The Substance Abuse and Mental Health Services Administration (SAMHSA) identified a safe and stable home environment as one of the key dimensions that support a life of recovery from a mental health or substance use condition.1 That’s why Optum strives to promote healthy living environments as part of their person-centered and recovery-based approach to improve the well-being and resiliency of those they serve. Frequently, Optum partners with local communities to develop supportive housing programs that offer safe and affordable living environments which are free of stigma and discrimination. The programs also provide available resources that promote resiliency and improve community tenure, including Peer Support Services.
Optum works to identify and develop key community-based resources in each market that we serve. One size does not fit all, and partnerships are essential to develop needed services in each community to support housing and social supports. One such example is the Permanent Options for Recovery‐Centered Housing (PORCH) program. The PORCH program is a partnership between the Washington State Division of Behavioral Health and Recovery (DBHR), Optum Pierce County and Chelan‐Douglas Regional Support Networks (RSNs), Washington State Department of Commerce, and local mental health and housing providers. PORCH’s goal is to encourage independent living among adults with a history of mental illness and housing instability or homelessness. PORCH is funded through a five‐year Mental Health Transformation Grant from SAMHSA.
Optum has partnered with the PORCH Team at Greater Lakes Mental Healthcare, a community mental health agency, in Pierce County, Washington. The program includes a Team Leader — a mental health professional who provides program administration, grant administration, clinical supervision, education and outreach — and four Certified Peer Counselors.
Optum’s experience in developing systems of care has demonstrated that Certified Peer Counselors are effective advocates for supporting recovery-based practices and can help foster resiliency for those they serve. The Certified Peer Counselors associated with the PORCH project are typically individuals who have lived experiences with mental health and wellness challenges, received peer support and recovery training, and are well-grounded in their own recovery. Additionally, they model competency in ongoing coping and resiliency skills for program participants.
Examples of the actions taken by Certified Peer Counselors in the PORCH project are outreach, providing peer counseling, conducting independent living skills training, and assisting with crisis intervention and stabilization when needed. The Certified Peer Counselors are able to use their personal lived experience and training to successfully engage and support PORCH participants. This includes helping them to identify person-centered health and wellness goals that promote recovery and identify services and activities to help them reach their goals. They are able to assist participants in developing their personal skills in order to achieve successful independent living. This is achieved as they are able to obtain and maintain stable housing which supports their ability to pursue vocational and educational goals. Additionally, the Peer Counselors help participants develop effective natural supports, and assist them in obtaining and maintaining use of appropriate mental health, medical and other community resources based upon self-identified needs.
Since May 2011, the PORCH program has served 162 individual participants in two sites in Pierce and Chelan-Douglas counties. At any time there are 50 participants at each of these sites. Optum’s preliminary data indicates that two thirds of enrollees completed one or more years of services. For those PORCH participants who were enrolled for at least 12 months, more than half demonstrated improved recovery scale scores, and housing stability and satisfaction scores improved substantially. The overall average length of enrollment in the PORCH program was 20 months.
One element of the PORCH program which was designed to foster engagement is the PhotoVoice project. The mission of PhotoVoice is to build skills within disadvantaged and marginalized communities using innovative participatory photography and digital storytelling methods to promote and achieve recovery. PORCH participants have the opportunity to represent themselves through photos and create tools for advocacy and communications to achieve positive engagement. Individuals were given cameras to record sites or items that had an impact on their recovery journey and provide a qualitative view of the impact of the services provided through the PORCH program. Individuals were then interviewed to articulate the significance of their pictures.
As an example of what the program could represent, we have included a sample illustration below showing the journey. One of the PORCH participants in this program selected a photo of the hospital where she had resided for many months. As a starting point for her PhotoVoice, this image was a powerful expression of how an imposing building structure represented the challenges she faced at the beginning of her recovery journey. A second picture selected by this individual for the PhotoVoice project was a painting that had been created while she was in the hospital. This was dark colored picture with entangled lines and confusing images.
The next picture selected by the individual in this example was the front door of her new apartment. This was a rather plain photo, but it had an image of a solid door on the front and it looked secure. She was able to describe how the peer support counselor from the PORCH program met with her and helped identify the ideal apartment for her needs. This included locating a place to live that was convenient and accessible to resources for her behavioral health needs and for everyday living (e.g., grocery stores and public transportation). The participant described how the peer counselor was able to assist her in completing the necessary paperwork for the Housing and Urban Development program that currently supports her rent.
The final picture in this PhotoVoice series was from the inside of her apartment. This was a well-organized picture of a table that included a laptop computer and books, and an inspiring poster. She articulated that she is attending a local community college and with the assistance of her peer counselor working on a degree in community services. She was able to articulate that as a result of the PORCH program, with secure housing and safe living environment she was able to begin her recovery journey. This included the support of her peer counselor, and the necessary supports to improve her health along with her education and community involvement.
The PhotoVoice project allows PORCH participants to easily give voice to their experiences within the program through pictures. Like the example above, the personal expressions are usually creative, personal and powerful — and are well-received by the participants, their peer counselors, and the community.
All too often, care for those with behavioral health conditions is focused on symptom management. Optum recognizes that in order to improve the health of those we serve there is a corresponding need to also address their overall social well-being. A safe and stable place to live is essential to achieving this goal. In collaboration with diverse community stakeholder groups, Optum strives to promote supportive housing and healthy community environments in which individuals are able to develop and maintain their own recovery.
Optum does not recommend or endorse any treatment or medications, specific or otherwise. The information provided is for educational purposes only and is not meant to provide medical advice or otherwise replace professional advice. Consult with your clinician, physician or mental health care provider for specific health care needs, treatment or medications. Certain treatments may not be included in your insurance benefits. Check your health plan regarding your coverage of services.
- Substance Abuse and Mental Health Services Administration, SAMHSA’s Working Definition of Recovery Updated, March 23, 2012. Available online at http://blog.samhsa.gov/2012/03/23/defintion-of-recovery-updated.