Community Integration Through the Development of Peer Leadership

Article originally published in the USPRA Newsletter

Contributing Authors: Kelly Wesp, MS, David Granger, MSSA, Deborah Wilcox, PhD, Stephanie Rich, BSSW, LSW, and Gregg Pieples, BA

There has been increased information in the last few years about the importance of social inclusion and community re-integration to mental health recovery. In Ohio, one state-wide program has tried to remove the barriers that limit inclusion and civic engagement by spearheading community-based gatherings that acknowledge and encourage leadership among peers.

A foundation of the Wellness Management and Recovery Program (WMR) in Ohio has been the building and sustainment of collaborative relationships between providers and service recipients in the mental health system. WMR promotes the idea of parity of expertise of providers and service recipients in the wellness group process. Through group process, participants begin to realize the value of their experience to others. All WMR Programs in Ohio are facilitated by two individuals who represent this collaboration and model for program participants that ongoing relationships are critical to delivering and receiving quality healthcare.


While the model is paramount to the success of the WMR Program, it soon became apparent there needed to be ongoing dialogue on how to improve partnerships and relationships in communities to support ongoing wellness and recovery for everyone. Facilitating WMR groups challenges persons whose identity may be primarily as a recipient or consumer of services to see themselves as providers of services as well. This can inspire increased involvement in community organizations and activities. The WMR Leadership initiative started as a grass roots effort where individuals living with psychiatric disorders and providing WMR Groups in their communities gathered on a quarterly basis to discuss the challenges they were experiencing in their role as co-facilitators. This dialogue opened up new doors for advocacy, activism, and ongoing support.

In the winter of 2008, the first State-Wide Leadership Summit met to identify goals that would help the WMR Program remain focused on supporting individuals in the center of their recovery. The two-day gathering consisted of relationship building and deliberative dialogue about the potential for peer leadership in Ohio. This gathering not only recognized and appreciated the leadership that existed among the members, but helped to identify ways in which the leadership could spread across the various communities in Ohio. Outgrowth ideas included peer involvement in leadership opportunities through ongoing representation on local boards, increased involvement in organizations, and the development of peer led wellness advocacy groups.

Over the next year, many of the individuals continued to stay active in their communities, but with an added emphasis on peer leadership. As a result, several WMR Alumni Clubs began to develop for the purpose of ongoing dialogue and learning about how to sustain wellness not only for the members of the group, but for the organizations where they facilitated groups, and in the communities where they lived. The Alumni Clubs are peer led, have an identified membership, and have increased the social inclusion for many individuals who would have remained isolated. Additionally, some individuals who attended the first Leadership Summit volunteered for work groups and committees at the state level. Because of their active work experience within WMR, they were able to express the needed changes. This group emphasized the importance of small group work, the use of deliberative dialogue, and the continuous involvement of peer membership.

A second State-Wide Leadership Summit was held in March of 2009. The membership at this gathering doubled from the previous year. The group discussed the “movement” that happens with WMR and the need for peer involvement in the change process. As a result of this Summit, peer leaders have been instrumental in planning, organizing, and assisting with a State Wide Conference where many of the peers facilitated workshops. Most recently, a small group of leaders from three different areas around the state came together to facilitate The WMR Facilitators’ Workshop for new WMR facilitators. The workshop participants included both peers and clinically oriented mental health providers. Finally, peer leaders from the most recent summit have been engaged in facilitating community forums and others have completed additional certification to assist them in their role as peers and advocates.


Throughout this process we have learned some valuable lessons:


1. That everyone has leadership skills and unique gifts to bring to wellness and recovery work.


2. Engaging in group process opens up a “safe space” for people to build authentic relationships across human differences. This supports the tenet that all groups are multicultural and that individuals are unique. Contributors to the process bring a distinctive combination of experiences and beliefs to the group, based on family, culture, race/ethnicity, gender, education, and peer group experiences.


3. Holding a space open for individuals to engage in collective learning experiences as well as good deliberative dialogue supports the leadership development process.

Ohio’s WMR Project is engaged in a number of activities that help to develop and sustain peer leadership. It is actively working with leaders across the state to make the necessary policy changes to increase the parity among peers and providers in the delivery of quality health care services.


Overview of Ohio’s WMR Project and Program

Program Support and Implementation


The Wellness Management and Recovery Program (WMR) is based on a psychoeducational curriculum and is presented through a 10 week group process that is co-facilitated by a person providing services in the mental health system and a person receiving mental health services. The WMR program is delivered in a small group-level intervention with adults who have a psychiatric disorder and may have co-occurring substance use and other health disorders. It is based on Social Cognitive Theory and, as such, focuses on the development of skills, positive expectations, and promoting self-efficacy. New behaviors are learned through modeling and practicing new skills. The inclusion of a mental health peer as a facilitator not only enriches the group learning process but provides a model for recovery as an empowered, collaborative process between the peer and the professional treatment team.


In the WMR Program, knowledge about good health and recovery is developed collectively which supports individual empowerment. As a result of participating in WMR, individuals begin to (1) identify and achieve personal goals, (2) develop informed, collaborative approaches to selecting and managing effective treatment, and (3) achieve an overall healthier lifestyle. The curriculum and learning process is inclusive of cultural competence, dual diagnosis, and co-occurring health problems. The skills developed are assertive communication, decision-making, and problem-solving which support individual choice and informed decisions about personal wellness.


Outcome data for graduates of the WMR Program reveal that 64% of participants showed improvement on measures of recovery. They reported increased knowledge and skills to manage their mental illness, an increased sense of empowerment, improved quality of life, decreased symptom distress, and evidence that they were integrating a recovery philosophy into their lives. There were no differences in these outcomes between WMR groups in traditional community mental health agencies and those in consumer-operated organizations, suggesting that WMR has the flexibility and adaptability to be utilized for promoting mental health recovery in multiple settings.

For more information about Ohio’s WMR Program, please visit www.wmrohio.org.