Expanding the Peer Bridger Program
Overview of Problem
Psychiatric hospitalization, while often life-saving, can be a traumatic experience for people with serious mental illness and their families. Hospitalizations occur at times of crisis or severe distress, times when it is difficult to absorb the large amount of information about a new diagnosis and its management that is offered by clinical providers. This lack of information and resources can interfere with effective outpatient treatment, and increase the risk for re-hospitalization and adverse social outcomes (such as unemployment, homelessness, and incarceration).
The Peer Bridger program is an evidence-based intervention that has been shown to reduce hospitalization length of stay, and to improve quality of life and reduce re-hospitalization rate after discharge from psychiatric hospitals. Program staff are state Certified Peer Specialists who have had experience living with mental health and substance use challenges. Peer Bridgers provide information and resources, create a trusting relationship, and help people who have been hospitalized stay motivated for recovery. A recent two-year demonstration program in two King County psychiatric hospitals resulted in reduced hospital use and increased engagement in community-based mental health services among the 494 clients it served. The model, however, is available in only a few inpatient facilities. Moreover, the program focuses on the individual who is hospitalized, and does not address the needs of families who may also be in crisis.
To expand the mental health workforce in WA state through individuals with serious mental illness and their family members serving as “bridgers” from crisis settings back to the community.
First, individual Peer Bridgers could be deployed within the WA Recovery Help Line, a service of Crisis Clinic, that is a 24-hour crisis intervention and referral line for those with issues related to mental health and substance use. This central service coordinates assessments for involuntary and voluntary hospitalizations, and emergent evaluations in community settings. Under the supervision of mental health professional staff, Peer Bridgers could extend the outreach and engagement services that WA Recovery Help Line is able to provide.
Second, the Peer Bridger model could be adapted as a Family Mentor intervention to provide critically needed support and education for family members of youth and young adults who have a first psychiatric hospitalization for psychosis. An initial focus on this special population will provide the opportunity to develop this role to align with the evidence-based Family Psychoeducation intervention, a core component of the Coordinated Specialty Care for first episode psychosis.
Confirm priorities with King County leadership
Develop Peer Bridger support model with Medicaid. Connect with Medicaid providers and begin to develop a payment plan and model.
Develop a plan for integration of community health workers into the Peer Bridger Model. Experiment with a model in one setting by May, 2018.
Please contact Topher Jerome (topher.Jerome@kingcounty.gov) for information on how to get involved in expanding the Peer Bridger program in Washington state.
Lydia Chwastiak, MD