Peer Support Workforce

The Most Significant Change in the Mental Health Workforce

The power of peer support between individuals with similar health conditions has been recognized for some time. What has been the informal practice of peer support in mental health has become much more formal over the past two decades with the training and certification of peer support workers. Certification of peers began in 2001; Medicaid released its first memo on peer support in 2007; and by 2016, 44 states offered peer specialist training and certification (Wolf, 2016). A compelling case can be made that this represents the most significant change to the mental health workforce during the current century.

Foundations of the Peer Support Worker Movement

There have been strong philosophical and moral arguments for advancing peer support. These have been complemented by research evidence demonstrating its effectiveness. The economic driver of reimbursement has fueled further development of peer support, which has been viewed as a complement to, and, in some cases a replacement for, standard therapies.

The development of peer support specialists as a segment of the mental health workforce has occurred in ways similar to the development of the core mental health professions. Formal peer support competencies have been identified and disseminated. Formal peer support training programs have been created, linked in many states to worker certification. Reimbursement for peer support services has become available for those who are certified.

Developmental Issues

The rapid advancement of the peer support workforce has highlighted other developmental challenges. These workers have not always been welcomed in mental health service agencies, highlighting the need for organizational culture change that more fully embraces recovery-oriented care. The need has emerged to clarify who should supervise peer support workers and build appropriate models of supervision. Currently, there is wide recognition of the importance of fostering retention, advancement, and career development among peer support workers.