In honor of National Recovery Month, we spoke with MC Violet Taylor, CPS, Regional Peer Bridger, a consumer in recovery who works as a peer specialist in Northern Virginia. She recently participated on the Consumer Panel "Recovery Perspectives on Medications" at the APNA 9th Annual Clinical Psychopharmacology Institute and currently holds the Community Bridger position as an adjunct to the Nursing Department at Northern Virginia Mental Health Institute. She generously took the time to answer a couple of questions and tell us more about her work as a Peer Bridger:
How did you get into Peer Bridging?
I came to Northern Virginia Mental Health Institute (NVMHI) by way of a pilot project that was developed between a local consumer operated employment center called the Laurie Mitchell Employment Center, (LMEC) and NVMHI’s Center of Excellence called the Regional Community Support Center (RCSC). The RCSC and LMEC joined together on a pilot project which developed a position for a Peer Bridger at NVMHI. After the grant money ran out at LMEC, NVMHI decided to keep the position and I have been working there ever since. In essence, this consumer-professional collaboration in many ways defines what we’re hoping to see more in practices: a lot fewer power-differences, and a lot more healthy egalitarian relationships where we treat each other and ourselves with respect; where we collaborate together in a healthy way for everyone.
In the very first introductory meeting with hospital staff I mentioned that I spoke several languages. I was immediately put to work with a consumer going to go out to a group home who couldn’t hear or speak well, and was illiterate. Fortunately, limited English proficiency was not an issue to me. I tried to 'wake up' the consumer while a psychiatric technician was stood beside me. I soon realized that the consumer understood “home” and “house,” but had no idea what a group home was. The psychiatric technician started describing what goes on in a group home and while she spoke, I mimed eating, sweeping, and all the things people do in group homes. The consumer was mesmerized as I kept signing, “Yes! You’re going to eat and sweep and do lots of things, you! Your house!” Pretty soon the psychiatric technician and the consumer were laughing at me acting such a fool, and before we knew it, the consumer was ready to go and visit the home. The consumer is now very happy in the community. She has a tutor, she lives in a beautiful group home, and has many benefits in life that she never had before. This consumer also taught me one very important lesson: Do not assume to know the person’s past. The group home was the finest, biggest house that the consumer had ever been in.
Tell us a little about what you do as a Peer-Bridger.
Even before I can introduce people to services and resources in the community, I have to build a solid and trusting relationship with my peers, and role model how to make healthy relationships happen. With a mutual trust, we can find out what the person really needs but may not want to say to the treatment team. They know I don’t diagnose and that I’m discrete. If I run into problems I ask my supervisor - she’s a nurse and has probably run into the situation before. I role model professionalism for my peers as well: how adults work together, and how our personal ethics are the foundation for a good relationship.
I leave time for helping people find work, taking them to the DMV, and showing them where things are in the community that will be important to them upon discharge. I take people to community events where they can network for support, jobs and housing with other peers. I also work alongside the social workers and other treatment team members. Recently, I worked with a man that will be discharged into what he considers to be a rural area, yet within ½ mile there is a huge mall, hospital, etc. where he will be able to find work. I took him and his interpreter (English is not his primary language) to the area so he could see all there is to offer. I’ve taken people (along with two cats) to DC’s train station. I've driven a young peer who needed to be near family members to a shelter over 120 miles away. All of these tasks are simply different forms of helping someone transition back to the community.
It's nice that I normally don’t do these tasks alone - I am often able to take a peer who is still receiving services in the hospital out with me for the day. It is a great way for that peer to see there is life outside of the hospital and to see people in recovery. These outings can be a source of hope for people! One thing about driving people is you have a captive audience and so do they. This is a good time for peer counseling. That means I’m listening, just listening. Not being heard is the major complaint of people in psychiatric hospitals.
What is a typical day like?
Currently I lead about 10-14 groups per week in the hospital. My day starts on one of the inpatient units. I work alongside the nursing staff, infusing recovery principles into all that we do. We start with the “community meeting” where people gather on the unit for announcements and updates. The community meeting can include a vocabulary quiz, trivia questions, or just an interesting question of the day to get the synapses firing. People come and go from the hospital. We meet people where they are. When people first start coming to the daily community meetings, they may be having a lot of difficulty, but then they become healthier and stronger and before you know it, they are leading the community meetings, and then they get discharged! We see miracles and great changes happen. From my perspective, I see people being patient, resilient and stronger than I’ve ever been, and when I see someone with a sense of humor, well, that’s the best thing to see and hear - that’s health!
My day for the most part, is filled with little things, little chores and details to help our consumers. Obtaining a pair of socks, some toothpaste, “…can I call my dad in Oregon?” and so many other little tasks that mean a lot to a person. Sometimes just a smile…. This may sound a lot like your day! Taking people to picnics, conferences, celebrations, presentations, and even stand-up comedy is also part of my job. I find that people who are in the hospital a long time sometimes need a place (alongside a peer) to brush up on and practice their social skills. They need to see how others are dressing and acting and how they are dealing with things. They watch me and we learn a lot from each other. Several places in our area have hired us to help cater and manage an event, or work the parking lot helping people park and assisting them with getting to the right building.
Along with these tasks, I keep my supervisors aware of things going on in the community, like drop-in centers opening or closing or moving, who’s hiring, if it’s a consumer-run program, and how the leadership in the mental health recovery community is doing. Keeping my supervisors aware of what’s shaking around the area in the consumer/recovery community is important. All of this impacts the lives of people in the hospital, and may open up opportunities we never had before.
It’s proven that employment helps people recover. The schedule and routine helps with getting enough sleep and taking meds. Life falls into a healthier pattern with a paycheck and the status of working and being independent. When I first started here, one consumer partnered with me to establish peer-led groups. While he was here, we had 27 peer-led groups every week! Whew! What I found was that the consumers receiving treatment as inpatients had worked or had families before and were really looking forward to increasing their responsibilities. We trained consumers in group facilitation and they were dependable and accountable. They are all out of the hospital now, and most are working. I did promise them one thing if they volunteered with me and helped me keep these groups going: that I would write them a letter of reference for being my “motivational group facilitator.” It worked! They didn’t have such a big gap on their resumes when they went to look for work. We’ve had people leave and go into drug and alcohol programs as peer specialists, as auto technicians, accounting technicians and many other occupations. More importantly, they haven’t come back!
What are the challenges of the job and what parts do you most enjoy?
Wow, it seems like every day there are so many challenges. I would say that keeping myself on an even keel all day is difficult some days. Keeping myself strong against burn-out and becoming over-tired, these are challenges. Ninety percent of my day is face-to-face contact with consumers and it’s usually non-stop. It’s no news to say that there’s never enough space, time, private meeting places, and quiet time in our days. Just battling uphill to place a person’s humanity before bureaucracy and finding a pathway to do this is a great challenge, and one that I enjoy. I can see a few small cracks in the foundation of the old system when I’m able to outmaneuver some nonsensical policy and actually help someone with what they need. I will say one of the greatest benefits to this job is I have so much peer support! Even in my very dark moments, another peer will intuitively reach out to help distract me. Repairing personal relationships is hard after lengthy hospitalization or rehabilitation. We talk among ourselves about how we have to deal with things, and to hear that a father or mother has gotten visitation rights or is working on getting their children back, this really makes me feel great. Miracles that I never knew would happen on this job – these buoy my spirits.
How has your perspective changed since you started?
I found out that a lot of what I think and do are actually the right things! I thought there was some big secret about mental health and diagnoses, and it turns out that as human beings we all struggle with something in life; some struggles are more difficult than others. I have found that people with faith or some spiritual beliefs, fare better. Practicing our spirituality does enrich our lives greatly in many unspoken, undefined ways. Yes, and I’ll admit that I hadn’t met so many professionals in the mental health field before, and the staff here are as diverse and opinionated as our community is. And all of that is really great! Everyone has a preference and responds differently to different approaches, so it seems to me that diversity is one of our greatest assets in the workplace.
You use two different recovery formats – could you tell me a little bit about each of them?
I’ve been trained and am certified to lead the NAMI Peer-to-Peer groups. This program leads people through a workbook. There’s a lot of DBT information, as well as explanations of various diagnoses. There is a section on medications, and there is a place for a family member to come in and speak, as well as a time people can speak. Everything is very structured, and much of the time, people are sitting reading from large workbooks. When you’re through with the class, you’re done. A lot of people like the format of the class.
About 5 years ago, consumers across the Commonwealth of Virginia chose to use the Wellness Recovery Action Plan (WRAP) from the Copeland Center as our recovery tool. There are over 13 different recovery “formats” or plans. I have a WRAP plan. I got well and stay well with it. It’s simple, and adaptable to many situations. In WRAP groups, people get to know each other; they form relationships and start sharing their wellness tools with each other. WRAP groups have a format, but the facilitator has the discretion to change the format as needed. I prefer using the WRAP because you don’t have to use all of it. When I started, I could only manage the “Daily Maintenance” section. That worked for me, and helped me heal to the point of being able to create my action plans which ultimately led to my completing my own WRAP. I re-work my WRAP every few months, and keep improving my health. I’ve also kept a lot of the peers I was in group with as friends today. WRAP is more about a healthy lifestyle and WRAP stresses there are no limits in recovery this is so very hopeful. I really enjoy these groups.
Any closing thoughts?
Current research shows that when Peer Support Specialists are on the job, your job becomes easier, and you’re much more effective. If you don’t work with a good Certified Peer Support Specialist, get one! As people in recovery, Peer Support Specialists are role modeling everything you’ve been trying to tell people. In my opinion, working with nurses has been great, because what you say in your way, I say or enact in my way for my peers. The recovery concepts, wellness tools, or mental health education is being processed audibly, visually, and tacitly through healthy relationships in many ways. This is a successful approach.
To listen to the recording of Violet Taylor's session at the CPI Conference, visit the APNA eLearning Center.
*An Oxford House is "a democratically run, self-supporting, and drug free home." http://www.oxfordhouse.org/userfiles/file/purpose_and_structure.php