Rob, who works with government agencies and peer-run programs on the East Coast, often wonders whether he is part of the problem or part of the solution. He decides he is both: “I think a key to the continuance of peer-run programs is to get more sophisticated in how we measure/demonstrate our outcomes. We are getting better at this all the time but have a ways to go. We are good at telling our recovery stories and that is the real evidence that what we do works. We are getting better at telling the story in language that funders understand, with metrics like fewer hospitalizations, greater employment, less contact with the Correctional System, and fewer ER visits. Outcomes should be part of every organization’s ‘elevator speech.’"
As he looks into the future, Rob sees both opportunity and hard work. “I think it is challenging, but doable to be part of a larger ‘traditional’ behavioral health system, but maintain our integrity as peers. Peer-run services will need to become more entrepreneurial in outlook and in management style if we intend to keep up with the workforce demand. Peers have a lot to offer to related disciplines, and peers have a lot of training and skills that are transferable beyond behavioral health.”
He also sees another trend that could expand the potential of peers and peer-run organizations: “I see the role of peers and peer-run organizations growing on both ends of the age spectrum. In my state, we are growing our peer-mentor workforce to work with youth and young adults. Increasingly, I see peers working in roles with senior services in ways they haven't worked before. The challenges of aging, such as the loss of loved ones, the loss of hope, isolation and depression, the loss of a life role, and the loss of health are eerily similar to the challenges that many served in the behavioral health system face.”
Deborah is the Executive Director of The Transformation Center, and is active in helping both policy and practice to evolve faster. Deborah puts the question of peer-run programs into perspective when it comes to healthcare reform. “In Massachusetts’ peer-operated Recovery Learning Communities, there are many individuals each year who discover that mental health recovery is possible. They meet others who are living a day-to-day recovery journey, and within a few short months, they stop the fast-cycling and expensive ins and outs to psychiatric hospitals. The cost-savings for just one of these people funds a good portion of the overall cost of the RL.”
Deborah is encouraged by a new project that was initiated in July 2013 when the Commonwealth of Massachusetts and CMS signed a demonstration contract with three companies for a capitated model of integrated healthcare. The contract requires inclusion of peer-operated organizations and peer support workers.
As healthcare reform proceeds, she believes the attention of state regulators and insurers will be drawn like a magnet to medical institutions in search of new answers and cost-saving models for integrated health and behavioral health service delivery. Peer-run programs can be a big part of the solution: “Key aspects of good health outcomes, very much including recovery health, are generated in the community - where down-to-earth solutions, day-to-day choices and basic access to resources are pivotal needs. It is especially at this time that policy attention needs to turn to a key source of cutting edge solutions: peer-operated, recovery-focused organizations.”
“These organizations understand what it is like to live a life while hearing voices or experiencing debilitating depression, suicidality, co-occurring addiction, physical illness, and poverty. Peer-operated organizations and certified peer specialists are at the source of generating down-to-earth solutions, and therefore are necessary as services and supports in emerging systems.”
“Any investments in the infrastructure of peer-operated and community-based innovations will be returned in social value many times over; new investment is a reflection of the emerging understanding that there has been underinvestment in the past.”