2690 TA Session Presentation for CRSS Success Program (814)

  1. CRSS Success Program Objectives
  2. Scope of Services
  3. Definitions
  4. Evidence for Recovery Support
    1. Feasibility Studies
    2. Comparison Studies
    3. Person-Centered Care for Psychosis
    4. Recovery Mentor
  5. Comparison of CRSS & CPRS
  6. Performance Domains
  7. Self-disclosure
    1. Mentoring & Self-Disclosure
  8. Recruiting Students
  9. Program Components
    1. Classroom Component
    2. Supervised Practical Experience Component
    3. Affiliate Agreements
    4. Faculty Standards
    5. Training Program Evaluation
    6. Wrap-around Supports
    7. Data Collection & Reporting
  10. Resources
  11. Questions & Answers

CRSS Success Program Objectives

  • Broaden and strengthen the pipeline for individuals to enter the behavioral health workforce
  • Increase the number of individuals in Illinois who successfully obtain the CRSS or CPRS through the Illinois Certification Board
  • Increase the number of CRSS and CPRS certified individuals employed by mental health and substance use providers that receive funding from the State of Illinois

Scope of Services

  • IDHS/DMH will contract with colleges and universities to:
    • Develop high quality recovery support training
    • Coordinate supervised practical experience (internship) opportunities
    • Provide wrap-around supports

Definitions

  • Recovery Support Specialist: A professional employed specifically to use their own lived recovery experiences to support the recoveries of others and help improve the overall system of care. Recovery Support Specialists work in a variety of systems, including:
    • Mental health treatment and recovery
    • Substance use treatment and recovery
    • Crisis response systems
    • Primary care
    • Jails, prisons, courts, and other components of the justice system
  • Lived experience: The experiences and choices of a given person, and the knowledge they gain from these experiences and choices

    1 SAGE Encyclopedia of Qualitative Research Methods

  • Lived expertise: Personal knowledge about the world gained through direct, first-hand involvement rather than through representations constructed by other people 2 OxfordReference.com  
  • Recovery:
    • The process in which individuals are able to live, work, learn and participate fully in their communities. For some individuals, recovery is the ability to live a fulfilling and productive life despite a disability. For others, recovery implies the reduction or complete remission of symptoms. Science has shown that having hope plays an integral role in an individual's recovery. (New Freedom Commission on Mental Health, 2003)
    • A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. (Substance Abuse and Mental Health Services Administration, 2006)
  • Illinois Certification Board (ICB): A private, non-profit organization that writes and publishes standards for non-licensed substance use, gambling, and mental health recovery professionals in Illinois. ICB's professional standards meet or exceed all international standards for practitioners. ICB's credentials verify an individual has demonstrated competency through minimum standards in the areas of education, work experience, professional and ethical standards. ICB owns the CRSS credential and exam. (ICB originated in the field of substance use and it continues to "do business as" IAODAPCA).
  • Certified Recovery Support Specialist (CRSS): A competency-based credential designed for individuals with lived expertise in recovery from mental illness or co-occurring mental illness and substance use recovery.
  • Certified Peer Recovery Specialist (CPRS): A competency-based credential designed for individuals with lived experience in any aspect of life/recovery. CPRS is not limited to mental health/substance use recovery and therefore opens the door for individuals with lived experience to be trained and certified to work in a variety of different capacities in the human services field.

Evidence for Recovery Support

Feasibility Studies

  • Feasibility studies showed that it is possible to train and hire individuals with histories of severe mental illnesses to serve as mental health staff
    • Four randomized controlled trials
    • Individuals with self-disclosed lived experience were able to produce outcomes at least on par with those produced by non-self-disclosed lived experience
    • Two studies showed slightly better outcomes for individuals receiving recovery support in addition to usual care as compared to those receiving usual care only

Comparison Studies

  • Comparison studies: compared staff with self-disclosed lived experience with traditional staff, with both functioning in conventional roles, such as case managers, rehabilitation staff and outreach workers
    • Staff with self-disclosed lived experience functioned at least as well in these roles as traditional staff, with comparable outcomes
    • Services provided by staff with self-disclosed lived experience generated superior outcomes in terms of:
      • Engagement of "difficult to reach" clients
      • Reduced rates of hospitalization and days spent inpatient
      • Decreased substance use among persons with co-occurring substance use disorders

Person-Centered Care for Psychosis

  • The addition of a person-centered care facilitated by a person with self-disclosed lived experience:
    • Increased the degree to which participants felt their care was responsive and inclusive of non-treatment issues
  • Community connector program run by RSS
    • Increased their sense of hope and degree of engagement in managing their illnesses
    • Increased their sense of control and ability to bring about changes in their lives
    • Decreased their level of psychotic symptoms

Recovery Mentor

  • Participants assigned Recovery Mentors did significantly better than those without an RM
  • Statistically significant findings for the number of hospitalizations and the number of days spent in the hospital
    • Admission events (0.89 vs 1.53)
    • Number of hospital days (10.1 vs 19.1)
  • Significant decrease in substance use for people with RM services
  • Decrease in depression and increases in hope, self-care, and sense of well-being

Comparison of CRSS & CPRS

CRSS

  • Must have lived expertise in recovery from mental illness or co-occurring mental illness and substance use challenges
  • Recognized as "mental health professional" in Illinois Medicaid Rule 140 (mental health provider billing code)
  • Included as a requirement for many State mental health provider grants
  • Non-transferrable outside of IL

CPRS

  • Must have lived expertise - can be recovery from substance use only
  • Not yet recognized by Illinois Medicaid Rule 2060 (substance use provider billing code)
  • Included as a requirement for many State substance use provider grants
  • Reciprocal across states

Pre-requisites: 1. Minimum high school diploma, GED, or equivalent; 2. Willingness to self-disclose lived experience

Performance Domains

CRSS

  • Advocacy
  • Professional Responsibility
  • *Mentoring
  • Recovery Support

CPRS

  • Advocacy
  • Ethical Responsibility
  • *Mentoring and Education
  • Recovery/Wellness Support

*Mentoring includes self-disclosure

Self-disclosure

Mentoring & Self-Disclosure

  • Self-disclosure: Individuals who obtain either CRSS or CPRS certification agree to share their lived experience with their colleagues and the individuals they serve.
  • Mentoring: Effective use of self-disclosure is one of the competencies in the domain of mentoring
  • Hope and Trust: Positive self-disclosure increases individuals' sense of hopefulness and increases their ability to engage in a trust-based relationship with the provider
  • Superior Outcomes: Services provided by individuals who share their lived experience with the people they serve have been shown to generate superior outcomes in terms of:
    • Engagement of "difficult to reach" clients
    • Reduced rates of hospitalization and days spent inpatient
    • Decreased substance use among individuals with co-occurring mental health and substance use disorders

Recruiting Students

Lived expertise: Students will develop the knowledge, skills, and ability to use their personal lived experience in recovery from mental health and/or substance use challenges to help others who are seeking support and assistance in their recovery process.

Regions and districts: Depending on how many awards are granted statewide, grantees may want to consider recruiting students out-of-region/out-of-district.

Occupational Outlook: According to the Bureau of Labor Statistics, employment for social service occupations is expected to grow 13%-17% by 2026, faster than the average for all occupations.

  • Behavioral health workforce shortage
  • Certified community mental health centers (DMH)
  • Licensed providers of substance use services (SUPR)

Program Components

All activities should follow the standards outlined in Peer Recovery Support Training Program Accreditation Standards for CRSS and CPRS, issued by the Illinois Certification Board.

NOTE: This list is not comprehensive. For the comprehensive list of standards, refer to Peer Recovery Support Training Program Accreditation Standards for CRSS and CPRS posted on the NOFO webpage.


Classroom Component

  • Minimum of 110 clock hours of training
    • 1 college credit hour = 15 clock hours
    • 40 hours recovery support specific
      • minimum of 10 hours in each domain:
        • Advocacy
      • Professional/Ethical Responsibility
      • Mentoring & Education
      • Recovery/Wellness Support
    • 16 hours in professional ethics and responsibility, with primary emphasis on the CRSS/CPRS Code of Ethics
    • 54 hours in the Core Functions
      • 5 hours specific to family
      • 5 hours specific to youth

Supervised Practical Experience Component

  • Practical experience (internship) component
    • Must be supervised
    • Minimum 300 contact hours
    • Minimum 3 months
  • CRSS Supervisor Training
    • CRSS/CPRS Competencies
    • CRSS/CPRS Code of Ethics
    • CRSS Provider Workbook

Affiliate Agreements

  • Written agreements
    • Variety of practical experience sites
  • Maintain linkages with:
    • Recovery support community
      • National Alliance on Mental Illness (NAMI)
      • Depression and Bipolar Support Alliance (DBSA)
    • Education community
      • Secondary education, vocational schools
      • Health and human services departments
      • On campus counseling programs
    • Other related professions
      • Domestic violence advocates
      • Homeless services
      • Federally qualified health centers (FQHC's)

Faculty Standards

  • Coordinator:
    • Keep abreast of the advances and changes in the recovery support field
    • Incorporate such changes into the curriculum.
    • Maintain contact with ICB to ensure coordination between the accreditation and certification functions of ICB
  • Minimum requirement for faculty:
    • Experience in providing services for recovery support, substance use, mental health, or co-occurring disorders (mental health and substance use)
  • Most qualified: Faculty who have experience in delivering recovery support services
  • Recommended: Faculty credentialed by ICB

Training Program Evaluation

  • Ensure accountability of the recovery support training program
    • Constant attention to quality of the content of material presented to students
    • Constant evaluation to identify problems, implement solutions, and initiate innovative responses to the changing demands of the field

Wrap-around Supports

Provide wrap-around supports for students to overcome practical barriers to full participation such as:

  • Student tuition, books, and fees
  • ICB credentialing fees
  • Stipends for practical experience (internship) component
  • Stipends to cover costs of childcare, transportation, or other needs and/or accommodations essential for students to maintain participation in the program

Provide a plan for making determinations of need and oversight/distribution of funds

  •  Subcontracting is an option

Data Collection & Reporting

  • Submit financial and program documentation to the IDHS/Division of Mental Health monthly
  • Submit performance documentation to the IDHS/Division of Mental Health monthly
  • Submit a fiscal year-end program and performance measures and outcomes report at the end of the fiscal year
  • Participate in evaluation efforts as directed by the IDHS/Division of Mental Health and collect and report data accordingly

Resources

DHS/DMH Recovery Support Services

Illinois Certification Board

International Certification & Reciprocity Consortium 

Recovery Support Services

Questions & Answers