Peer counselors to the rescue?

Tuesday, January 24, 2023

By Courtney Wise

Plus, a preliminary study suggests that virtual reality sensory rooms may help people with neurodevelopmental disabilities. And in case you missed the series, check out the songs in the TV musical comedy hit Crazy Ex-Girlfriend, which trace the main character’s journey and her embrace of a mental health diagnosis. We also – sadly – include a new guest essay on the wide-ranging mental health impacts likely to follow two new mass shootings in California.

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Peer counselors may offer solution to Washington State’s mental health workforce shortage

What’s the advantage that peer counselors have over many regular outreach workers? Unbeatable knowledge of what people are going through, according to supporters. Having mastered the day-to-day of mental health challenges or overcoming substance use, they’re able to connect with people in a way many traditional clinicians don’t. In addition, they’re not required to have the same formal education and licensure as professionals either, enabling them to get trained and ready for work faster – filling gaps in a field desperate for more support, the Seattle Times reports. On the downside, peers tend to be underpaid and undervalued. And because peer work is not yet listed as a health profession in Washington, they can’t bill commercial insurance companies for their services and can only work with clients at community mental health agencies.

In his 2022 State of the Union, President Joe Biden called for the creation of a national certification program for peer counselors. That has yet to happen, but recognizing peer counseling as a health profession could incentivize more people to enter the field, despite the difficulty of the work. “There is a ton of stress and responsibility placed on them,” said Megan Boyle, director of children’s services at Compass Health in Washington. “I would like to see them receive pay that matches their contribution.”

As peer counseling grows, the state is looking toward the opening of a new respite facility, SafetyNet, that will offer round-the-clock mental health support entirely by peer workers. Greg Jones, SafetyNet’s administrator and clinical supervisor of peer services, described the respite center to the Times as a place where folks can “go seek refuge and engage in activities that enhance our wellness.” These will include group yoga or therapy sessions in a home that also offers a sauna room with a Himalayan salt wall. There are no restraints or forced medication, and therapy at SafetyNet is optional. In other words, it’s a place for someone with mental health ills who is under great stress and needs some healing time, but who is not in the throes of a mental health crisis. (People in crisis, Jones said, should go to a hospital.) As a behavioral health center and home health center, the respite center will accept Medicaid and private insurance.

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Bureaucracy kept LA mental health chief from building his own version of the ‘Trieste model’

Can you imagine, in the United States, dropping by a mental health center for lunch or just to hang out? What about encountering a psychiatric treatment facility where the culture is so approachable and relaxed that sorting patients from therapists might be tough with a quick glance? It’s not rare for the residents of Trieste, a coastal Italian city recognized the world over for a psychiatric treatment model so humane, warm and community-oriented that it’s revolutionary.

MindSite News editor Rob Waters – who visited Trieste and wrote about its mental health care for Health Affairs – found the big difference in the Trieste model compared to the United States’ is that it centers the mentally ill person, not their disorder, when mapping a plan of care. It also integrates patients into the community. It’s an approach that psychiatrist and former LA County mental health chief Jonathan Sherin was so passionate about that he tried to bring it here. But, in a city nearly 20 times the size of Trieste, with an obstinate bureaucracy to boot, Sherin couldn’t get it done. His replacement, Lisa Wong, will have an uphill battle too, suggests a recent article in the Los Angeles Times.

“[Sherin] said we need psychiatrists to go out in the street; the positions were funded by the state and he still couldn’t get it through,” said Heidi Marston, former executive director of the LA Homeless Services Authority. “He had an organizational chart that took months, if not years, to approve.”

The problem? An entrenched bureaucracy and decades of underinvestment, neglect and misguided regulations, which have created “a fragmented, woefully inadequate mental health system” across the state of California, according to expert consensus. That said, it’s a wonder Sherin was able to shift what he did – and with a little less bureaucratic interference, Wong might be able to do more. As Marston told the Times, “They need to give those people the authority they need to get the job done.”

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Turning to the airport for nighttime refuge from the cold

Housing advocates say it’s nothing new, but it may come as a surprise: The Chicago airport is a refuge for many unhoused. “I had no choice,” Norbert Pikula, 77, told the Chicago Tribune when asked about his temporary stay at O’Hare International Airport. He had been sleeping on a friend’s sofa for the past six months, but when the friend fell ill and had to be admitted to the hospital, Pikula began using his senior citizen transportation pass to ride to O’Hare at night to sleep there. It provided the most practical location to stay warm and safe right away.

Jessica Dubuar, director of health and specialty services of Haymarket Center, which conducts outreach to the unhoused at O’Hare, said there’s been an increase in the number of outreach encounters they’ve had in recent years. She and others point to a few reasons for why: Homeless shelters reduced the number of available beds at the start of the pandemic and those beds haven’t been restored; migrants to the Chicago are turning to homeless shelters in higher numbers, and shelters are overwhelmed. 

The Chicago Department of Aviation funds the Haymarket Center O’Hare Outreach, which in addition to providing basic hygiene kits, partners with the Department of Family Support Services and other community partners to connect people to shelters, substance use treatment, and housing programs.

“What we’ll also do is invite people to come in and sit down and talk to us. And we do a small assessment with them, exploring all sorts of things from health care, mental health care, substance use, benefits and IDs and all of those things,” Dubuar said. More people are coming in with complex needs, she said: “This isn’t just a ‘somebody needs a sandwich today’ and that’s it…Navigating through these systems is hard and they need as much support as they can possibly get.”

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In other news…

Using virtual reality to treat anxiety in adults with neurodevelopmental disabilities: A recent study published in Scientific Reports suggests that adults with neurodevelopmental disabilities may benefit from virtual reality sensory rooms, New Atlas reports. The team of researchers at Western Sydney University in Australia found that VR sensory rooms helped reduce anxiety and depression in users with neurodevelopmental disabilities. It’s promising news for people who might struggle with navigating traditional sensory rooms. 

Ever watched Crazy Ex-Girlfriend? It’s a show that used musical comedy to present conversations about mental health and personal development. It ran for four seasons on The CW Network, and Movieweb created a fun look back at 10 songs from the series that demonstrate the mental health journey of Rebecca, the main character. Some of the best choruses refer to her finally receiving an accurate mental health diagnosis and how taking prescribed medication in service of mental wellness is “so not a big deal.”

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If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.

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