What is a Mental Health Peer Specialist’s Role in a Care Team?
The recent expansion in the number of peer support specialists in the mental health workforce have left many wondering: what is a peer specialist’s role within the organization and within the care team? Linda Cabral and colleagues at the Center for Health Policy and Research at UMass Medical School explored these questions by interviewing peer specialists, supervisors, and clients in Massachusetts.
A Unique but Ambiguous Role
The supervisors that were interviewed represented three different mental health service types: community-based services, programs for Assertive Community Treatment, and emergency room services. The peer specialists were both newly trained and experienced (more than 6 months in the job), capturing a range of experiences over time.
Supervisors and peer specialists shared many of the same understandings about the peer specialists’ role despite coming from a range of backgrounds and service types. Both groups described the shared lived experience of peer specialists and the ability to “empathize” not “sympathize” as valued contributions of peer specialists that could not be filled by other mental health staff. Clients also identified this as a key element of the role, citing equal footing between client and peer specialist and relating to recovery stories as unique contributions of peer specialists.
Furthermore, peer specialists often became the “role model” for the reality of recovery, educating co-workers about mental health recovery. This educational role extended to their own job description, with peer specialists often educating non-peer staff about what peer specialists do.
The role of peer specialists was perceived to vary by mental health settings across the state, with one setting having different responsibilities than others. One supervisor noted that while the peer specialist role is embraced, it is also not understood, leading to providers not knowing when to ask a peer specialist to be involved in a client’s case. This confusion about roles also complicated a supervisor’s ability to evaluate peer specialist performance. Supervisors and peer specialists both recognized that clarity on the formal expectations of the peer specialist role would be beneficial, echoing prior research (Chinman et al., 2008; Salzer et al., 2010).
Incorporating Client Needs into Role Guidelines
Cabral and colleagues uncovered an interesting new perspective from the interviews conducted with the 10 peer support clients. Most clients were able to clearly describe what the peer specialists did that made them so valued. This included activities that other staff could not do, such as running errands and helping with individual needs like paying bills; as well as mental health support activities, such as acting as a liaison between client and staff, being available to talk about problems, and personifying a recovery success story.
These concrete descriptions of the peer specialists’ role contrast with the lack of role clarity described by peer specialists and supervisors. The authors of this study suggested that this juxtaposition between ambiguity of role felt by peer specialists and supervisors and the clarity of role felt by clients should be more closely examined. Furthermore, the client’s perspective should be taken into consideration when defining the role of peer specialists or other non-clinical staff, like community health workers.
Defining Peer Specialists’ Role
By nature, peer support is dynamic and fluid, which complicates attempts to define it in a work setting. The four key functions of peer support may provide a guiding framework to define peer support roles by function rather than actions and tasks. Describing roles and responsibilities to reflect client needs may also clarify peer specialists’ role within a care team and help providers have a clearer picture of how and when a peer specialist can step in. Despite ambiguity about the role of peer specialist, their contributions to the care team can deliver new dimensions of support to clients. To help strengthen the relationship between peer specialists and care teams, professionals need to receive training to work with and supervise peer specialists.
Cabral, L., Strother, H., Muhr, K., Sefton, L., & Savageau, J. (2014). Clarifying the role of the mental health peer specialist in Massachusetts, USA: Insights from peer specialists, supervisors and clients. Health and Social Care in the Community, 22(1), 104-112.
Chinman, M., Lucksted, A., Gresen, R., Davis, M., Losonczy, M., Sussner, B., & Martone, L. (2008). Early experiences of employing consumer-providers in the VA. Psychiatric Services, 59(11), 1315-1321.
Salzer, M.S., Schwenk, E. & Brusilovskiy, E. (2010). Certified Peer Specialist roles and activities: Results from a national survey. Psychiatric Services, 61(5), 520-523.