Accelerating Best Practices in Peer Support Around the World

Integrating Peer Supporters Into the Workforce

In recent months, peer supporters have been increasingly recognized in the field of mental health. In September, President Obama announced the Department of Veterans Affairs (VA) will “hire 800 peer-to-peer support counselors to help veterans support each other and ensure that their mental health needs are met.” Later that month, the administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA) announced they were awarding 2.3 million dollars in funding for consumer networks to “foster peer support groups and offer training for peer support leaders.”  While great news for the field of peer support, these announcement also raise questions of how peer supporters in mental health can be trained, licensed and implemented.

As discussed in our recent blog on community health workers, policies for training and licensing can have a dramatic impact on worker reimbursement. Similarly, there have been major changes to policies regarding licensing and/or certifying peer supporters in the area of mental health. A recent article by Grant and Colleagues noted that the role of Certified Peer Specialist (CPS) is a recent addition to the field of mental health and at least 16 states have developed Medicaid reimbursement for CPS services delivered in the mental health system. In light of the upcoming expansion of Medicaid under the Affordable Care Act, it is critical to understand how these new workers can be implemented into the workforce.

Fortunately, some of this information may already be available from a 2010 study by Salzer and colleagues that featured a survey completed by 291 CPSs across 28 states. The authors found that overall, CPSs spent almost twice as much time on site as in the community; however, the reverse was true in some program structures like case management. Additionally, CPSs devoted almost twice as much time to supporting individual peers compared to groups. Not surprisingly, peer support was by far the most prevalent activity for CPSs, but other reported activities included addressing hopelessness, communication with providers, illness management, addressing stigma in the community, developing friendships, education, transportation, and developing wellness recovery action plans.

Understanding the different kinds of activities and programs in which CPSs work is critical given their eligibility for Medicaid reimbursement. Salzer and colleagues found that CPSs were employed in many different kinds of programs including case management, partial hospitalization or day programs, vocational rehabilitation centers, therapeutic recreation or psychiatric rehabilitation, drop in centers, education and advocacy, and independent peer support. Further independent evaluation would need to determine the effectiveness of CPSs for patient outcomes in this wide variety of settings. Nevertheless, Salzer and colleagues have demonstrated that CPSs operate in a wide range of workplace activities and settings.

With the increase in funding for peer support workers in the field of mental health, Peers for Progress will continue to research and evaluate the different roles and activities of workers in the field and promote best practices around the world. We encourage our readers to continue to check our scientific evidence section, peer support resource center and sign up for our newsletter.

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