By Kirsty Groff
Special to Capital News Service
SYKESVILLE – Once a week, John Allen picks up his keys, unlocks the door to his office and prepares for nine hours of mentoring sessions.
Allen works at Springfield Hospital Center, where he runs support groups and one-on-one sessions with patients seeking his guidance as they try to make sense of their problems before transitioning out of the institution.
And why wouldn’t they come to him? Allen knows better than other counselors what it’s like to be a patient here at the psychiatric hospital; he was once one himself.
Allen is one of just three peer support specialists in the state working for the Olmstead Peer Support Program, coordinated by the mental health advocacy group On Our Own of Maryland. The other two specialists work at Thomas B. Finan Center in Cumberland and Eastern Shore Hospital Center in Cambridge.
“I think it’s very promising, and the fact that we’ve been so slow to recognize the important role that peers can play in helping other peers recover shows how behind the curve we’ve been” in the mental health community, said Ron Honberg, director of policy and legal affairs for the National Alliance on Mental Illness.
Peer support has for decades been a part of other recovery programs. For example, Alcoholics Anonymous, which began in 1935, has long used “sponsors” to help recovering alcoholics. When community-based care began to gain momentum in the early 1960s for patients with mental illnesses, peer support options evolved to help former institutionalized patients into group homes, in counseling and support groups and through other recovery services.
What sets the Olmstead program apart from the rest is its focus on patients in psychiatric hospitals.
The Olmstead vs. L.C. U.S. Supreme Court case decided in 1999, among other outcomes, that patients in institutions who could likely recover through community-based services should be transitioned out of mental health hospitals. The case inspired On Our Own of Maryland to create a peer support program in 2003 specifically for the transition process.
“It’s not that common yet in other states, it’s a reasonably unique consumer-directed approach,” says Kenneth Wireman, executive director for Main Street Housing – a partner group of On Our Own of Maryland that aims to create permanent housing for individuals with psychiatric disabilities. “Not many times have I come across examples where other hospitals elsewhere have had peer counselors in the hospitals.”
Eight or nine Olmstead peer support specialists had helped 143 patients as of June 30, 2011, according to On Our Own of Maryland Executive Director Mike Finkle, who runs the program with Wireman.
Peer support can be incorporated into many stages of the recovery process, from leaving an institution to finding a job and place to live to finding support groups to continuing the cycle by mentoring others.
Olmstead specialists speak to patients directly about life outside a psychiatric hospital.
Currently in his third year as a peer support specialist, Allen says he sees any patient who chooses to take advantage of the mentoring; he has no scheduled appointments.
“My work at the hospital is basically my time to help people understand why they’re in the hospital,” says Allen. “A lot of them are court-ordered, and they don’t understand the complexity of what’s taken them there. And if you don’t know what’s holding you, you’re frustrated and negative.”
Allen said he was a Springfield patient in the ’90s, and today he works with patients in the same hospital to get them back out into the community, too.
“I think in many different ways, if you’ve had direct experience with something, you have the inside understanding of what it’s about,” he says. “It’s like if you want to be an artist or a journalist; you might be able to learn from somebody who won a Pulitzer prize, someone who has experience in the field. That’s what peer support is about. I’ve been down the road, and you can do it, too.”
One of his main tasks is to help patients come up with a list of questions the two of them can discuss. Some examples: if patients can get work, if they have found housing and why they are in the hospital in the first place.
The state does not yet offer a uniform peer support specialist training program; Allen was trained through On Our Own of Maryland for his specific job as an Olmstead peer support specialist.
Guidelines issued by the Centers for Medicare and Medicaid Services in 2007 state that peer support providers should be in recovery themselves, must be supervised by a mental health professional, should use methods to engage and empower the participant and must be certified.
“Patients seek me out,” Allen said, “so I think that’s a statement about what I’m doing there, that they come to talk to me.”
Clarissa Netter, Maryland’s Mental Hygiene Association director of consumer affairs, predicts there will be increased demand for use of peer-delivered services. “The drive will be toward more community-based initiatives,” she said.
Research on the effectiveness of peer-support initiatives is new. However, several studies have found correlations between peer-run recovery programs and positive patient outcomes.
One study published in the January 2012 issue of the Psychiatric Services journal found that participants in a peer-run program held themselves more accountable for both themselves and their peers in the recovery process.
“There isn’t a strong body of research that shows that it works yet, but I think sometimes innovation is inevitably going to occur before data and evidence can be collected,” Honberg said. “I think over time, it will be proven that peers should be an essential part of the mental health system.”
“The reinstallation of hope is really important; the mere presence of the peer person changes the nature of the interactions,” Wireman said. “There’s a difference when somebody has experienced what the patient is sitting at the table talking about.”