Peer-Led Projects:
Assessing the priorities of recovery communities across Massachusetts.
The COE partners with Peer Consultants (PCs), who are individuals with lived experience of mental health and/or substance misuse challenges. PCs are community leaders affiliated with Massachusetts recovery learning centers, and they consistently inform our research by giving voice to the priorities of community members. Together, we work to assess unmet needs and implement projects, including quality improvement initiatives, across the Commonwealth.
The main goal of this project was to identify care concerns among those in recovery from mental health or substance misuse challenges.
Our PCs designed and piloted a semi-structured interview guide for listening groups, which included questions related to lived experience and topics of interest. A total of 18 listening groups were held with diverse participants across the state of Massachusetts.
5 main themes emerged from these listening groups: 1) Reducing stigma, 2) Improving care access, 3) Providing wholistic care, 4) Including peers in research, and 5) Strengthening the quality of providers.
Guided by these original listening groups, our PCs have gone on to develop and implement the Parents in Recovery Video Project as well as the Cultural Access, Inclusivity, and Racial Equity (CAIRE) Project.
METHODS
PCs designed and piloted a semi-structured interview guide for listening groups, which included questions related to lived experience and topics of interest.
A total of 18 listening groups were facilitated with 159 participants, and were held among recovery communities spanning the state of Massachusetts. Historically underrepresented groups were recruited to participate, including: Latinx, African Americans, LGBTQ+, homeless persons, students/young adults, and deaf and hard of hearing community members.
RESULTS
A total of 18 listening groups were facilitated among 159 participants, with two conducted in Spanish and one conducted in American Sign Language. The median age of participants was 48.0 years (IQR: 33.5-59.0), and the majority of respondents self-identified as White (57%), female (57%), and non-Hispanic (63%). Approximately 20% of participants distinguished themselves as Certified Peer Specialists.
Listening groups were audio-recorded and transcribed, and those conducted in Spanish were translated through consensus by two native Spanish speakers. A diverse coding team that included a PC, a research fellow, and a clinical research coordinator used rapid analysis coding to consolidate findings and identify themes within and across listening groups.
The themes that emerged after coding were 1) Reduce stigma from family members, providers, and community, 2) Improve access to services and research results, 3) Provide holistic care that accounts for the entire person, 4) Include peers in the development and implementation of research projects and the recovery process, and 5) Strengthen the quality of providers and improve training in effective and person-centered approaches.
These findings were shared back to MA recovery communities, and are the guiding priorities for the new research projects that PCs design and implement.
Guided by findings from the listening groups and PCs’ interests, the Parents in Recovery Video was created to promote the importance of the parenting role, reduce stigma, and lessen feelings of isolation among parents with mental health and substance use challenges. After our initial video, due to high demand, we filmed a second video featuring the adult children of parents in recovery.
We are actively working to integrate the video in interactive trainings and among different groups, including parents, child mental health providers, adult mental health providers, families, and DMH-affiliated groups.
CAIRE is a quality-improvement project to help the Southeast Recovery Learning Community (SERLC) become more culturally diverse and have a more vibrant and engaged presence of BIPOC and other minoritized individuals in the communities it serves. We are working on implementing this project at the SERLC sites of Brockton, Hyannis, Fall River, and Quincy.
A community needs assessment was conducted with the leadership of various SERLC centers, and a six priorities and implementation strategies emerged from these assessments. The main objectives focus on reaching minority groups, underrepresented populations, hiring more diverse staff, increasing social events and community engagement, and improving the SERLC spaces.
Objective 1: Enhance SERLC Marketing
Brochures and flyers tailored to each of the four Recovery Connection Centers (RCCs) were created to cater to more diverse language needs and reach a wider audience. These materials were translated into Haitian Creole, Chinese, and Urdu with the help of the bilingual SERLC Peer Community Facilitators and RCC employees (see Appendix for brochures and flyers). Peer Bridgers shared the materials with individuals while making connections in settings where these individuals were transitioning out of restrictive facilities and back into the community.
SERLC swag was created and utilized at community events hosted by the RCCs. The flyers and brochures were also distributed at these events, including handouts describing the CAIRE project.
We created the first quarterly newsletter in June 2024, with a Diversity, Equity, and Inclusion (DEI) focus that featured the CAIRE Project, BIPOC and LGBTQIA+ Young Adult support groups, and volunteer committee information. It also included Juneteenth and Pride sections with resources for BIPOC and LGBTQIA+ communities. Finally, SERLC staff from BIPOC and LGBTQIA+ backgrounds were showcased with bios, recovery stories, art, and poetry.
Objective 2: Strengthen Connections Between the SERLC and Local Under-represented Communities
The SERLC Program Director continued to meet regularly with the Area Program Directors (APDs) from each RCC to make plans for outreach to underrepresented communities.
The APDs and staff participated in numerous community resource events emphasizing diversity, including Pride festivals and Juneteenth gatherings. They showcased the new marketing materials and set up resource tables at twelve celebrations to enhance engagement with underserved communities.
The BMC Haitian Facilitator established connections in the Brockton area with local city council officials and shelters with guests from the Haitian Community.
Objective 3: Hire More Diverse Staff and Enhance Staff Training Among Existing Staff Around Cultural Sensitivity and Humility
We have continued to hire and promote BIPOC staff at the SERLC. BMC Haitian/Cape Verdean and LGTBQIA+ Peer Community Facilitators were hired. Additionally, the Quincy RCC recently welcomed a bilingual Transitional Age Youth (TAY) leader who is fluent in Urdu and has strong ties to the Muslim community. His position is anticipated to boost engagement with young adults near Quincy and foster connections within the Muslim community.
Objective 4: Provide More Social Activities
An annual calendar was created marking heritage months, awareness days, and remembrance days. From this calendar, the SERLC arranged multicultural events and holiday celebrations in the RCCs and neighboring communities, including events for Black History Month, Juneteenth, Kwanzaa, Mental Health Awareness Month, Minority Mental Health Month, LGTBQIA+ Pride Month, and Disability Pride Month. (See Appendix for calendar).
The centers hosted virtual and in-person monthly guest speakers from diverse backgrounds to educate and connect with staff and community members. Brockton RCC held monthly potluck meals, most of which were multicultural-themed. The Quincy RCC held an informative presentation by a funeral director for the older adult members about end-of-life planning.
Word-cloud collaborative art projects on “Why do you return to the RCC?” were initiated at each center and will continue into Y7. The Brockton RCC created an art project with painted tiles depicting a cityscape of Boston in an art group led by a Veteran community member (See Appendix for art projects)
Ninety-two peer community members responded to an anonymous survey distributed by the SERLC. Online and paper versions were distributed. Members provided demographic information, responded to questions about their satisfaction at the RCCs, and provided ideas for new groups, social activities and events. 86% of respondents said they were ‘Satisfied’ or ‘Very satisfied’ with the groups offered at the RCCs. See here for respondent demographics.
The Fall River RCC held a special group once per month entitled, “Why do you come back to the RCC?” which helped the peer members formulate what should happen next in their community.
Objective 5: Increase Engagement of Different Communities Using Technology
The SERLC website was enhanced to be more user-friendly and representative of diverse members. Additions include a Mission Statement, Land Acknowledgement, CAIRE project section, career page, comfort agreement, newsletter, and creative endeavors of peer members. The Hyannis, Quincy, and Fall River web pages now have updated group descriptions and graphics. Local RCC calendars are updated monthly with RCC and community events. We also introduced a new website feature that has users fill out a contact form and provides them with an email containing a welcome packet containing flyers, brochures, RCC information, calendars, newsletters, and career opportunities, and details about the Peer Support Line. Finally, the SERLC created an email address (southeastrlc.ma@gmail.com) for newsletter submissions and for committee volunteers to express interest.
The SERLC recruited volunteers for three committees, including DEI, Young Adult Advisory Council (YAAC), and Community Engagement. Surveys were used to gather information from potential members. Four individuals joined the DEI committee and two individuals joined the YAAC and Community Engagement committees, which will start in October 2024.
We enhanced our social media presence to have more engaged Facebook and Instagram accounts to promote activities and events at the RCCs. Various diverse holidays and awareness days were acknowledged on the Facebook page.
The centers hosted events and guest speakers via Zoom. The Brockton RCC hosted the BIPOC Peer Professional Panel, the Council on Aging, the Disability Law Center, the Massachusetts Behavioral Health Help Line, the Bureau of Substance Addiction Services, and the MassRehab Commission. These presentations were offered both virtually and in person to increase accessibility.
Objective 6: Improve the Aesthetics and Inclusiveness of Meeting Spaces
Along with community input, the RCCs continued modifying their physical spaces by introducing softer furniture, better social group seating, plants, improved lighting, and more displays of artwork and crafts made by community members. The RCCS continued to create opportunities for peer members to become involved with further enhancing the aesthetic environments of the RCCs by sharing design ideas and hanging artwork for display.
Goals to Further Objective 1: Enhance Marketing of the Southeast Recovery Learning Community (SERLC)
Marketing materials will be expanded to more languages for underserved communities. A brochure and flyer for veterans will be created. The SERLC plans to acquire additional swag for community events and provide a Canva tutorial for staff to enhance their own marketing materials.
The upcoming quarterly newsletters for Y7 will maintain a DEI focus, featuring content from diverse community members. The Fall edition will cover substance use and suicide prevention specifically for veteran, BIPOC, and LGTBQIA+ communities.
The SERLC will continue to recruit volunteer members for the three committees mentioned above. Support will be given to community members lacking technology access by providing iPads or laptops for virtual meeting participation.
Goals to Further Objective 2: Strengthen Connections Between the SERLC and Local Under-represented Communities
The SERLC plans to continue building relationships with community organizations and venues to reach underrepresented neighborhoods by distributing flyers, attending local events, and hosting resource tables.
Informational and support sessions in multiple languages will be held and tailored marketing materials will be distributed to engage Haitian, Asian American/Pacific Islander, and Veteran communities. The SERLC will continue to seek facilitators with connections to Portuguese, Latine, Indigenous, and Black communities in the Southeast, advertising positions on the SERLC and BMC websites, as well as on Facebook and Instagram.
The SERLC plans to collect qualitative data and provide a more comprehensive picture of the services of the SERLC. This will be modeled after Hyannis RCC’s daily online survey which gathers qualitative feedback from community members. Other RCCs may adopt a similar approach.
Goals to Further Objective 3: Hire More Diverse Staff and Enhance Staff Training Around Cultural Sensitivity and Humility
The SERLC will enhance staff development by offering peer-focused trainings that emphasize inclusivity, anti-racism, and cultural diversity. Additionally, the SERLC plans to create internal trainings in partnership with the COE and other RLCs. Ryan Markley, a trainer in many peer-focused areas, will help find trainings for staff and aid in the development of original SERLC trainings focused around suicide prevention, Trauma-informed Peer Support, and Digital Peer Support. A team building/staff development day is also in the works for all SERLC staff.
We will hire BMC Peer Community Facilitators with diverse community connections. The initial Community Navigator and assistant positions at SERLC are pending re-design based on needs. The Quincy RCC will hire a TAY Leader and a Peer Bridger, the Fall River RCC will hire a TAY Leader, and the Brockton and Hyannis RCCs will try to hire Community Connectors.
The COE will develop an orientation training that covers SERLC services, mission statement, peer support basics, sharing of recovery stories, ethics, intersectionality, sexual orientation and gender identity, and job details for new BMC Facilitators.
Goals to Further Objective 4: Provide More Social Activities
The SERLC will continue its anonymous survey annually to assess the demographics of RCC attendees and their satisfaction with their respective centers.
The SERLC will continue to plan more social activities. The Veteran art group at Brockton RCC will resume this fall.. The Brockton RCC Guest Speaker series will continue into Y7. The RCCs will have open houses this Fall and the centers will continue to prioritize multicultural holiday events while seeking input from community members for activity ideas.
Goals to Further Objective 5: Increase Engagement of Different Communities Using Technology
Another technology needs assessment will be done regarding community members’ access to SERLC virtual spaces. Five laptops and five tablets will be distributed, prioritizing committee volunteers.
The SERLC website will expand to include an events page, trainings with a DEI focus, and activities from peer agencies and the SERLC. It will also feature upcoming outings, the virtual Brockton guest speaker series, RCC-planned events, and community engagements.
Goals to Further Objective 6: Improve the Aesthetics and Inclusiveness of Meeting Spaces
The Quincy RCC will continue seeking input from community members to enhance and redesign areas within the center, creating a more inviting and soothing environment. Vinfen has pledged to thoroughly clean the center and repaint the walls. Other centers will continue to adapt their spaces to be more comfortable for their members.
The purpose of the Peer Integration Project (PIP) is to assess the challenges and successes of integrating peer support into care systems across Massachusetts, and to provide subsequent recommendations in an effort to optimize the efficacy and career satisfaction of Peer Specialists.
The PIP project consisted of four virtual listening groups. Participants were Certified Peer Specialists (CPSs) who identified as having worked for at least 10 hours per week for a minimum of one year in Massachusetts, were proficient in spoken English, and gave permission for the group to be audio-recorded. Participants were recruited through email network listservs to various organizations (e.g., CBHCs, hospitals, etc.) across Massachusetts. COE peer consultants and a clinical research coordinator facilitated each group before the sessions were audio-recorded and transcribed by a HIPAA-compliant transcription service. Participants completed a brief demographics questionnaire prior to the group. Groups were facilitated using a semi-structured interview guide broken into four primary topics: organizational culture, resource availability, training and education, and role definition. During each topic, members were prompted to consider barriers to providing quality peer support services as well as recommendations to better integrate peer support services in the future.
Data Analysis
The coding team conducted a rapid analysis to systemically identify themes from transcripts. They developed a template that allowed coders to generate concise codes under each of the four topics, list impactful quotations, and generate a summary paragraph. A thematic analysis was conducted to identify common ideas that were frequently referenced in participants’ responses, and transferred the data into one primary template. Efforts were made to create themes that were inclusive of participants’ responses.
Results
Our assessment of Peer Specialist working conditions, through listening groups and rapid qualitative analysis, revealed several areas of improvement desired by this group and subsequent recommendations to aid in the implementation of peer support services in healthcare organizations across Massachusetts. These areas of improvement fall into the four content areas the listening groups were structured around: organizational culture (e.g., interactions with clinical colleagues, supervision, number of CPSs at an organization, data collection), resource availability (e.g., access to transportation, office supplies, and reintegration programs, time management, collaboration, low salary), training and education (e.g., access to peer-focused, substance use, DEI, and technology training), and role definition (e.g., trust between clinical staff and CPSs, lack of career ladder and understanding of the peer role, inconsistent salary and benefits, and burnout). As a result, in Y7 we will make recommendations to policy makers, behavioral health providers, and fellow Peer Specialists and other peer workers, with the goal of improving the working conditions, effectiveness, and satisfaction of CPSs.
For the full methodology, procedures, data analysis and results, please see the PDF – Full Report tab.
COE PROJECT STAFF
Anne Whitman, PhD, CPS
SENIOR PEER CONSULTANT
Paul Alves, CARC, NCPRSS, MAPGS
PEER CONSULTANT
Valeria Chambers, CPS, EdM, CAS
PEER CONSULTANT
Stan Langston
PEER CONSULTANT
Sharina Jones
PEER CONSULTANT
Ryan Markely, BA, CPS
PEER CONSULTANT
Jacqueline Martinez, FPS, CPS
PEER CONSULTANT
Cynthia Piltch, PhD
PEER CONSULTANT
Sandra Whitney-Sarles, MS, CPS, COAPS
PEER CONSULTANT
Corinne Cather, PhD
PRINCIPAL INVESTIGATOR
Derri Shtasel, MD, MPH
CO-INVESTIGATOR
Katherine Kritikos, MPH
PROGRAM MANAGER
Lisa LeFeber, BA
CLINICAL RESEARCH
COORDINATOR
Julia London, BA
CLINICAL RESEARCH COORDINATOR
Hannah Skiest, BA
CLINICAL RESEARCH
COORDINATOR
Additional Collaborators
Diana Arntz, PhD; Jonathan Burke, JD; Cheryl Foo, PhD; Scott Francis, CPS; Reverend Norma Heath; Beth Starck, BA.
Funding
Funding for these projects was provided by the MGH COE/Massachusetts Department of Mental Health.