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Implementing Recovery-based Care: Tangible Guidance for SMHAs - page 18 / 44





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NASMHPD/NTAC e-Report on Recovery – Fall 2004

META has created a variety of other successful programs, including a recovery housing program that recently graduated 104 students out of 120 enrolled, with 90% leasing apartments, and 70% of those renters free of entitlement programs.

However, META’s transformation effort did not come without its share of challenges. When peer specialists are inserted into a traditional mental health system, it can ruffle some staff feathers. When META’s existing staff were introduced to the first crop of peer specialists, Johnson heard a variety of complaints. Staff were concerned about confidentiality issues, fears about losing their jobs, jealousy, etc. “We had to find ways to acknowledge these fears,” said Johnson. “It was kind of like having a new kid brother in the family.”

Another issue that surfaced was the awkward possibility of peer staff needing psychiatric crisis services while on the job. “Our position was that we had to have understanding and flexibility,” said Johnson. “Most of the people want to receive services from their peers anyway, not the psych staff, so we try to give them the choice, and then we help them get back to work.”

“We’ve also had challenges around issues of ethics and boundaries; this happens whether we hire consumers or non-consumers,” said Johnson. “However, the retention rates are pretty much the same with the regular staff. We’ve hired about 500 peer specialists, and we have terminated only about ten people.”  

Staff production is also measured by META management, and all staff are accountable. “These peer providers have to hit the same production that other staff do,” said Johnson. “It’s fee-for-service, and they have to handle their own paperwork. Our software monitors this, and we have business meetings just like anywhere else.”

To help peer staff, META has designated team leaders to serve as mentors. “We have a career ladder that people can move up,” said Johnson. Positions include recovery specialists, recovery coaches, team leaders, administrative positions, and faculty.

“We always find a way to maintain the ‘peerness’ of those services,” said Johnson. “The credential of what peers bring is who they are. Their lived experience is what their contribution is. We don’t want them being clinicians, using clinical jargon. We want them to tell stories. We want them to tell us who they are. We created this peer support role as a unique discipline, and the training just helps people bring their experience into a therapeutic recovery process,” said Johnson.

“META Service has been able to create opportunities and environments that empower people to recover, to succeed in accomplishing their goals, and to reconnect to themselves, others, and meaning and purpose in life,” said Leslie Schwalbe, deputy director of the Arizona Department of Health Services/Division of Behavioral Health Services. “META has made an outstanding effort in developing a comprehensive system of recovery-oriented services,” she said.

NASMHPD/NTAC e-Report on Recovery – Fall 2004

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