The state of Wisconsin Department of Health Services is working to incorporate tobacco treatment into the training of peer specialists as they work to become certified. Specifically, it is using a report created by UW-CTRI in collaboration with two certified peer specialists.
The report, called Roles for Certified Peer Specialists to Support Peers as they Address their Smoking, was written by UW-CTRI Distinguished Scientist Bruce Christiansen and Certified Peer Specialists Marcia Mason and Gretchen Wolfe.
“There is a pressing need to help smokers coping with a mental health challenge to quit tobacco,” said Christiansen.
“It is important for peer specialist training and other programming to address the complications and cost of tobacco addiction,” said Mason.
Research has documented the benefits of peers supporting others who are coping with a mental illness. Sharing lived experience is the cornerstone of this support and establishes peers as unique contributors to the behavioral healthcare system, the authors wrote in their report. Peer support and peer-run organizations are promoted by federal agencies such as the Substance Abuse and Mental Health Services Administration (SAMHSA).
Now, the Wisconsin Department of Health has developed peer support programs. There is now a Wisconsin training curriculum and certification test to become a Certified Peer Specialist (CPS). To date, more than 1,400 individuals have been credentialed as CPS. Roughly up to 288 people are being trained in the model annually, with approximately another dozen classes held each year that are purchased by private organizations, communities or counties.
“Also, we currently have the class available at Madison College and Northwestern Technical College,” said Joann Stephens, Consumer Affairs Coordinator at the Wisconsin Bureau of Prevention Treatment and Recovery, part of the Wisconsin Department of Health Services. “They each hold a class a semester of up to 18 students. We’re hoping to have more technical colleges providing the training in 2022.” In addition, there are CPS certification programs in Wisconsin prisons and mental health institutions.
The Wisconsin Peer Specialist Employment Initiative is managed by Access to Independence, a non-profit, consumer-controlled Independent Living Center (ILC) that provides advocacy, resources, and services to people of all ages with all types of disabilities in Dane, Columbia, Green, and Dodge counties in south-central Wisconsin. ILCs are a nationwide network of disability resource centers, where the majority of board and staff are people with disabilities.
Access to Independence is the hub for the education and training of all Wisconsin certified peers. They have added a link on their “Continuing Education” page to the UW’s Addressing Tobacco Dependence in the Behavioral Health System: Training in the Bucket Approach for all Wisconsin Certified Peer and Parent Peer Specialists who are seeking continuing education opportunities. The Bucket Approach was developed by Christiansen with support from UW-CTRI, the Wisconsin Nicotine Treatment Integration Project (WiNTiP) and the state.
These resources, already available on the UW-CTRI and WiNTiP sites, will be included in the Wisconsin CPS Curriculum by the end of 2021.
“The report will be assigned as homework and will include a targeted discussion about the topic,” said Stephens. “The link to the training will also be included in the curriculum so new certified peer specialists can take the class at their leisure.”
State officials hope to complete a revision of the Wisconsin Certified Parent Peer Specialist Curriculum as well as the development of the Wisconsin Certified Youth and Young Adult Peer Specialist Curriculum by the end of 2022. The format listed above will be included in both of these curricula as well.
“We will keep the link to the training in all three curricula as long as it is still live,” Stephens said. “I commend the team who worked on this project!”
Certified peer specialist services are also being offered in the Wisconsin Department of Corrections prison facilities. Every facility in the state has certified peer specialists providing services within the institution. Last fall, the state trained a team of peers who were serving as CPS within the institutions as state certified CPS trainers so the Department of Corrections would have their own internal training team. They continue to provide CPS trainings to inmates around the state and grow the CPS services within the institutions.
“It’s great that the state supported this study,” Wolfe said, “and that so many stakeholders were enthusiastic when envisioning roles for support in a peer-peer relationship.”
“It’s gratifying to know that, going forward, certified peer specialists will have a better understanding of the burden tobacco imposes on those coping with a mental illness,” Christiansen said, “and how to support their peers who smoke.”
In their report, Christiansen, Mason and Wolfe reviewed relevant literature and conducted 54 informant interviews. The literature documents numerous tobacco roles for consumers.
“I personally believe frequent contact (even if brief) is important to support the individual on their individualized journey and apply the Bucket Approach,” Mason said. “Rural peer specialists need the funds, means and technology to maintain constancy.”
There was a very high level of consensus and enthusiasm across informants that certified peer specialists can have many roles supporting the tobacco journeys of those facing mental health challenges, provided that areas of potential conflict in roles are addressed.
“Our study specifically was concerned with individuals who dealt with chronic mental illness/mental health roadblocks,” said Mason. “Smoking often is seen as a remedy, emotional regulation, a break from their uncomfortable or unmanageable inner world. Tobacco addiction most often accompanies other alcohol or drug addictions, an association of behaviors. Peer specialists often are working with this population. Many are on fixed income or underemployed. The cost is prohibitive, let alone interferes with good health habits and daily energy levels.”
Certified peer specialists said it’s not always easy to help people quit, but it’s well worth it.
“There is a positive energy for change when linking arms with a peer,” said Wolfe.
“Our CPS are such valuable team members,” said Donna Riemer, RN-PMH, Nurse Consultant at the Wisconsin Bureau of Prevention Treatment and Recovery. “I so appreciate partnering with them on this tobacco cessation work.”