Introduction: Crisis and Transition Services (CATS) provides transitional mental health services to high-acuity youth discharging from emergency departments (EDs). A novel component of CATS is the inclusion of a family peer support specialist (FSS) on the care team, who provides direct support to the parent or guardian in developing self-advocacy, crisis management skills, and self-efficacy in navigating systems. The FSS is not a typical role in a clinically oriented crisis program; empiric evaluation of this role can help guide quality improvements in the program and in workforce recruitment, training and support.

Methods: Demographic and service data were collected from CATS providers, and families were surveyed two months after completing CATS to collect feedback and clinical outcomes (n=147). Participants were sorted into two groups: did engage with FSS (n=89) and did not engage with FSS (n=58). Predictive factors for successful engagement with a FSS were analyzed using Pearson’s chi-square tests. Descriptive statistics of services provided to families and family satisfaction ratings were also evaluated. A qualitative analysis of family feedback comments identified common themes regarding family experiences of the FSS.

Results: When the FSS attended the first team meeting after intake, parents were more likely to engage with peer support χ2 (1, n = 147) = 20.60, p < .001. As part of the follow-up survey, parents rated their experience with the FSS on a scale of 1 (completely unsatisfied) to 10 (completely satisfied). Over 70% (n = 65) of families rated their experience with the FSS as a 7 or above. The most prominent theme in the qualitative comment analysis was that parents had positive experiences with the FSS. The most common negative comment was that the parent didn’t understand how the FSS would be helpful or did not feel the FSS role would be useful for their family.

Conclusions: The program elements that predict the likelihood of a family engaging with peer support, together with parent satisfaction ratings and feedback comments, provide insight into the successful implementation of parent peer support in a crisis program for youth. These have important implications for FSS professional and workforce development.

Key Take Away Points

  • Providing family with a clear description of what family peer support offers may increase meaningful family engagement with this service
  • Improved training specific to engaging families in a high-acuity crisis program may have a positive impact on youth and family outcomes, as well as strengthening the family peer workforce
  • A deeper understanding of the positive characteristics of a highly effective family peer support specialist can inform recruitment, training, and supervision of the family peer workforce
  • Family engagement with family peer support is higher when the peer support role is introduced early in the service period

Author Biography

Julie Magers is an Oregon-certified Family Support Specialist. She was instrumental in break-through Oregon legislation on safe transitions from hospitals and emergency departments. She helped develop Oregon’s first Youth Suicide Intervention and Prevention Plan and is a member of the Alliance to Prevent Suicide, which oversees the plan’s implementation. Awards include SAMHSA Voice Award (2016) and OCCAP Advocate of the Year Award (2017) for her high-profile work in elevating the voice of families. At the Child and Adolescent Psychiatry Division at OHSU, Julie provides program development and technical assistance for Oregon’s Youth Crisis and Transition Services (CATS) program. Amanda Ribbers is a Research Associate in the Division of Child & Adolescent Psychiatry at Oregon Health & Science University. She supports the CATS Outcomes Study, and has played an active role in developing effective data collection processes. She has clinical experience in a variety of settings, including providing direct care in residential treatment and serving as an advocate for sexual assault survivors presenting to emergency departments. She has a master’s degree in Applied Psychological Science, and hopes to use her background in mental health research, social justice, and outcomes-driven care to inform best practices in youth treatment and program development. Sophia Nguyen is a Research Assistant in the Division of Child & Adolescent Psychiatry at Oregon Health & Science University. Sophia provides technical assistance to the CATS Outcomes Study by following up with families, collecting outcomes data, and contributing to the improvement of the program. Some of her research accomplishments include completing an independent research study through the Ronald E. McNair program and becoming a QUEST scholar at New York University. With a Bachelor’s degree in psychology, Sophia’s research interest lies at the intersection of mental health and childhood development. Dr. Rebecca Marshall is a child, adolescent and adult psychiatrist who completed medical school, adult psychiatry residency and child and adolescent psychiatry fellowship at OHSU. Dr. Marshall provides psychiatric care to children and adolescents in Doernbecher Children's Hospital and emergency department. She specializes in the evaluation and treatment of youth with acute psychiatric issues, as well as with medical and psychiatric comorbidities. She is the primary investigator for OHSU's Crisis and Transition Services (CATS) Outcomes Team, which leads development and evaluation of the statewide CATS program. Dr. Marshall is also involved in several other projects to improve clinical and public health services for children and adolescents struggling with mental health issues.