According to the National Alliance on Mental Illness, one in five adults experience mental illness in a given year; yet our health care system does not have enough behavioral health workers to meet service demands. Psychiatrists, psychologists, advanced practice nurses, therapists and other behavioral health specialists are in short supply or are inaccessible for many people who need care. Peer providers cannot only help fill in coverage gaps; they can also play an essential role in supporting clients’ long-term recovery past the point of acute crises. Included are case studies from leading peer provider programs, which offer state and federal policymakers actionable information they can use to shape training, certification, reimbursement programs and policies for peer provider services.

What are peer providers?

Peer providers are individuals who provide services in behavioral health settings, both mental health and substance use disorders (SUDs) treatment, based on their own experience of recovery from mental illness or addiction and skills obtained from formal peer provider training. They are part of the transformation of behavioral health care into a “recovery-oriented” model of care. Traditional mental health care focuses on treatment and control of symptoms of mental illness and addiction with services primarily provided by licensed professionals. By contrast, the recovery model focuses on maintaining long-term recovery past acute crises. Key components of this model include empowering and involving consumers of behavioral health services in shaping their own care and the integration of peer providers into the workforce supporting recovery and resilience.

How was this study conducted?

This study used a case study approach and included a national panel of subject matter experts who suggested best practice states. Data was gathered through site visits to Arizona, Georgia, Texas, and Pennsylvania; as well as document review and interviews with state policymakers, directors of training and certification bodies, peer providers, and other staff in mental health and substance use treatment and recovery organizations.

Conclusions and Main Findings

Because of their lived experiences with mental health and substance use disorders, peer providers are uniquely positioned to prevent acute crises and support long-term recovery, especially for clients in underserved populations and rural areas. It is clear that these workers can play a key role in the long-term recovery of people with mental illness and substance-use disorders. However, structural, policy and organizational barriers create roadblocks. For example, peer providers are often paid low wages, face stigma on the job and need to maintain their own recovery. Policymakers should work to develop national and state standards for training and certification, billing and reimbursement and sustainable funding models so that more peer providers can help others find their path to recovery.