SC Clinical & Translational Science Institute, Office of Community Engagement 


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Volume 1, Issue 5                                                                                                                                     February 2012

In This Issue 

What are the next steps for the Peer Health Navigator Project? 


What else is the CTSI doing for DMH and the mental health community?


These and other questions will be answered in the

future editions

of ...



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In the last issue we described the Peer Health Navigator project, discussed why it was needed, and listed its goals. In this issue we will further describe the role of the Peer Health Navigator pilot project and explain its findings.


What is the role of the Peer Health Navigator?


A peer health navigator is an individual who has had experience with the health and mental health system and who has been trained to help people with a serious mental illness with their physical health care and wellness needs. A trained health navigator can help make a meaningful difference in the lives of people with serious mental illness.


The role of the peer health navigator is complex and critical. The health navigator is the main link among consumers, agency staff and medical care providers. The peer health navigator may be responsible for a wide variety of tasks including:

  • Working with agency staff and/or family members to decide which consumers can work with the health navigator
  • Conducting an initial assessment with each participating consumer to assess his/her health and wellness status and experience with getting health care
  • In collaboration with the consumer (and, in some cases his or her family and/or care team) set healthcare and wellness goals
  • Acting as a coach, work with the consumer to help him/her achieve and maintain those goals through behavioral strategies such as shaping, reinforcement, modeling, and fading. Other strategies such as role playing and problem solving may be used.
  • Navigate the medical system with the consumer including such things as helping the consumer make medical appointments, going with the consumer to appointments, helping the consumer communicate with medical personnel and/or coaching the consumer about ways to talk with medical personnel, helping with any follow-up necessary such as lab tests, getting prescriptions filled or taking paperwork to the consumer's mental health provider
  • Coordinating the consumer's navigation and goals with appropriate agency staff
  • Communicating with consumers on a regular basis to keep them engaged and to assess progress
  • Tracking the progress of consumers including conducting follow-along assessments



How many consumers participated in the pilot study?


Twenty-four consumers diagnosed with severe mental illness who were receiving mental health services at Pacific Clinics were randomized to either immediate navigation or to a wait-list condition with navigation beginning after 6 months. Within and between group analyses were conducted.


Immediate outcomes included self-reported measures of health status, satisfaction with health care, service utilization, and health care efficacy. More distal outcomes included measures of functional level, satisfaction with life, internal and external stigma.





What did they learn?


Significant differences in favor of the treatment group were found on several indicators of reported health status. Number of currently reported health problems was significantly lower in the treated consumers compared to the untreated group. Self-rated general health condition was significantly higher in the treated group. There were also significant differences in the amount of overall bodily pain and the pain that interfered with productive activity favoring the treated group. There was also a significant shift in the chosen location of services away from the hospital emergency room and urgent care, and towards outpatient medical services, which suggests possible cost impacts.   The team is still analyzing the data.


The findings of the Peer Health Navigator Project (now called the "Bridge") indicate the promise of the intervention in reducing health problems, improving self-rated general health, reducing pain and the impact of pain on activity, and shifting the locus of care from the emergency room to the outpatient clinic. The Bridge successfully improved health behavior and outcomes in the context of a novel, peer navigation program that integrated health and mental health services. The Bridge intervention holds tremendous promise in terms of addressing and resolving the issue of health-related premature mortality, which disproportionately plagues individuals with serious mental illness. The Bridge, in connecting the mental health and health care sectors, facilitates a fuller and healthier life.



Submitted by Holly Kiger, RN, MN, CNS, Research Navigator, SC CTSI, Office of Community Engagement