When thinking about effective pathways to recovery, the mental health community must consider a largely untapped resource: Certified Peer Specialists (CPSs). People with mental illness who are employed as CPSs have proven to make a significant difference helping others in therapeutic settings.

CPSs (also referred to as peer specialists, peer navigators, peer providers, peer supporters or peer support workers) are “hired into designated peer positions or traditional mental health positions who must publicly self-identify as a peer and have been or are a service user themselves for their own mental health challenge.” Their role is based on a “system of giving and receiving help founded on key principles of respect, shared responsibility and mutual agreement of what is helpful.”

Essentially, CPSs can help peers manage their mental illness and other mental health challenges, like trauma, substance use or comorbid physical illness(es). This work supports recovery and helps with other recovery-oriented goals, such as education, employment, housing and social connectedness.

While there are more than 30,000 CPSs trained to do this work, the widespread implementation of peer support remains limited. This represents a significant issue in our health care system and a largely untapped part of the solution. Beyond the obvious benefits to those needing help from a peer, A CPS career can foster a sense of meaning and purpose for specialists, which is critical to their own recovery. For anyone who has mental illness and is looking for a meaningful career, it is a worthwhile option to consider.

How Peer Support Has Grown

Peer provided services have existed in some form since the 18^th century (and it has evolved over time from mutual help into more formalized activities) . In fact, research has found that the real historical breakthroughs in psychiatric care have come from people in recovery.

Several factors have contributed to significant growth in CPS services, including:

• Growing evidentiary support
• Medicare and Medicaid reimbursement status in most states
• Alignment with current policies of recovery-oriented care
• Significant increases in demand for mental health services
• Severe shortage of mental health providers representing a tremendous societal need

How Peer Support Can Help

Peer support serves a number of functions to help people with mental illness on their recovery journeys. SAMHSA has identified four major dimensions that support a life in recovery, including health, home, purpose and community. Peer support has been shown to:

• Increase levels of hope, empowerment and quality of life, including physical health and wellness
• Increase self-efficacy and engagement
• Improve relationships with providers
• Reduce hospital readmissions, days in hospital and frequency of recurrent psychiatric hospitalizations

The role of CPSs is based on the principle that care should be recovery-oriented. By sharing their wisdom from their lived experience, CPSs offer hope to the peers they serve. They can help others envision and achieve a meaningful and purposeful life by identifying and building on their strengths. This empowering process can help peers recognize that there are multiple paths to recovery. CPSs also reinforce another key principle: care should be person-centered, voluntary, relationship-focused/centered and trauma-informed.

CPS Workplaces

Peer support services are more commonly being integrated with mental health, substance use and physical health services as a part of multidisciplinary health care teams. Services are provided in one-on-one and group format and largely offered in-person but also digitally.

CPSs primarily work in the public sector in:

• Community behavioral health centers
• Psychosocial clubhouses
• Respites
• Hospitals (inpatient and outpatient units and emergency rooms)
• Jails and prisons
• Crisis response teams: The widespread public outcry and advocacy following numerous tragedies involving emergency response to people with mental illness contributed to growth and focus on integration of CPSs into crisis response.
• The Veterans health administration

Becoming A Peer Specialist

There are a few basic requirements, but these may vary by state, namely:

• A history of mental illness
• Possession of high school diploma (GED)
• Completion of State Peer Specialist Certification Board (SPSCB) approved educational and ongoing educational and paid and/or volunteer work experience requirements
• Issuance and renewals of formal SPSCB Certification

Successful peers are hopeful, empathetic, compassionate, accepting and nonjudgmental. More specifically, SAMHSA has identified 12 core competencies, which is the knowledge, skills and attitudes a person needs to have to successfully be a peer supporter. A few of these include: engaging peers in collaborative and caring relationships, sharing lived experiences of recovery and helping peers manage crises.

Peers report a significant amount of satisfaction with their work, but there are many aspects of a peer specialist career that can be significantly improved. This is to be expected in an emerging profession. A few potential areas for improvement include: higher wages and fair pay increases, greater career mobility and comprehensive benefits.

While a CPS career may be a good opportunity for some, people living with mental illness should always remember that our community has as diverse a skill set and capabilities as any other. People with mental illness should pursue the career of their own choosing. Self-determination is critical to recovery.

Our community needs the empathy and compassion only our peers can offer. This support helps us reach and stay in recovery. This movement is here to stay and that’s a wonderful thing for all people living with mental illness.
Author’s note: I am proud to be a New York Certified Peer Specialist-Provisional! Thank you so much to my peers for the incredibly important work you do and for being a tremendous source of inspiration to me.
Katherine Ponte is happily living in recovery from severe bipolar I disorder. She’s the Founder of ForLikeMinds’ mental illness peer support community, ForLikeGoals, collaborative goal management, BipolarThriving: Recovery Coaching and Psych Ward Greeting Cards. Katherine is also a New York Certified Peer Specialist-Provisional and a faculty member of the Yale University Program for Recovery and Community Health and has authored ForLikeMinds: Mental Illness Recovery Insights. She is on the NAMI-NYC Board.

Helpful resources: Peer Support Workers for those in Recovery; You Are Not Alone: The NAMI Guide to Navigating Mental Health; Partnering for Recovery in Mental Health: A Practical Guide to Person-Centered Planning; The Power of Peer Providers in Mental Health Services; A Practical Guide to Recovery-Oriented Practice: Tools for Transforming Mental Health Care; The Roots of the Recovery Movement in Psychiatry: Lessons Learned; What it Takes: Wisdom from Peer Support Specialists and Supervisors; and Certified Peer Specialists.

Courses that help people study for PSCB exams: New York State Certification Board’s free Academy of Peer Services courses accessible throughout the U.S., the DBSA’s Peer Specialist Training and local training programs such as Howie the Harp in NYC.

Evidence-based courses and/or tools that can enhance peer specialist skills:

Building Recovery of Individual Dreams and Goals, Emotional CPR, Health and Recovery Peer program, Honest, Open, Proud, Illness Management and Recovery. Intentional Peer Support, Pathways to Recovery, Psychiatric Advance Directives, Shared decision-making, Wellness and Action Recovery Plan, Wellness in Eight Dimensions and Whole Health Action Management.