Making the Case for Peer to Peer Supports and A US Peer Workforce

MAKING THE
CASE FOR PEER
TO PEER
SUPPORTS AND A
US PEER
WORKFORCE
DAPHNE KLEIN, CEO
ON OUR OF
MONTGOMERY
COUNTY
GAITHERSBURG
MARYLAND
K | P + ASSOCIATES |
MARYLAND
12/2/2017 Jennifer M. Padron (c) 2017. All Rights Reserved. 1

ASYLUM photo, artist unknown
12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved.2

HOW THE NUMBERS STACK UP
• December 7, 2016, the 21st Century Cures Act passed 94-5 out of the
House of Representatives with turgid fanfare and horror.
12/2/2017Jennifer M. Padron (c) 2017. All Rights Reserved.
3

LACK OF CONTROL (THE PATIENT’S PERSPECTIVE)
• A medically, clinically necessary diagnosis substantiating the use of psychotropic
medication dosing is geared to control and manage exhibited DSM-5
symptomology popularized and normalized by the American Psychiatric
Association, the American Medical Association, National Association of Social
Work and the American Psychological Association.
4

THE DSM-V AND SPMI
SERIOUS PERSISTENT MENTAL
ILLNESS
• Diagnostic Statistical Manual’s (DSM-5,
2016) symptomology of “Serious
Persistent Mental Illness” (SMI) includes
anxiety or panic disorder(s), behavioral
and mood disorder(s) with the more
complex or complicated issues being
major depression and the bipolar or
schizophrenia spectrum disorders.
5

HOW THE
NUMBERS
CONTINUE TO
FALL
35.5% percent of all US Social
Security Disability Insurance (SSDI)
beneficiaries live with such a
diagnosis. The SSA 2012 numbers
of 10,088,739 SSDI beneficiaries
nearly doubled from 5,044,388
since 1995.
National Association of State
Mental Health Program Directors
Research Institute, Inc. (NRI), (2013)
http://www.nri-incdata.org/
Annual Statistical Report on the
Social Security Disability Insurance
Program
6

45% OF ALL PEOPLE
WITH MENTAL
ILLNESS, HAVE 2+
PHYSICAL
DISORDERS (CO-
MORBIDITIES)
Nearly half (45%) of all individuals
living with any mental disorder have
two or more debilitating physical
disorders further lowering their
quality of life and leading to a
significantly high rate of comorbid
physical issues.
01
Average age of death is now 52
years old for an individual living with
an SPMI diagnosis.
Harvard Mental Health Letter, (2003);
NASMHPD, (2006); Parks, Svendsen,
Singer, Foti, (2006).
02
7

MORBIDITY AND MORTALITY EQUATES TO PHYSICAL
DEATH <25 YEARS EARLIER THAN OTHERS
Physical comorbidities is the leading
reason why people with SMI are dying
25 years earlier than the general
population. There is a higher frequency
of multiple general medical conditions
that more than double the rate of
premature deaths from these
conditions.
01
Fricks, (2012); Mental Health America,
(2010); National Alliance on Mental
Illness, (2011).
02
Kelly, Boggs, and Conley, 2007; Mauer,
2006; Parks et al., 2006; Sokal et al.,
2004; Saha, Chant, and McGrath, 2007;
Laursen et al., 2013).
03
8

MEDS, MEDS
AND MORE
MEDICATIONS
12/2/2017
Jennifer M. Padron (c) 2017. All Rights Reserved.9

MORE NUMBERS
• Forty-six (46) years ago, in 1967, 1:3
American adults filled a prescription
for a “psychoactive” medication, with
total sales of such drugs reaching
$692 million. In its’ June 2008 report
the GAO determined that one in
every sixteen young adults in the
United States is now diagnosed with
an SPMI (Whitaker, R., 2010).
• In 2010, $16.1 billion was spent on
antipsychotics in the US, to treat
depression, bipolar disorder and
schizophrenia. $11.6 billion was spent
on antidepressants, while $7.2 billion
for the treatment for ADHD
10

SUICIDE AND
COMPLETION Suicide completion numbers
worldwide today tragically occur
every 40 seconds and injury
accounts for 30-40% of excess
mortality, where 60% of premature
deaths in persons with a diagnosis of
schizophrenia are due to medical
conditions such as cardiovascular,
pulmonary and infectious diseases.
World Health Organization (2016).
Retrieved April 11, 2016
http://www.befrienders.org/suicide-
statistics
01
National Association of State Mental
Health Program Directors
(NASMHPD) Medical Directors
Council Report, 2006
02
11

SOLUTIONS

A NATIONAL US PEER WORKFORCE STEPS UP
Peer roles in mental health, substance abuse
and community health are evolving, as people
with lived experience offer a potent resource
to help other peers who are facing these
health concerns through education, support,
and coaching.
01
Peer roles are evolving within the context of
emerging “recovery-oriented” integrated
health systems (Tucker, S. J., Tiegreen, W.,
Toole, J., Banathy, J., Mulloy, D., Swarbrick, M.,
2013).
02
13

CERTIFIED PEER SPECIALIST CERTIFICATION (AND
ENDORSEMENTS)
The CPS and Endorsements (Transition Age Youth,
Certified Peer Specialist, Forensic Peer Recovery
Specialist, Vet to Vet, Family to Family, Aged &
Across the Life Span, Crisis First Responder,
Recovery Coach and Community Health Worker
Promotora)
01
Offers a workforce of professionals whose shared
life experience opens the door creating a recovery
based workforce who have empowered
themselves using the principles of Recovery Based
Practices
02
14

SEAMLESS • Peer Supports & Services function as seamless
efficient teams that are triage based (MD,
PhD, RN, LCSW, LPC, CPS, FPS, RC, TAY)Technical, training and
assistance services
15

PEER SUPPORTS & SERVICE
16
• As of July 2017, 46 States, two Territories (Guam and
Puerto Rico), the District of Columbia and the Veterans
Administration system have established programs to
train and certify peer specialists.

NEXT STEPS
HIGHER QUALITY OF
LIFE (QOL)
INCREASED PHYSICAL
HEALTH QUALITY OF
LIFE (PHQOL)
LOWERED INPATIENT
INCREASED
OUTPATIENT
LONGEVITY, HEALTH &
WELLNESS
SUSTAINABLE
INNOVATIVE
EMERGENT

TODAY’S
POLITICAL
CLIMATE:
CHALLENGES
AND
OPPORTUNITIES
PRESERVATION

COMMUNICATION
TOOLS
STRUCTURAL AND INSTITUTIONAL
PUBLIC HEALTH WELLNESS AND
RECOVERY MODELS

ENGAGE
TARGET
COMMUNITIES

IMPLEMENTATIO
N & EVALUATION

IMAGINEA WORLD WITHOUT
FORCED MENTAL
HEALTH DIVERSITY

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Making the Case for Peer to Peer Supports and A US Peer Workforce

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