Peer Support for Persons with Mental Illness Joshua A. Craig, FNP-S SUNY Institute of Technology Health Promotion and Disease Prevention

Peer Support: A Short Introduction Video http://www.youtube.com/watch?v=us4G5LOjLek

Peer Support vs. Counseling: What’s the Difference? Counseling is professional guidance in resolving personal conflicts and emotional problems (“Counseling”, n.d.) Peer Support Group is a voluntary gathering of people with similar challenges, usually weekly or monthly for an hour or two, to share experiences and coping strategies and offer understanding (National Alliance on Mental Illness [NAMI], 2014) Please note: a peer support group does not replace psychiatric counseling by a professional mental health counselor.

Additional Basic Mental Health Terms Mental health is a state of well-being in which the individual (Centers for Disease Control and Prevention [CDC], 2013): realizes his or her abilities can cope with the normal stresses of life can work productively and fruitfully able to make a contribution to his or her community Mental Illness is defined as “health conditions that are characterized by alterations in thinking, mood, or behavior associated with distress and/or functioning” (CDC, 2013)

What Are Some of the Most Common Mental Illnesses in the United States? Anxiety disorder (40 million American adults) Depression (14.8 million American adults) Post-traumatic stress disorder (7.7 million American adults) Bipolar disorder 5.7 million American adults) Schizophrenia (2.4 million American adults) Source: (National Institute of Mental Health [NIMH], n.d.)

Stigma Toward Mental Illness

How Does Stigma Affect Mentally Ill Persons? Stigma can lead to (NAMI, n.d.): Fear, violence and mistrust against people who suffer from mental illness as well as their families Family and friends turning their back on people with mental illness Prejudice and discrimination Discourages the person with mental illness from seeking help Violates their rights and denies opportunies The person with mental illness often feels discrimination in the workplace, education, housing, and healthcare.

Stigma: How does it affect mental health persons (cont’d): People who agree with self-stigma of mental illness experience lower self esteem and efficacy (Corrigan, Sokoi, & Rusch, 2013b) Leads to less satisfaction with work, housing, relationships, and spirituality (Corrigan et al., 2013b)

How Does The General Public View Mental Illness? Stigma levels found to be highest involving (Pescosolido et al., 2013, p. e5): family members with mental illness children with mental illness persons who inflict self-harm Generally unwilling to see persons with mental illness in positions of authority or power (Pescosolido et al., 2013, p. e5) Uneasy interacting socially with mentally ill persons and may fear violence from persons with mental illness (Pescosolido et al., 2013, p. e5)

How Does The General Public View Mental Illness? General public has different perceptions about different mental illnesses The public is better able to correctly identify a person with signs of depression than a person with signs of schizophrenia (Pescosolido et al., 2013, p. e5) The general public is more likely to view schizophrenia as a serious mental illness caused by a brain disease (Pescosolido et al., 2013, p. e5) More likely to believe depression is caused by moral or behavioral problems (Pescosolido et al., 2013, p. e5)

Positive Experiences of Mentally Ill Persons in Health Care Studies have found mentally ill persons look for the following qualities in a health care provider: For someone to be understanding and caring (Schroeder, 2013, p. 33) To be encouraging (Schroeder, 2013, p. 33) To feel as if they belong (Schroeder, 2013, p. 33) To be accepted as a normal person (Schroeder, 2013, p. 34)

Negative Experiences of Mentally Ill Persons in Health Care Sometimes find health care staff to be untrustworthy (Schroeder, 2013, p. 34) Uncertainty that if their health care is dropped or can no longer afford psychiatric services they will be left untreated (Schroeder, 2013, p. 34) Finding the right kind of help so as to limit feeling as if they spend several years in and out of treatment, in and out of society, in and out of reality (Schroeder, 2013, p. 35)

Peer Support Groups

What Do They Offer? Participants in peer support groups not only benefit from sharing with and learning from others but also from offering assistance to their peers who experience mental illness (Corrigan, Kosyluk, & Rusch, 2013a, p. e4) Shared help through peer support groups and/or mutual help programs has been found to bolster a person’s self-esteem, hope, and confidence (Corrigan et al., 2013a, p. e4) Satisfaction with peer support participation as well as group identification is found to be highly correlated with a better quality of life (Corrigan et al., 2013a, p. e4)

Embrace Your Identity Peer support positively facilitates identity and disclosure of a person’s mental illness (Corrigan et al., 2013a, p. e4) Mentally ill persons who identify with a mental illness group are more likely to attend a peer support program (Corrigan et al., 2013a, p. e4) Peer support programs can provide a range of services, such as (Corrigan & Kosyluk, 2013a, p. e4): Encouragement for public acceptance of their mental illness Shared experiences to foster a sense of community Advocate to promote group pride

Improves Recovery from Acute Mental Illness Episodes Peer support groups can also help a person recover from an acute episode of mental illness Aspects of recovery include fostering hope, self- determination, knowledge, life satisfaction and increased consideration of peer support (Rabenschlag et al., 2012, p. 755)

Peer Support Groups: Improving Recovery (cont’d) Participants in peer interventions had a much higher feeling that recovery from an acute episode of mental illness was possible up to six months after taking part in an individual peer-to-peer session (Rabenshlag et al, 2012, p. 758) Perceived difficulties such as setbacks, stigma and different forms of recovery were found to be much lower six months after participating in the peer intervention (Rabenschlag et al., p. 758)

Peer Support Groups: Providing a Social Network Peer support groups can expand the social network for persons with mental illness 84% of people with mental illness feel socially isolated compared to 29% of the general population (Forrester- Jones et al., 2012, p. 5) Developing relationships in a social network can be time-consuming but helps to create an identity beyond a “former mental patient” (Forrester-Jones et al., 2012, p. 11)

Peer Support Groups: Providing a Social Network a functional social network can lead to greater access to services, leisure activities, employment and personal autonomy (Forrester-Jones et al., 2012, p. 4) Having a mutually supportive group of peers or friends can result in a better quality of life (Forrester-Jones et al., 2012, p. 11)

References Centers for Disease Control and Prevention. (2014). Mental health: Mental health basics. Retrieved from http://www.cdc.gov/mentalhealth/basics.htm Corrigan, P.W., Kosyluk, K.A., & Rusch, N. (2013). Reducing self-stigma by coming out proud. American Journal of Public Health, 103 (5), e1-e7. doi: 10.2105/AJPH.2012.301037 Corrigan, P.W., Sokoi, K.A., & Rusch, N. (2013). The impact of self-stigma and mutual help programs on the quality of life of people with serious mental illnesses. Community Mental Health Journal, 49, 1-6. doi: 10.1007/s10597-011-9445-2 Dictionary.com. (2014). Counseling. Retrieved from http://dictionary.reference.com/browse/counseling Forrester-Jones, R., Carpenter, J., Coolen-Schrijner, P., Cambridge, P., Tate, A., Hallam, A.,… & Wooff, D. (2012). Journal of Mental Health, 21 (1), 4-14. doi: 10.3109/0963827.2011.608743 National Alliance on Mental Illness. (n.d.). Facts about stigma and mental illness in diverse communities. Retrieved from http://www.nami.org/contentmanagement/contentdisplay.cfm?ContentFileID=5148 National Institute of Mental Health. (n.d.). The numbers count: Mental disorders in America. Retrieved from http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml Pescosolido, B.A., Medina, T.R., Martin, J.K., & Long, J.S. (2013). The “backbone” of stigma: Identifying the global core of public prejudice associated with mental illness. American Journal of Public Health, 103 (5), e1-e8. doi: 10. 2105/AJPH.2012.301147 Rabenschlag, F., Schustershitz, C., Conca, A., Knuf, A., Needham, I., & Hoffmann, H. (2012). Influences of single peer interventions on the recovery attitude of persons with a psychiatric disability. Scandinavian Journal of Caring Sciences, 26, 755-760. doi: 10.1111/j.1471-6712.2012.00995.x Schroeder, R. (2012). The seriously mentally ill older adult: Perceptions of the patient-provider relationship. Perspectives in Psychiatric Care, 49 (1), 30-40. doi: 10.1111/j.1744-6163.2012.00338.x

Post-Presentation Questions

1. What is true concerning a peer support group? A. It offers professional guidance in resolving personal conflicts and emotional problems B. It is a voluntary group of people with similar challenges who share experiences, coping strategies, and offer understanding C. Does not replace professional psychiatric counseling D. Both b & c Answer: D

2. Stigma can lead to: A. Fear, violence and mistrust against persons with mental illness B. Increase the mentally ill person’s confidence and trust C. Encouraging the person with mental illness to seek more help D. Reducing prejudice and discrimination against persons with mental illness Answer: A

3. The general public is more likely to be unwilling to see persons with mental illness in a position of authority or power. A. True B. False Answer: A

4. The general public is more likely to believe schizophrenia is caused by a moral or behavioral problem and depression is a serious mental illness is caused by a brain disease. A. True B. False Answer: B

5. What are the potential benefits that peer support groups can offer to persons with mental illness? A. They share and learn from other peers’ experiences B. Offer assistance to peers who experience mental illness C. It can bolster a person’s self-esteem, hope, and confidence D. Peer support groups can create a higher feeling that recovery is possible after experiencing an acute episode of mental illness E. All of the above Answer: E

Thank you for your time!! 