Project Newsletter Number 3

Project Newsletter February 2012

by Scott Mitchell on February 23, 2012

No. 3, February 2012 — In this issue:

» Round Table Discussions across Ontario
» Diabetes and Mental Health Evaluation Update
» Diabetes and mental Health Peer Support Project – from a Peer Supporter’s Perspective
» Training Module Update

» Download PDF version


 

Diabetes and Mental Health Peer Support is a two-year project to provide competency training for Ontario mental health peer supporters in diabetes prevention and self-management strategies.


Round Table Discussions across Ontario

Christine Grace McMulkin
Christine Grace McMulkin
Project Consultant

Much awareness of the Diabetes and Mental Health Peer Support Project was generated in 2011, through project sharing and promotion website, newsletters, presentations), as well as through the delivery of a series of regional peer supporter training sessions in the spring. A growing number of inquiries about the project are being received: “How can we learn more about mental health peer support?” “How can we connect with trained peer supporters?” “How can we best collaborate around creating opportunities and paid positions for mental health peer supporters within our agency, organization and/or region?”

In response to this demonstrated interest in the project, and a growing recognition of the integral role that mental health peer supporters can fulfil around the prevention and self-management of diabetes, a series of Regional Round Table Sessions on the topic are being hosted by local consumer/survivor initiatives (CSIs) throughout the winter. The Regional Round Table Sessions are intended to foster connections, build relationships and expand or design mental health and diabetes prevention and self-management strategies incorporating mental health peer supporters and peer support services.

Invitations are extended to those invested in the issue, including mental health peer supporters, CSI members, service providers from the mental health, physical health and diabetes sectors (hospital and community-based mental health services, Diabetes Regional Coordination Centres, Family Health Teams, Community Health Centres, Community Care Access Centres), as well as representatives from the Local Health Integration Networks.

Here are some highlights from the first Regional Round Table Session, hosted on December 15, 2011, by members of the board of the Patient, Client and Family Council affiliated with Waypoint Centre for Mental Health Care in Penetanguishene. (Thanks to host lead Dianne Stringer, Project Trainer and Peer Support Coordinator/Recovery Educator, Patient, Client and Family Council, as well as to WENDAT Community Programs in Midland for providing the meeting space.)

The event created an opportunity for regional participants to make acquaintances and connections with providers from services, agencies and organizations both within and across the mental health and diabetes sectors. “Ninety-five percent of the people at the round table, I met today for the first time,” observed one participant. “It was great making new connections.” Feedback from the day consistently identified networking with other community members as a valuable activity. “Glad this community of care is there.”

The session encouraged the sharing of information about services and initiatives as well as perspectives around diabetes and mental health. Here’s what some participants say they learned: “Better understanding of the diabetes resources available in our community and how they could be playing a role in our patient health education.” “The resources available in the community and the roles of peer support.” “That more agencies are prepared to work together to serve our constituency.”

The forum furthered participants’ understanding of the contribution of mental health peer support in the prevention and self-management of diabetes: “Completely unaware of the program before. I would like to learn more.” “Exceptional!!! I had no idea just how involved peer support was and the education modules they have done.”

“This has opened my eyes.”

The conversation generated energy and excitement as well as ideas and suggested next steps around the prevention and self-management of diabetes: “[I will be] advocating the benefits of peer support, and for expanding resources and services.” “We are going to discuss how to incorporate peer support at our CHC.” “I see lots of potential opportunities for peer supporters to make their contribution.”

The regional conversations continue across the province. Following Penetanguishene, sessions have been held in Hamilton (January 11), Smiths Falls (January 16), North Bay (January 25), Richmond Hill (January 25), London (February 8), and Ottawa (February 15). Future sessions are scheduled for Thunder Bay (February 28) and Toronto (March 28).


Diabetes and Mental Health Evaluation Update

Cheryl Forchuk
Dr. Cheryl Forchuk

A project evaluation has been conducted by Dr. Cheryl Forchuk and Amanda Kurtz of Lawson Health Research Institute. There were three main sources of data to be evaluated: (1) a telephone survey completed by the diabetes module trainers after they took part in their train-the-trainer workshop; (2) a Diabetes Knowledge Test and Peer Support Questionnaire completed by peer support workers before and after their regional training days; and (3) follow-up focus groups with peer support workers six months after their regional training took place.

Seven of the diabetes module trainers took part in a telephone survey in March 2011, following their mid-February workshop. The purpose of the telephone survey was to get feedback on the usefulness of their training and suggestions for improvement. In general, the trainers were pleased with the training they received. They were invested in becoming diabetes informed by learning more of the core information about diabetes, so that they could feel more comfortable in speaking with others about the topic.

Amanda Kurtz
Amanda Kurtz

After the diabetes trainers received their training, they went out to their communities to provide regional training sessions to peer support workers. During this training, 63 peer support participants completed a Diabetes Knowledge Test and Peer Support Questionnaire immediately prior to receiving the training and immediately following the training. According to the results, the training module was most effective in increasing knowledge around diabetes symptoms, risk factors, and the importance of exercise and meal planning. An area of potential improvement after the training module is around how to support participants in further expanding their core diabetes knowledge.

In August and September 2011, 45 of the trained peer support workers participated in focus groups in their communities. At focus groups, many participants expressed that they had used the knowledge gained through the training module in their various consumer/survivor initiatives.

The evaluation has revealed that, in general, the training modules (both for the diabetes trainers and for peer support workers) were enjoyed by participants, effective in increasing diabetes knowledge and helpful in allowing participants to share their knowledge with their CSIs. In addition, many useful recommendations were provided for future modules, one of the most common being the need for more core diabetes knowledge.


Diabetes and Mental Health Peer Support Project – from a Peer Supporter’s Perspective

Lynn Piccione
Lynn Piccione
Peer Support Worker

The Diabetes and Mental Health Peer Support Project offered diabetes competency training to a number of people in the province of Ontario (through CMHA and OPDI). I happened to be previously trained in peer support through the PREFER Program (Peer Recovery Education for Employment and Resilience) offered by the Krasman Centre.

Through the Diabetes and Mental Health Peer Support Project, I have been able to “pass on,” so to say, my education.

I co-facilitated a diabetes and mental health peer support group with the lovely Linda Chamberlain. We were able to implement a program that allowed people in our group to become close to one another, and who now are “peers” to one another, even though the support group has finished. This group was so successful that they did not want it to end. In fact, we managed to keep the group going on our own even after it had officially ended. We, as the facilitators, were able to watch the group grow in their mental health and their self-management of diabetes.

During the group, one member was finding it especially difficult to keep his blood sugar within target range (below 7 when fasting in the mornings, and below 10 two hours after eating). We found out through our weekly check-ins (which was how we began our sessions) that this man was eating out for two of his three meals every day and was not handling eating healthy snacks in between meals. Because he was too embarrassed, he failed to mention this to his diabetes dietitian. As a result, his insulin use went up, as well as his use of diabetes medication.

I co-facilitated a diabetes and mental health peer support group with the lovely Linda Chamberlain. We were able to implement a program that allowed people in our group to become close to one another, and who now are “peers” to one another, even though the support group has finished. This group was so successful that they did not want it to end. In fact, we managed to keep the group going on our own even after it had officially ended. We, as the facilitators, were able to watch the group grow in their mental health and their self-management of diabetes.

During the group, one member was finding it especially difficult to keep his blood sugar within target range (below 7 when fasting in the mornings, and below 10 two hours after eating). We found out through our weekly check-ins (which was how we began our sessions) that this man was eating out for two of his three meals every day and was not handling eating healthy snacks in between meals. Because he was too embarrassed, he failed to mention this to his diabetes dietitian. As a result, his insulin use went up, as well as his use of diabetes medication.

Since we were there to support and encourage, the group as a whole decided to “brainstorm” ideas so that he could possibly rediscover how to eat healthy again and in doing so his blood sugar would not be so high. After brainstorming, he took to heart the idea “to eat out less and eat more at home.” He began having fewer “fast food” meals and was able to manage eating at home.

With the weekly support that this man was getting out of our group, his blood sugar finally dropped. One day he came up to me before the start of group and told me that his blood sugar had been 6.9 that morning. Even though he was still on his medications as well as insulin, this was an excellent beginning for him. Now he only “eats out” on special occasions.

Going back to the program, I was able to learn what “diabetes informed” meant. As a result of this I managed to run a workshop from a diabetes-informed perspective at the Toronto East General Hospital’s women’s recreation group. I felt this was important because there are so many group who are unaware of their risk of getting diabetes, and others who may not recognize signs and symptoms that should prompt them to seek treatment.

After this workshop, I wrote a proposal to a Family Health Team to run a peer support group in their diabetes education department. From that step, several future opportunities have opened up to apply my diabetes and mental health peer support training.

I think this project should be further funded so that other mental health peer support workers can become involved in this growing field. It is a program that is definitely needed in our society with the increasing number of people who are becoming diabetic, especially people with mental health challenges who are at greater risk due to psychotropic medication, economic challenges and the fact that they are not diabetes-informed.

Lynn Piccione is a peer support worker in the Toronto area.


Training Module Update

A more complete Diabetes and Mental Health Peer Support training plan has emerged from the project pilot experience and evaluation results.

The original proposal for the Diabetes and Mental Health Peer Support Project included the idea of a half-day training session for peer support workers. When we reached the pilot stage, the training had become a full-day session. Based on our pilot experience and the results of our project evaluation, the training has now evolved into a two-day session with an accompanying pre-training study assignment, as well as a test before and after the session.

Becoming diabetes informed is an intended outcome of the training experience. Pilot participants reported that while they recognize the boundaries of their own role and expertise as a mental health peer supporter, which is distinct from that of a diabetes educator or clinician, they nonetheless wanted to have a more solid grounding in the facts related to diabetes as they step into offering support to their peers in this area. The Ontario government’s “Diabetes and You” resource (ontario.ca/diabetes) was distributed to participants during the pilot phase, and as we move forward it will be sent to registered participants prior to any future training sessions. Participants will also be provided with study guidelines. They will be expected to review the information contained in “Diabetes and You” and complete an online Diabetes Knowledge Test prior to the training session. Our diabetes expert on this project, Betty Harvey, CNS/ Nurse Practitioner, St. Joseph’s Health Care Primary Care Diabetes Support Program, is providing guidance as we finalize the training.

At the conclusion of each training session during the pilot stage, participants were invited to share an intention — that is, to describe how they envisaged using their new knowledge within their peer supporter role. Through conversation and the evaluation focus groups, we have learned much about the activities and initiatives that peer supporters are offering — sharing information and experiences, encouraging healthy eating and physical activity, and connecting peers with diabetes resources in the community. We will continue to include examples of such activities during the training sessions.

Facilitating a diabetes and mental health peer support group has emerged as an important peer supporter offering. We are now consulting with peer supporters so that within the training experience we can include guidelines and practice opportunities related to facilitating such groups. Leading a diabetes and mental health peer support group is one way that peer supporters can demonstrate their contribution to the prevention and self-management of diabetes and take one step closer to establishing their role within health care.

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