Wednesday, September 1, 2010

NAMI Peer-to-Peer: An Intersection

 By Sarah O’Brien, Director of the NAMI Peer-to-Peer Program

The Peer-to-Peer vision

Many people come to NAMI’s Peer-to-Peer Recovery Education Program with feelings of guilt and self-blame—they feel they’ve brought mental illness upon themselves. When we teach them about other dimensions of mental illness—genetic causes, environmental factors—they begin to deconstruct those beliefs. It can come as a revelation when people realize that it’s not them, but a mental illness, a serious condition that can be treated.

Sarah O’Brien, Director
NAMI Peer-to-Peer
Peer-to-Peer is an intersection between the wisdom people gain through lived experiences and the need to know more about recovery. 

It is a body of knowledge and a place to be with people who understand where they’re coming from, a meeting place between the materials and the students—the potential that they’ve always had and a new understanding of their experiences.

A personalized approach

Recovery is such an individual process because mental illness affects people in similar ways and also in areas that are extremely personal. The Peer-to-Peer program offers a selection of tools and techniques from which people can choose what works best for them and tap into their own resiliency.

Some of our recent students said in their evaluations, “I plan to go back to school”; “I’m going to re-enter the job market” or “I can communicate better with my family”. The diversity within our testimonials illustrates the course’s usefulness for to people with different needs.

Peer-to-Peer works on several levels simultaneously. First and foremost, we want to communicate that recovery is possible. Once people have that sense of hope they can work on improving their lives in any number of ways. One of our goals is to empower people to make better choices. When individuals are educated about different aspects about mental illness, when they learn how to work better with a provider or what to expect from a hospital environment, they can choose to make the most of their options.

We also help participants develop effective coping mechanisms. This can range from strategizing how to meet basic needs during an episode of severe depression to creating an advanced directive for mental health care, which will ensure that someone’s treatment preferences are honored when they are in crisis.

One of the most important things Peer-to-Peer offers is a safe place to bond with peers. So many people come to us feeling isolated and find that they are not alone.

Finally, we want to nurture an individual acceptance of wherever someone is in their recovery process. Recovery is not linear and it doesn’t require perfection every day.

Areas of growth

The third edition of the Peer-to-Peer curriculum, released in winter 2010, places a greater emphasis on interactive activities than previous editions. This new edition will be available in Spanish at the end of October. Our upcoming Train the Trainers meeting with new instructors from around the country will involve some bilingual teachers as well.  Peer-to-Peer will also be expanding its online presence with a Facebook page and  materials available on the web to reach people who don’t have a class in their community.

One of Peer-to-Peer’s major goals is within the area of research. Currently, we’re partnering with a researcher from the University of Maryland to submit a proposal for a study with the National Institute of Mental Health. Our aim is to follow a similar path as that of NAMI Family-to-Family groups, which now have peer-reviewed research supporting their effectiveness.

Learning from participants

Like any good grassroots program, Peer-to-Peer doesn’t just teach students­—it learns from them. My experience has taught me that people are extremely resilient. Recently I met a teacher-in-training at a meeting in Washington state. After being homeless for many years and also incarcerated on drug-related charges, he had finally overcome many obstacles in his recovery process. He was at the training because he wanted to become a Peer-to-Peer instructor and help others who were confronting challenges similar to his own.

Watching people overcome so much hardship so they can reach out to others is one of the most incredible parts of my job. I am privileged to watch people with many challenges turn their lives around because suddenly they have tools and knowledge that they didn’t have access to before.


Rachel said...

All I can say is "It takes one to know one." It should say "It takes one to help one." In a hospital setting there just isn't a produced sense of giving hope or that desire to help ones self! Too many "Pull yourself up by the boot straps," or "Oh, just get over it all ready." The hospital provides a safe environment, but that is about all which in addition is not fool proof. There is no money in mental illness and hospitals would rather not even have mental health units. The goal I saw was to treat them in a way that they won't come back. Yes, there is some minimal out dated coping skills provided by nurses with outdated education on what a mental illness really is which is usually a lack of even wanting to try. Hospitals just cannot compare to what a peer who also has a mental illness can provide. Programs like this is instrumental in changing how persons with mental illnesses can live a life without being institutionalized which at this point is mostly in our jails and our prisons. Tax money saved.

Denise said...

Sara, Thank you for putting up this blog. I appreciate having this resource. It will be very helpful when people want to learn more about Peer2Peer. The blog has good stuff for me, a mentor. It is nicely written. The story about the homeless man becoming a mentor is inspiring.
Denise Fay-Guthrie

Bipolar Disorder said...

I like your approach. I don't really understand the premade forms of therapy, like you have to do this this this. Cases need to be approached individually, and assign what works better for the individual. Kepp up good work!

Dianne Derby said...

Hi Sarah, Wonderful article.
Dianne Derby

arizona said...

I agree with focusing on deconstructing held beliefs about mental illness being a first step in this program. Aside from genetic causes & environmental factors referenced as "other dimensions", I would like invite the author's opinion concerning the underlying model used by psychiatry to diagnose & treat mental illness - namely Biomedical Reductionist Model (BRM). Simply defined, this model speaks to the fact that psychiatry utilizes the Single gene/Single disease theory to inform diagnosis & to prescribe. The problem is that it does not address comorbidity - when more than one diagnosis has been made. For example, a 14 year old boy who has been diagnosed with severe behavioral problems, attention deficit disorder & oppositional defiant disorder. Proposition: Is recovery hampered by omitting the fact that comorbidity is often accompanied by significant rates of childhood trauma? And isn't that inherent in the BRM? (citing his intellectual property, please see Colin A. Ross, M.D. - "The Trauma Model: A Solution to the problem of comorbidity in psychiatry."

Sarah O'Brien said...

Thank you for responding to my blog post. Your point of view is certainly valid, and I think it points us to a quite viable conclusion that more than one treatment approach is needed for those of us in recovery. This is because our experiences are so unique. For some children and adults past trauma is a stark reality, as is being on the receiving end of multiple diagnoses. In Peer-to-Peer we see trauma as one piece of a larger life "mosaic". We also recognize that there is trauma inherent to living with mental illness symptoms themselves. For this reason we document the direct impact our symptoms have had on our lives. (for instance on employment, relationships, and spirituality). It would most definitely be oversimplifying things to say that mental illnesses are caused by one thing only, or that people fall perfectly into one or another diagnostic criterion. Our approach in Peer-to-Peer is to provide people with multiple tools so they can choose what is the most effective and helpful for them. Therefore, regardless of the root they still find solutions that work. I enjoyed your comments and appreciate the further thinking on this topic that they have encouraged. I am curious to hear what others think of this also!

Rosie Burgos said...

Hello, and good day to everyone. I am a P2P mentor, and have only one class on my belt. I was planning on giving up on mentoring, but after reading your blog, I have gainned a new inspiration in overcoming my fences. I plan to contact Nancy Smith, before the year is over with high hopes of getting back to mentoring in my county. Thanks again!

wjnorbom said...

Thank you for facilitating the Training of Trainers Program recently held in St. Louis. I have so much gratitude for NAMI's insightfulness in seeing the empowerment that comes from having a purpose; advocating and mentoring for others who are or will soon follow the paths that we once trod. Networking with other peers expands the vision, showing all of us that recovery is indeed possible. The gift is seeing in take shape in many different forms through many different faces.
The third edition is excellent, having taught it. And the peers that graduated have moved on to the Connection program, solid, strong and interdependent.
Keep up the excellent work Sarah. You set a fine example for us all to follow.

Anonymous said...

I don't see how to access this program. I see the hospital setting is a place for "safety" (though it can be dangerous there) and not much else besides really fragmented services. It is very frustrating for a caregiver to see this when a loved one is there. The help just isn't sufficient.