Building the Case for Peer Support Services
In 2012, President Obama signed an Executive Order requiring VA to hire 800 peer specialists.In response, over 900 new peer specialists and apprentices have been integrated into VA mental health programs to enhance recovery for Veterans diagnosed with serious mental illnesses.Peer specialists are Veterans who have personal experience managing and recovering from mental illness and who bring this unique expertise to the treatment setting. Their work involves sharing their recovery stories, acting as role models of recovery, serving on interdisciplinary treatment teams, advocating for Veterans, and connecting Veterans to helpful resources. But what effect do peer specialists have on Veterans’ treatment outcomes? Studies conducted outside of VA have shown that including peer specialists in treatment results in less inpatient use, better treatment engagement, and greater life satisfaction. Including peer specialists in treatment also helps improve quality of life and social functioning. Researchers in the VISN 4 and VISN 22 MIRECCs conducted a rigorous study focusing specifically on Veterans within VHA. This study, called Peers Enhancing Recovery, compared 149 Veterans with peer specialists on their mental health case management teams to 133 Veterans whose case management teams did not include peer specialists. The researchers followed both groups over one year and asked Veterans about their quality of life, relationships, symptoms, and their ability to self-manage and be active in their health care. Veterans who had peer specialists on their treatment teams reported significant improvement in their perceived ability to actively manage their own health care. This suggests that integrating peer support into treatment may play a key role in encouraging Veterans to become more active in their treatment and recovery.
Readiness to Serve: Training Peer Support Providers
The VISN 1 MIRECC has been promoting peer support practices since 2002 when they developed “Vet-to-Vet,” the first peer support program for Veterans. The Vet-to-Vet program has an educational focus and is facilitated by peer educators. It has been implemented in more than 50 VA facilities and non-VA community settings throughout the country. As increasing numbers of peer specialists are hired within VHA, it is essential to ensure that they are well trained and that their roles and responsibilities are clearly defined. Responding to this need, the VISN 1 MIRECC collaborated with VA Mental Health Services in developing a list of expected knowledge and skills for VA peer support providers and establishing training manuals which are offered throughout VHA. Their Peer Education Center provides free, in-person, monthly workshops and seminars focused on topics relevant to the work of peer specialists. Topics covered include confidentiality and boundaries, crisis prevention and intervention, and group facilitation skills. More than 95 trainings have been offered to Veterans who are either currently serving as a peer specialist or are interested in becoming one. Over 325 Veterans have participated in at least one of the monthly training events. The Center has also collaborated with the VISN 4 MIRECC to develop the Peer Specialist Toolkit: Implementing Peer Support Services in VHA. The toolkit is intended to help VA medical centers and community-based outpatient clinics implement peer support services at their facilities. It contains information vital to training, supervising, and integrating peer specialists into clinical teams in VA facilities.
Wellness Recovery Action Planning Comes to VA Medical Centers
The VISN 5 MIRECC is bringing Wellness Recovery Action Planning (WRAP) to VA Medical Centers. WRAP is a group treatment that is facilitated by peers and uses illness self-management skills to improve recovery among individuals with serious mental illness. WRAP has been shown to decrease mental health symptoms, increase hopefulness, and improve quality of life. The VISN 5 MIRECC has established procedures for the training and implementation of WRAP groups and has adapted the WRAP facilitator training curriculum for the unique needs of VA. Peer specialists hired within VISN 5 VA will have the opportunity to receive training in this nationally recognized, peer-led intervention. They will also participate in an evaluation of this training and implementation program. Following the training, peer specialists will create WRAP groups at their local VA and complete a six-month follow-up consultation with an expert WRAP consultant. Each site will be visited by a WRAP consultant who will provide detailed, expert feedback on the program. This training program will be evaluated to better understand peer specialists’ experience in the program. The information collected will include how well the program prepared them to facilitate WRAP groups at their local VA. This evaluation is key to understanding how well the training program worked and whether it met the needs of the peer support specialists and imparted all of the skills needed to run WRAP groups. This information will inform the broader implementation of WRAP.