This three-part series started when Ron Manderscheid, executive director of the National Association of County Behavioral Health and Developmental Disability Directors, wrote an article on the future of peers in our workforce in a Behavioral Healthcare blog last December. Manderscheid described the roles peers could play in integrated care under the Affordable Care Act (ACA). He is often able to see a vision of the future that gives the rest of us a glimpse of how things could be if we were courageous and behave ourselves. The vision he imparts in that article does just that.
For example, he said an opportunity will exist for a peer to serve persons who have no behavioral health conditions.
In this piece, you’ll hear the voices of leaders in recovery and peer work from all around the country. They will give us the real scoop, plus guidance on how to best navigate the new world of ACA while not surrendering what we’ve learned about recovery and the value of peer work.
Steve Harrington is executive director of the International Association of Peer Supporters and has written three books on mental health. Steve is sick and tired of the poor hand dealt to peer run programs. Especially since study after study has shown that peer support can be at least, if not more,
effective than services provided by traditional human service professionals.
"Peer operated services and organizations experience an insidious discrimination best evidenced by the way funding is distributed,” Harrington says. “Federal and state funding is too often granted to academic institutions or traditional service providers. For example, we have seen anti-stigma initiatives funded heavily but peers see little, if any, of those funds. We have also seen funds used by agencies to support programs, such as Mental Health First Aid, better suited for peer-operated endeavors. Hundreds of thousands of dollars become windfalls for traditional service entities at the expense of peer-operated organizations."
He says, as advocates we must be cognizant of the funding mechanisms and processes and speak out.
“We must no longer be afraid to recognize and draw attention to economic oppression,” Harrington says. “We must shine the light on those in power for their actions they deem ‘recovery oriented’ but, in reality, perpetuate the status quo and prevent us from taking our rightful and appropriate roles in service provision. Will we make enemies? Perhaps. But I learned long ago that if no one is complaining, it means you aren’t doing anything."
Eduardo Vega is the executive director of the Mental Health Association of San Francisco and the director and principal investigator of the Center for Dignity, Recovery and Empowerment. He hopes ACA will bring more clarity to the simple things that sustain wellness for most people with behavioral health conditions: jobs, meaningful relationships and a sense of connection to themselves and their communities.
“When these supports are available, people are motivated and recovering,” Vega says. “In Los Angeles alone we saw hundreds of individuals move from disability to full employment within the first five years of Mental Health Services Act programs, which include educational and occupational supports as well. Many of these people who had been considered ‘clients’ for life, have not returned to services at all. And some have been smoothing the way for others as peer specialists.”
He sees a great opportunity for peers, whether they are working in peer run programs or other programs, to expand opportunities for wellness.
“Through Medicaid expansion there is good reason to hope that the differences between recovery-driven and traditional maintenance programs may be significantly amplified by an influx of people who probably won’t accept service denials, demeaning messages or institutional stigma, in the way that many ‘consumers’ of services have,” he says. “Peers with lived expertise working in peer run programs or other recovery programs can have a major influence on positive outcomes.”
He is banking on ACA prevailing, and he believes prevention, wellness and early intervention may finally get the funding and focus they deserve. “This will create new possibilities for reducing the long-term effects of mental health, reducing suicide, isolation, premature death and disability as well. Here again, peers and peer run programs have successful experiences at providing these services,” Vega says
Allen Daniels believes there is a reason to be worried about the future of peer run programs due to the way healthcare is moving.