The Peer Provider Workforce in Behavioral Health: A Landscape Analysis with Individual State Case Studies

Peer providers provide direct support to those undertaking mental health (MH) or substance use disorder (SUD) recovery. The key distinction between peer providers and traditional providers is the ability to draw from lived experience and experiential knowledge. Peer providers have traditionally worked as volunteers, but changes in treatment modalities and recognition of the importance of long-term recovery support have led to a professionalization of the role, including formalized training and certification, and the potential for paid employment.

In a series of complementary reports: The Peer Provider Workforce in Behavioral Health: A Landscape Analysis, a synthesis titled Education, Certification, and Roles of Peer Providers: Lessons from Four States and the accompanying State Case Studies: Arizona, Georgia, Texas, and Pennsylvania, UCSF Health Workforce Research Center authors Susan Chapman, Lisel Blash, Krista Chan, Joanne Spetz, along with California Institute for Behavioral Health Solutions authors Kimberly Mayer and Victor Kogler present a review of the published and gray literature on a variety of emerging topics concerning use of peer providers in MH and SUD treatment services and case studies on best practices in providers in four states. Among the authors’ findings:

  • Peer providers work in a number of roles in a variety of settings, including, community, residential/in-patient facilities, and forensic settings
  • Medicaid billing authorization is key to the growth of peer provider employment and sustainable funding
  • Class action lawsuits and strong consumer advocacy have expanded behavioral health access and use of peers
  • The required hours of training, curriculum, and certification vary widely by state
  • There are challenges in acceptance from non-peer colleagues and the stigma of lived experience
  • There is little consistent data available on employment numbers and work settings

Concerns have been raised that standardization and professionalization of the role might jeopardize the special components of peer support that speak to lived experience, despite the potential benefits, including expansion of peer roles, greater capacity to serve people in need, and paid employment.

The authors advocate for more rigorous research to help establish the efficacy of peer support, and which peer support interventions may provide the most benefit.