Peer Support @ BIG - Mental Health Professionals Network (MHPN) - 09/02/2017
Peer Support @ BIG
Bayside Initiatives Group Inc.
Good morning everyone. For those of you who don't know me, my name's Samuel Walker and I'm a Peer Worker at Bayside Initiatives Group, otherwise known as BIG.
Today I'm going to be speaking to you about peer support and the work that we do at BIG supporting people on their journey of recovery from mental illness.
So first I thought I'd give you a bit of history on Bayside Initiatives Group. BIG was started in the year 2000 by a group of 5 mental health consumers who came together and envisaged a community where those with a lived experience could come together for support. A place for us, run by us and about us; a truly peer-operated service. From this simple idea we've seen some amazing things. Those first 5 members planted a seed which has not only grown, but will continue to flourish through the years.
We weren't alone in this. Every step of the way we've had the support of QLD Health, Metro South and services like Brook Red, FSG and Open Minds. These collaborative relationships have helped BIG to become the service that it is today.
But what is BIG?
BIG is a boutique, grass roots mental health service, run entirely by people with a lived experience. From our Board of Management, to our Coordinator, to our staff; everyone at BIG has experienced mental health issues firsthand and sees the inherent value that lived experience brings when supporting people who are on that same journey. We are a member driven and member focused service. Our model of peer support is based on members helping members, supporting each other and developing positive social networks.
At BIG we aim to provide a sanctuary, a home away from home; a community. A place where people can find fellowship among their peers and form natural relationships which support them in their recovery.
Everything that we do is developed with the input and guidance of our members and based on consultation with the wider community. We run a variety of recovery-oriented programs like PeerZone and Hearing Voices, as well as recreational programs like our Art Groups, Pool Competitions and Outings. We also have some collaborative projects like our music group with FSG's Symphonics and our upcoming REACH Wellbeing Program with Metro South.
We also provide outreach services at Yugaipa Ward, Redlands Hospital and on the Southern Moreton Bay Islands with the Bay Islands Wellbeing Group, as well as our continued involvement in community events like Thrive by the Bay and the Bay Islands Multicultural Festival.
But the core of what we do at BIG is Peer Support.
Now I'm sure you all have some understanding of the concept of Peer Support, and when I was asked to present today, I had to really stop and think about what it was that I was wanted to speak about. What message did I want to convey and what did I want people to walk away with?
So as I was doing my mind map and looking at research papers, and to be perfectly honest, planning a really boring presentation, I had to stop myself and really think;
"If I was a not a part of the Peer Movement, what would I want to I know? What would help me to gain some insight into what this was all about?"
This is actually a really key point. All of the research says that for Peer Support models to be implemented effectively into mental health services, everyone working in that system, particularly the managers and decision makers, need to have an understanding of the peer model and be able to articulate the value that lived experience brings. So again I asked myself, how do I illustrate this value in a way that is meaningful and understandable?
This is no small feat. We all know the language and have some understanding of the concepts. In fact many of us know it by rote; it's about hope, empathy, understanding, self-determination, role modelling recovery; and this is all true. But it still doesn't fully explain the mechanism that's at work when people with a shared experience support each other.
So I asked some other peer workers; what is it that you actually do? And I got a variety of answers;
"I sit with people and I listen to them. I talk to them and support them with what they're going through."
"I validate people by connecting my experience with theirs and offering them compassion and understanding."
"I work with people on their recovery, using methods that we BOTH agree are helpful and beneficial."
And again, this is all true, it makes perfect sense. But I still didn't feel that I was there yet. So I delved a bit deeper into my own experience.
I'm someone who has battled with my mental health since I was a small child. I was diagnosed with clinical depression at age 14 and I've lived with mental illness my entire adult life. But I was actually very lucky. Despite the pain, missing out on the education I wanted and being left behind by many of my peers growing up; I was actually very blessed to have the relationships I had and have.
This for me was the key to my recovery. Now I'm not someone who is against medication and psychotherapy. In fact they've played a part in my journey and I still take medication and I still see a therapist. However, for me, and for many of the people I work with, they are just components of a much bigger picture. This picture includes many components; physical health, nutrition, home environment, community involvement, connection to nature, and for some, spiritual practice. But the core foundation of my recovery is the relationships that I have with people.
When Mary Ellen Copeland, a significant figure the peer movement, did her initial studies into mental health recovery, she found that one of the key factors that separate people who recover, rebuild their lives and learn to live well with mental illness and people who are less successful, is the number of supportive people that they have around them who are there for them when they become unwell.
Many of you in this room will see this reflected in your own lives by the people you have around you who you call on in times of distress and difficulty. But for many people who experience severe and persistent mental health issues, these relationships tend to fritter away over time. The truth of the matter is that no one enjoys being around someone who is unwell. It's uncomfortable to be with someone who is constantly crying, or hurting themselves, or persistently frightened and paranoid. Most people can do it when the need arises. But when it's day in and day out, for years on end, many people simply aren't cut out for that kind of stress and discomfort.
And this is how it ends up for so many of us who experience protracted periods of illness; the one thing that we need most of all is the one thing that we don't have, supportive people. We end up relying on the support of services and professionals, who despite the very best of intentions, aren't able to give us what we really need. This is one of the biggest differences between the medical model and the peer model. It's about the dynamic between people - the connection.
As peer workers, we work with people as people, not clients. It's about person meeting person, being real, being genuine and being open to what a person is going through. For long time consumers of traditional mental health services, there comes a point where we simply disconnect. The intakes and processing, diagnostic criteria, case notes, questions, and analysis, data being entered into a computer system; there comes a point where this is no longer as helpful as it once was.
While it seems like I'm painting a pretty grim picture, I want to pause and say that I am not someone who doesn't see the value in the clinical model. In fact I think that it plays an essential role for people when they are at a certain point in their journey. We need clinical services when people are in crisis, need to be stabilised, diagnosed, and if they choose, medicated. However, this is only a very small piece of a very large puzzle.
I recently heard another presenter say, "we don't need to learn how to be good pill swallowers, we need to learn how to live well with mental illness". This struck a real chord with me. Mental health recovery is a journey, and while it's certainly not linear, there are certain stages and these stages require different kinds of support. As a peer operated mental health service we support people when they are trying to heal, rebuild their lives, grow and move forward and what we need when we're in this stage of recovery is human connection.
This is the essence of what we do at BIG; we facilitate connections between people who understand each other and have compassion and empathy for what the other person is going through. I tried to think of a good analogy here and I really struggled. I thought about the relationships between family members, between close friends, within close-knit cultural groups; but none of these really spoke to the nature of the peer-to-peer relationship. I needed a way connect the experience to something in your lives that could provide some insight and understanding.
The best thing I could come up with is the experience of losing a loved one. Many of us have experienced this and can attest to the bonds that are formed shared through grief and suffering when someone passes. It's the hardest of experiences, but it also brings out the very best in people. Again, it isn't a perfect analogy, but it does speak to the kind of relationships that people form when they experience a shared pain. It is an experience that is based in human connection.
For those of you have had this shared experience, think of the impact that it had on your life, the potential for growth, insight, understanding and support that was achieved through the relationships of those left behind. No one else can understand it because they weren't there, they didn't live it. This may start to paint a picture of the impact that peer-to-peer relationships have on people when they are working on their recovery.
It's something that's hard to quantify. There's a lot of really great research coming out that demonstrates the efficacy, cost effectiveness and ethical implications of peer-operated services. But it's still something that is difficult to articulate in way that makes sense to people who haven't lived it. You can't do a nice, neat double-blind study on human connection and the way that it impacts people. It's something that is so fundamental, so holistic and deep-seated that unless you've walked that path and been through it yourself, the only way you can articulate it is through the language I mentioned earlier;
HOPE, INSPIRATION, MUTUAL SUPPORT, SELF DETERMINATION, COMPASSION, UNDERSTANDING, NATURAL RELATIONSHIPS, SHARED EXPERIENCE.
So this is what we do. We be with people, we listen to them, we talk to them and we support them. Our expertise is our lived experience. While we receive formal training and continue to educate ourselves and develop our practice tools, the foundation of our expertise is our lived experience, that's what we bring to the table every day that we are working with the people who use our service. We can do this because of our extensive experience in mental health; an experience we live each and every day. This isn't a qualification that is as widely recognised as a Masters in Psychology, but it is something of immeasurable value when supporting people who experience mental distress.
This is where a lot of the tension comes from between the medical model and the peer model. As with any true reform, there will always be difficulties and challenges when two seemingly opposed philosophies try to find common ground. But I look at this dichotomy as an opportunity. An opportunity for collaboration and to support people holistically at different stages of their recovery. Giving people choice and options to access the kind of support that works for them.
While there can be challenges when we try and combine the two frameworks and deliver them in the same setting. These can be minimised by changing the culture and machinery behind services wanting to implement peer-to-peer models of support. I applaud the work that is being done at services like the CCU where we are seeing peers and clinicians working shoulder to shoulder. This is a great example of how to implement collaborative partnerships between lived-experience practitioners and clinical staff. I’ve worked with several residents of the CCU and I’ve witnessed the transformative power that an integrated model such as this can have on people’s lives.
Sometimes a great way to measure how far we’ve come in our collaborative partnerships is to look back and reflect on where we’ve been. 50 years ago, could we ever have imagined that former patients could have returned as consumer consultants and peer workers within a clinical environment to provide a more holistic approach to mental health recovery?
We’ve gone from lunatic asylums, to mental health recovery services #.
When you reflect in these terms, our practice has come light years from where we were; it’s been a snowball effect. Despite coming from different philosophical underpinnings, the peer clinical collaboration is becoming more of an alliance. It’s evolving into a symbiotic and holistic relationship that benefits all involved by encouraging peers to mentor in the clinical system, to be heard and understood and it allows the medical model to be valued by peers in a way that was perhaps not possible before. From this place, a new model of mental health practice may evolve.
Looking forward, if we continue to invest in research, collaboration and development of this partnership I believe, as many others in the peer and medical fields believe, it will revolutionise how we view, think about, treat and prevent mental illness. I’ve been fortunate to meet many clinicians who value and adopt modes of practice that are inclusive and reflective of peer values. We don’t even have to look that far from home to see evidence of this. The development of community care units which adopt peer models of practice which I’ve already mentioned. Hospitals environments that have been modified to be less frightening and intimidating and staff who have been well trained in peer vales and the rights of the consumer. This all bodes incredibly well for the future.
In conclusion, I’d like to recognise all the peer and clinical pioneers that have come before, and are with us now, in continuing to develop the mental health services of tomorrow. I can say that I’m genuinely excited to see what this future brings and to work with you all as we move towards a new tomorrow in mental health.