Hello and welcome. I'm Dr. Amy Cohen, a clinical psychologist and director of SMI Advisor. I am pleased that you are joining us today for today's SMI Advisor webinar, Forensic Peer Specialists, Partners for Effective Reentry and Recovery. Next slide. SMI Advisor, also known as the Clinical Support System for Serious Mental Illness, is an APA and SAMHSA-funded initiative devoted to helping clinicians implement evidence-based care for those living with serious mental illness. Working with experts from across the SMI clinician community, our interdisciplinary effort has been designed to help you get the answers you need to care for your patients. Next slide. Today's webinar has been designated for one AMA PRA Category 1 credit for physicians, one continuing education credit for psychologists, and one continuing education credit for social workers. Credit for participating in today's webinar will be available until March 14, 2023. Next slide. Slides for the presentation today are available in the handouts area found in the lower portion of your control panel. Select the link to download the PDF. Next slide. Please feel free to submit your questions throughout the presentation today by typing them into the questionnaire found in the lower portion of your control panel. We'll reserve 10 to 15 minutes at the end of the presentation for Q&A. Next slide. Now I have the complete pleasure of introducing the faculty for today's webinar, Lindsey Sizemore and George Brott. Lindsey Sizemore is a Georgia Certified Peer Specialist of Addictive Disease. She's employed with the Georgia Mental Health Consumer Network as a Forensic Peer Mentoring Training Project Director. She supports the training of forensic peer mentors in the criminal justice system in an effort to support citizens successfully in their return to our communities to live a life of meaning and purpose. Over the years, she has successfully supported others in telling their recovery stories all over the state. Lindsey is a woman herself in long-term recovery who has survived 13 years of addiction, a year of homelessness, and three years of being incarcerated. She's been in recovery for almost nine years and feels it is her responsibility to network and connect with diverse communities to help advocate for peer support and provide evidence that recovery is real. George Brott is a licensed professional counselor and a Certified Professional Counselor Supervisor who has over 14,000 hours of supervised psychotherapy and applied community psychology experience. His specialty is professional and peer workforce development and continuous quality improvement consulting in behavioral health and social justice settings. In 2009, George co-founded the Certified Addiction Recovery Empowerment Specialist Academy, also called CARES, a peer recovery coach training that is operational in several states. Before retiring from the state of Georgia, he created the Transitional Housing for Offender Reentry Directory and the Reentry Partnership Housing Initiative. He also implemented a statewide recovery counseling program for people on parole. George is a Level 2 Certified Trainer with Better Outcomes now and is a charter board member of the National Alliance for Recovery Residency. Thank you, Lindsay and George, for leading today's webinar. Okay. Well, thank you so much. We're going to go over the learning objectives, but first I also want to just introduce myself a little bit and tell you a little bit of who I am. So I am Lindsay Sizemore. I'm the Forensic Peer Mentor Training Project Director with the Georgia Mental Health Consumer Network. And I am a Certified Peer Specialist of Addictive Disease. And it is through my experiences, my lived experience with mental health and substance use and the years in the criminal justice system that I now offer valuable contributions to my community by simply being evidence that recovery is real. The connection to recovery and the empowerment that I found through the Forensic Peer Mentoring Program, it helped interrupt that story I was telling myself. And it was when I realized that I wasn't alone that I began to create a new vision for my life. And this vision was greater than my circumstances. Having consistent support, being talked to like a human being, and being taught how to focus on what was right, began to feed the person I was becoming, not the person who I used to be. You see, I went from never being able to communicate my feelings to sharing my whole heart with random strangers. And from feeling like I had no voice to being on webinars just like this and talking to hundreds of people. I went from walking into prisons and getting that door shut behind me for years, to now walking in and out of prisons all over the state of Georgia on purpose. I went from running from the same police officers in the same system that I now sit at the same exact tables with and in the same meetings with and we work together for positive change. I went from being considered a threat to my community to now having state and federal departments, as well as some of the largest recovery support networks working together to expand peer support throughout the criminal justice system. Today, recovery is the expectation. And with hard work, a little bit of passion, and some lived experience, we've been able to pour into the Forensic Peer Mentoring program that we're about to dive into. And I'm looking forward to sharing with you a little bit more about what it is we get to do here in hopes that we can enhance the services that we all do together. And with that, I'll let George talk a little bit about himself. So thanks, Lindsay. And I appreciate you sharing that introduction. So my background is actually in community psychology. And years ago, I kind of made the decision to shift focus. There's lots of things that are available for people early on in the recovery process and even in middle recovery. But the challenge was how do we help people who are in that 5, 10, 15 year mark in terms of developing their sense of value and worth within community. And so I kind of went all the way downstream and decided to begin developing these peer recovery service trainings. And of course, the Forensic Peer Mentor is near and dear to my heart because that's the system that I spent the most time working in. But as you heard Lindsay talk about, it really comes down to each individual sense of who they are and where they belong. And that's a transformation that takes time to develop. And fundamentally, this training is about helping people begin to tell that new narrative because we're all so much more than the worst thing we've ever done in our lives. So with that, we really do plan to explain how we developed this Forensic Peer Mentor Ready for Reentry training, and then talk about the returning citizens and the community's role as the foundational crime assistance theory of the Forensic Peer Mentor training, and then review the impact of the Forensic Peer Mentors on metrics that are relevant to our community safety and health. So I've got a couple of polls, we'd like to find out who's in the audience, if you don't mind. First poll is, so who are you? Whose are you? Are you a medical doctor or nurse? Are you a licensed psychologist, counselor, social worker, marriage and family therapist? Are you a certified or licensed addiction counselor, or a certified peer specialist? Or are you something else? You would just reach up and touch your screen, use your mouse, whatever. Give you about 54321. Our survey says, I don't see the results. Anybody see the results? We have 35% in choice B, licensed psychologist, counselor, social worker or marriage and family therapist, 29% certified peer specialist and 32% other. Oh, nice. And so those others, I'm guessing maybe folks that are employed in the justice system itself, lawyers, supervision officers, etc. Good. Well, that's helpful. It's good to know who we're working with today. So here's a little more pointed question. Do you have lived experience in a part of the carceral system? If you would just select all that apply. You've been in jail, you've been in prison, or you've been on parole currently or before, or you've been on probation currently or before, or none of the above. Give you about 54321. Our survey says 75% selected none of the above. 20% were in jail and 19% are on probation currently or before. Interesting. Very good. Well, so it really is about that wide gap. And it's almost like in the United States in particular, depending on where you live and where you were born, your likelihood of being involved in the justice system can be very different. For example, in Georgia, if you happen to be black, you have a much better chance of excuse me, have a much better chance of going to prison than you do of graduating from high school. And the system itself is kind of self-perpetuating to some extent. So just wanted to acknowledge the folks who have had that experience in the carceral system. It's about how do we learn to do better and pull ourselves into a pro-social way of living. All right. Thank you so much, George. A little bit about our organization, the Georgia Mental Health Consumer Network. I'm truly honored to work for an organization like this. In 2001, we were the first in the US to actually develop and implement the medical reimbursable certified peer specialist training and services. And so with that, we continue to teach education and advocacy. And we do this to reduce stigmas and empower individuals so that at the root of it all, that they can learn to live self-directed lives, lives of purpose, lives that you're out there thriving, and that you're productive despite any of these challenges that may be in place. All right. Next slide. Back in 2004, the Georgia Mental Health Consumer Network, we actually developed the peer mentoring project pilot program. This began to start the beginning of serving individuals who live with behavioral health diagnosis. Fast forward in 2015, we were able to get with our governor, the Department of Behavioral Health and Developmental Disabilities, as well as a team out in Pennsylvania who worked specifically with the sequential intercept model, which some of you may actually be familiar with. And so we were able to begin our building process during these years. Next slide. So forensic peer mentors, the absolute biggest thing that we are all about is that we have the firm belief that everyone has the capacity to recover. They have the capacity to have successful lives of meaning and purpose in the communities of their choice. There's a few qualifications, and this might start stemming questions from our audience. But we, in order to be a forensic peer mentor, you must first go through the training of becoming a certified peer specialist. You can be a peer specialist of mental health or a peer specialist of addictive disease. We've also branched out and there are trainings here in Georgia that are training peer specialists for parents and for youth. And so the other piece to this qualification is going to be your lived experience in the criminal justice system. So if you have been to jail and to prison or if you've been under supervision of any kind, it's kind of cool to me because what would typically make you ineligible for most things is actually a requirement to do this work. And I think that this is radical and it's amazing. So the collaboration has, this relationship has continued to grow strong between our Department of Behavioral Health and Developmental Disabilities, our Department of Community Supervision, which is, you know, serving returning citizens in our community. And then, of course, the Department of Corrections has worked closely with the Georgia Mental Health Consumer Network so that we can start implementing forensic peer mentors within the prisons. In 2018, the Georgia Mental Health Consumer Network applied and was awarded a three-year federal grant through the Substance Abuse Mental Health Services Administration. This grant was specific to help us develop and sustain a peer-based forensic peer mentor training program. And so we're about to get into how we were able to jumpstart that in just a second. But in 2009 or 19, because of that first grant, we were actually able to develop a service definition that is recognized in Georgia and is also now Medicaid reimbursable at an enhanced rate. Go ahead. Okay, so this is the fun stuff. So we wanted to hear from our state. And so what better way to do that than to look at our service regions in our state? We have six. We went around and one listening session took place per month in a different region. And so we invited every justice-involved individual that we could find, officers, currently incarcerated individuals. We had family members. We had anyone who had been impacted by the justice system or people who had loved ones. They all came, they came out and we spent a couple hours gathering information. We used a appreciative inquiry. We asked things like, you know, what's working here in this community? We asked, you know, where are there room for improvement? And who's our recovery champions out here? We had over 300 participants overall. We found that a lot of the improvements in the justice system were access to medication and housing and trying to get education on mental health out to families and officers, as well as returning citizens who may not have access to these things that are also so important for someone's recovery. Employment, transportation, just being able to communicate across so many different systems. Once someone is actually involved, they have to go from one to the other. And so how can we better that communication? We have some amazing recovery champions that are our allies that are a part of the forensic training. Organizations like the Georgia Justice Project, who focus on advocating and they're lawyers and they work really, really hard to help reduce people's sentences. They are able to, people who have been on supervision or have years to go, they're able to finish their supervision early. We have housing authorities that help us find housing for returning citizens. And then of course, we have the forensic peer mentors and peer specialists all throughout. So these are pretty well-known recovery champions in all communities. But it's really important that we heard from all of these people because it is this data that we collected that then poured into the development of the curriculum that we now have today. Next slide. So in the midst of the Georgia specific curriculum, and hopefully as you guys go through this presentation, you can be thinking about your state or your organization on some of the topics and the things that you might feel are also important. But these are the ones that we have selected that are in the midst of our five-day training. We have a huge resource guide. This resource guide is actually updated every single training to the best of our ability because as you know, there is always going to be new resources developing. I just spoke with a new employment resource just yesterday. We are infusing our curriculum with the Georgia Mental Health Consumer Network projects as well. The WRAP plan, some of you guys might have heard about the WRAP plan, the Wellness Recovery Action Plan. This is a powerful tool that is used for people to begin that process of really developing a plan for their life. It's proven to be extremely empowering to have the person create it for themselves versus someone else laying out a guideline for them to follow. So we do recovery messaging. We have a cultural competency aspect where we focus on the cultures that take place not only in our lives, but the cultures that we deal with when we're actually incarcerated. And then to take it even further as a forensic peer mentor with that lived experience, the cultures that we also have to face going back into that same system that we came from, and how do we navigate through that so that we can do our best job in serving others. We do touch on the sequential intercept model. We have a lot of re-entry planning tools as well, some of which we will share here shortly. We believe we can't do anything without our self-care. So we know that we have to stay connected and we have to be able to take care of ourselves in order to do this work. We have also found that this work is not for everyone, you know. And so we talk about this in depth because we are entering into a system that has been around longer than any other system there is. And we want to make sure that we are supporting not only that same system, but also the returning citizens that are in that process of rebuilding. So we have many different presenters that come throughout this week. We have people from our state, Department of Behavioral Health and Developmental Disabilities. We have the Department of Corrections. We have the Department of Community Supervision, as well as some people who are actually actively working in our day reporting centers as well. So throughout the training, we get to hear from many different perspectives. We also make sure to teach on many different platforms. The training is extremely interactive with activities and real life scenarios, and it just has proved to continue to help our growth. Next slide. Okay, so we hope that as we move forward, that the objectives of being able to talk about the five-day forensic peer mentoring training, including how we gather the data and listening sessions are conducted around our state. We hope that you'll be able to also start visualizing this to be started in your state as well. Again, to just give you a little bit more to describe the returning citizen and the community's roles as forensic peer mentors are approaching and accepting and adopting really the crime desistance theory. So the forensic peer mentor role, this can also be really hands-on and useful and important for you to know as you start introducing forensic peer mentors into your organization. We create mutually beneficial relationships. This is a relationship where no one is above either person. This is where you can express your needs and your concerns, and the same goes with the returning citizen that you are also working with. And we've found when a relationship is mutually beneficial, a true connection, most of the time a connection people have not even experienced in their life has even happened yet can take place. And for me personally, I believe that this is the missing link. We've been trying for years to help people recover and having someone with that lived experience who's been there, who's done that, and who's thriving is exactly what people need to see. They need to see that it's been done so that they can also start visualizing and making those dreams for themselves as well. And I might point out here that this is one of the fundamental differences between the sorts of professional relationships that therapists and counselors and others may have with an individual as well as the difference in the relationship between the supervision officers and the person who's being supervised. The forensic peer mentor, really the emphasis is on peer. And it's about us having a relationship where you challenge me and I challenge you. But even more importantly, you support me and I support you. So it's not exactly an equal balance in terms of the relationship, but you don't have that offset where I've got all the answers for you, come and let me share my wisdom. It's more about can we develop a mutually beneficial and mutually supportive relationship that benefits both of us. And that's a different way of engaging, but it's about how we're able to do this in a way that taps into the strengths and the abilities of the individual. And yeah, there'll be times when we need to bring other resources in, but it starts with, as Lindsay alluded to earlier, it starts with the question of what's right with you and what are you already doing and who do you already know that are essential elements of you living a pro-social life. And when the person is more open and feels safe in that sort of relationship, then they are able to find those answers that are already within themselves. And you tend to find that when someone is more involved and their experience is being considered and what their dreams and goals are being considered, they're going to stick to it a whole lot more. I know that was the case for me as well. A couple examples on some of the activities that we go over or just an activity that forensic peer mentors do when they work with a paternity citizen is we have like a re-entry checklist. You might have seen many checklists before, but this is all going to be individualized. And so everybody's situation is different. Just because you're in a certain area in a prison does not mean that that's where you're going to be released and go to. Some people, when they go through this, they'll find, hey, I actually don't have a lot of supports out here or, hey, I'm going back to that same place where there was tons of trauma that existed. Maybe I need a little bit more behavioral health support. Maybe I need to focus on some of the fun that I'm going to have when I get out versus all the things that I'm going to make sure I do and don't do. And so we try to help by implementing these checklists so that not only is there a plan in place, but it's completely individualized and chosen by the person that is filling it out. Some people may want to focus on getting employment, but they may not have a place to live yet. By doing these checklists, we're able to maximize the time that's spent with the forensic peer mentor so that we can make the most of our meetings. That way they are set up for greatness from the time that they walk out the door. So it's a little small. I just want to note that this is a document that the returning citizen completes. And you can see on the right-hand side there, it's about helping them identify what are your top needs and how do you go about addressing those. And it's a matter of simply having these conversations and beginning to think intently about how you're going to be able to make this transition from institutional living to community-based living. And most of you are familiar with the fact that there are folks who really don't know how to live in the community. They become institutionalized. And then you've got the folks who are just sitting on ready and just need the opportunity to have that gate unlocked, and they'll do well. And everything in between. And so it's about the forensic peer mentor being able to accommodate any and all of those sorts of individuals. And by the way, we refer to them as returning citizens. It's my preference to refer to people by where they're going or what their goals are rather than where they've been. And is there any term that you could call a human being that's more offensive than offender? And I get it. I understand how that became a useful term. But in our world, it's a way of acknowledging the potential of the individual to in fact change. Thanks, George. Well, another activity that we feel is very important, we believe that there's multiple pathways to recovery. Some people have experiences and they've tried before different options. Some of those experiences may have been extremely positive. Some of them may have not been so good and some people may not have any experience with any of these things on this list right here. But having the returning citizen complete this, not only are we able to see where they stand, but as a forensic peer mentor, we're going to be able to offer up an array of options. We'll share our lived experience, connect on certain aspects of this. And then on the things that maybe even us, we don't have experience with, that maybe they do, it's opening up this door to where the returning citizen is able to share and teach with us just like we're able to show options. By having someone complete this, that first year of being released back into the community, it's a very vulnerable year. And so this is a great tool to be able to figure out how or where to, hey, you want to try out this faith-based program since you seem to have some good experience with it in the past. Would you like to try that again? And that way we can help share or support whatever option may have worked better for them. Maybe they're an artist. Maybe they would love to go see some sort of theater or get involved. It's programs and it's supports like this that help us continue to strengthen our recovery and get us into what's called long-term recovery, which is the goal. And it's really interesting to hear the forensic peer mentors in the training when they take this worksheet and fill it out. Because for a lot of them, the initial reaction is, I don't like this. I don't see the point of this. And then as the conversations evolve, it becomes obvious that much like therapists and our preferred therapy type, which is an evidence-based practice, people get into particular pathways of recovery and they think that's the pathway. That's the one everybody ought to choose. And the challenge is for the forensic peer mentor, can you work with a person with the same enthusiasm and the same persistence who chooses a pathway that's different from yours as you do the one that says, yes, your pathway is the one that I think I want to try and it's the best thing since sliced bread. And so it's about how we support each other and kind of figuring out how do we do these things that are really kind of foreign to us in terms of our own personal recovery. Exactly. Thank you. So I just want to take a minute here and talk about the kind of the traditional approach in the criminal justice world. And I assume that those of you who are others are probably criminal justice professionals. And so you're really familiar with this, but for the clinicians, there is an approach that's really rampant in the United States. It's the predominant way of providing criminal justice services. And it follows what's called a risk need responsivity model. And just very quickly, the whole notion is that we can assess people's risk of being of the potential of being rearrested. And based upon that, we can identify who are the folks who really should get the lion's share of a supervision or supervisory officer's attention. And then a subset of those risk factors are what's referred to as needs. Needs obviously are things that folks need in order to be successful under supervision and in returning to the community. And so these criminogenic needs, as the phrase is used, help to identify what should be focused on both while on supervision, but also in terms of the service delivery system that people are engaged with. And then responsivity is to me one of the keys that really is most significant. And that is, are we providing services that are responsive to the individual? You might look at this as a type of cultural competency or cultural congruency. And the idea is that if what we're providing to the individuals working, obviously keep doing more of that. But if it's not, part of the answer might be to look at, are we really matching the needs of that individual with culturally congruent services? And so the responsivity model is about how we help and how we set ourselves up to hopefully be successful and to really recognize that it's a two-way street here. We often develop programs and they are evidence-based practices, but the key question is who's evidence? And if a model was developed on a population that's different than what you're serving, then you have to kind of question, is that really something that's going to work with the folks that I am providing services to, or is there something else? And so this is the typical approach that's really focused on in the criminal justice system. And so as a therapist or as a counselor, as a forensic peer mentor, it's important to be able to understand this language. And much as we have our own vernacular and our own sense of what we're about in providing services, so does the criminal justice system. And to be able to talk in terms of risk, needs, and responsivity is an important way of learning the culture that you actually are joining and becoming a part of. So I also want to just mention the fundamental shift that is beginning to happen in the United States is towards a model of changing behavior that's based upon what's called crime desistance. And desistance is kind of a funny word. People aren't really all that familiar with it, but it means you stop some behavior. You desist from that behavior. And as you heard when Lindsay introduced herself, a lot of that is based on the person's identity, how they see themselves, and can they develop that sense of belonging that's relevant in terms of the community that matters to that individual. Well, a lot of this is based on the work of Fergus McNeill and others, but there's references in our handout where if you want to watch a video with Dr. Fergus, you can certainly do that. We won't have time to do that here today. But it's about three essential research-based desistance factors. And I just want to point out the last one down there is how a person sees or labels themselves is really a key factor, as well as with what consequences and effects. So a lot of what happens is people beat themselves up and experience the stigma, and they have self-stigma that really can impair their ability to begin to see themselves in a different way, to get rid of some of those biases that they have. But it's based upon obviously having connections and bonding with pro-social institutions and having bridging capital, meaning people who are able to connect them with different resources. And then there are four forms of rehabilitation that are proposed by the desistance model. And I really want to emphasize the fact that obviously we put a lot of emphasis on the emotional or psychological rehabilitation. That's a good thing. And yet there are other aspects that are relevant. So to what extent do we focus on de- or relabeling people so they're able to be grafted back into a role that's valued both by themselves, but also by the community they belong to? And then morally, the state and the community owe a retributive debt at some point to end punishment. And this is where it really kind of stretches some people to think this way. But there are folks who, for me, it's about have you gone through the entire process and have you gotten something from the state that says you are hereby forgiven? And in Georgia, that's a pardon. And I can tell you that a relatively small percentage, and I'm going to just guess and say 15% of the people who complete the forensic peer mentor training have received a pardon. So the idea is that there is a point at which people should receive that sort of designation. And it's the responsibility, frankly, of the state and the community to provide that. And then the last one is judicial. Record restrictions, expungement, the restrictions on what sort of job you can do, all of those are areas where we continuously punish people. And without really any evidence to suggest that this is effective in terms of promoting public safety or health, getting some of those restrictions removed would be a viable way of increasing the likelihood that people will be able to do what they're good at and be valued by the communities that they live in. So this is a different way of looking at the whole social justice focus. And it's kind of the core of what's built into this forensic peer mentor training that we call Ready for Reentry. Anything you want to add to this, Lindsay? No, my favorite part of this is how do we as a community celebrate every single milestone as a person is in this rebuilding and moving to a crime-desistant life? And so for me, I try my best to just get the community together and celebrate every single step along the way versus focusing on all the things that have happened in the past. And so that's my favorite part of crime-desistance. Moving on, so the training itself, it's a six and a half hour Monday through Friday training. We work through our lunches. As I said before, we have included facilitators throughout every single day of our training, which means we have allies. We have developed relationships with these allies that believe in this program. They see the effectiveness. Facilitators like the State Board of Pardon and Paroles. We have the Clemency Division come in day one to start off the training. We hear from Department of Corrections on day two. The Georgia Justice Project as well as, or the Georgia Justice Project, we talk about how to get certain parts of our record restricted, what we qualify for, how do we get our rights back? How do we get to vote again? What does this actually mean? And we stay up to date on what's going on at our capital as well. The Department of Behavioral Health and Developmental Disabilities, they come in a couple of different times throughout the training and they talk about all the services that we offer at the state so that we as Forensic Peer Mentors can continue to provide that linkage to resources to help people rebuild. And I just want to mention that the Friday afternoon highlight is the commencement. And that's where for many folks, they are basically taunted into delivering an elevator speech. And so what you heard Lindsey do at the beginning is what I would call a mature elevator speech. But when people first start doing this, it can be a challenge because the tendency is to kind of want to do the drunk a lot thing and talk about how bad things have been as opposed to showing the contrast between this is who I used to be and this is who I am now and this is where I'm headed. And that's one of the, again, that's one of the highlights of the training because it helps people begin to think through who they are, the image that they're presenting to the world, and then what about that image do they want to change and to really be intentional about moving in a pro-social direction. Thank you. All right, so it's been four years. We have got a ton of growth with the forensic peer mentors positions itself. We have, we're currently in 12 different state prisons, soon to be 31 as of this year. We have the positions funded by our state. We are just in the process of filling those positions as we speak. We are in the Day Reporting Centers, which is a one-year program. It's a diversion program, so high-risk returning citizens that have gotten into some sort of legal trouble, so to prevent them from going to prison, there are programs throughout the state called Day Reporting Centers. So we are putting forensic peer mentors within those centers as well, and we're also in 11 mental health accountability courts as well. So forensic peer mentors, their lived experience, their training from this program, they're getting to sit in these courtrooms, they're having conversations with judges. This is like definitely taking a huge change, a turn for the best, you know, for many different lives. And so after what we just talked about, hopefully you can know a little bit more about the, how we developed the five-day forensic peer mentor training, and we talked a bit about the crime desistance theory, and not only the returning citizens' role, but the community's role in what they play in the crime assistance theory as well. So the impact of forensic peer mentors is definitely on the rise and it is supporting those goals of safety and it's being effective in what you see now on reducing recidivism. We believe that, you know, having a forensic peer mentor work with someone to navigate through the system versus going deeper into it is truly the goal. We're also able to reduce that psychiatric hospital readmissions as well. Here's some more outcomes. We are going to kind of just let you guys look at this due to time, but we are at when a forensic peer mentor is working with an individual, you will see that our recidivism rate is extremely low. Next slide. So so far, here's some dates of the people that we have served, where we have served them at. So we are approximating a little, a little under 4,000 individuals have been impacted by the services of a forensic peer mentor. On this screen, you will see that we have touched on employment, enrolling in mental health services, which is huge, housing services, and then of course, how people can, you know, go about getting the benefits that they need, you know, and sometimes that can take a lot of time, but we try our best to make sure forensic peer mentors are educated on how to do that. And through the forensic peer mentor program growth, we have discovered that reuniting people returning citizens with their family, not only educating the returning citizen, but also the family member with education and how we can empower each other, the free program has been developed. And so we had, we've always worked together with those first four sponsors and stakeholders, but what is new is that the National Incarceration Association has now collaborated with us as well. We have a curriculum for the free program that has been, you know, in place and it is starting now. Everything from learning to set boundaries within those relationships, how to communicate, how to best take care of yourself when a returning citizen gets released, you know, back to whatever person they deem as their family member or support person, they're able to go through these topics and work together. So we have the forensic peer mentor who is working alongside the returning citizen. Then we have the peer specialist who facilitates the individual's actual family member. And then if we have a clinician from our community service boards, they are also able to follow up and together they all, so the returning citizen, the family member, along with the forensic peer mentor and the CPS, they are able to work together to really, I guess, make that connection upon release a lot more fluid. And I think building those family relationships is the greatest form to healing in our community that we can start. And that is a cool program that has started, you know, since the development of the forensic program. So hopefully you have a sense that we're really promoting this notion of recovery and pro-social lifestyles through what is perhaps best known as the social model of recovery. Dr. Thomasina Borkman, who is one of the originators of the social model, characterizes it with this wonderful quote that says, you alone can do it, but you can't do it alone. And the idea here is that what we're proposing with the forensic peer mentor and another peer support services is an enhancement to the existing clinical as well as in the forensic case criminal justice services. By adding peers who have lived experience and who can demonstrate how to live a pro-social life successfully, I think it improves all of our outcomes. And that really is the emphasis of our program. And you have a list of references that you are certainly welcome to take a look at. And with that, I think we're done. Well, you're not exactly done because I'll tell you, it's been a very active conversation board, which we'll get to in a minute. But before we get to that, I just want to thank you so much, obviously, for going through those slides. Amazing. And in a minute, we'll talk about how important I think this enhancement is. But before we shift into the Q&A, I want to take a moment, let the audience know that SMI Advisor is accessible from your mobile device. Use the SMI Advisor app to access resources, education, and upcoming events, complete mental health rating scales, and even submit questions directly to our team of SMI experts. Actually, someone even asked in the question about the sequential model, and we sent them to SMI Advisor. You can find that on the app or on our website. Download the app now at smiadvisor.org forward slash app. So one of the things you, I have lots of questions that have come in, so I won't hog the time just for me. But I do want to just emphasize how important that word of enhancement is. You mentioned how important enhancement peers are to the clients, right, to forming a whole clinical team, which includes those with lived experience. But I would also want to emphasize how important the role peer supports are to the rest of the clinical team. They provide hope and models for the rest of the clinical team as well. Sometimes at points in our career, we lose hope as clinicians that people can recover, that they can live full lives, and we forget that. I know that at times when I've been at a low point, a burnout point clinically, the peers have been really helpful to me as a clinician to show me the way forward, to provide hope for me as well. And so I just want to remind everybody that peer supports play a role both for the team and also for those that they serve. So I just wanted to remind folks of that. Oh, wow. Let me break into these questions because we've got a lot of them. I tried to answer some of them, but, you know, I can only do so much. So let's get right to it. In peer support for people who use substances, do they typically use a harm reduction model during support? Well, I don't know about typical, but yes. And I'll say this. It can be a stretch because the traditional approach in the United States, anyway, says that recovery happens when you stop using alcohol and all other drugs. But what is the single most evidence-based practice in the alcohol and other drug use world? Methadone. But yet there are people who say, oh, if you're on that, you obviously aren't in recovery. Well, yes, you are. And we are to the point of recognizing the value of that just as much as AA or NA or Celebrate Recovery or Women for Sobriety, all of that. So that's kind of a long answer, but it's not typical. And there are some folks that really, you have to address that bias, but it certainly is a key part of what makes this peer system work even better. Great. Lindsey, would you mind talking just for a minute about the difference between a certified peer specialist and a forensic peer specialist? Yes. So a certified peer specialist is typically trained, depending on whether they're certified peer specialists for mental health or substance use, they're usually trained to use that lived experience with those challenges. And specifically, when you talk about a forensic peer mentor, you are now going into a more specific realm where you are now working with those who are justice involved. And so, yes, you have your peer specialist lived experience training, but when you're able to get a little bit more specific and also couple in the justice system and learning what, how the justice system works, you are now going to be able to serve individuals in a much deeper, more specific way. Because when you are working as a forensic peer mentor, not only do you have the internal challenges of mental health or substance use, but you also have all the other external challenges and limitations put on your life, such as employment and housing and having to rebuild and having to really work with that criminal record that's now attached to your name. And so that's the biggest difference, which is why being a peer specialist is a core requirement before you're able to even go to the forensic world. So in your mind, or at least this is the way I think of it, and correct me if I'm wrong, I think of peer specialist as a big umbrella. And there are almost like specialties underneath it. And forensic peers are a specialty group underneath that. I know when I worked, I used to work in the Veterans Administration, there were veteran peer specialists, and they had a very specific set of knowledge that they used within that system. So it sounds like there's a way to kind of specialize in this area. Would you say that's true? I would say that's true. That's exactly how I would explain it as well. Perfect. So we have a person who wrote in, this is like super exciting. They're in the process of putting together a forensic peer module for training in the state of Mississippi, your neighbors. They would like to connect further with the two of you. And so is the best way to do that, George, to go to your website? I know there's a contact George button on there. No, not the best way. Best way to do this, go to George Mental Health Consumer Network, GMHCN.org. Hold on, I'm going to type that down. What is it? G-M-H-C-N.org. Okay, I will send that to that person. Perfect. And we'd love to hear from you. I think that would be great. And I have this available as well. Many, many states, we have a running list of states that are interested. And so we are definitely able to have that conversation. Perfect. I also have a person who wrote in and said, I completed FTC in Hall County, Georgia. It saved my life. I live in Virginia now. Thank you for your work. I work for a CSB and inside a regional jail reentry program. So a success story right there. Perfect. Someone says, how do I begin talking to people in my state about getting a model like this going? How do they start? I would go, I would start with linking up if they're not already a part of an organization that, you know, promotes advocacy for mental health and substance use. Find an organization similar to that and get with them. There are so many different statewide consumer grants that are offered through SAMHSA. That's how we got started. I could not believe when we got awarded, we got a game plan together. We were able to get some allies at the table. And so, yeah, I would start with some sort of advocacy group, people who are in your state. I think certified peer specialists are in just about every state in some sense, some more than others. But I would get with them and come together and apply for one of those grants. So you can really get a game plan together and start building it off the ground like that. And, of course, you don't have to invent the wheel in every single way. And so, you know, that's why it's so exciting to be here today just to kind of talk about the route that we took and how it is working. And what I'm seeing and I'm like so jazzed up about all of the comments is I'm seeing a lot of people who are either right on the edge of doing this or just starting to hear about it in their state. And so I think they joined today because they're really starting to think about it and get excited about it. So here is a person who said good information, especially regarding reducing psychiatric inpatient hospitalization admissions. I work in an ER. Have you heard of the freedom model of recovery? I don't think I've heard of that specific model. No, but I am learning more about it. Okay. Okay. Wonderful. I've heard of it, but we do have a significant number of hospitals in Georgia where we have peers who are providing services in the ER, as well as in, for example, the. Oh gosh, what's it called? Pregnant. Pregnant. Well, no, women. Thank you. Thank you. There you go. Thank you. One thing that always comes up on these when we when we throw out new innovative ideas for how to help the population who are struggling with mental health issues is how do we pay for it? So someone wrote in and said how much more I don't think we need to go into this part, but how much more forensic peers paid compared to regular peers. That probably varies from place to place, et cetera. But can you talk more about the enhanced rate through Medicaid? Can you say anything about that, George? Well, Lindsay probably knows more about it than I do, but you want to address that, Lindsay? Yeah, we are we have I mean, as far as the rates, it does vary. It depends on if you're going to work into a prison, for instance, and I'll give this idea or estimate, you know, the prison positions that are now being taken over in our state. They are they're making anywhere from, you know, forty forty to forty five thousand a year full time health benefits are feeding their families. They have badges, jobs, desks. It's unbelievable. And it does vary whether you're going to go work for a day reporting center. I don't know too much about the accountability court rates, but but yeah, it took it took it took a couple of years of this first grant. We are on our second grant. This is why I'm pushing for others to apply for the statewide consumer grant. So after the first grant, we were able to successfully on our on our year three get with the Department of Behavioral Health and Developmental Disabilities. And we were able to actually come together with that what that new surface definition looks like. And so that is a conversation with multiple allies that has to take place. It's not just us, as you all know, doesn't work like that. But yes, it does vary. I'm hoping I'm answering that question as best as I can in this short amount of time. But yeah, no, I think it's right. And I think all of this really stems back to talking to your state mental health commissioners. Absolutely. The people who are going to help you build the evidence to show that this is a worthwhile position, that it's reimbursable should be reimbursable at X, Y, Z rate. And like you said, in year three, you probably had enough evidence to show, listen, we're reducing this, we're reducing this, we're improving this. And then the mental health commissioners can help advocate for payments, reimbursements, et cetera. So I think this is kind of a mental health commissioners kind of conversation. You have to get real friendly with those folks around these things. And it's moving towards it's moving towards the data is there. You're right. And that's our that's our bread and butter. That's our power right there. But now we're having conversations with the correctional system. You know, we're having conversations with the community supervision offices because what we're doing is helping them do their job. And so now it's becoming it's on the table now to to receive funding from from them as well. So wonderful. All right. There's so many good questions. OK. Lots of you two are super. So I just will just summarize that in one thing here. OK, so one of the things. What roles are peers performing in the ER? Can you speak at all to that? That's a little bit out of scope. No. Yeah, I can. We so we do specialized training for folks who are hired to work in emergency departments. But it's essentially the same peer role. It's basically going in and and connecting with people, finding out what's going on. In a lot of cases, people are there because of misuse of alcohol or misuse of alcohol. And that's another whole set of biases. But then there's the overdoses and then all sorts of accidents where the accident is caused by alcohol or the drug use. And then you've got the folks who have mental health challenges, who decompensate. And so it's about having somebody who can say, yeah, that's really that's tough. And I remember what it was like for me. And that's a very different sort of bedside manner than the clinicians who come in, who do the essential services. But the point really is that if you can make that connection and be the bridging capital to the resources, it's it's the difference between saying, here's a card. Go see this person as opposed to go. I'm going to go with you and talk to John, because John is the person who really can help you facilitate whatever your next step is in this process. So it's about having that opportunity to build the quality of the relationship while the person is in the emergency room and in their hospital stay, just like it is coming out of a psychiatric hospital, same sort of process. I think we would all three agree and many people in the audience that there's really no point in the continuum of care where we shouldn't have peers. Right. There's just no point in the whole process from when someone calls, we should have them in mobile crisis response, should have them in the ER. We should have them all the way along. And so I appreciate the two of you really highlighting the forensic peer aspect, but also representing the role of peers generally today. And reminding us again of the importance of that voice and that really companion along our recovery journey. So really appreciate that today. Let me move forward to the audience. If there are any topics covered in today's webinar that you would like to discuss with colleagues in the mental health field. Post a question or comment on the SMI advisor's webinar roundtable topics discussion boards. These are an easy way to network and share ideas with other clinicians or peers who participate in this webinar today. If you have any questions about this webinar or any other topic related to evidence-based care for serious mental illness. You can get an answer within one business day from our experts here at SMI advisor. This service is available to all mental health clinicians, peer support specialists, administrators, anyone else in the mental health field who works with individuals who have SMI. It's completely free and a confidential service. SMI advisor is just one of many SAMHSA initiatives that are designed to help clinicians implement evidence-based care. We'd encourage you to explore the resources available on the mental health addiction and prevention TTCs. As well as the National Center of Excellence on eating disorders and the Suicide Prevention Resource Center. These initiatives cover a broad range of topics from school-based mental health through the opioid epidemic. To claim credit for participating in today's webinar, you'll need to have met the requisite attendance threshold for your profession. Verification of attendance takes about five minutes after we end today. You'll be able to select next to advance and complete the program evaluation and then claim your credit. Please join us on January 19th as Jennifer Black, Dr. Debra Pinals, and Dr. Donna Roland present the roles of forensic nursing and caring for individuals with serious mental illness. Again, this free webinar will be January 19th at three o'clock Eastern time. That's a Thursday. Thank you both for joining me today. What a pleasure meeting you both. Thank you to our audience for being so active. Until next time, everyone, take care. That will be well.

SMI Advisor

forensic peer specialists

evidence-based care

peer workforce development

recovery journey

crime desistance theory

re-entry checklists

individualized recovery plans

reducing recidivism

peer support