , , , , | 4 Comments

Man battles stigma

Here is a wonderful article from a Canadian paper The York Region that I felt belonged here.  This article tells you about having a mental illness from the perspective of the ill person.

This is also an article of hope, not despair, which is not the norm.  Peer services are wonderful for people in crisis.  We have peer services at my hospital and I know that my patients get quite a lot out of seeing someone who is mentally ill yet who can contribute in a positive way to the community.

This article may resonate with some of you.  If so, please leave me a comment below about your thoughts and feelings regarding this post.

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Constantin Nastic has lived with agonizing depression, anxiety and attention deficit disorder since childhood.
The 46-year-old Newmarket resident and social service peer support worker has also survived the stigma of his conditions.   Barely.   Until June, 2007, the big man with the articulate, melodic voice and expressive smile avoided hospitals.

Often, he experienced stinging humiliation from frontline practitioners who were too clinical and rigid. He thought he was being judged and felt ashamed.  The lack of sensitivity magnified my sense of ugliness,” he said. “Because of the chain of command, nurses adopted doctors’ attitudes. I never felt any compassion.”

Hypersensitive, Mr. Nastic shut down. The behaviour earned him the label of “unco-operative”, worsening an already difficult situation.   Addicted to drugs and alcohol as a means to numb the emotional pain, a tumultuous personal phase, including divorce, bankruptcy and cancer, drove him to the brink.

He was suicidal. Methodically, he collected the paraphernalia he planned to use for his hanging.
The day, June 27, and time, 2:38 p.m., are etched in his psyche. “At that moment, I heard a voice,” he said. “Go now, go now,’ it said. It was telling me to go to the hospital. If I hadn’t listened, I’d be dead now.”

In turmoil, Mr. Nastic admitted himself to Markham-Stouffville Hospital.  “I was desperate,” he said. “I checked into the psych ward. All I thought about was suicide. They had taken my shoe laces.”  Before he could orchestrate his own execution, a series of epiphanic events occurred.

A nurse saw his lonely, distraught and vacant state. She entered his room, touched his arm and kneeled to his eye level and said, “I can’t imagine what pain you’re going through, but we’re going to work together, and we’re going to find a way to help you. You’re not alone.”

He hesitates momentarily and looks skyward.   “It wasn’t the words so much as the compassion, the kindness, the fact someone took the time. The stigma was removed. It gave me validation that help and hope was there. It gave me the will and love to live.”

A trio of friends from a support group buoyed his spirits further with visits, he said. Those simple, heartfelt acts of kindness turned the key to unlocking the complexities of his emotional maladies.

Recovering, he is on a quest to share his story and shift perceptions about mental health and the barriers of stigma. His job, counselling the distressed, their families and friends and directing them to available and appropriate resources, has given him renewed purpose and passion, he said.

Speaking at schools, hospitals and Ontario Central Local Health Integration Network (LHIN) workshops called Mental Health and Addictions: Understanding the Impact of Stigma, is draining and gratifying.   “I tell people they have an opportunity to make a difference in someone’s life,” he said. “Without stigma, recovery is accelerated.”

Central LHIN chief executive officer Kim Baker describes him as courageous.   Created on a shoestring budget of $50,000 and intense collaboration in 2007, the Central LHIN’s anti-stigma curriculum for mental illness and addictions has been presented to 900 health care professionals in York Region.   So effective is the strategy, it has been adopted by seven health care facilities in British Columbia and a children’s hospital in Halifax.

“Stigma can be a tremendous barrier,” Ms Baker said. “The workshops focus on actions, use of words and how to be more caring and responsive. It teaches to treat the person, not just the condition and to assure the patient  they’re not alone.”  Understanding the impact of stigma is a one to two-hour workshop that uses experiential and informative education methods.

The curriculum includes an ice-breaker exercise designed to allow participants to identify their own stigmatizing attitudes, small group discussion and personal story of how stigma impacted a patient.  A significant part of the anti-stigma curriculum is reinforcing the importance of respect for the patient. By understanding and accepting mental illness is real, prejudices and perceptions and the associated behaviours, including derogatory terms and indifference, are eliminated.

Front-line health professionals are told the first casualty of mental illness is hope.   Anti-stigma courses advise on how dismissive, pre-conceived notions further the vulnerability of someone in an already fragile state. The curriculum suggests health care providers see the patient as a person with intrinsic worth and accept the fact issues, such as addiction, are not choices, but are as serious, valid and worthy of treatment as disease or injury.

The Mental Health Commission of Canada has adopted the Central LHIN model through a 10-year anti-stigma program called Opening Minds.   The commission is evaluating more than 40 similar programs Canadawide, including the Central LHIN program. Each program is designed to reduce the stigma commonly experienced by many people living with a mental illness, Opening Minds director Mike Pietrus said.

The teaching protocol sensitizes health care professionals about unfair stereotyping, he said. Since mental health issues don’t present themselves like a cut or broken bone, they don’t always seem real, he said.   “The stigma of the mental illness is worse than the illness itself,” he said. “Changing attitudes and behaviour is very positive toward reducing stigma.”  Educating professionals and having recovering mental health patients share their experience is pivotal, Mr. Pietrus said.  “It works,” he said. “Constantin has lived experience. People listen. They begin to understand stigma and they take it seriously.”

Mr. Nastic agreed. He witnesses how his clients relate to his compassion and shared experience. His advice to people struggling with mental health problems is to seek help.  “Never give up hope,” he said. “Accept the illness. Know there’s help.”

To health care workers, he recommends sensitivity and sensibility.  “Don’t give up on those with mental health issues,” he said. “If you’re a triage nurse with 50 people in line, focus on the person in the chair in front of you. That type of kindness and compassion made a difference in my life.”

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August 11, 2011 Posted by | Mental Health | , , , , , , | 2 Comments

Magellan Health Services Offers E-Courses for Providers, Consumers and Families

This is an exciting press release  about online classes for peer specialists.  At my hospital, we currently use peer specialists and the feedback from our patients has been overwhelmingly positive.  I was really pleased to find this press release and am just as happy to post it here.  Being a peer specialist is a valuable way for mentally ill people to help not only themselves, but to help others who are dealing with similar issues.

Please tell me what you think about this program?

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May 20, 2010, 11:23 a.m. EDT · Recommend · Post:

E-Courses Focus on Critical Role of Peer Specialists

AVON, Conn., May 20, 2010 (BUSINESS WIRE) — Magellan Health Services, Inc. , an industry leader in specialty health care management, has joined with the Depression and Bipolar Support Alliance (DBSA) to offer a new series of online learning opportunities to consumers, families and providers that address the pivotal and growing role of peer specialists in helping individuals work through and recover from mental illnesses. DBSA, which is considered the leading patient-directed national organization focused on prevalent mental illnesses such as depression, bipolar disorder and anxiety, designed the four new e-courses.

As individuals recovering from mental illnesses themselves, peer specialists are trained and certified to help others with mental health challenges gain hope and move forward in their own recovery. Magellan employs a number of peer specialists, directly and through its provider network, and regularly offers educational opportunities about their role through community presentations and provider-specific trainings.

“The Magellan/DBSA e-courses are unique in that they highlight the advantages of working with peer specialists for providers, consumers and families, in addition to those who supervise peer specialists,” said Anne McCabe, senior vice president of Magellan’s public sector behavioral health business unit. “To our knowledge, these are the only online courses that serve to educate a broad group about peers’ role in mental health recovery.”

Facts:

— The e-courses are offered free of charge at www.MagellanHealth.com/training.

— There are four e-courses that aim to help participants better understand the peer specialist’s role in helping others recover from mental illnesses:

#1: Research, Core Competencies and Ethics

#2: The Five Stages of Recovery and the Role of Peer Specialists

#3: Using your Recovery Story

#4: Effective Supervision of Peer Specialists

— The e-courses offer greater convenience than traditional on-site training programs, and each takes 30-45 minutes to complete.

— Each of the four new e-courses is tailored toward the beginner or intermediate skill level and offers providers in the Magellan network the opportunity to earn 1.0 Continuing Education (CE) credit hour. All other health care professionals who complete the new trainings will be issued a certificate of participation. Magellan is approved as a continuing education provider/sponsor by the American Psychological Association (APA), Association of Social Work Boards (ASWB), National Board of Certified Counselors (NBCC) and the National Association of Alcohol and Drug Abuse Counselors (NAADAC).

— These e-courses join 10 other interactive, self-guided training e-courses in the Magellan Resiliency and Recovery e-Learning Center, developed by Magellan in 2008. Since their launch, more than 8,400 e-courses have been completed by individuals spanning all 50 states. When asked about their value, behavioral health providers in particular reported that the e-courses were helpful in refreshing their skills, providing ideas to implement in their area of practice and generally in helping them to do a better job serving consumers.

“Peer specialists are an integral part of the recovery process, as they’re able to empathize with consumers and understand their experiences in a very personal way,” said Lisa Goodale, vice president of training at DBSA, who is also a featured trainer in the new e-courses. “With the extensive behavioral health expertise of Magellan and DBSA as their foundation, we expect the e-courses will be a powerful benefit not only to consumers, families, providers and peer specialists’ supervisors, but to the behavioral health field, overall.”

About Magellan: Headquartered in Avon, Conn., Magellan Health Services, Inc. is a leading specialty health care management organization whose customers include health plans, employers and government agencies nationwide. Magellan’s public sector behavioral health services assist approximately 1.9 million individuals in managing mental illnesses and substance abuse through innovative, community-based programs that deliver measurable outcomes and are grounded in the principles of recovery, resiliency and personal choice. In addition to behavioral health, the company operates in the areas of radiology benefits management, specialty pharmacy management, and public sector pharmacy benefits administration. Visit www.MagellanHealth.com for more information.

About DBSA: The Depression and Bipolar Support Alliance (DBSA) is the nation’s leading patient-directed organization focusing on depression and bipolar disorder. The organization, which has more than 1,000 support groups nationwide, fosters an understanding about the impact and management of these life-threatening illnesses by providing up-to-date, scientifically based tools and information. Assisted by a 38-member scientific advisory board comprising the leading researchers and clinicians in the field of mood disorders, DBSA supports research to promote more timely diagnosis, develop more effective and tolerable treatments and discover a cure. More than five million people receive information and assistance each year.

DBSA is nationally recognized as a leader in providing peer support services across the country. DBSA Vice President of Peer Services Larry Fricks has received national recognition for his groundbreaking efforts to establish and promote the role of peer specialists in helping others to recover from serious mental illnesses.

For more information about DBSA, please visit www.dbsalliance.org or call 1-800-826-3632.

SOURCE: Magellan Health Services, Inc.

Magellan Health Services, Inc.
Christine Barnhart, 410-953-2421

Here's the link to the original article

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May 24, 2010 Posted by | Mental Health | , , , , , , , , | 3 Comments