6.3 Peer Support

Peer Support Services

Peer support services are those led by a person or persons who have lived experience with mental illness (Muralidharan et al., 2021). A peer support specialist is a nonclinical person who uses their experiences with mental illness and recovery to help others (George, 2022). These services can be conducted in an inpatient, outpatient, or group setting, as part of an interdisciplinary treatment team, in a one-to-one format, and in a virtual setting (Fortuna et al., 2022). The original definition for peer support was that it involved services offered to those with a mental health condition. Today, the more broadly accepted term is mental health challenges, as that covers a wider range of mental health issues, such as “trauma, extreme stress, feelings of loneliness…comorbidities including substance use disorders and chronic medical conditions, criminal justice, and child welfare” (p. 572).

Peer support began as informal self-help groups that offered mutual support. The current model has expanded to focus on the benefit that the client receives from the peer support specialist (Fortuna et al., 2022). It has also grown to be a model that can be paid for and reimbursed through Medicaid. A recent survey found that 25 percent of the time that paid peer specialists spent with their clients was in groups (Muralidharan et al., 2021).

Functions of Peer Support Services

Deinstitutionalization, when people with mental illness were discharged from state hospitals and returned to the community, led to peer self-help groups springing up because the clients being discharged into the communities were mistrustful of health professionals and had difficulty even finding outpatient mental health services (Fortuna et al., 2022). These peer services have continued to grow and are available to help clients with psychological, comorbid diagnoses, and social functioning.

Peer support specialists can assist the individual with mental health challenges by helping them, for example, learn how to build better relationships with others. Not only does the development of social skills give the client hope, but it addresses the loneliness that is often part of severe mental illness. Having the support of a person who has gone through some of the same experiences has yielded positive outcomes, such as “decreases in hospitalizations, self-stigma, psychotic symptoms, depression, substance use and fewer feelings of social isolation” (Fortuna et al., 2022, p. 578). By sharing their own lived experience and practical guidance, peer support workers help people to develop their own goals, create strategies for self-empowerment, and take concrete steps. They promote self-esteem, self-determination, understanding, coping skills, and resilience through mentoring and service coordination supports.

Examples of Peer Support Services

There are many types of peer support services available as a resource for clients with mental health challenges. What follows is just a small sample of those resources.

• Alcoholics Anonymous (AA) and Narcotics Anonymous (NA): These 12-step programs are examples of peer-led support groups. The main purpose of AA and NA is to help people with substance (alcohol or narcotics) use problems live a sober lifestyle (Alcoholics Anonymous, 2023). The meetings are free to participants and held in a variety of settings, including churches, hospitals, and recovery treatment centers.
• H.E.A.R.T.S. Peer Support Center of Greater Nashua, New Hampshire: This is a free community center for adults living with mental challenges. It offers peer support, crisis respite of seven days/six nights, and step up/step down (H.E.A.R.T.S., n.d.). This support center was formed to help people with mental health challenges stay in the community as much as possible, with the support of others with lived experience.
• NAMI Connection Recovery Support Groups: These are free support groups for adults with mental health conditions. These sixty- to ninety-minute groups are held weekly or every other week and are led by a trained peer with lived experience (NAMI, n.d.).
• NAMI Family Support Groups: These are free, peer-led support groups for adult family members of those with a mental health condition (NAMI, n.d.). These groups are offered either weekly or every other week and usually run sixty to ninety minutes. The groups create a safe space to share experiences with one another. Groups are led by family members of those with mental health conditions.
• The National Association of Peer Supporters (N.A.P.S.): This organization was formed in 2004 by a group of peer specialists in Michigan (N.A.P.S., n.d.). It has since expanded to become an international organization. Its goal is to bring together peer support from around the world through conferences, community resources, and education.
• VA Health Services PACT (Patient-aligned Care Team): This began in 2010 with the purpose of bringing the health-care team together to work collaboratively toward addressing veterans’ health-care goals and needs (U.S. Department of Veterans Affairs, n.d.). The inclusion of trained and certified peer specialists adds a more personal layer to the care provided.

Peer support services can be found across the United States in all different formats. Additionally, there are virtual options and apps for on-the-go support. A full list of available apps can be found at the Digital Peer Support website.