Enabling Change: MassHealth Expansion of Enhanced Peer Support in Child Behavioral Health

There is an unmet need in mental health services for youth and young adults ages 14-25 years in the United States, with only 20-35% receiving needed treatments (NIMH, 2017). Transition Age Youth (TAY) are older adolescents, ages 16-24 years, that are particularly at risk for mental health crises when transitioning from child to adult social services or from child services to complete independence. This vulnerable population faces challenges across diverse social systems, including poverty, education, justice system, housing, and unemployment. To expand efforts to address gaps in the continuum of mental health care and to improve mental health outcomes for TAY, the Massachusetts Medicaid and Children’s Health Insurance agency (MassHealth) in partnership with the Massachusetts Department of Mental Health (DMH) developed a treatment innovation: the Young Adult Peer Mentor (YAPM) therapeutic intervention model. In the YAPM intervention, young adult peer support staff utilize their lived experiences from the successful management of their own mental illness to assist youth with similar mental health challenges through therapeutic mentoring techniques. The DELTA Project provided a broader knowledge base for the MassHealth statewide implementation of the YAPM model by examining the MassHealth Providers’ interest in and organizational readiness to implement the YAPM peer support intervention. Data was collected through electronically administered surveys to staff and through key stakeholder interviews. The Project findings showed that education and advocacy were vital for organizations to understand the valuable role of peer support staff. Unfortunately, the stigma of mental illness remains an issue among mental health professionals working with young adult peers. Training and support were reported as being critical to the successful integration of the YAPM model. Fidelity of the YAPM model was essential to its sustainability in organizations. Interest and organizational readiness surveys, educational materials, an executive summary, and an issue brief were developed as deliverables to MassHealth. The key leadership lesson learned from the DELTA Project was that when facing an organizational challenge, one must continually self-assess, learn from unanticipated experiences, and believe that flexibility of perspective, flexibility of thought, and a willingness to compromise can lead to the right solution.