The Arizona Peer & Family Coalition (APFC) supports the expansion of many necessary prevention services, including Peer Support and Parent/Family Support, and Assertive Community Treatment. We support the identification and allocation of additional funding to provide a full range of preventative services for youth, young adults, adults and families with mental health and substance use challenges in Arizona.

APFC BACKGROUND

The APFC was established in 2009 with a mission of advocating for, connecting, promoting, and developing leadership by peers and family members throughout our state. Today, the APFC has approximately 180 members located throughout the state and represents the perspectives of individuals and family members who have first-hand lived experience navigating the publicly funded behavioral health system for themselves or on behalf of a loved one with mental illness. The APFC educates our law makers to influence policy, while participating in community organizing and civic leadership efforts. We want to be part of the solution and are available to participate in systems change work. 

IMPORTANCE OF PREVENTION

Mental health is essential for individual and public health. To improve mental health, promotion of mental health, prevention, and the treatment of disease are required. These three kinds of interventions are interrelated but independent from one another.

Prevention services play an important role in recovery maintenance and relapse prevention.

PEER SUPPORT

A peer support worker is someone with the lived experience of recovery from a mental health condition, substance use disorder, or both. They provide support to others experiencing similar challenges. They provide non-clinical, strengths-based support and are “experientially credentialed” by their own recovery journey (Davidson, et al., 1999).

Peer support workers bring their own personal knowledge of what it is like to live and thrive with mental health conditions and substance use disorders. They support people’s progress towards recovery and self-determined lives by sharing vital experiential information and real examples of the power of recovery.

Peer Recovery Support Specialists:

SAMHSA provides the following, “Peer support encompasses a range of activities and interactions between people who share similar experiences of being diagnosed with mental health conditions, substance use disorders, or both. This mutuality—often called “peerness”—between a peer support worker and person in or seeking recovery promotes connection and inspires hope. Peer support offers a level of acceptance, understanding, and validation not found in many other professional relationships (Mead & McNeil, 2006). By sharing their own lived experience and practical guidance, peer support workers help people to develop their own goals, create strategies for self-empowerment, and take concrete steps towards building fulfilling, self-determined lives for themselves.”

PARENT SUPPORT

Parent peer support offers hope, guidance, advocacy, and camaraderie for parents and caregivers of children and youth receiving services from mental health, substance use, and related service systems.

This support can help parents meet their children’s needs more efficiently, and with greater confidence and hope. (Kutash et al., 2011, Hoagwood et al., 2009).

Parent Support Providers offer:

ADULT FAMILY SUPPORT

Adult family supports provide hope, guidance, advocacy, education and support to families who have adult children that receive behavioral health services. Adult family support is underutilized. When families are given tools and education, they become a useful part of the treatment team. Adult family support can be very beneficial, such as reducing the need for hospitalizations and reduces the need for alternative housing options since the families have the support they need to assist their loved one.

According to the National Alliance on Mental Illness, at least 8.4 million people in the U.S. provide care to an adult with a mental or emotional health issue and caregivers of adults with mental or emotional health issues spend an average of 32 hours per week providing unpaid care. Studies in New York and Maine show that involving the member and their family in the treatment process can save the system money. Ratios of $1 spent for this service to $10 in saved hospitalization costs were routinely achieved.

Family Support Providers offer:

CARE COORDINATION

Care Coordination involved communication between all providers involved in a member’s care. SAMHSA defines it as an activity of organizing care activities among different services and providers, and across various facilities.

A study of Medicaid members with high needs found that a complex care management program reduced total medical expenditures by 37%, a savings of over $7,700 per member per year (American Journal of Managed Care, 2020).

ASSERTIVE COMMUNITY TREATMENT (ACT)

ACT is a way of delivering comprehensive and effective services to consumers who have needs that have not been well met by traditional approaches to delivering services. At the heart of ACT is a transdisciplinary team of 10 to 12 practitioners who provide services to about 100 people.

ACT is for a relatively small group of consumers who are diagnosed with serious mental illness, experience the most intractable symptoms, and, consequently, have the most serious problems living independently in the community. Because of the severe and recalcitrant nature of their symptoms, these consumers are more likely to: frequently use emergency and inpatient medical and psychiatric services, be homeless or live in substandard housing, be involved in the criminal justice system, or use illegal substances.

Communities should develop enough ACT teams to serve approximately 50 percent of their populations of persons with severe mental illness or roughly .06 percent of their adult populations. (Psychiatric Services 57:1803–1806, 2006).

APFC RECOMMENDATIONS

1. Peer and Family Support services be included in primary care where “as many as 70% of primary care visits are driven by patients’ psychological problems, such as anxiety, panic, depression and stress”
    
2. Peer and Family support services, in both a 1:1 and group format, be covered services from all primary payers and offered by all treatment providers within the Arizona marketplace. In addition, this services should be advertised throughout the treatment and beyond the traditional behavioral health provider. 
   
3. Increased use of specialized peer and family support, such as Forensic Peer and Family Support, can help the peer and  the family not only navigate the mental health system but also the criminal justice system.
    
4. Care coordination should be a requirement amongst all providers.
    
5. Expansion of ACT teams within our community. 

This statement was completed on January 18th, 2023. For questions or more information, please contact us at info@azpeerandfamily.org.