Live and Learn with Laysha Ostrow


Learning about a Mental Health research and consulting company (Live & Learn) based right here in Morro Bay.  Founded (in 2015) by Laysha Ostrow.  This article (Feb 26, 2020 by Peter Simons) provides a good overview of her and the organization.

Area of Focus

  • Community-driven interventions for inclusion of people with lived experience of mental health system
  • Improve the experience of mental health service users

Research

  • Here’s a link to research by Laysha

About company – Live & Learn

  • Small, and with primary focus of inclusion of those with lived experience of mental illness
  • Works with various stakeholders – providers, admins, policymakers, etc
  • Research projects
    • Independent investigator-initiated research (ie academic setting)
  • Consulting projects
    • Small contracts with peer-run organizations reporting their outcomes
    • Work with state and county mental health systems
  • Grants
    • Multi-year federal research grant (National Institute on Disability, Independent Living and Rehabilitation Research)
      • Study career and financial outcomes of people who get certified as peer specialists
        • Researching efficacy of role; sustainability; work environments
      • Key: People need meaningful and well-paying work.  People should be paid and treated well for their work.
      • Term – Peer Specialist: People providing mutual support to one another, which has now become more professionalized within mental health system.  Requires training in mental health field, state credentialed, certificates, exams, supervised hours, towards full certification.  Billing towards Medicaid for peer specialist work.  Important to maintain quality and EBP (scientific evidence) within the specialty.
      • Grant Focus:
        • What are the outcomes for mental health service users? Are peer specialists helping the people that they serve?
        • What’s happening with the workers themselves?  This is Laysha’s interest.  Dissertation was on peer-run organizations.  Laysha’s perspective is of the workers.
        • Note: One thought that came to mind was at Fordham, where the Math professor effectively encouraged us to work in three’s of mutual support specialists.
        • Q: How is it going for the peer specialists, who are both doing the work, while also receiving services?  Goes towards objectivity.  Areas of Focus and Responsibility.  Roles.  The Peer Specialist could be in the same financial/disadvantaged/marginalized context as their “client” – how does that affect the work?
        • Q: How does the peer support credential give additional advantages over traditional education and work?  People can realize they can actually do things, which is empowering.
        • Q: What are the various measures?  Level of job satisfaction.  How peer specialists experience the workplace.  Measure: burnout, self-esteem, self-efficacy.  Understand better the relationship between work peer specialists do and these various outcomes.
        • Q: What do Peer Specialists have to deal with at the intersection of patients and providers?  Research has shown that they are marginalized by colleagues not diagnosed.  Issue appears that those with “higher” academic credentials (social worker, psychologist, etc) can distance themselves and don’t see the P.S. as being an equal.  Providers can consider that the P.S. is closer to the patient or more aligned with the patient, and therefore less objective.  Laysha distinguishes herself as not being a peer support specialist, and more an objective researcher/clinician.
        • Question: Why is it that society somehow figures it’s OK for a P.S. Specialist to work in mental health fields?  Is it because someone who is “well” can’t imagine working absolutely side-by-side them?  Possibly a fear?  While society acknowledges that everyone should be able to work, I’m thinking that “well” people wish to distance themselves from workers with diagnosed mental illness.
  • Laysha’s lived experience:
    • Age 14; runaway; didn’t make it very far; hospitalized.
    • Paxil; bad reaction to Rx.
    • Manic episode; back to hospital.
    • Revolving door – removed from school; different Rx; off Rx; different school, etc.
    • Residential Treatment Facility for 2.5 years.  Get’s a H.S. Diploma.
    • Parents took guardianship over her at age 18.  Lost all legal rights.  On court-ordered anti-psychotics.  On Disability.
    • Because of court-order, limited to which college to attend – within state of MA.
    • LOA from school; believing the hype that school wasn’t for her; working jobs that didn’t last long.  Being told by parents and providers that work wasn’t for her, and she should just be fine with her “disability”.
    • What’s the turning point?  Switching focus to being of help for others
      • Taking research assistant jobs.
      • Switching Area of Focus within a BA Program – mental health policy (systems level, vs individual level).  “The psychology of the individual never really spoke to me.  It was not reflective of my experience.”  Key: Laysha feels a lot of empathy, while working at the systems level.  Still encounters quite a lot of negativity within employment and education, that further energizes her mission.
      • Getting a Master’s in Public Policy
      • Getting a PhD
      • Learning Public Speaking
  • Money and Work
    • We spend most of our time at work
    • There is 100% thru-line toward money. Needing money.
    • Being personally connected to work can be both a blessing and a curse.
  • Starting a Business
    • Initially created Lived Experience Research Network (non-profit)
    • Didn’t really know how to run a business, initially
    • It’s important to have a viable market, but…
    • Personnel Policies; contacts; budgeting; division of labor
    • Freedom to choose your direction and location
    • Success and challenges getting of psychotropic drugs – issues with sleep
    • Overcoming feelings of failure
    • Nearly went out of business (no money coming in) and then contracts came.
  • Laysha’s perspective – not an advocate
    • Big priority is representing alternative perspectives, and not advocacy
    • Marginalized perspectives from people on the ground about how we’re helping ourselves or helping each other.
    • Work: Observational; cross-sectional; large-scale surveys.
    • First step in elevating our perspective.  Using quantitative data.  Bringing something into the conversation so that we can do more research.
  • Elevating the research – stepping up the game:
    • Focusing on project – career outcomes
    • Longitudinal – answer more questions than with cross-sectional data.
    • Experimental studies.  Difficult.  Working with colleague at USC.
      • Effectiveness of peer respites compared to other kinds of crisis diversion.
      • Review board returns because the methods are not including a randomized controlled trial.
      • Note: Peer respite is like peer-run programs in a home environment.  These are not designed to be randomized, as people choose to enter it.
      • Needing different statistical methods – different observational methods to control for some of those other variables; use alternative statistical methods if you want to research alternative services.
      • Strategy with grants (and applications) is to not get too far ahead of yourself.  Work in measurable increments.
    • Ideal changes in mental health systems
      • Listen more
      • Trying different things and not being so attached to the way that we do things.
      • Problem: Many people in the system are burned out
      • It’s worse for people whose lives are entrenched in the system, not just their jobs.
      • Too many people in the system; things are too complicated.
      • Peer support has become a victim of its own success.
      • Some things go wrong (or could be better) about way that peer support has been integrated into mental health systems.  It’s still overall a benefit to people.

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