Health Policy Event Log-week 6 (2)

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Dedan Kimathi University of Technology *

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Nursing

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HEALTH POLICY 1 Week 6 Health Policy Event Log Your Name Course Institution Affiliation Date

HEALTH POLICY 2 Health Policy Event Log Name of event, sponsor of the event, and the link to the event: The webinar "Effective use of peer supports in behavioral healthcare and crisis intervention" was sponsored by Families USA and can be accessed at https://familiesusa.org/resources/health-justice-now-webinar-series-part- 7-effective-use-of-peer-supports-in-behavioral-health-care-and-crisis-intervention/ Place of event, date of the event, length of event: The webinar took place on September 12, 2022, from 3.00p.m to 4.00 p.m. Name of participants and their titles: The discussion was moderated by Staci Lofton, Senior Director of Health Equity, Families USA. The speakers include Patrick Corrigan, Distinguished Professor of Psychology, Illinois Institute of Technology; Dr. Paul Pfeiffer, MD, MS. Susan Crumpacker Brown, Research Professor of depression and Director of the Mental Health Innovation, Services and Outcomes Program (MHISO), U-Michigan Department of Psychiatry; Keris Jan Myrick, Vice President of Partnerships Inseparable and Caren Howard, Director of Policy and Advocacy, Mental Health America. Summary of the topic Recently, there has been a growth in the use of peer specialists- people with lived experience among states and communities in crisis intervention and recovery for people with mental illness and substance abuse. States have incorporated peers in their 988 suicide hotline responses and recruited them into their mobile crisis teams. In this webinar, the panelists sought to explore the effective use of peers in behavioral health teams and the tools required to administer service effectively.

HEALTH POLICY 3 When engaged, peers use their recovery experience to instill hope and help patients attain their recovery goals self determinedly. Also, peers provide an equal and inclusive community view that helps to break down the boundaries in many different ways. In a study reviewed, it was established that using peers makes interventions highly acceptable through the connection between peers and patients. Several tools have been termed appropriate to enhance and advance the effectiveness of peers. Peers require undergoing training such as job coaching and education support. Some universities are providing free training and internships for peers. Besides, state legislators need to involve peers in state planning and policy development for behavioral health. It ensures that people who are end recipients are involved in the making of interventions. Moreover, a job description clearly defines the scope of intervention for peers and clinician supervision requirements. Supervisors also require an understanding the peer support practices. Finally, rethinking alternative peer funding mechanisms in addition to Medicaid can help support peer activities. My analysis of the issue and its implications for healthcare According to Koons & Tozzi (2019), the U.S. is facing a mental health crisis with a substantive increase in suicide rates; in 2017, more than 47,000 Americans died by suicide. It indicates the increasing need for behavioral health support and interventions. Lately, there has been a growth in the peer workforce in mental health services, shedding more relief to people with mental health and substance use disorders and their families. Peers workers are people who have recovered from substance abuse disorders, mental health illnesses, or both and possess specific peer support competencies. Even though peer support has proved beneficial in

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HEALTH POLICY 4 behavioral health support, its integration is still lagging in the U.S., which calls for much more effort to spearhead interventions. Peer support is relatively new in U.S. healthcare and is faced with several key challenges. First, there is a lack of role clarity between peers and clinicians. Johnson & Brookover (2020) argue that peers find it difficult to maintain role-related boundaries, negatively impacting their working relationships with mental health specialists and supervisors. The other issue is the conflicting expectations of peers working part-time with related workload expectations. Peers face two conflicting demands: organization demands on their time that involves attending events and administrative requirements such as record keeping despite their limited engagement time. It also relates to funding based on client contact hours despite the administrative demands. Self- disclosure is the other challenge. It relates to how much and when to disclose personal information. Peers must develop self-awareness on how and when to draw boundaries between being a supporter and a friend. Finally, the integration of peer support is associated with the challenge of supervision. Schriger et al. (2020) argue that adequate professional supervision is essential for peer support workers. A study by Kemer et al. (2021) established that there was a lack of appropriate supervision and mentoring, which is a major drawback in developing peer support in mental health interventions. Policy strategies will help address the barriers in peer support for behavioral health teams and practices. According to the National Alliance on Mental Health (n.d.), policy changes can help improve interventions, service delivery, and health outcomes. States need to set up training and education programs for peers. There is a need to have an accredited peer support course. Moreover, training about boundaries and ethical issues is necessary to address the disclosure issue. Peers will understand the purposefulness of disclosure while still keeping themselves safe.

HEALTH POLICY 5 On the aspect of supervision, managers and clinicians must be trained to develop a better understanding of peer support worker roles and have knowledgeable and competent supervisors. Recruiting adequate peer support by extending Medicaid and peer funding can also help with the issue of conflicting demands. Peers' engagement time can be extended to capture organizational and administrative demands. Lastly, peer workers require more than experience and training with behavioral problems; providing a precise job description will be appropriate to avoid conflicts of roles. A job description will give a better understanding of peer position, skills required, and the expectations of practice (Jacobson et al., 2012). Legislators and health practitioners must advocate for more peer inclusion and ways to improve effectiveness in providing mental health care to address the U.S. mental health crisis.

HEALTH POLICY 6 References Corrigan, P., Howard, C., Lofton, S., Myrick, K., & Pfeiffer (2022, September 12). Effective use of Peer Supports in Behavioral HealthCare and Crisis Intervention: [Webinar]. Families USA. https://familiesusa.org/resources/health-justice-now-webinar-series-part-7- effective-use-of-peer-supports-in-behavioral-health-care-and-crisis-intervention/ Jacobson, N., Trojanowski, L., & Dewa, C. (2012). What do peer support workers do? A job description. BMC Health Services Research , 12 (1). https://doi.org/10.1186/1472-6963-12- 205 Johnson, K., & Brookover, D. (2020). Counselors’ Role in Decreasing Suicide in Mental Health Professional Shortage Areas in the United States. Journal Of Mental Health Counseling , 42 (2), 170-186. https://doi.org/10.17744/mehc.42.2.06 Kemer, G., Rocha, J., Reiter, A., Dominguez, V., & Giresunlu, Y. (2021). Structured Peer Feedback Exchange in Group Supervision of Beginning Supervisors. Counselor Education And Supervision , 60 (2), 148-163. https://doi.org/10.1002/ceas.12200 Koons, C., & Tozzi, J. (2019). As suicides rise, insurers find ways to deny mental health care . National Alliance on Mental Health. (n.d.). Priority policies . Schriger, S., Becker-Haimes, E., Skriner, L., & Beidas, R. (2020). Clinical Supervision in Community Mental Health: Characterizing Supervision as Usual and Exploring Predictors of Supervision Content and Process. Community Mental Health Journal , 57 (3), 552-566. https://doi.org/10.1007/s10597-020-00681-w

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