1 Agenda Welcome and Introductions Your

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Agenda • Welcome and Introductions Your Panel : Andy Cox Stephane Grenier Leslie Bennett • Part 1 – Background and Context in Nova Scotia • Part 2 – Our blueprint for implementation of Peer Support • Part 3 – Merging of Cultures. Requires consideration and careful planning • Questions and discussion 2

Part 1 Andy Cox Background and Context in Nova Scotia 3

NS Mental Health & Addictions Strategy • Together We Can – 2012 • A report that honestly did not ‘sit on a shelf’ • Peer Support a highlighted recommendation and priority action • One of the first to be acted upon • Legitimized peer support that had been going on in Nova Scotia • Pride in NS government 4

Early Challenges • NS Department of Health and Wellness restructuring • 9 Provincial Health Authorities consolidated into one • Arms-length non-profit organization / no previous experience for such a large venture • No model to work with and lack of experience in developing partnerships • Importance of arms-length! When is it to much? 5

Nova Scotia Health Authority 6

Early Wins • 5 PSAC certified peer supporters • Presently 8 working peer supporters (1 completing practicum for certification; 1 starting practicum) • 4 full time; 2 (0. 8) • 3 of 4 zones have peer support (many areas in the zones do not yet) • Engaged leadership, resources and plans to expand appropriately (data informed) • Well received by many clinicians and their management. Many clinician say they see the benefit of peer support with their clients. • Hosted first national PSAC(C) Peer Support conference April 7 2014

Nova Scotia Certified Peer Support Program 1 April 2016 NS Department of Health and Wellness decentralizes peer support. Peer Support is being transitioned into the formal mental health system. Come a long way 2012 to now! 8

Part 2 Stephane Grenier Our blueprint for implementation of Peer Support 9

Positioning Peer Support Certified Peer Supporters Clinical Care Peer Support Formal Peer Support Informal Peer Support Friendship

Positioning Peer Support Friendship Casual acquaintance 1. Informal PEER SUPPORT Naturally occurring, voluntary, reciprocal relationship(s) with peers one-to-one or possibly in a community setting Peer Support 2. Clubhouse / walk in centre Mainly psychosocial and social recreational focus with peer support among participants 3. Self-Help, Mutual PEER SUPPORT consumer operated/run organizations/activities/programs, voluntary, naturally occurring, reciprocal relationships with peers in community settings e. g. , housing, social/recreational, arts/culture, traditional/spiritual healing, recovery education/work, anti-discrimination education/work, human rights/disability rights education/work 4. Formalized / intentional PEER SUPPORT Normally paid peer support services in community settings (group or individual) and focuses on issues such as education, employment, systems networking/navigation, systemic/individual advocacy, housing, food security, clothing, internet, transportation, recovery education, anti-discrimination work 5. Workplace PEER SUPPORT Clinical Care 6. Community clinical setting PEER SUPPORT Outpatient, A. C. T teams, Case Management, Counselling 7. Clinical/ conventional MH system based PEER SUPPORT Hospital setting, Inpatient, Outpatient, institutional peer support, multidisciplinary groups, recovery centers, or Rehabilitation Centers Crisis response, Crisis Management, Emergency Rooms, Acute Wards Specialized Clinical Services NSHA Certified Peer Support Program

PEER SUPPORT Implementation “Blue Print” ng i Pl nn a ls s t co te en oc to da t ro di ro t sm p n on s p n ti n ca n e se s t io pm ua tio of A en al at lo ta n nt e ss em ion Ev en tio e ne ag at m m dev e am t di g le lec ing l y l p e n p ic gr ea En su R • on Im • S rai Im ol ro P T C • P • • Standards of Practice • Competencies • Knowledge • Code of Conduct • Experience ls o

Project Structure STEPHANE GRENIER Project Team Leader 1 2 SERVICE DELIVERY PROGRAM DESIGN MJ MICHAUD ANDY COX (80%) PPC INTERIM Program Coordinator (Primary Point of Contact) PEER SUPPORTERS CURRENT SITES PEER SUPPORTERS SITES TBD Margie Archibald Carrie Lee Geoff Alcock Kyle Hillier Michael Smith Vince Daigle Reid Lohnes Brenda Martin. Hurlburt ? ? ? ? ? ? Timing To Be Confirmed Human Capital Innovator LESLIE BENNETT Human Capital Innovator INTERIM Self Care Coordinator Self Care Starting: 1 April 2016

1 Year Project Jan 2016 3 PROGRAM DESIGN Mar 2017 GOVERNANCE * Advisory Committee - Creation (Terms of Ref & 1 st Meeting) Development of a sustainable Provincial Peer Support Training capacity (may require out of province resources) SERVICE INTEGRATION & CULTURAL ALIGNMENT Engagement in NSHA Engagement New clinical Sites Final engagement Current clinical sites ENGAGEMENT & CULTURAL ALIGNEMENT Engagement Peer Supporters ? ? ? Site Readiness analysis of current + pending clinical sites Design and Prep for Peer Supporter Integration workshop clinical and Peer Supporter (Current Sites) TEAM BUILDING Integration Workshop - For Clinical Staff and Peer Supporters TEAM BUILDING Individual Sites Cur rent Site s ACCOUNTABILITY Program Development - (Policy / Procedures) Work Description - Peer Supporters (Common) 3 A Role Clarification Document Peer Supporter - Program Coordinator & Community of Practice Leader Accountability Structures, Performance Reviews, KPI Work Description of Provincial Program Community of Practice Leader Work Description of Provincial Program Coordinator Work Description - Peer Supporters (Site Specific tasks and responsibilities) 41 ACCOUNTABILITY POLICY ROLE CLARIFICATION Program Development - Self Care procedure and initiatives - Design and Recommendations Finalise & Validate KPI IMPLEMENTATION * * Hiring of Provincial Program Coordinator Hiring of Provincial Program Community of Practice Leader CREATION OF POSITIONS SELECTION TRAINING * Advisory Committee goes to steady state mode 2 to 3 meetings yearly Creation of Peer Support Positions Open competition for Peer Supporter Positions New program Launched (Mental Illness Awareness Week: October 4 to 10 2016 (Date to be determined) * PROGRAM EXPANSION Open competition for Peer Supporter Positions New clinical Sites hire peer supporters Re Design Integration Workshop to leverage PS and Cinicians new sites Training for New Peer Supporters if required 3 C Workshops team building PS and Clinicians (NEW SITES) IMPLEMENTATION CONTINUOUS IMPROVEMENT * Design of Interview Questions ( Recruit and selection tools) Current clinical sites hire peer supporters (recompete) Peer Supporter Technical Knowledge Training upgrade (If necessary 3 B EVALUATION & CONTINUOUS LEARNING Design P Dev Mid Year P Dev for employees Design P Dev Mid Year P Dev for employees Refresher training / professional development ( to be scheduled yearly in person / teleconference quarterly )

Part 3 Leslie Bennett Merging of Cultures. Requires consideration and careful planning 15

Differences in Cultures What are the differences? Peer Support Culture & Clinical Cultures? 16

Clinical Sites Peer Supporters Client/Patient Peer Clinic/office Community Customer Service relationship with Client/Patient Reciprocal / Egalitarian relationship with Peer Structured time Person’s need and organic Formal Informal Doing Being Learned Expertise (knowledge and skills) Experiential Expertise (knowledge and skills) Professionally certified Integral member of team 17

Differences in Models Medical Model Recovery Model The diagnosis is the foundation The relationship is the foundation Begins with illness assessment Begin with welcoming, outreach and engagement Services based on diagnosis and treatment needed Services based on personal suffering and help needed Services work towards illness reduction goals Services work towards quality of life goals Treatment is symptom driven and rehabilitation is disability driven Treatment and rehabilitation are goal driven Track illness progress towards symptom reduction and cure Track personal progress towards recovery Services end when illness is cured Services end when the person manages their own life and attains meaningful roles The relationship only exists to treat the illness and must be carefully restricted to keep it professional The relationship may change and grow throughout and continue after services end Mark Ragins MD - leading psychiatrist in the recovery movement. 18

5 Stages of Organizational Culture Low Performing Tribal Leadership: Leveraging Natural Groups to form a Thriving Organization (Dave Logan, John King, Halee Fischer Wright: 2008) High Performing

Value Exercise Clinical Sites Peer Supporters Integrity Mutuality Courageous Dignity Caring Self Determination Accountable Personal Integrity Leadership Trust Equality Respect Health, Well-being and Recovery Social Inclusion Collaboration Lifelong Learning

What’s Next ? Relationships build on Trust, Framework, Talent Development, Culture Alignment Process: • Integrative workshops - gaining buy in • Attracting, developing, and retaining people with the capabilities needed for current and future program success, accommodation where needed • Embedding Self Care into Policy Framework • Integrating recovery culture and clinical culture • Strategy development – The future of the program, sustainability, continued ownership , includes strong governance, professional development.