1. The Future of Peer Support in Florida: The Respite Center as Crisis Alternative May 11, 2011

2. Presenters: Cindy Highsmith Myron cindy@breathespace.org Dana Foglesong dana@breathespace.org

3. Learning Objectives Understand what a Respite Center is and how it can help a person Identify the various Respite Centers operating in the United States and how each differ Learn about plans for a Respite Center in Southwest Florida

4. What is Respite? Respite is a period of rest and relief. -Merriam Webster’s Dictionary

5. Pronounced REH-SPIT

7. There are different types of respite: respite for those in cancer treatment respite for caregivers attending to elderly relatives or children with disabilities.

8. In mental health recovery, respite is an alternative to psychiatric hospitalization that provides a safe environment and peer support.

9. Peer Support is at the heart of the Respite experience. “Peer support is not based on psychiatric models and diagnostic criteria. It is about understanding another’s situation empathically through the shared experience of emotional and psychological pain.” Shery Mead

10. What are your choices when things are breaking down? Hospital Don’t go to hospital because can’t afford it or other reasons Get worse Respite

11. Respite may better fit a person’s needs and is the most affordable alternative. Respite saves people and communities money because many people need only the less expensive services that a respite center provides.

12. Peer-run respite centers are for individuals who are in crisis but not a danger to themselves or others. Respites help divert people from psychiatric hospitalization and avoid reaching a dangerous state.

13. UK study shows that crisis care may need less security, not more Study authors concluded that locked doors lead to Patients feeling frustrated, stigmatized and depressed Physical violence risk increased by 11% Self-harm risk increased by 20% Medication refusal increased by 22% The study was based on approximately 50,000 responses from 130 hospitals in England.

14. Crisis does not have to be a negative experience. It is an opportunity for growth, even in overwhelming situations.

15. Advantages of Peer-Run Respites over Psychiatric Hospitals 75% less expensive Jobs for Peer Specialists Restoration of Hope Empowerment Trauma-Informed Enables continuity of care and life in community

16. Effectiveness of Peer-Run Respites A randomized control study found greater satisfaction among users of peer-run respites than with a locked psychiatric facility. In the same study, guests in the respite scored higher on self-esteem tests in follow up interviews. An evaluation of Sweetser House in Maine by a researcher concluded that peers were highly satisfied with their peer- run respite as an alternative to hospitalization. A compilation of testimonials at Georgia Peer Support and Wellness Center, also verified greater satisfaction with the peer-run respite than the hospital. One such testimonial describes the contrast between staying overnight there as opposed to a locked psychiatric ward as “the difference between heaven and hell.” *This summary of research is from National Empowerment Center; further research is compiled on NEC’s website.

17. Quotes from Peers at Georgia Peer Support and Wellness Center “In the hospital the treatment approach is to treat me with meds, at the PSWC I am given the opportunity to explore choices and move toward my strengths.” “Respite is a lot more comfortable than a hospital; no one is controlling.” “…this whole experience was pleasant, with superior staff interaction” “It is better for me to have peers to talk to than to have doctors talking down to me. I don’t want to think about what I would do without this.”

18. “This respite period helped me to refocus on the lifestyle changes I needed to make, and the groups were very therapeutic.” “I had to come off a medication, and if I had stayed home, the stress may have sent me to the hospital.” “The best part is the peace you find and feel when you walk through the door.” “I was free to do things in and out of the house instead of being restricted. I can choose how to help myself, find info online, talking with peers, journaling, walking, etc.”

19. Comparison of Rose House and Hospital Greeted Warmly Oriented to Program Recovery- based & Trauma- informed Staff non- judgmental Set own schedule 70%58%39%62%66% 0% 4%0% Rose House Hospital

20. The Georgia Peer Support and Wellness Center Daily Wellness Activities 3 Respite Beds 24/7 Warmline

21. GPSWC Wellness Activities Daily activities address whole health, wellness, and having a life in the community Mind/Body/Spirit/Nutrition Whole Health/Smart Shopper Education Job Readiness Creative Writing Wellness Recovery Action Plan (WRAP) Peer Support Services Trauma Informed Peer Support Double Trouble in Recovery (DTR) Exercise/Recreation/Mindfulness Stretching, Walking, Aerobics, Weights, Swimming Bowling, Tennis, Kick Ball, Volley Ball, Basketball Yoga, Meditation, Tai Chi, Zen

22. GPSWC Respite 3 respite beds Proactive Interview to establish a relationship Focus is on learning and growing together 87% of respite guests report that accessing a respite bed kept them out of the hospital

23. Georgia Peer Support and Wellness Center is funded by the state of Georgia through the Georgia Mental Health Consumers Network (the Georgia equivalent of Florida Peer Network) was recently given the go ahead to open two new locations is supporting us in modeling our center after theirs

25. The Breathing Space Recovery and Respite Center is a peer-run alternative to traditional mental health day programs and psychiatric hospitalization.

26. What is The Breathing Space? The mission of The Breathing Space is to provide support, hope and empowerment to Southwest Floridians living with mental illnesses. The Breathing Space will promote this mission through an eco-friendly, peer-run facility known as the Recovery and Respite Center. The Center will offer a variety of classes, support groups and wellness activities during the day. At night, individual respite rooms will be available to help prevent crisis hospitalizations through power of peer support.

27. How it works: Initiative Interview Before a person will be allowed to access respite they must first meet with peer staff to do an initiative interview. The interview must happen while the person is doing well and will help determine what respite supports the participant prefers. The Respite Experience Each participant will have a private room for up to a week at a time while receiving peer support and respite. Participants are free to leave to utilize their medical and community resources. Participants are responsible for taking their own medications and keeping them locked in their room.

28. To be eligible for a respite bed a person must: Identify as a current or former recipient of mental health services Be 18 years old or older Not be a danger to self or others Have already completed an “Initiative Interview” with peer staff

29. The Recovery Center During the day The Breathing Space will offer recovery groups, art groups, support groups, relaxation training, WRAP, movement therapies, eco- therapies, self-directed learning and social activities.

30. The Breathing Space Organizational Values Recovery Oriented We believe and will promote the truth that recovery is possible for everyone. For some, recovery is the ability to live a fulfilling and productive life despite a disability. For others, recovery might mean the reduction or complete remission of symptoms, or a transformation that brings the person to an even healthier state than before their diagnosis. The Breathing Space supports and celebrates all these paths and others, and encourages hope, which has been shown to play an integral role in recovery.

31. Peer Run The Breathing Space believes in the power of one individual supporting another based on their shared experience with a mental illness. All employees will be trained Peers ensuring that peer support is at the heart of all Breathing Space activities.

32. Holistic The Breathing Space understands that there is no singular path to recovery. We believe in choice, self- determination, and addressing the needs of mind, body and spirit.

33. Empowering The Breathing Space supports individuals with mental illnesses in exercising their right to live a full and meaningful life. Through increased self-confidence and practical tools, individuals are empowered to realize their dreams and to fight for their civil rights.

34. Eco-Friendly The Breathing Space was founded by individuals with a passion for the environment. We will consider the Earth in every decision we make in the creation and maintenance of the Breathing Space and its delivery of services.

35. Respite at Northside Mental Health Center in Tampa Alfred Jefferson butlerofbw@yahoo.com

36. Some Other Respite Centers Stepping Stone Peer Support and Crisis Respite Center Claremont & Lebanon, New Hampshire Contact: Jude Dolan 603-543-1388 or 603-448-6941 www.steppingstonenextstep.org Rose House Hospital Diversion Program by PEOPLe, Inc. Milton & Carmel, New York Contact: Steve Miccio or Vanessa Turner 845-452-2728 or 845-795-2346 www.projectstoempower.orgwww.projectstoempower.org – Click ‘Hospital Diversion Program’

37. Essex County Crisis Alternatives Program Westport, New York Contact: Darlene Trout, Director 800-440-8074 http://behaviorhealthnet.org/memberProfile.cfm?ProviderID=37 Foundations: A Place for Education and Recovery Canton, Ohio Contact: Val Greenlief, Coordinator 330-454-2888 New Beginnings 2 - Charleston, West Virginia Contact: Kimberly Murphy, Director of Community Supports 304-345-7312

38. Voices of the Heart, Inc. – Glen Falls, New York 508-747-8404 www.voicesoftheheart.net Keya House – Lincoln, Nebraska 888-902-2822 http://keya.mha-ne.org Living Room – Peoria and Phoenix, Arizona http://www.recoveryinnovations.org/riaz/crisis_support.html

39. Key We Way – Wellington, New Zealand http://www.wellink.org.nz/services/keyweway.htm Soteria-Alaska – Anchorage, Alaska 907-333-4343 www.soteria-alaska.com Soteria-Berne and others in Europe http://www.ciompi.com/en/soteria.html

40. Further Resources Shery Mead Consulting – training on peer-run crisis alternatives www.mentalhealthpeers.comwww.mentalhealthpeers.com Florida Certification Board – to become a Certified Peer Specialist www.flcertificationboard.orgwww.flcertificationboard.org National Empowerment Center- lots of info http://www.power2u.org/peer-run-crisis-alternatives.html http://www.power2u.org/peer-run-crisis-alternatives.html

41. What you can do to help Questions? Survey