Hello and welcome. I'm Alexia Wolf, Director of the Delaware Behavioral Health Consortium and SMI Social Determinants of Care Expert, or SMI Advisor. I'm pleased that you're joining us for today's SMI Advisor webinar, Peer Specialists, Enriching the Crisis Continuum. Next slide. SMI Advisor, also known as the Clinical Support System for Serious Mental Illness, is an APA and SAMHSA 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. Back one. Today's webinar has been designated for one AMA PRA Category 1 credit for physicians, one continuing education credit for psychologists, one continuing education credit for social workers. Credit for participating in today's webinar will be available until May 16, 2023. Next slide. Slides from 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 by typing them into the question area 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'd like to introduce you to the faculty for today's webinar, Eric Eason and Wendy Tigreen. Eric Eason, Licensed Professional Counselor, is an Account Executive with Carillon Behavioral Health, formerly Beacon Health Options, and currently supports the New Hampshire Rapid Response Access Point, a 24-7 call, text, and chat crisis resource that serves the residents of New Hampshire. He has worked in mental health for more than 25 years and has specialized in crisis for the past 10 years. Wendy White Tigreen, MSW, is the Director of Medicaid and Health System Innovation for the Georgia Department of Behavioral Health and Developmental Disabilities. She has almost 30 years of experience working in service delivery and administration in the public health, public behavioral health sector. The majority of her career has been spent as liaison to the state Medicaid authority. In her various departmental roles, she has led in the design, development, and implementation of the Georgia Crisis and Access Line, Administrative Services Organization, Crisis Stabilization Unit Certification, Adult Youth Parent Peer Support, 988 Crisis Implementation, and System of Care Frameworks for the state of Georgia. Thank you all for leading today's webinar. Hello, everyone. We are so glad to be with you today. And I will begin by saying, for disclosures, there are no relationships or conflicts of interest related to the subject matter of this presentation. And then here are our learning objectives. So upon completion of attendance today with this activity, we hope that you are going to be able to analyze the value of integrating peer specialists into crisis systems, to be able to recall specific examples of how one might integrate peer specialists into this work, and to develop ways to pursue funding for peer specialist integration. So we want to begin with this visual for you because we want folks to have your minds opened to the potential for peer specialist roles in a 988 crisis system. And so I think for folks who are familiar with the 988 law, it's not just about a call center. It is about the infrastructure that is part of the supporting service array to help individuals in that moment of crisis and immediately following that moment of crisis so that they find some relief in that particular event. So it's not just then about certified peer specialists and their capacity thinking about crisis and access lines, and in that also including text and chat functionality, but also in crisis stabilization units, mobile crisis, crisis service centers, peer wellness and respite centers, and outpatient crisis interventions. And I do want to just take a moment before we move on into the meat of our presentation and just say you heard Eric and I's bios when we began this call, and he and I both strongly believe in the nothing without us, about us philosophy related to peer specialists. And so we brought that to bear in mind for this presentation, and we had a CPS presentation partner who was going to be on with us today, but unfortunately at the last minute was unable to join us. But we do want you to know the content, the slides, the visions, and the thoughts here in reflect the input of that certified peer specialist partner. And as you look at this array here today, just really understand that these ideas are highly influenced by not just that certified peer specialist, but by many of the certified peer specialists that Eric and I had the chance to work with across the country. So again, the 988 law requires states to enhance the current system's ability to respond to folks in behavioral health crisis. And SAMHSA has so nicely organized this into kind of three large structural areas, someone to talk to, someone to go, and somewhere to go. So for those of you who don't have a really good anchoring into the 988 law, we want to spend a second here just to be sure that we're all starting from the same foundational page. So when we talk about for the 988 crisis infrastructure and saying someone to talk to, we're really talking about a call center that is staffed by trained individuals that are available 24-7 for calls, texts, and chat. And then also in a complimentary manner around the country, there are also peer-run warmlines. And they offer callers some emotional support, they are staffed by not just by volunteers, they're also staffed by professionals who are also in recovery themselves. And then when you think about someone to go, so someone who can be deployed into the community in order to provide some behavioral health support. We organize a lot of services that are around this concept, including mobile crisis response, hopefully available statewide as states continue to enhance and develop their capacity. We contemplate coordination with 911 and the public safety response centers or EMS as appropriate. And we're also contemplating outpatient community provider responses. So again, there's an infrastructure of community behavioral health centers, providers, and agencies who also have a role in partnership to deploy into communities and provide immediate support. And then finally, we are conceptualizing this somewhere to go notion. So for crisis stabilization units, crisis service centers, peer crisis respite facilities or programs or models, which are also sometimes called a living room model in the peer vernacular, detox and substance use treatment, inpatient beds and outpatient crisis services in a facility, like for instance, a local mental health or behavioral health center. So all of these things can provide an individual somewhere to go when they are in experiencing a particular behavioral health crisis. So again, when you think about these icons here that you see in the dark blue, I want you now to look at that picture once again and conceptualize these roles for peer specialists in the someone to call, someone to go, and somewhere to go type of framework. So why peer specialist? There is nothing more clear or succinct than to say recovery matters. So on a day or in a situation where an individual may be experiencing one of their most challenging health crises, it is important and I would say absolutely crucial that an individual has the opportunity to be exposed to the notion of recovery. That in that moment, particularly we know that behavioral health crises often are somebody maybe in a mindset of this is such a challenge in a way that I might be contemplating ending my life or I am afraid of this being kind of an ending. Recovery is crucial. So it is so essential that we are able to infuse the idea of this will be better. This can be stabilized. This can improve. Recovery is an opportunity for you. And so whether or not it is in that moment where you're talking to somebody, chatting with somebody, IMing somebody, or whether somebody is going to deploy into the community to support someone in crisis or whether or not you are receiving somebody into a space to provide crisis intervention, that in all of those places that we are talking about recovery, and it may be briefly, right? Because we're in a crisis moment, but if at every turn we are able to speak to someone with hope messaging, recovery messaging, and that it will be better messaging, these things are necessary elements to that stabilization and to the future recovery for that individual. So I think it is important probably for many folks in the audience today to understand that there is a lot of research already out there about peer specialists and providing crisis intervention, prevention, and diversion. And while it is not nearly all that we hope that it would be, we know that there is much more research emerging on this. So again, look at some of these high spots here. Research is showing lowered rates of hospitalization when a peer specialist is involved in crisis intervention, that we have lowered health expenditures, we have lowered arrest rates, reduced likelihood for emergency protective custody, effective in suicide interventions, showing promise in addressing suicide risk, lowering utilization of emergency and crisis services, reducing isolation, higher consumer satisfaction versus an inpatient arrangement when a peer is involved in an intervention. And then of course, with a star here, this encourages recovery in service practice and culture. So again, hearkening back here, infusing the notion of recovery for individuals when they may be experiencing one of their worst days, it is essential that we are talking to them about hope and the potential for wellness and stabilization and recovery. So I am going to begin turning it over at this point to my colleague, Eric, and letting him begin to talk to you a little bit about how this starts to function operationally in the service lines when working and utilizing the expertise of peer specialists. Thanks, Wendy, and good afternoon, everyone. I do want to talk a little bit about the ways that we can integrate peers into our crisis work. And just for a little bit of background for myself, I have worked primarily in the realm of crisis contact centers and mobile crisis for the past 10 years and have seen firsthand how the integration of peers into those services can really bolster them and make them so much more effective and impactful in our communities. So thinking about the way that we can integrate peers into crisis contact centers, first of all, let's establish that ideally what we are talking about are 24-7, 365 centers that operate phone, text, and chat support. However, we could be talking about other variations of crisis contact centers depending on your local municipality or whatever your funding source is or whatever the contract is that you are operating for that service. When we think about the team composition, of course, we have a variety of crisis specialists which could, depending on the model, be a number of different professions. We usually think about having either licensed or associate clinicians. Perhaps you could have nurses. You may also have paraprofessionals who have appropriate experience, training, and education. And you can also have peer specialists. I'm aware that there are some contact centers around the country that are utilizing volunteers as well. I'm less familiar with those models personally, but I'm aware that they can be very effective in doing this work. Also, of course, most crisis contact centers would want to have some sort of clinical and or medical directorship in place to oversee their operations. When we think about the purpose of these contact centers, we're thinking about the concepts of crisis de-escalation, identification of immediate needs, and appropriate referrals. We're also, of course, thinking about the types of diversion that are so important, reducing the involvement of law enforcement or 911 resources, legal resources in general, and also reducing the need for any sort of higher level of care or out-of-home placement for a person in crisis, which we know contact centers can be very effective at doing. And if you'll notice, many of these objectives align with the impacts that peers can have, making them a very natural fit for each other. Next slide, Wendy. When we think more about the role that peers can play with contact centers, next slide. Thank you. I want you to think for a second. I know it's, I have seen firsthand in some organizations how it can be really easy to pigeonhole peers into a special pocket, a special place, almost treating them in some regard as a token peer on your team. And I want to really encourage people to think differently about how peers can be integrated. Peers can play a variety of roles. The roles that they can play are just as varied as the individuals themselves. They can be, they can take on administrative roles, serving in an advisory capacity, informing and writing policies and procedures. They can hold leadership positions in the organization. They can provide tremendous educational resources and can be teachers for your organization, trainers. They can also do direct work. So they might be the ones in a contact center answering the phones or the texts or the chats. And they can do other specialized work as well. Particularly when we think about a lot of the peer work that has been done, there's so much work in the warm line, the warm line arena that peers are able to provide. Warm lines, respite, those kinds of things. And also the concept of following up. When we've had a person who has experienced a crisis and has reached out to a crisis call We know that following up with that person a day or two or three or, you know, four, for several days can be very effective at ensuring that that person has really had their needs met and that they're following through with the recommendations that they agreed to and that they haven't encountered any barriers to that care. Peers are particularly great at helping people access their community resources and being aware of what services and supports might be available. And so they're a very natural fit for this type of service. It's also good to be able at that point, once you're slightly beyond the point of crisis, to speak with someone who has that personal history and that ability to really continue to inspire hope in someone. And to say, you know, I've been there, I've been through this, and let me tell you, I know it gets really hard, but things can get better, and I'm an example of how it can get better. So again, peers bring such a richness to this kind of work. Next slide. Moving along to, admittedly, my personal favorite in the crisis continuum, mobile crisis teams. This is where I've done the majority of my work. Of course, when we think about mobile crisis teams, there are, again, a variety of ways that people define this. So when I talk about mobile crisis teams, I'm focusing primarily on teams that have capacity to provide community response. This would be responding to homes or public places, including places like homeless encampments or street corners. Could be places of business, it could be schools, jails, hospitals. But the point is that these encounters are occurring in the community. Some teams might also provide additional clinic-based services, but for the purposes of this talk today, I'm thinking of mobile in the sense of those community responders. As a primary goal, of course, mobile crisis is going to focus on de-escalation. And they do that through building rapport, grounding people, remaining focused on that person's needs, taking a trauma-informed approach, and providing them with some really practical strategies. There's also a huge emphasis on safety, and that, of course, is the primary focus of a mobile response, is to establish the safety of the individual involved and then to develop an appropriate treatment and or safety plan from there. Mobile, of course, also is very focused on diversion, as all crisis services are. And again, these are the same types of diversion tactics that all crisis services hope to do, reducing the involvement of any kind of non-mental health service in a mental health crisis, reducing the need for higher levels of care or out-of-home placements, and reducing negative legal entanglements. There also, of course, is an emphasis for mobile on right-sizing the interventions and linkages, recognizing that the treatments of care or treatment planning should be an individualized process. Peers are particularly good at helping to focus that process on the person sitting in front of you and really connecting with them in a personal way to identify the natural supports and resources and skills that this person already brings to bear, which is ultimately gonna be the foundation of the most effective kind of safety plan or treatment plan that you can develop with a person. Next slide. So again, when we think about the roles that peers can play on a mobile crisis team, they can be pretty varied. When I'm thinking of mobile crisis team, I do think of a team that includes typically a kind of clinical responder, which may be a licensed or in some cases, perhaps an unlicensed clinician with appropriate training and skills. They may also include nurses or other allied medical professionals. They often include peers, and they may also include other types of paraprofessional crisis specialists. Mobile teams responding in the community, of course, are typically going to be composed of two or more responders who go as a team to support safety. And so it's a particular, I've seen particularly effective to have clinicians responding with peers. And as long as those team members are able to respect each other's roles and support each other's roles in that encounter, those, that composition of a team can be incredibly powerful and incredibly effective. The ways that peers contribute, again, are aligned with all the things that we've been talking about. They're so good at building rapport, instilling hope. They can assess and support readiness for change in a person. They're also able to really help the assessment focus on immediate needs, risk factors, protective factors. They can help to identify supports and resources and provide some practical tips and strategies for safety planning and accessing care. Again, as with the call center, follow-up is an important component of a mobile crisis encounter. And as with the call center, peers are, again, a very natural, strong fit for this kind of follow-up. Next slide, Winnie. And I'm going to turn it back over to Wendy, too. Wendy, we just lost your slides. Are the slides back? Yes. Okay, excellent. So, yes, I'm going to take the helm for a second and talk about crisis stabilization units and crisis service centers. So, you know, we just kind of wrapped the someone to call and the someone to go. And then the predominant emerging model around the country right now for the somewhere to go is crisis stabilization units or crisis service centers. And so these are specialized, localized crisis settings for behavioral health specifically. And they're an established site, generally certified by some state entity. And it includes a variety of staff at that location who form together a crisis response team, very similar to mobile crisis, but more comprehensive, generally a larger cadre of professionals and who those still work together as a team to stabilize an individual who is in crisis, either in a brief moment, so just having a few hours of intervention, having some observation, like through a temporary observation function where you might have recliner chairs, or there may be an admission for this kind of acute residential support where you are overnight, you remain overnight for a few days for the stabilization process. So the practitioners who comprise that team are generally physicians, preferably psychiatrists, but always generally a physician or an extended practice, a physician extender, nurses, social workers, counselors, peer specialists, and then other peer professional specialists who may be just trained in crisis intervention. So, and then depending on different jurisdictions around the country, this can be a voluntary service or it can be an involuntary service. They can be highly partnered with law enforcement or lower engagement with law enforcement. Many of them can prescribe and administer stabilizing medication and it's very short term in duration. And I always like to cite a friend and colleague who worked in Georgia for many years, Sherry Jenkins Tucker, who always said there is no wrong place for a peer specialist. And in this case, I think many dialogues around the country have some concern, right, about when somebody has to be involuntarily treated. And in Georgia, very specifically, the state which I am representing here today, a lot of folks were like, do we want peer specialists to actually work in a place where there may be involuntary treatment? And our peer specialist leadership a while back just said, we want to be everywhere where somebody has the opportunity to receive support. And so long ago in Georgia, we began to build in the capacity for peer specialists in crisis stabilization units. And many, many, many states now have adopted having peer specialists on their staff for these facilities as well. So crisis stabilization units around the country also have some variety that's called like a living room model. And I have the quotations around this because it can be a variety of different approaches, but that's been a term that's been coined where a lot of crisis stabilization units have an adjacent designated area that may be less medicalized, may feel warmer, more homey, and the interventions are more engaged in this kind of recovery framework. And this has emerged as a really significant opportunity for having peer specialists engage with individuals in that crisis moment. So again, the place feels more like a home environment than a clinic or a hospital or the crisis stabilization unit that is adjacent. It is more of a friendly, accepting and supportive environment. It leads with respect, dignity and nonjudgmental acceptance. There's generally a policy of never using restraints or seclusion in that area. So again, if you think about the crisis stabilization unit definition from the previous page and the idea of sometimes law enforcement is involved with transporting individuals or bringing individuals in for their stabilization alternative and that being kind of one side of a facility, this type of adjacent living room approach is much more targeted to individuals who in no way are posing a significant threat to others or an immediate threat to themselves, but are still experiencing a significant self-defined crisis. Again, most of these models around the country are leading with peer support workers. There may also be intervention from professional counselors that can be in the form of training peer specialists or it can be individuals who are serving side-by-side in partnership with peer specialists and then generally providing linkages with emergency housing, healthcare, food and other services. And then again, as I indicated, transportation does not involve law enforcement and it's often attached to a CSU. So then I also want us to contemplate a little bit about outpatient peer support. So around the country, we have a thin but historical infrastructure that has traditionally been branded CMHC, Community Mental Health Center, approach to the public sector behavioral health benefit. And so many of these agencies now provide peer support on an outpatient basis. Additionally, in the past few years, Congress and HHS through the Federal Centers for Medicare and Medicaid Services, as well as through SAMHSA, have both been rolling out a new model for this type of community behavioral health intervention called a Certified Community Behavioral Health Clinic. And those entities that are now emerging around the country are also required to provide peer support. And so for those of you who may be working in a CMHC, a traditional CMHC or a traditional addiction community clinic, or you are in the process of becoming a CCBHC or are certified as a CCBHC, your role in crisis intervention is crucial. And then particularly considering peer support and employing certified peer specialists is really a necessity in these localized outpatient models. So I think it is important for all of us to not just think about the crisis support and intervention moment, but also diversion, which is really working with an individual to deploy all of his or her local outpatient supports, natural supports, to engage in the prevention of having to use a more restrictive intervention for crisis, or actually there's a critical role in also preventing crisis. And so we wanna spend just a few minutes talking about these crucial aspects of crisis intervention where peers have a significant role. So in many areas around the country, certified peer specialists are leading transition programs who support individuals leaving hospitals and prisons. And so that engagement with individuals who may be having experienced a removal from community for a moment because of a crisis stabilization need, or in the case of a prison who've just been removed from society for a while, this is a significant transition back to a new life and a new structure, a new culture. And so these points in times are really important for individuals to have peer support intervention where individuals are talking about self-management, they're talking about hope, they're talking about maintaining progress that they've been making on their behavioral health condition, and particularly talking about recovery. Crisis prevention plans are crucial in these outpatient models so that an individual begins conceptualizing how he or she, how they want to really consider what if I have a crisis again? What would I like to have happen? How can I self-direct that? What are the resources I want to bring to bear in that so that when there's a crisis, if there's a crisis, that they are really considering and bringing resources to bear for their personal best intervention. Of course, ongoing peer support is crucial to this outpatient model. Considering alternatives to suicide, wellness recovery action plans, enhanced support and harm reduction practices so that individuals are really kind of taking on the ownership of their behavioral health plans, their behavioral health services and their approach to recovery and wellness. And then there's two other really niche areas where peer specialists are emerging in the crisis response area that are, I think, highlights for the attendees today. So for somewhere to go, around the country, there are a variety of peer respite wellness centers. And so peer respite is often defined as being voluntary, very short-term, and it's an overnight program in many cases that can provide a community-based, very non-clinical crisis support to help individuals find new understanding and ways to move forward from that sense of crisis they may be experiencing and to be able to return to family, return to work without a significant, more complex, more highly intervention-oriented model like crisis stabilization or inpatient. So many of these operate 24-7 hours per day, and again, it's a home-like environment. And generally, these are being run by... Sorry, my slide jumped. Generally, these are being run by peer-run organizations or they're being overseen by an advisory group with 51% or more members of the advisory group or a board having lived experience of significant crisis or the behavioral health system. And those are a nice complement to some of these more intense, highly-staffed models for crisis stabilization. And then someone to talk to, and Eric mentioned this early in the presentation, but peer-staffed warm lines are also an amazing alternative. And in Georgia, we have two peer-run organizations who assist us with this, and we consider them an amazing complement to our crisis call center. So these warm lines, it often are set up for certain hours or for 24 seven, where you have someone to respond on a call, text or chat, who would respond to you as a person who has experienced a behavioral health condition and who are trained to help engage with somebody in a way that is crucial to their behavioral health, wellness and stabilization. We have volunteers, but we prefer a professional model where folks are engaged on and being paid to provide these services. They're recovery focused and they include training about when and how to make referrals to potentially other crisis services. So if they feel like they have provided dialogue to an individual, support to an individual, but that that is simply not resolving the crisis, they are prepared with certain protocols to know when and how to make those referrals. And then the best case scenario, of course, for that is to have warm connectivity to the 988 call center. So established protocols, for instance, the call center recognizing the number from the warm line when somebody is going to be calling over and experiencing those types of warm transfers. So at this point, Eric and I are just gonna engage in a little bit of dialogue for a few minutes before Q&A, just about the unique roles of peer specialists in the crisis system based on our experiences. And so Eric, I would just love to kick it over to you to kind of make some comments on some of the roles that we've got laid out for the group. Sure. One of the things that I wanted to really talk about was my experience through more of a managerial position about how you can lead an organization into the integration of peers. I had the privilege really of working with an organization in Georgia that did such an excellent job of integrating peer specialists into the crisis where they were doing for crisis call center and mobile crisis response. And I think the things that you need to consider, like if you're an organization, you're considering how you can maybe start from square one with this or improve your integration. I think the important thing is reach out to a peer organization or to a peer group to really get their feedback and to consult with them and understand. Understand as well that while it's difficult for me to imagine why anyone would, but some clinical folks have resistance to thinking of a peer as a colleague in a crisis realm. And I'll be very honest, there were times when I was responding to a mobile dispatch as a clinician and I kind of felt out of my element because the peer was so effective at reaching this person in crisis and really doing the work of building rapport, instilling hope and focusing on those practical safety planning techniques. So anything that you can do to role model that kind of acceptance and integration in your organization is wonderful. As a manager, get out there and do some work and show people what it's like to work with a peer and recognize that a peer can be a crisis expert just as much as a clinician. Just because the peer doesn't have a particular set of letters behind their name, they are very skilled at doing crisis work. And as I've said, I've seen firsthand they can be better at it than me in some cases. And so I had to take my ego and put it in check a bit. But that was a really good lesson for me to learn. And I think that's a lesson that a lot of teams would do well to learn as well, to really see peers as a true peer, an equal peer on a crisis team in the role that they can play. Some things to consider would also be about making sure that your policies are inclusive of peers and that your policies support that kind of integration. Even just the workflows that you use in your organization, make sure that you've had a peer or a peer organization to review them and to give that feedback and to think about ways that that workflow might unintentionally exclude the peer influence or the peer voice from the work. And I know that we're kind of running close on time, but that's something I thought was really important for folks to think about is being as an organization very proactive and intentional about including the peer voice in your work. And I can guarantee that after you've had peers integrated into your system and starting to do the work, you will learn very quickly, if you haven't already, just how effective peers can be at doing this work. Absolutely, Eric. Thank you for that. And I'm just going to wrap up with a couple of reflections and then we'll move to the Q&A. The one thing I just wanted to reflect on, and I think you indicated this, that sometimes a peer has a very niche way of bringing their lived experience to bear in that situation, and it so activates engagement. So again, in these crisis scenarios where somebody is feeling particularly hopeless, the infusing of hope becomes so critical. And I just wanted to reflect, particularly I've seen this in some crisis stabilization settings, that it feels like at that point there's a lot of loss of controls. You're already in crisis, and for instance, you may have been brought in by law enforcement and you are being rapidly assessed. There's just a sense of not being in control in that moment of your own self-wellness. And I found that when peers come in and are able to say, just do a quick introduction to explain briefly, you know, I have been there, and, you know, I'm trained to be a helper to you right now in this moment. As someone who has been in crisis before, has experienced a significant behavioral health condition, it creates this immediate alliance and kind of brings this hope, and it brings, you know, some sense of, okay, we're going to pull this together. And it's not always that type of situation, but when it happens, it is such an extraordinary thing for the individual who is experiencing that unique crisis in the moment. And then finally, I do want to just mention for a minute about the promoting recovery in service culture. So when peer specialists are on a team, the amazing thing that I think those of us who've had the opportunity to do peer-partnered work is to see the impact that the peer specialist has, for instance, like Eric was just sharing, on the way he approached these crisis interventions. These teaming models where you have multiple practitioners, the whole team then can become more focused on hope and recovery. And in that way, it begins to change the culture of that site, and it begins to change the culture of the agency. And then what I've seen, particularly in Georgia, as well as in other states, then that recovery mentality is contagious. And it's contagious in the best ways. And so anytime we can also recognize that the culture can be so impacted by a unique mindset and approach of this lived experience, I think can't be understated. So I think as any of you who are implementing crisis services, just being aware and prepared and open to that kind of radical change that can happen in the service culture to be more about the mindset of wellness and recovery. And then, again, we've just provided some resources here that we referenced earlier, but want you to have access to in the follow-up for these slides. Wendy and Eric, thank you for such an interesting presentation. And before we shift into Q&A, I want to take a moment and let you 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 reading skills, and even submit questions directly to our team of SMI experts. You can download the app from the link And I've seen a lot of wonderful questions coming into the chat. I'll start off with a great question. Someone asking, how would you navigate a peer potentially getting triggered during mobile crisis visit? I understand scenarios vary case by case, but I'm wondering what training, if any, is provided to mitigate such reactions. And then, I'll turn it over to you, Wendy, to answer some of those questions. Thank you. I'm wondering what training, if any, is provided to mitigate such reactions. I think that's a really good question and something that it's wise to anticipate. One of the things that is really critical when selecting peers for your mobile crisis team, just as with selecting any other member of your mobile crisis team, is doing the proper interviewing and kind of screening process. You know, just because someone has clinical training doesn't necessarily make them a particularly good crisis worker. The same is true for peers. Just because a peer may have a particularly strong work history or experience doesn't necessarily make them particularly well-suited to crisis work. So, I think a lot can be done by properly screening and using people who have demonstrated success as a crisis worker to be involved in that process and that hiring and interviewing process and really selecting the right folks. And then, of course, because inevitably, even with all the careful preparation in place, something might happen, I think really giving your supervisor staff proper training in how to effectively train peers. You know, consider having a peer in a supervisory role or an advisory capacity for your supervisor, someone who has, like, expertise. You know, on the mobile teams that I operated in Georgia, it was standard practice for us when any team member went through a particularly stressful event to hold a debriefing and to pull them out of the work and to provide them any support that they needed. And I think that's really critical. You're right, it's very case-by-case, and your response should be tailored to the particular needs of the people who were involved. But those are some strategies I would suggest to kind of be prepared for that possibility. Excellent. Thank you. And I know you talked about how peers are integrated among a clinical team. We have a question in the chat about how police accept working with peers in crisis situations. As far as my experience has been, when law enforcement is engaged with a mobile responder in particular, I've never known them to really get hung up on what the expertise is of the people on scene. You know, when you present yourself as a unified team and you've done the work beforehand to build those relationships organization to organization, and then you have kind of an awareness of each other in the community, I've never personally experienced that as an issue with law enforcement. I do think, however, that anytime you work with law enforcement, that preparation is so important. Having those meetings and having that collaboration before you get to the point of actually responding to a crisis together. Go to roll calls and sit down with leadership. Be sure they understand your team, your organization, what's your scope, what are the expertise that you bring, what are all the reasons why you're qualified to do this work? And I think as long as you've established that in advance, of course, you can't ever predict what a particular one-off situation might turn into. But like I said, I've never had a law enforcement encounter go south because there was a peer involved at all. Great information. And we have a question that I'm sure is relevant for a lot of people in our audience, given workforce, asking how you can recruit peers. There's someone who said she was having trouble finding peers and is looking for suggestions about how to recruit peers. I will begin. Yeah, I was just gonna say, I think a lot of it is having a great job description, which then I think really hinges on a relationship in an agency with your HR team and being sure that you really advertise in a way that shows the meaningful role for the peer specialist, defined very clearly what they would be doing in whichever one of these roles that Eric and I have shared. And then also like being really clear about the support that that individual will receive on the job. Because I think a lot of these scenarios like with mobile crisis teams, or sometimes if you're thinking about anything in the co-responder realm, you want to feel supported. It doesn't matter if you're a peer specialist or not, anybody who is gonna deploy into kind of a situation where there may be a crisis wants to feel supported. So even articulating that type of support that will come from the agency, I think helps that. The second thing I'll just quickly say is engage with the certifying bodies, right? So when individuals are being certified, there's generally kind of maybe a peer run organization helping with that certification, or the state is leading a certification or a university, be sure that you are connected with them so that when you have jobs, if there's like a listserv, or if there's a website where peers are going to engage with more often because they're registering their CEUs or seeking CEUs that are required in many states, that then they are learning about these job opportunities through those hubs. Eric, anything else you wanna say as someone who recruits more often on a daily basis? To be honest, in crisis work, the majority of my recruiting strategy has relied heavily, I mean, well, I mean, we've always tried everything, but word of mouth winds up being the best way to recruit people really to crisis work in my experience. And you'll find that there are communities of peers, and if you can tap into a community of peers, you'll typically develop a kind of pipeline for folks who are like-minded and usually generally well-qualified for the work. Oh, wonderful insights, thank you. And with that, I will move over into our housekeeping and our consult slide. If there are any topics covered in this webinar that you'd like to discuss with colleagues in the mental health field, post a question or comment on SMI Advisors Webinar Roundtable Topics Discussion Board. This is an easy way to network and share ideas with other clinicians who participate in this webinar. If you have questions about this webinar or any of the other webinars, please feel free to reach out to us at the SMI Advisors Roundtable Topics Discussion Board. If you have questions about this webinar or any other topic related to evidence-based care for SMI, you can get an answer within one business day from one of SMI Advisors National Experts on SMI. This service is available to all mental health clinicians, peer support specialists, administrators, and anyone else in the mental health field who works with individuals who have SMI. It is a completely free and confidential service. Next slide. 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 through the Homeless and Housing Resource Center, the Center of Excellence for Behavioral Health Disparities and Aging, the Suicide Prevention Resource Center, the Peer Recovery Center of Excellence, and Mental Health Technology Transfer Centers. These initiatives cover a broad range of topics relevant to your practice. Next slide. 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 may take up to five minutes. You'll then be able to select Next to advance and complete the program evaluation before claiming your credit. Next slide. Please join us next week on March 23rd as Dr. Mark Munz presents the Sequential Intercept Model Using Assisted Outpatient Treatment to Reduce the Need for Competency Restoration. Again, this free webinar will be March 23rd from 3 to 4 p.m. That's a Thursday. Thank you for joining us. Until next time.

peer specialists

crisis intervention

recovery-focused care

serious mental illness

crisis contact centers

building rapport

safety planning strategies

proper training

collaboration with law enforcement

job descriptions