Liz Woodley Gina Noel-Brown

1. An Overview of the Enhanced Curriculum to expand Peer Support Services to Service Members, Veterans & Their Families Liz Woodley Gina Noel-Brown

2. Where to begin… Demonstrating the power of Peer support: • What is my role in supporting a Veteran - Service connected person? • What impact do I want to make on a Veteran – Service connected persons’ recovery journey? • What challenges do I anticipate in making a connection?

3. Peer Support Principles • Voluntary • Non-Judgmental • Empathetic • Respectful • Honest and direct communication • Mutual responsibility • Reciprocal (Shery Mead, Darby Penny and Laura Prescott)

4. Peer Support Activities What can you think of?

5. Veteran Peer Support • An important strategy in supporting the behavioral health needs of service members, Veterans, and their families • A bridge to services and help ease transitions • Peers with military experience and experience with recovery offer valuable knowledge and skills to assist others • Improves the overall quality of life for those being served

6. Why, Veteran Peer Support Services? PA’s Veterans population: • PA has approximately 1 million Veterans. It is the fourth largest Veterans population in the country • 70% of PA’s Vets are over the age of 55 • PA has about 19,000 men and women serving in the National Guard, and the National Guard has deployed over 35,000 individuals during the Iraq and Afghanistan conflicts • PA has the 2nd highest suicide rate for Veterans in the country • Approximately 10% of all adults in U.S. jails and prisons are Veterans Source: U.S. Dept. of Veterans Affairs

7. Certified Peer Specialist – Veterans: Roles • Provide information • Act as a referral source to clinicians and other mental health professionals • Provide support and understanding to Veterans they serve • Partner with Veterans in problem-solving, decision-making, and setting goals • Identify resources in the community • Assist Veterans with attaining full integration into the community.

8. Responsibilities: General Guidelines The CPS who supports Veterans and Military personnel also: • Maintains confidentiality • Demonstrates appropriate and respectful language • Maintains appropriate boundaries • Demonstrates appropriate personal appearance and dress code in the workplace • Works in the interest of supporting those served • Able to ask for help and receive feedback

9. Military Culture : Why it matters

10. In this section we will… • Describe military structure and processes • Review the demographics of today’s military • Identify stresses by mission and conflict • Discuss ways for CPSs to support

11. Military Operational Organization • Status: • Active Duty • National Guard • Reserve • Doctrine and Regulations • Doctrines can change with leadership • Regulations are federal therefore the same for Active, Reserve and Guard Air Force

12. Today’s Military Demographics • Specifics vary by service • All volunteer force for since 1974 • 2.2 M total serving in uniform today compared to 15 M in WWII • Desegregation in 1948 • 39% ethnic diversity • 15% are women

13. Today’s Military Demographicsin Comparison to the Draft Population • Average age is older • Educational backgrounds higher—percent college graduates, high school/GED requirement, ASVAB scores • Marital status higher than civilian • Heritage: “military brat”

14. The Services Commonalities Differences The Mission Individual Service Cultures Uniforms Rank Insignias Language and Acronyms • Recruiting • Testing • Training • Core Values • Fitness • Joint Service • Some Language • Rank is Great Equalizer

15. Values • Army: • Loyalty, duty, respect, selfless service, honor, integrity and personal courage • Navy and Marine Corps: • Honor, courage and commitment • Air Force: • Integrity first, service before self, excellence in all we do • Coast Guard: • Honor, respect , devotion to duty

16. Missions • Army – fight and win our nation’s wars with sustained land dominance across full range of military operations • Navy – power projections, strategic deliverance and tactical delivery of combat power • Air Force – to provide strategic air lift and tactical air combat support • Marines – rapid deployment force; seizure of or defense of advanced naval bases for land operations • Coast Guard - safeguarded our Nation's maritime interests and environment around the world

17. Considerations, Challenges and Implications • Access to services • Effects (physical, psychological) of life in a war zone • Military rank and authority • Help-seeking and peer-to-peer support • Family well-being and reintegration • Civilian reintegration • Impact on Veterans returning from Iraq & Afghanistan

18. Peer Support in Action: Making the Connection • How to use military values and history to drive the peer process? • Loyalty • Respect • Selfless service • Honor and integrity • Excellence and commitment • Personal courage • Devotion to duty

19. ~ Civilian/Corporate ~ Military ~ Mental Health ~Criminal Justice When cultures meet

20. Service Systems

21. Veterans, The Criminal Justice System and Peer Support A Challenge & Implication of ReIntegration

22. Innovation: Veterans Treatment Court Why: • To divert those with mental health issues from the traditional justice system and • To give them treatment and tools for rehabilitation and readjustment. The progress: • As of February, 2013, there were 168 Veterans Treatment Courts in the United States. • Currently 17 in Pennsylvania Resource: http://www.justiceforvets.org

23. Innovation: Veterans Justice Outreach • The VJO provides direct services to justice-involved Veterans • Developed by the Veterans Administration • Each VA Medical Center has a designated justice outreach specialist who • functions as a link between the VA, Veterans, and the local justice system whether incarcerated or not incarcerated • The VJO specialist works with the courts to • help eligible justice-involved Veterans get mental health assessment, treatment planning, and referrals to VA services • communicate with officers of the court about Veterans' compliance with VA treatment programs • may assist in training law enforcement personnel on issues such as PTSD or traumatic brain injury. • For information and a list of VJO contacts, see Justice Outreach handout

24. Forensic Peer Support and The Sequential Intercept Approach PA Response

25. Forensic Peer Support for Vets • Peer Support offered to Veterans and military personnel with MH or Co-occurring challenges involved in the Criminal Justice System from initial contact with law enforcement through re-entry into the community from incarceration • To effectively offer support by understanding the Criminal Justice System and the resources needed for successful Community Re-entry

26. How? • Jail Diversions • programs that divert individuals with mental illness from the criminal justice system to community based services

27. The Purpose of FPS for Vets • To support VMPs during their involvement in the Criminal Justice System • To promote recovery principles including self-advocacy • To advocate for VMPs when they are unable to advocate for themselves • To educate stakeholders in VA and CJ systems about mental health recovery • To inspire hope • Ultimately, to keep people in the community

28. What’s the benefit? • Positive relationship development • Assistance with understanding and navigating the Criminal Justice System • Aids in finding and utilizing resources • Educates individuals about recovery • Supports completion of parole/probation requirements • Reduces the time in jail/prison re: the lack of community supports, housing options and resources

29. An Approach The Sequential Intercept Model

30. The Sequential Intercept Model • What is it? • A conceptual framework for communities to use when considering the interface between the criminal justice and mental health systems as they address concerns about criminalization of people with mental illness. • Use of the Sequential Intercept Model as an Approach to Decriminalization of People With Serious Mental Illness, 2006

31. 5 Key Points of Intercept 1. Law Enforcement and Emergency Services 2. Initial Hearings/Initial Detention 3. Jails and Courts 4. Re-entry (from Jails, Prisons, and Hospitals) 5. Community Corrections / Community Support Services

32. Peer Support in Action “Dialogue and Development” Coming Home: Military Veterans involved in the Criminal Justice System The Issue: • "Large numbers of Iraq and Afghanistan war Veterans are returning home with serious mental and emotional problems. Possible Responses: • What can peers do to support the healing of psychologically-scarred* troops? * profound stress and the challenges of adjusting to civilian life when returning home.

33. Objectives • Discuss origins and stages of impact of mental health issues • Compare and contrast “traditional” medical model and psychiatric rehabilitation approaches to understanding assessment and treatment of mental health issues • Brief discussion about medication and adherence issues • Identify approaches peer specialist can use when Veterans experience mental health issues

34. Why CPSs Need to Know This • To understand the common language used in behavioral and VA healthcare settings where CPSs work • To use the information as a bridge between clinical providers and Veterans receiving services

35. Approaches and Possibilities Treatments, Rehabilitation, Reintegration and Supports SAMHSA Wellness Project: http://www.promoteacceptance.samhsa.gov

36. CPS with Veterans Suggestions • Communicate a belief that the Veteran can and will recover. “I believe you can have the life you want to have, and I will support you in your journey to get there. I have hope for you.” • Listen. Really listen. Do not judge, dismiss, or advise. Just listen. • Engage in conversations about goals, dreams, and wishes. • Ask questions like, “What would be a satisfying life for you? How can you get there?”

37. CPS with Veterans Suggestions • Use snippets of personal recovery story to inspire. Also, encourage the Veteran to tell his/her story. Share success stories. • Believe in the potential of each Veteran to recover in his/her own way. • Advocate for the Veteran with VA and BHC clinical staff members and the Veteran’s family as needed and desired by the Veteran. • Share resource information and refer the Veteran to needed available services.

38. Objective • To identify some specific tools and resources to guide the CSP Veterans and Service Members process: • Personal Recovery Story; • Motivational Interviewing Skills; • Shared Decision Making; • Problem-Solving Skills; • Positive Self-Talk;

39. Thank YouLiz Woodley CPSliz921@yahoo.com(724)331-0417&Gina Noel-Brown CPSgmnoelbrown@gmail.com(412)277-2526