Shawn Carroll Palmer is the first person you encounter if you are looking for help at Central Montgomery Mental Health and Mental Retardation Center, a community mental health center in Norristown, Pennsylvania. “When you come in, my office is right there,” she says. “When people sit out in the lobby waiting for a doctor, they can come into my office and talk to me.”
Palmer is one of a growing number of certified peer specialists: people in recovery from behavioral health disorders whose job is to help their peers work toward their own recovery. They often are employed by agencies where credentialing requirements traditionally have excluded consumers from staff positions.
According to her job description, Palmer is a community integration specialist. “The therapists, doctors, and case managers send me clients who are interested in connecting to the community in such areas as employment, support groups, education, and housing,” she explains. “And I help them to meet their goals.”
Palmer also has goals: “To be in a position that I enjoy and be able to provide for my family,” she says. “After a certain amount of time, you have to find meaning in your life. Even if you have struggles and a [behavioral health] diagnosis, that does not limit you from being successful in life.”
New Professional Organization
To help Palmer and others like her accomplish their goals, a new professional organization has been created. The idea behind the Peer Specialist Alliance of America (PSAA), established at a national meeting in Philadelphia in July 2006, is to help certified peer specialists assume their proper place in the continuum of care.
The meeting was organized by the Mental Health Association of Southeastern Pennsylvania (MHASP), which is fostering the peer specialist initiative throughout Pennsylvania. “Being organized nationally and locally is going to be key in sustaining the effort to develop peer specialist programs, making them empowering of the consumers working as peer specialists and the consumers served by peer specialists,” says MHASP President and CEO Joseph A. Rogers.
Qualifications for certified peer specialists (CPSs) vary by state. However, these positions typically are open to people who:
are self-identified consumers of behavioral health services;
have experienced a serious mental illness or co-occurring disorder (such as substance abuse);
have a high school diploma or GED;
have good verbal and written communication skills;
demonstrate successful efforts at recovery;
are able to establish positive relationships with peers;
have maintained, within the past 3 years, at least 12 months of successful full- or part-time paid or voluntary employment or postsecondary education; and
have successfully completed an approved certification training program.
For example, Pennsylvania's Office of Mental Health and Substance Abuse Services has approved the CPS training provided by MHASP's Institute for Recovery and Community Integration. The Institute teaches aspiring peer specialists the skills for providing peer support, such as how to encourage self-determination, personal responsibility, and empowerment in their peers, and how to help them with problem solving and goal setting. An important part of the job is to serve as a role model. “Our initial premise is that we believe in recovery because we have seen it in our own lives first,” explains Institute Program Manager Matthew Federici.
The PSAA steering committee represents a who's who of national and regional mental health advocacy, service, and research organizations (including consumer-run organizations). It has begun to hammer out the new organization's mission, values, and infrastructure, including membership and board criteria. For instance, at least 75% of PSAA board members must be peer specialists.
At the same time, plans are under way to survey peer specialists from around the country on what kind of help they need and about the status of peer specialist services in their states. Among concerns that have been raised so far are the relatively low pay peer specialists receive and that applying for such a position automatically labels someone as having a behavioral health diagnosis.
Many are concerned that peer specialists seem to be undervalued in the behavioral healthcare system. Federici sees the Institute as a catalyst, helping change the provider culture so that peer specialists are appreciated. And he believes PSAA has the potential for an even greater impact.
“I am amazed at the potential I see for transformation throughout Pennsylvania's behavioral health system to support recovery and community integration simply by getting providers, family members, government agencies, and people in recovery at the same table,” Federici says. “The increased collaboration and dialogue at every level of the system in Pennsylvania, stimulated by the training and hiring of peer specialists, have created a transformative ripple effect in our community.”
Some providers are ahead of the curve, such as META Services, a large behavioral health services provider in Phoenix. “In Arizona, where peer support has been reimbursed by Medicaid since 2001, we have trained over 600 peer specialists and employ 225 peer specialist staff who provide over $7 million annually in peer services,” notes META Services CEO Gene Johnson. Besides Arizona, states with Medicaid-reimbursable peer specialist services include Georgia (the first state to make peer specialist services Medicaid-reimbursable), Iowa, Michigan, North Carolina, and Washington, as well as the District of Columbia.