National Conference on Peer Support April 27-29, 2016 Toronto

 Allan Strong: Team Lead - Skills for Safer Living Self Help, CMHA WWD  Keely Phillips: Team Lead – Centre for Excellence in Peer Support Self Help, CMHA WWD  Self Help is the peer support program of CMHA Waterloo Wellington Dufferin

 To provide participants with an overview of the literature  To provide participants to think critically about your own experience  To provide participants the opportunity to develop ways to implement information gained into their day to day reality

 The research being carried out is part of a major research project being done by Allan Strong as part of the requirements of the Masters of Arts in Leadership in the faculty of Business and Economics at the University of Guelph

 There is a growing number of peer workers in the system and there is very little knowledge on the nature of support that peer workers need in order to thrive  Supervision is seen as important but the nature of the supervision required is not understood

Peer support is a supportive relationship between people who have a lived experience in common. Sunderland, K., Mishkin, W., Peer Leadership Group, Mental Health Commission of Canada. (2013). Guidelines for the Practice and Training of Peer Support (pp. 1–54). Calgary. Retrieved from

 Peers are persons with mental health conditions who, though without professional credentials, are employed as service deliverers in the mental health provider system. Gates, L. B., Mandiberg, J. M., & Akabas, S. H. (2010). Building capacity in social service agencies to employ peer providers. Psychiatric Rehabilitation Journal, 34(2), 145–152.

Peer support work is about understanding another’s experience by means of an empathetic understanding of another’s experience by the shared lived experience of similar pain and distress. Mead, S., Hilton, D., & Curtis, L. (2001). Peer support: A theoretical perspective. Psychiatric Rehabilitation Journal, 25(2), 134–

For the purposes of this presentation a peer worker will be defined as an individual that identifies publically as having the lived experience of a “mental illness” and is employed to provide support

 The lived experience is the lens used by the peer worker in delivering service and support  The person has been hired to provide peer support as they have publically identified as having the lived experience  Important distinction to make as not everyone is comfortable “declaring”

Investigating the State of Peer Support Work in Ontario : Findings and Implications Taylor Newberry Consulting 2014

“ Broadly speaking, a consumer survivor initiative (CSI) is an entity run by consumers/survivors for consumers/survivors. Their activities may include various forms of peer support, systemic and individual advocacy, economic development, education, research, evaluation, information provision and recreation as well as cultural and artistic activities.”  O'Hagan, M., McKee, H., & Priest, R. (2009). Consumer Survivor Initiatives in Ontario: Building for an Equitable Future (pp. 1–105).

 An individual that does not have the lived experience of mental health distress that has required an intervention (treatment, hospital, etc.)

 An organization that is with in the mental health system of care that is not managed by peers  The primary function of the organization is the provision of what would be considered “treatment” (hospital, community mental health organizations) and the focus is not providing peer support functions

Supervision can be defined as, “a working alliance between practitioners in which they aim to enhance clinical practice, fulfill the goals of the employing organization and meet ethical, professional and best-practice standards of the organization and the profession, while providing personal support and encouragement in relation to the professional practice…..” Kavanagh, D. J., Spence, S. H., Wilson, J., & Crow, N. (2002). Achieving effective supervision. Drug and Alcohol Review, 21(3), 247–252.

Definition Peer Support Supervision occurs when a peer support supervisor and peer support specialist supervisee(s) formally meet to discuss and review the work and experience of the peer provider, with the aim of supporting the peer in their professional role.

 Some of the literature suggests that the supervision of peer workers be divided between two functions: ◦ Administrative functions ◦ Support functions  Suggested that the functions be provided by separate supervisors (ideally)  Training be provided to supervisors to be able to provide “support” to peer workers (Schmook, A., & Jorgenson, J. (2014). Enhancing the Peer Provider Workforce: Recruitment, Supervision and Retention (pp. 1–30).)

The focus of supervision be on the work performance of the peer and not on the mental health needs of the peer worker 1. Daniels, A. S., Turner, T. P., Powell, I., Fricks, L., & Ashenden, P. (2015). Pillars of Peer Support VI :Peer Specialist Supervision (pp. 1–77). Atlanta. Retrieved from 2. Schmook, A., & Jorgenson, J. (2014). Enhancing the Peer Provider Workforce: Recruitment, Supervision and Retention (pp. 1–30).

Position Paper: The role of supervision in the mental health and addiction support workforce. (2013).

In most states where there are peer support services paid for by Medicaid – it is required that peer workers are supervised by a competent mental health professional as defined by the individual State (Jorgenson and Schmook, 2015 p. 9) Schmook, A., & Jorgenson, J. (2014). Enhancing the Peer Provider Workforce: Recruitment, Supervision and Retention (pp. 1–30).

 To provide peer support staff and volunteers with a safe, confidential and supportive space to reflect critically on professional practice.  To enhance quality mental health services to Veterans by improving mental health practice via provider self- reflection, learning and competency development.  Supervision is central to quality management in a learning organization. Daniels, A. S., Turner, T. P., Powell, I., Fricks, L., & Ashenden, P. (2015). Pillars of Peer Support VI :Peer Specialist Supervision (pp. 1–77). Atlanta. Retrieved from

 There is very little literature about this topic – does it matter who supervises a peer worker  Most of the research focuses on the issues surrounding the integration of peer workers and the value of peer support in the process of recovery

 Current literature identifies the challenges such as lack of role clarity, wages, lack of advancement, etc.  Supervision and mentoring is mentioned but not in any detail and there is very little about peer workers being supervised by peers  Very little about the impact of supervision on the challenges associated with peer workers

 Several studies cite the fact that the number of peer workers in the system is growing – example Investigating the State of Peer Support Work in Ontario (TaylorNewberry Consulting, 2014) – 153 individuals responded to an online survey 110 paid workers and 43 volunteers

 The exact number of paid peer workers in Ontario (Canada) is not known  Most of the literature that has been examined has been in mental health – not sure what the situation is in other peer jurisdictions ( addictions, sex trade, cultural communities for example)

 Wide variance in what peer workers do, how roles are defined and what tasks are performed  Peer workers are primarily employed by either a peer organization or by a “mainstream” mental health organization ( hospitals, community mental health organizations)

 There appears to be three methods of peer worker supervision that is emerging ◦ One to one supervision/support provided by a “supervisor” by a peer – not a lot of research evidence, experiential knowledge ◦ One to one supervision provided by a non-peer supervisor – most of the evidence from the States ◦ The separation of the supervisory functions – administrative and support

 Keely will share a perspective about supervision

 Focus of the research will be to understand if there is a difference between supervision done by a peer and a non-peer  The operating assumption that there will be a qualitative difference experienced by the peer when supervision is done by a peer