Peer Advocacy: It Takes One to Know One By Carl Blumenthal, Peer Advocate
Hello, our names are Albert, Chrispin, Tamara, Stephanie, and Clyde, and we have mental illness!
If you’re familiar with how Alcoholics Anonymous begins its meetings, our chorus of voices may sound like the same melody in a different key. Every AA meeting is led by someone who has “been there and overcome that” so that person can encourage group members in their recoveries.
For people living with mental illness, Catholic Charities offers a peer advocacy program. We have become peer advocates here by coping with psychiatric difficulties and training to meet the needs of folks like us. That’s paying our dues twice. We do not replace mental health professionals. Rather, we complement them by using our recoveries as a road map for peers’ journeys toward wellness. We’re like driving instructors who double up on the gas and brake-pedals.
Albert Sypher: “I’ve learned how to navigate New York City’s mental health and substance abuse systems for myself and other peers. I see myself through them. I’m grateful for my family’s support and encourage peers to get backing from their families and friends. I try to engage peers with the confidence of someone who’s turned his disability into a strength. I love my job. It sustains me in my recovery.
“Users of our program report such challenges as homelessness, unemployment, limited education, poor insurance, inadequate food, and unpaid rent and utility bills. To reduce these barriers, we’re certified by the State’s Office of Mental Health to work with peers on their life-goals, health education, financial benefits, social services, and access to healthcare. One-stop shopping for assistance is a necessity not a fashion.”
Chrispin Charles: “In smoking cessation group we encourage members of our program to make positive choices about their health. Many have quit and/or reduced their tobacco use. Understanding the effects of second-hand smoke has also motivated people to change because they don’t want to hurt their family and friends.
“We collaborate with Catholic Charities’ clinical and rehabilitation counselors to assure clients obtain holistic, self-directed care. We relate to peers as equals with shared experiences rather than different illnesses. Feeling safe, they tell us and each other what might be too personal for their therapists to know. It’s like having a buddy or a 'sponsor' (AA talk) to confide in when the going gets rough.”
Tamara St. Fleur: “In co-occurring disorders group (mental illness and substance misuse), we keep an open mind. There’s no judgment, only understanding how to get over our fears. From the experiences of others, I’ve learned a lot about myself. The group is a place where people can be heard and know it’s safe to express themselves. We give them hope, purpose, and self-confidence.”
In a recent group on self-help and peer support, here’s what participants said about the peer advocacy program: Gary: “It helps with my well-being.” Machelle: “Allows me to set step-by-step goals.” Dennis: “Learn how to use a computer.” Howie: “I express concerns about my housing.” Terrica: “Because the groups teach self-love, I get therapy and meds.” Barbara: “An advocate goes with me to my medical doctor.” James: “Good to have others to talk to.” Eric: “I’ve stayed out of the hospital for five years.”
These are not just soundbites. Between August 2015 and February 2016, consumer satisfaction rose 18% on nine measures of quality. If the program has improved, members’ expectations have risen. Their desire to meet one-on-one grew by 32%. They deserve the attention and the City's Department of Health and Mental Hygiene (DOHMH) emphasizes this approach, like tutoring, is the best way to learn.
Samuel James, director of rehabilitation, elaborated: “Peer advocacy began here in 2011 with two advocates. Now we have six. DOHMH and Catholic Charities’ management guide us. Peer advocates have walked in the shoes of the members. They work together here and in the community to instill the message ‘we can recover.’
“Advocates are much better trained now in motivational interviewing, the basis for working individually with peers. Getting certified and practicing more, they’ve also improved as facilitators of groups: smoking cessation, co-occurring disorders, food education, wellness self-management, wellness recovery action planning (WRAP), and SAMHSA’s (Substance Abuse and Mental Health Services Administration) eight dimensions of wellness.” Stephanie Thompson: “I was first trained as a spiritual life coach at the Inner Visions Institute. Then in addiction recovery. With harm reduction and trauma-informed care, there’s more than one pathway to recovery. You’ve got to have a holistic approach. I’m inspired when peers go through the many stages of change I have. In food education we see mind, body, and spirit as one. I’ve been diagnosed with diabetes—“diagnosed” because language is important. Plus I know nutrition is connected to mental health. It affects your mood. Some psychiatric medications cause weight gain.”
Clyde Walcott: “I want to serve, reach out, motivate, and inspire. I’m trained in theater arts and worked in radio and TV. Being productive and creative is important for recovery.” Mr. James added, “Peer advocates are an integral part of the recovery system and will play a more prominent role, especially as insurance companies look for proof of quality outcomes. Reimbursement is possible for person-centered care, WRAP, advanced directives, coping skills, recovery concepts, self-sufficiency and self-care. The new Medicaid Home-Based Community Services will also pay for peer support.” Bottom line: Peers are hospitalized less, work more, are better educated about their health, and have greater social support. Equally important: With behavioral health workers striving to improve care while saving taxpayers’ money, peer advocates have a role to play in making this “brave new world” freer and more humane.