eSolutions: December 2013
Feature article: The Gifts Peer Providers Bring
Grantee Feature: Peer Wellness Coaches: Wellspring
Quick Tips: Promoting Successful Peer Support Services
Featured resource: Peer Providers Page
In the United States, peer support traces back to as early as 1772 when Native Americans joined in mutual support groups to self-manage recovery from alcohol abuse problems.¹
Peer support happens whenever people who have similar lived experiences with mental illness and/or addiction share their hope, strengths, and experiences to promote recovery and resiliency. Peer support can be done anytime and anywhere when two or more peers share a mutual supportive relationship. It can be provided in clinical settings and the community, in groups and one-to-one, and on treatment teams that include non-peers. In primary care, peer support links people living with chronic conditions, such as diabetes, in sharing knowledge and experiences.
In an integrated primary and behavioral health system, peer support services focus on the shift from stabilization and maintenance to recovery and resiliency, from what’s wrong to what’s strong, from mental illness and addiction to whole health, and from social segregation to social inclusion.
A peer provider (e.g., certified peer specialist, peer support specialist, recovery coach) is 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 resiliency.
Peer providers are often hired because of their recovery experience, rather than their clinical education. This puts peer providers in the unique position of being service providers who have lived experience in successfully addressing the impact of the illness rather than just the symptoms of the illness.
The perspective and unique abilities of peer support providers strengthen the integrated care team in many ways. There are six key gifts peer providers bring to the integrated care team:
The Gift of Insight. Internalized shame shatters a person’s sense of self-worth. For many, the impact on their daily lives and interactions can be harder to overcome than the symptoms of their illness. Peer providers have insight on how internalized shame results from discrimination, social exclusion, poverty, homelessness, and hopelessness.
The Gift of “Been There, Done That.” Peer providers eliminate the “you do not know what it’s like” excuse. Peer providers can make others living with mental illnesses or addictions feel comfort in the fact that they are not alone; they have a person on their side that has been through similar experiences and has gotten through them.
The Gift of Compassion. Because of their lived experience, peer support providers understand and are inherently grateful for the very services they are now providing to others. This gratitude often manifests itself in deep compassion for their peers.
The Gift of Hope. Working with someone who has moved from hopelessness to hope is extremely empowering. People can often see themselves in the peer providers, which gives them hope over their whole health.
The Gift of Trust. Peer providers are in a unique position to develop a relationship of trust. Peers are often more willing to share their real issues, concerns, hopes, and dreams with a peer provider rather than non-peer, clinical staff.
- The Gift of Whole- Health Self-Management. Peer providers have developed the gift of self-managing their lives holistically, including both mind and body. This experience with self-managing their whole health is one of the most powerful gifts peer providers can give. They have learned to recognize triggers and early warning signs, counteract the negative impact of stress, and create plans for taking care of themselves.
Integrated primary and behavioral healthcare centers who build a strong peer workforce benefit from these gifts, along with their clients. Peer providers are an essential element to a strong, comprehensive integrated care team. When more integrated care teams include peers as service providers, we will discover even more gifts that they bring.
What gifts and talents do you see that peer providers bring? Share your experiences with us at firstname.lastname@example.org.
White WL. Slaying the Dragon: The History of Addiction Treatment and Recovery, Lighthouse Institute Publications, 1998.
WellSpring Resources, a PBHCI grantee in Alton, IL, attributes much of its health integration project’s success to its peer coaches.
WellSpring Resources’ peer wellness coaches are people who have lived behavioral health experiences and who are stable in their recovery. People are assigned a peer wellness coach when they enter the integration program. At their initial interview, they meet their peer wellness coach. Work with a peer wellness coach means that individuals commit to increasing their understanding of how physical health and wellness affects overall mood and mental health. The coaches serve as a daily example for the people they work with.
Participants are so interested and engaged that the very popular peer wellness coach concept has quickly grown to meet demand. WellSpring’s integration program started with four part-time coaches and expanded to two additional full-time coaches and one additional part-time coach.
Wellness Recovery Action Plan (WRAP) Behavioral Health and Wellness Center
The wellness coaches now run groups on stress management, walking, meditation, women's issues, and WRAP for individuals in the integrated care program. One innovative group, Scribbles, helps to improve health literacy using journaling and dialogue. There are also groups on the dimensions of wellness (including social, emotional, physical and environmental wellness), and a specialty group on diabetes education.
One individual lost more than 50 pounds since joining the integrated health program. He developed a weekly menu with healthy options for his week, based on what he had in his kitchen cabinets. By sharing his menu and shopping experiences with others, he became the go-to person for shopping and menu preparation for others who want to lose weight and eat sensibly, leading to their shared success in achieving wellness goals.
Isaac Sandidge, team leader for the peer wellness coaches, says, “Seeing somebody succeed, overcome major obstacles and live a healthy life helps create a support group. Clients learn that they can do it; they can change.” He adds that he is always looking for new leaders among people in the integrated care program because he needs more coaches to continue to motivate and inspire progress. For WellSpring, having peer support staff means increased outcomes for their integration program.
“It works; it really has an impact on people’s lives,” notes Sandidge.
Maintaining a peer workforce can bring many benefits to your organization, your staff, and to the people you serve. Here are seven steps you can take to build and maintain a strong peer workforce:
Train all staff on the role of peer providers and how to promote an agency culture of strength-based, holistic self-management.
Foster financial sustainability by ensuring peer services meet criteria for reimbursement like Medicaid billing (when approved for direct billing by the specific state) and have clear guidelines on how to bill for these services.
Address boundary issues such as if peer providers need to receive mental health or substance use services outside of the agency they work for. If peer providers choose to continue receiving these services where they work, ensure their files are kept confidential to only approved staff.
Require peer providers to complete formal training that teaches them implementation of holistic self-management skills.
Write job descriptions for peer providers to ensure they have meaningful, defined roles within the care team.
Train supervisors on the role of peer providers and how to support them.
- Implement personal self-management tools like a Wellness Recovery Action Plan (WRAP) for peer providers to promote their ongoing recovery and whole health.
Learn more about peer providers on our new Peer Providers web page. The page includes billing resources, sample job descriptions, the Whole Health Action Management (WHAM) training and participant guide (now available in Spanish , and the latest research on the effectiveness of peer providers.
Divided into six sessions, CIHS’ Telebehavioral Health Training and Technical Assistance Series guides safety net providers through the crucial steps to implement a telebehavioral health program. Each recorded session is led by subject matter experts, can be watched at your own pace, and lasts approximately one hour. In addition to the primary recorded training, each session includes recorded Q&A discussions and additional resources for further exploration into each subject.
HRSA announced the availability of up to $1.275 million for the Rural Health Network Development Planning Grant Program. The purpose of the program is to help develop an integrated healthcare network, if the network participants do not have a history of formal collaboration. Deadline to apply is Jan. 16.
The U.S. Department of Health and Human Services announced that it plans to issue a $50 million funding opportunity to help community health centers establish or expand behavioral health services for people living with mental illness and drug and alcohol problems. Community health centers will be able to use these new funds, made available through the Affordable Care Act, for efforts such as hiring new mental health and substance use disorder professionals, adding mental health and substance use disorder services, and employing team-based models of care.
The American College of Cardiology, American Heart Association, and The Obesity Society jointly released clinical practice guidelines for overweight and obesity management. The first official obesity guidelines to be released in 15 years, the guidelines update the 1998 National Heart, Lung, and Blood Institute’s Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Highlights include the Treatment Algorithm – The Chronic Disease Management Model for Primary Care of Patients with Overweight and Obesity.
The Patient-Centered Primary Care Collaborative has a new, free online database that identifies innovative primary care workforce training programs across the U.S. The database, Strengthening the Primary Care Workforce: A Collection of Interprofessional Health Professional Training Programs, includes 100 programs from a wide range of institutions, including academic medical centers, community health centers, integrated health systems, and universities, that focus on interdisciplinary, comprehensive, care team models.
To those of you who had a chance to respond, thank you for taking our webinar survey to let us know what topics you’d like to explore with integration experts in 2014. We’re preparing our 2014 webinar lineup based on your votes.
In the meantime, check out our past webinars to see what you missed. Popular webinars in 2013 covered trauma-informed care, embedding behavioral health into primary care, and addictions treatment innovations.