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This study explored care models and policies that enhance the utilization of peer providers in California and to identify and describe best practices in peer support roles and practices for individuals with mental health or substance use disorders in California. This research focused on services and programs that employed peers to help individuals transition out of incarceration and hospitalization.

Who are Peer Providers?

The Substance Abuse and Mental Health Services Administration (SAMHSA) defines a peer provider as “a person who uses his or her lived experience of recovery from mental illness and/or addiction, plus skills learned in formal training, to deliver services in behavioral health settings to promote mind-body recovery and resilience.” The key factor that defines peer providers is that they use their own lived experience(s) of recovery from mental illness and/or substance use disorders (SUDs), in conjunction with specialized training, to assist others on their path to recovery.

Peer provider titles vary across the organizations to include peer specialist, peer mentor, peer navigator, health navigator, and community worker. Peer roles are very similar across most organizations studied, and encompass some aspects of case coordination. At most sites, peer providers meet with program participants pre and/or post-discharge and assist them with linkages to housing, health care, SUD and mental health resources, benefits and bus passes.

Impact of Peer Provider Roles on Clients

Peer providers and other interviewees were asked to reflect on the impact of peer provider support on their clients and the benefits peer providers bring to the workplace. Common factors included the following:

• Peer providers serve as role models and symbols of hope.
• Peer providers establish rapport in a way that other professionals cannot, partially because they are not intimidating and partially because they have an intimate knowledge of what participants are going through from their lived experiences.
• Peer providers can spend time with participants and help relieve their anxiety.
• Peer providers can relieve the burden on clinical staff and social work staff by working with participants to set goals and obtain resources.

Policy Recommendations

• Develop statewide certification and training for peer providers to enhance visibility and legitimacy of the profession. Defined state requirements would also meet the requirement for billing Medicaid for peer support, which may lead to more sustainable funding.
• Establish a learning collaborative for training and resource-sharing to prepare organizations for implementation of successful peer support programs.
• Provide peer support programs greater direct access to hospital and jail/prison populations.
• Commission additional research on the efficacy of these types of programs
to establish what elements of these models are most effective in reducing re-hospitalization and re-incarceration.