Peer wellness workers help Cascadia clients achieve better health

OPB News, Oct. 16, 2013


As the Affordable Care Act rolls out, the federal government has given Oregon wide latitude to come up with new ways to keep people healthy.

A group that’s been particularly difficult to help over the years, is people with mental health issues.

But one Portland clinic says it’s having success employing people who’ve been treated successfully for mental illness to help others who are in treatment.

Vietnam veteran Cliff Bedell says peer services help with his PTSD.

Vietnam veteran Cliff Bedell says peer services help with his PTSD.

Cliff Bedell says he survived his tour in Vietnam with a knee wound. But he’s only talking about the physical injuries.  He also has Post-Traumatic Stress Disorder (PTSD) that he says sometimes resulted in delusions.

When he hears a loud noise, he says he immediately finds himself in  “fight or flight” mode. He can’t even go into a room without being hyper vigilant.

“I was always looking to see who was behind me, making sure of what was behind me. But I’m also looking at the door,” Bedell says.

The last 40 years have been hard for Bedell. His health has been slipping and he’s gained a lot of weight.

“In two years, I had six different providers and the last one started changing my meds without telling me. Which is a no-no. Not going to happen.”

Now he’s a patient at Cascadia Mental Health in Portland.

Under a federal grant from SAMHSA — the Substance Abuse and Mental Health Services Administration — Bedell now has a whole group of people who work with him — a psychiatric prescriber, a case manager, a nurse and Sybil Berkley, a peer wellness coach.

That’s a fancy title for someone that helps him pick up better health habits — like eating well and exercising.

“I’ve helped him create three- and six-month wellness goals, and that’s called a wellness recovery plan,”  Berkley says.

But Berkley is not someone who just left nutrition school.

Ten years ago, she was diagnosed as bipolar with a panic disorder. And she suffers PTSD from a traumatic childhood.

She’s now on medication and considers herself in recovery.

Peer Wellness Coach Sybil Berkley is in recovery from a diagnosis of PTSD and bipolar disorder.

Peer Wellness Coach Sybil Berkley is in recovery from a diagnosis of PTSD and bipolar disorder.

But she remembers believing for example that she was a “half-breed angel.”

She says it’s the kind of delusion that’s common among people with some mental health conditions, so she can relate to their fears and symptoms.

“What I have found working is that I’m able to connect on that level and say, ‘Yeah, well I had that experience,’  and working with people I’ve found that, that wasn’t a real experience and I take medications to help me. And they’re not for everybody. My job is not to push medications on you, but to help you find out what you want.”

Berkley went through about five months of training to become a “peer wellness” coach.

She says sharing her life experiences with clients builds trust and a bond.

She’s also admits she’s dealing with some of the same problems they are, like being overweight.

“I talk about my struggles with weight. And I weigh myself alongside my peers. They really respond to that positively because I’m one of them again. And I’m not just telling them ‘This is what you have to do to lose weight.’ “

Berkley says this isn’t just a job for her. It has turned her whole life around.

“I was very ill for a very long time and I was on Social Security. I really didn’t see that future. I didn’t have any role models in the community that could show me,  ‘Yes you have a diagnosis, but you can still have a rewarding life.’ “

Now she is a role model for her clients.

So, how’s it working? Vietnam vet, Cliff Bedell says. “She’s been there. She’s done it. She has the insight to be able to see where some counselors, yeah, they’ve had the training and everything else. It’s just they don’t always see past what’s showing. And I’ve had Sybil see past what’s showing.”

Bedell says since he started working with Sybil Berkley in February, he’s less stressed and he’s gone down one whole pants size.

Renee Boak,  director of integrated services for Cascadia, is impressed with Berkley’s work.  “She’s been amazing at developing rapport with the clients and building the trust.”

And Sybil Berkley’s story is not unique.

Jamie Lynn Montoya is another peer wellness counselor at Cascadia Health. She has a bipolar diagnosis and says she has tried to kill herself multiple times. But now that she’s stabilized she wants to help others.

“I can relate to my peers and they can tell that it’s genuine. And it’s not book-learned or any of that.  And so there’s a connection there and we work alongside with the case manager and I feel that there’s more trusting through peers. They know that we’ve been through it,” she said.

Peer wellness counselors like Montoya and Berkley work part-time and make up to $15 an hour — depending on their experience. Their salaries are currently being paid under a four-year federal grant from SAMHSA — an agency within the U.S. Department of Health and Human Services that works on the behavioral health of the nation.

It requires a series of metrics to be recorded, so it can gauge whether the effort saves money and provides better outcomes.

Cascadia director, Renee Boak, says the aim is to keep people out of the ER.

“It’s hard to measure prevention and money saved that way. But I really think that by not only helping to diagnose physical conditions that people might not otherwise have realized they have, we’re able to provide the treatment and then also the skills and knowledge to make the behavioral changes so people can lead the lifestyle that better addresses that condition so I think we’re extending lives,” Boak says.

And that’s not insignificant. SAMHSA finds that the life expectancy of a person suffering from a mental illness is 25 years shorter than the general population.

The grant has another three years to run. About 100 mental health services around the country have received similar grants.

If the idea’s successful, the program could be expanded across the country.