Peers in the Behavioral Health Workforce: Costs and Contributions

Prior studies have analyzed the effectiveness of peer support workers (or consumer-providers), those who have lived experience with mental illness and/or substance use disorder, in the provision of behavioral health services. A 2013 Cochrane Review of 11 randomized controlled trials concluded that service use outcomes for clients were no better or worse when mental health teams included consumer-providers. In contrast, a systematic review published a year later concluded that, with the exception of one included study, programs that added peers to service teams and provided peer-delivered curricula showed positive outcomes compared with use of professional staff only. Both reviews noted weak evidence and lack of methodological rigor in the studies included in the reviews. Lack of consistency in training requirements and role definition among peer providers make rigorous comparative effectiveness studies difficult to conduct.

This two-year study is being conducted jointly by HWRCs at the University of Michigan and UCSF. It builds on recent work from the Michigan Behavioral Health Workforce Research Center that identified facilities nationwide that are providing peer services, as well as work by the UCSF HWRC on the roles of peer providers. This study is separately considering peer services in mental health treatment facilities and substance use treatment facilities.


Key Questions

  • Using a systematic literature review of peer services, can worker roles across behavioral health settings be better defined?
  • How do direct costs compare for behavioral health services in a sample of facilities with peers to those of facilities without peers?
  • What is the assessment of treatment outcomes or treatment adherence with and without peers?

For more information, contact Susan Chapman.



Bates, T, Chapman, S, Gaiser, M, Buche, J. Measuring the Financial Contribution of Peer Providers. Available online April, 2022.