Oklahoma has a robust treatment court system that integrates people with lived experience of behavioral health disorders and criminal justice involvement throughout the treatment court process, according to Nisha Wilson, M.S., LPC, director of criminal justice services for the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS). Certified Peer Recovery Support Specialists (PRSSs) are the lynchpin in services for many of the more than 7,000 participants in felony drug and mental health courts that the state serves annually, adds Heath Hayes, M.A., M.H.R., director of recovery support services for ODMHSAS.

Wilson and Hayes describe a state approach that is unique in several ways. First, ODMHSAS is not only the state’s behavioral health authority, but also the supervisor of the mental health and drug treatment courts’ administrative operations, which extend to include such specialty dockets as those serving people with co-occurring disorders, those arrested for driving under intoxication, and Veterans. ODMHSAS ensures that every treatment court program has at least one certified treatment agency that is specifically contracted to provide care for those participants.

“A treatment court is one way that people may enter the door into services,” Wilson says. The contracted agencies develop individualized treatment plans for each court participant, and the state reimburses them on a fee-for-service basis for the work they do. Everyone connected with services by a drug court will receive substance use treatment, but they will also receive support for additional needs, such as parenting classes, trauma-specific interventions, or family-based care, Wilson notes. She adds that treatment court participants have access to more than 100 types of individualized services.

Second, one of these wraparound services is wellness planning provided by the more than 700 certified and Medicaid-reimbursable PRSSs currently working in Oklahoma. All peers providing services are trained and certified by the state, Hayes explains. Once they have an agency that is prepared to hire them, they apply for a 40-hour intensive training overseen by ODMHSAS that leads to certification as a PRSS. All peers in Oklahoma receive the same training, regardless of whether their lived experience is with mental illness or substance use. “We very much believe that co-occurring disorders are the expectation, not the exception,” Hayes says.

Peers may also apply for additional training in specific tracks, such as youth and young adults, Veterans, or criminal justice. Though they do not have to have criminal justice experience to work with treatment court participants, that lived experience is often what makes the difference, Hayes notes. Peers with lived experience of criminal justice involvement can help engage treatment court participants just by listening and sharing their stories. PRSSs also help treatment court participants navigate services, connect with schooling and employment opportunities, and engage in physical wellness interventions such as tobacco cessation and exercise classes.

Depending on the services a treatment agency provides, PRSSs may be involved at every stage of the treatment court proceedings. “We’ve had defense attorneys working with peers to have a conversation with their clients about what the program entails,” Wilson says. Some agencies send peers into the jails to help individuals make the decision about treatment court participation. PRSSs are also an important component of a new best-practice aftercare program the state has instituted for treatment court participants, thanks to a recent U.S. Department of Justice grant. Called Recovery Management Checkups, peers are the recommended staff for the program, which helps treatment court participants transition successfully from the formal oversight of the treatment court to life in the community. PRSSs can help quickly identify if a person who is struggling needs to reengage in treatment services outside the authority of the treatment court model, Wilson notes.

Both Wilson and Hayes consider the use of PRSSs in treatment court proceedings an unqualified success, but they note it is not without its challenges. Education about the appropriate use of PRSS is critical, both for the court system and for treatment agencies. “The concept of having an individual with lived experience in the criminal justice system working with that population is not necessarily one that is traditionally viewed positively,” according to Wilson. For example, she explains that people on probation often are told to stay away from individuals who have similar histories. In addition, because treatment court participants may disclose their struggles to peers, court personnel need to understand that PRSSs are not an extension of the probation system. Likewise, Hayes notes that treatment agencies themselves often need to be educated about how best to use PRSSs to reach those who have criminal justice involvement.

Wilson would like to see the reach of the program expanded. Internal data show that about fifteen hundred drug court participants received services from a PRSS in 2018; that’s about half of the participants in the state’s drug courts. “But those participants received almost 24,000 unique services, so we know that when they receive these services, they’re getting a substantial amount of interaction with PRSSs,” Wilson notes. This interaction can literally be lifesaving. “I’m the beacon of hope for you because I’ve been in your shoes,” is a powerful message that peers convey, Hayes concludes.

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