Setting up peer services in Counties Manukau - threefold benefits for users, peers and clinicians

I was looking for information about peer services in NZ and found a very informative interview with Sue Hallwright, manager of the mental health development team in Counties Manukau DHB, who talks about the experience of setting up peer services. Sadly I wasn't allowed to embed on blogger.com so I've provided a summary and then a link for anyone who wants to have a look at the video (it's about 30 minutes long, but goes fast, very interesting!). 
Sue first talks about how some team members were sent to in Phoenix, Arizona, and came back inspired and impassioned. This service also provided their training programme so that helped get things up and running in a shorter time. Over the last few years, about 120 people with experience of mental health services have been trained to become peer support specialists who work within the multidisciplinary team. All service users have the right to receive peer support. 
This move has benefitted not only users, who receive support and regain hope from "living proof that recovery happens", but also the peer support specialists who through the training reshape their own experiences as strengths and are recast as "heroes" and "experts". Graduating from the training programme and having employment are strong evidence of recovery and a better future for users. Interestingly, she said that clinicians also benefitted because (for some of the jaded ones) the peer support specialists reminded the clinicians that there was hope!
Here is the link to the video and for anyone interested, here is a link to Sue Hallwright's current portfolio on the DHB website. I'll try to find a video of a user's or a peer's perspectives, or if anyone knows of any, please let me know!

A bit of history

Gawith and Abrams (2006) wrote a great article tracing the journey of mental health services in NZ. Consumer advocacy and consumer-led services have their roots in the 1980s and a series of inquiries (eg Cartwright Report of 1988 and Mason Reports in the 1990s) brought to attention the dire state of patient rights and questioned the total authority traditionally associated with the medical profession. The Mental Health Commission was set up to do something about this and services have been, well, recovering from the past ever since. I would really recommend this article for anyone interested in a well-written overview of the evolution of services in NZ from the historical psychiatry-led biomedical focus to today's recovery and consumer rights focus. I found it really helped my understanding to step back and look at the bigger picture, politically, socially, all the events that propelled and impacted the development of services (including peer-led services) along the way.
Reference
Gawith, L. & Abrams, P. (2006). Long journey to recovery for Kiwi consumers: Recent developments in mental health policy and practice in New Zealand [Electronic version]. Australian Psychologist, 41(2), 140-48.

So what are peer-led services anyway?

Before we go any further I thought it would be useful to explain what exactly are peer-led services. I found an excellent webpage describing this on the Te Pou website. Te Pou is the National Centre of Mental Health Research, Information and Workforce Development so their website is full of useful relevant information on mental health in New Zealand, including academic research, services, workforce development and so on. I'll put a link in the column on the right for anyone who is interested to have a browse.
Basically, a "peer" in "peer support" or "peer-led" (sometimes known as "consumer-led") services, refers to services that are provided by people with experience of mental health issues, who have used services before, and who are trained to provide support/services to others (Te Pou, 2009). This is very consistent with the Recovery Approach, which defines recovery as a journey, on which there are those who have gone before you and there are others who will come after. So someone who is further along on their recovery journey can provide support for someone earlier on theirs. These quotes (from the linked page above) were from the 2009 National Peer Support Forum and sums up the importance/relevance of peer services very well:

“Its like asking someone who has never tasted apples or apple juice to describe the taste of apple juice to you”.

“If you were building a house, who would you want to help you? Someone who had read a book about building a house or someone who had done it successfully?”

Well, if it were me, I'd definitely want someone who's "been there, done that" to help me. I really like the description of someone who had "read a book" versus someone who had built a house successfully. It may seem a bit harsh to say so but essentially, I guess that describes mental health providers who aren't users and have been trained to provide traditional services. We've gone through the courses, done the training, read the books and articles, but we haven't "walked the walk".
Anyone with any thoughts on that? What if it were you?

Reference

Te Pou. (2009). What is peer support? Retrieved August 27, 2010, from http://www.tepou.co.nz/page/697-service-user-workforce-development+peer-support+what-is-peer-support 

How I found out about peer-led mental health services

Last year I had my first mental health placement, which turned out to be fantastic - educational, inspiring, encouraging. The organisation I was with had what I thought was a very positive and progressive approach to service provision. They treated every person as unique and really tried to empower people. They used a recovery/strengths approach and I really enjoyed it because their philosophy fit very well with my own personal beliefs, and was also consistent with occupational therapy philosophy of enabling, empowerment and being client-centred.

During my placement I got the chance to take part in a human rights workshop for mental health service users, organised by Case Consulting, a peer-led service. I was the only person who did not identify as a service user/provider in the workshop. It was led by a very vocal, funny and assertive woman who wasn't at all like most of the service users I had met so far. She led a full, busy life, running workshops and seminars, educating people, had her own business, and what really struck me was how she was entirely unafraid to be known as a service user. At the time I thought, wow this is like gay pride, as in people who are normally ostracized by society but who have turned around and gained a sense of community and pride from who they are. The atmosphere was so positive, affirming and empowering, I felt a bit left out! Not that the other participants weren't warm and friendly, but I sort of thought to myself, well this must be what it's like to be the "odd one out", which I never really felt before even though I am really a minority in this country too. It was strange but inspiring and I went away with much to reflect upon, about myself, my identity, my own status as a minority...

This workshop also sat well with occupational therapy, in particular occupational justice as it dealt with issues like rights as job-seekers and employees. Now that I think about it, human rights education is all about empowering people through information/education, which is one way of targeting discrimination and stigma. We know that stigma is a huge barrier to occupational participation and quality of life in all areas of life (Byrne, 2000) so this is a wonderful step forwards.

Case Consulting is still holding these workshops as far as I know and for those who are interested in inviting them to your part of the country to hold one, here is the link to their human rights workshop series, Korowai Whaimana.

Here is a picture of the certificate I got at the end! :)

REFERENCES

Byrne, P. (2000). Stigma of mental illness and ways of diminishing it [Electronic version]. Advances in Psychiatric Treatment, 6, 65-72. Retrieved from http://apt.rcpsych.org/cgi/content/short/6/1/65

Hello, and welcome!

Today marks the birth of this new blog, which will be a journey of exploration into peer-led mental health services in New Zealand. This is an area of mental health services that has recently begun to emerge in the country and I came across it last year whilst on placement in the capital.

Over the next few posts I will introduce you, the reader, to how I came across this phenomenon, I will attempt to uncover the history of peer-led mental health services in New Zealand and what's been happening so far, I will poke my nose around to find out what's currently available and I will try to make some sense of all the information and ponder what all this means to me, and what it might mean for the mental health sector. And along the way I'm sure I'll come across interesting links, websites and other resources too.

Hope you enjoy the ride!