A couple of weeks ago I was talking to some clinicians about the idea of social supports within the context of the biopsychosocial assessment and the importance of people having an effective support system when they are challenged with a mental health or substance use issue. It was a pretty basic conversation, but it triggered some thoughts I’ve had on a corollary topic – peer support services.
I don’t hear many people talking about peer-based services these days. Maybe it’s just that the linkage is more aligned with community mental health than those of us in private or group practice.
But it’s a topic that I thought I’d reflect on here.
I was first introduced to Peer-based services over a decade ago. The company I was working for at that time was working to be the first health insurance company to sort out coverage for peer services. As part of the conversation, we brought together the leaders in the field to a meeting in Washington D.C. to discuss what this might look like and what needed to be transformed in order for this to be possible. Part of the conversation, of course, was how a peer specialist might document the service to allow it to be billable.
For those of you who have not been introduced to peer-based services, a peer is a person who shares the experience of living with a psychiatric disorder and/or substance use disorder, who operates as a support for the client. Quite separate from therapy, the peer support relationship offers the individual encouragement and assistance to achieve long-term recovery. Peer support specialists, though these connections, offer education, emotional support, provide practical experience, teach skills, and connect people with resources, opportunities, and communities of support. While they are part of the “treatment team” they are typically not part of the treatment plan. There are no real goals, our clients, consumers, are not coerced to participate in peer-based services, and they can end the connection at any time. The consumer is empowered to participate. They have control over the schedule and frequency of meetings with the peer worker.
The Peer Services universe grew out of the 1970’s self-help movement. The reality of recovery is that, for many experiencing a psychiatric or substance use condition, there is more to it than just symptom reduction and management, and that individuals with lived experience could support one another to and live more meaningful lives in the community.
When we met with these peer service leaders, I was moved and converted to a clear understanding of that. They were not trying to replace psychotherapy or substance use treatment, but instead opening doors for people like them in their community who needed to feel more connected and supported.
Since those first conversations a lot has happened. There are now more than 24 thousand certified peer support workers across all 50 States, and now 41 States include peer services as a reimbursable service under Medicaid. SAMHSA recognizes peer services as an evidence-based practice.
Peer-based services continue to expand and are a part of a broad range of diverse teams at various levels of health care systems. They have been shown to have a significant positive impact on individuals with significant mental health or substance use conditions.
For many of us in private practice, it is easy to lose track of those individuals experiencing significant mental health and/or substance use challenges who have few available supports and resources. Peer services offers an incredible opportunity for connection with a trained individual who can provide support and mentoring in also allows them to feel empowered to lead a full life.
Some information for this blog entry was used from Mental Health America. For more information, please visit mhanational.org.