[NYAPRS Enews] Coalition Highlights Parachute Respite in NYC

Tue Mar 18 08:50:54 EDT 2014

NYAPRS Note: Below is a RECOVERe-works brief from the Coalition of Behavioral Health Agencies that reviews some of the progress of the NYC Parachute respite centers so far. Directors and guests discuss the benefits of the model and the opportunities for further implementation. Read the full story here<http://www.coalitionny.org/the_center/>.
Parachute NYC: Dream, Deployment, Data
For many mental health advocates, Parachute crisis respite centers-short-term refuges that help people in distress regroup-are a dream. Funded by the city through a federal grant, they follow several empowering recommendations from the Substance Abuse and Mental Health Services Administration, such as the principle that "recovery is supported by peers and allies."
In addition, as RECOVERe-works noted in Peer Support Services: The Next Game Changer in Behavioral Health, peer support services can reduce the rate of re-hospitalization, a major cost in the health care system. Respite care would also appear to have fewer iatrogenic complications-problems due to medical care-than hospitalization, as we mention in Post-Hospitalization Syndrome and Its Relevance to Peers.
Now that Parachute NYC has been funded, we can hardly wait for outcomes data. Will this innovative program live up to its promise?  Will managed care and other stakeholders make the less expensive, less restrictive respites (vs hospitals) the default option for crisis care? Will payors adopt a model that uses fewer professionals, and more paraprofessionals with lived experience?
The Future of Parachute Crisis Respite Centers
Lauren D'Isselt, Director, Manhattan Respite Center, Community Access

How does a crisis respite center staffed by peers fit the vision of Community Access?
Community Access has for many years sought to create an alternative to hospitalization that would promote wellness and recovery in a non-restrictive environment, while avoiding the trauma often experienced by individuals being admitted to a psychiatric hospital. The agency has a longstanding organizational goal to employ at least 51% of staff who have lived experience within the mental health system. In fact, one of our stated values is that we believe that people with psychiatric issues should have a voice in promoting social justice and positive change within the mental health community. This is very aligned with who we are as an agency.
Is there anything you would change about these centers to improve them?
I think it is too early for me to say what could be improved about them, since, so far, feedback from guests has been overwhelmingly positive. We hope to expand our admission criteria to reach an even larger community going forward.
Are these crisis respite centers the wave of the future?
I believe so. It is not only a less expensive model, but more importantly, a very person-centered approach to recovery and wellness. As the landscape of insurance and healthcare changes, respites are going to emerge more as a cost-effective option. However, that is only part of the story; a respite center is a place where a person can connect with others who may have had similar experiences, and work through a crisis in a healing, and nurturing, environment that promotes personal growth, introspection, understanding, and wellness and recovery skills to move forward.
How can staff-including peer staff-and administrators maintain both funding, and enthusiasm, for these centers?
Enthusiasm is no problem. Every guest who comes through is unique, and this creates a dynamic environment with extraordinary possibilities for change, healing, and growth. We are at the mid-point of our grant funding, but we have many interested parties, including insurance and managed care companies, that see crisis respite centers as worthwhile, cost-effective endeavors that promote improved quality of care, better individual outcomes, and savings.
The Parachute Experience: Reflections from Guest
A Comfortable and Personal Solution
Karen S, Guest, Community Access

What brought you to the Parachute program?
I was in a downward spiral, and I had the ready-to-jump-off-the-roof feeling. My case manager recommended the program, and I wanted to go there, rather than to a hospital, because I thought it would give me more attention, and be more personal.
It was a better environment for me because it was more comfortable. You could go to breakfast, and sit, and know there would be someone to talk to. You could just ease your way into talking about your problems, and not wonder when you would see anyone, the way you might in a hospital.
I think if I had had more of an emergency, though, my case manager might have called 911.
What did you like most about the Program?
Life didn't stop altogether, the way it would have if I'd gone to the hospital. That's a big difference. I had things set up before I came to the program, like a doctor's appointment. I didn't have to reschedule it. I could also have my personal things, like my phone.
I was glad the environment was more like a home, and I felt more like I was interacting in a family setting. In a hospital, you really feel like you are in a hospital.
Also, if you don't participate in a group at the hospital, the staff holds it against you. At the Parachute program, the staff wants you to attend, but it's okay if you don't. If you don't attend the group, you'll just get help one-on-one.
What did you like least?
I needed an iron. That's all!
Coalition Wiki and Trainings for Parachute
Running a Parachute crisis respite center necessitates hiring peer staff, and integrating peer staff into an agency that is usually dominated by non-peer professionals. How can managers meet this challenge? To present complementary perspectives, and practical guidance, the Coalition for Behavioral Health Agencies is developing a wiki for members, available without a password at coalitionparachute.<http://www.coalitionny.org/the_center/> A wiki is an online collection of resources which people can collaboratively add to, create, and edit.
On February 18, the Coalition hosted, "Creating an Inclusive Workplace: Strategies for Supporting Peer Integration," to explain reasonable accommodation, hiring, supervision, termination, and other personnel issues as they relate to peers. Afterwards, presenters Susan Salazar, JD, attorney at the employment law firm of Raff and Becker (far left), and Janis Tondora, PsyD, assistant clinical professor in the Yale Department of Psychiatry (far right), joined training participants Oscar Dimant and Deborah Cumberbatch of Services for the UnderServed.
This month, the Coalition is hosting a free follow-up workshop, "Developing Policies and Procedures for Employing Peers in the Workplace." For the event, Susan Salazar, and Janis Tondora, who led our discussions in February, will return. They will discuss the development of policies and procedures related to the employment of peers in the workplace. Sample templates will be made available. Register online now to reserve your seat for this event<http://www.coalitionny.org/prof_learn_ctr/training/registration/registration.php?series_id=1250> on March 27 from 1:30 - 3:30 p.m. at the Coalition.
If you have any questions around employing peers in your workplace, we would love to know about them before the meeting so we can include them in the discussion. Please send your questions to kkrampitz at coalitionny.org<mailto:kkrampitz at coalitionny.org>
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Parachute Resources
Visit the New York City Department of Health and Mental Hygiene's basic Parachute page<http://www.nyc.gov/html/doh/html/mental/parachute.shtml> for answers to practical questions about the program, including eligibility, and the number for referrals (1-800-LIFENET, or 1-800-543-3638). Elsewhere you can find out about mobile crisis teams, and support lines, that can dovetail with the services of the centers.
Another Parachute page<http://www.nyc.gov/html/doh/html/mental/parachute-training.shtml> summarizes the foundations of this innovative program in the seven key principles in the Need Adapted Treatment Model (NATM), and in Intentional Peer Support (IPS). Three links on this page can guide you to in-depth information.
View videos by the DOHMH<http://www.youtube.com/watch?v=GmVIDq4EVBU> and Community Access<http://www.youtube.com/watch?v=ub2mWy9sVWg&feature=youtu.be>.
You may also contact the four Parachute NYC programs directly:
Bronx Parachute NYC Program<http://rmha.org/programs-and-services/parachute/>
Riverdale Mental Health Association
<http://rmha.org/>640-642 West 232nd St
Bronx, NY 10463
718-884-2900 or omariano at rmha.org<mailto:omariano at rmha.org>
Brooklyn Parachute NYC Program<http://www.sus.org/parachute/>
Services for the UnderServed<http://sus.org/>
2118 Union Street
Brooklyn, NY 11212
347-505-0870 or SUSParachute at SUS.org<mailto:SUSParachute at SUS.org>
Queens Parachute Program (web page coming soon)
Transitional Services for New York, Inc.<http://www.tsiny.org/>
80-45 Winchester Boulevard
Creedmoor Grounds - Building 20
Queens Village, NY 11427
718- 343-0248 or jgordon at tsiny.org<mailto:jgordon at tsiny.org>
Manhattan Parachute NYC Program<http://communityaccess.org/what-we-do/respite-center>
Community Access<http://communityaccess.org/>
315 2nd Ave
New York, NY 10003
646-257-5665 or Idisselt at communityaccess.org<mailto:Idisselt at communityaccess.org>
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