On Our Own, Together: Peer Programs for People with Mental Illness

Appendix B

Appendixes 273 Appendix B. Common Ingredients of COSPs, CAP Definitions Structure Definition Extracted issues Consumer operated Consumers constitute the majority (at least 51%) on the board or group that decides all policies and procedures. With limited exceptions, staff consists of consumers who are hired by and operate the COSP. Consumers have control of the operating budget. Role opportunities for participants may include board and leadership positions, volunteer jobs, and paid staff positions. Board of directors or decision-making group Staff composition Budget control Leadership roles for participants Participant responsive A COSP responds flexibly to the needs of participants. Consumers have ways to indicate dissatisfaction with their program and to have grievances addressed. Flexible program Process for complaints or grievances Linkage to other supports A COSP offers linkage to other supports, with referrals to other community services, and networking with other consumer groups. Linkage and referral to other services Networking with other consumer groups OnOurOwnFinalPages.indd฀฀฀273 4/16/05฀฀฀6:11:04฀PM 274 On Our Own Together Environment Definition Extracted issues Accessibility Consumers can walk to the COSP or get there by public transportation; or the program comes to the consumer. Hours of operation are geared to the needs of participants. COSP programs are either free or charge a nominal fee. Program use is not dependent on ability to pay. Efforts are made to ensure that consumers with physical and sensory as well as psychiatric disabilities can participate in programming. Transportation to the COSP Hours of operation Cost of program or activity Accessible to persons with physical and sensory disabilities Safety The COSP provides a noncoercive milieu in which fears due to past traumatization are appreciated and assuaged, including trauma induced by the mental health system. There is no threat of commitment, clinical diagnosis, or unwanted treatment except in cases of suicide or physical danger to other participants. Cluster for drop-in: Norms/rules to protect the physical safety of participants are developed by consumers for consumers— either by the participants themselves or by consumer staff— and they are agreed to by all participants. De-emphasis on clinical treatment or diagnosis Policy for calling police or other agents for involuntary treatment or arrest; policy for expulsion or suspension from the COSP Rules of daily behavior Informal setting Working toward common goals in a comfortable setting creates a sense of belonging and support. Rigid distinctions between “provider” and “client” do not exist. While some program components may be structured, there remains a sense of freedom and self-expression. The COSP provides a sense of fellowship, in which people care about each other and create community together. Physical environment Relationship between staff and participant Spontaneity of participant behavior Observed goodwill among participants OnOurOwnFinalPages.indd฀฀฀274 4/16/05฀฀฀6:11:04฀PM Appendixes 275 Reasonable accommodation Cluster for drop-in: No timeline is attached to participation in the COSP. No pressure to join and no time limit to participation. Schedules and tasks can be flexible and adapted to individual needs. Core consensus: Reasonable accommodation to disabilities of all kinds is advocated and practiced in program and work settings. Length of time allowed for participation Requirements for membership or participation Reasonable accommodation or flexibility in staff schedules and tasks Reasonable accommodation for all disabilities Belief Systems Definition Extracted issues Peer principle Relationships are based on shared experiences and values. They are characterized by reciprocity and mutuality. A peer relationship implies equality, along with mutual acceptance and mutual respect. Shared values, shared consumer experience Relationships peer to peer, participant to staff Helper’s principle Helping oneself and others is a corollary of the peer principle. Working for the recovery of others facilitates personal recovery. Help or advice is friendly rather than professional and does not demand compliance. All services at COSPs are based on peer-to-peer relationships, as part of the peer principle. Peers help peers Help does not require compliance Skilled services provided peer to peer OnOurOwnFinalPages.indd฀฀฀275 4/16/05฀฀฀6:11:05฀PM 276 On Our Own Together Empowerment Personal empowerment: Empowerment is honored as a basis of recovery. It is defined as a sense of personal strength and efficacy, with self-direction and control over one’s life. Consumers are expected, but not forced, to be accountable for their actions and to act responsibly. Self-reliance is encouraged. Group empowerment: Belonging to an organized group that is...