Peer Services & Recovery Orientation
What is a Peer?
Peer is defined by the Random House Dictionary as, a person who is equal to another in abilities, qualifications, age, background, and social status.” (see http://dictionary.reference.com/browse/peer) Simply put, a peer is someone like you. We all may have a number of “peers” in our lives – people of the same age range, people who do the same work, people who live in the same town or in the same economic bracket. We think of “peer pressure” for teenagers affected by other teenagers or “peer support” as a way that people in similar situations provide support for each other
Peers in Traditional and Non-Traditional Mental Health Work
The c/s/x (consumer, survivor, ex-patient) movement of the 1960’s was instrumental in promoting the idea of “nothing about us without us,” stressing that the presence of a psychiatric diagnosis doesn’t equal inability or incapacity. While people with other disabilities had been successful at having their voice heard and their ability seen, despite having a disability, people with psychiatric diagnoses have had to advocate longer and from many different angles to get the same rights and respect. Those early activists stressed that those of us with “lived experience” of mental health diagnoses and treatment need to be consulted on every facet of mental health care. These early roots led to today’s growing practices of having people who have “been there” have greater roles in supporting others in the recovery process.
There is a certain paradox in having “peers,” meaning equals, working as a “professional” in a mental health agency, which often means “unequal” or “power over.” Regardless of role, a peer working within a traditional mental health system must be mindful of the inherent power differential, and always draw from the place of shared experience and equality in the services they provide.
Some peer roles include:
Peer Support:
Peer support is when two or more people with similar experience support each other towards wellness and recovery. This can be in pairs or in groups. Some agencies and DMH facilities currently offer either peer support staff or peer support groups. Peer support is a system of giving and receiving help founded on key principles of
respect, shared responsibility, and mutual agreement of what is helpful. Peer support is
not based on psychiatric models and diagnostic criteria. It is about understanding
another’s situation empathically through the shared experience of emotional and
psychological pain. When people find affiliation with others whom they feel are “like”
them, they feel a connection (Shery Mead).
Peer Facilitator
A peer facilitator is a person with lived experience who has been trained in leading recovery groups. Peer facilitators, ideally working in pairs, often run groups in state hospitals and other inpatient settings.
Certified Peer Specialist
A Certified Peer Specialist is a paid staff person with a mental health diagnosis who has received training in ways to use their own recovery story and other strategies to partner with and assist her/his peers to identify and achieve specific life goals. The Certified Peer Specialist promotes self-determination, personal responsibility and empowerment inherent in recovery, and assists people with mental illnesses to regain control over their lives and their recovery process.
(http://www.mhrecovery.org/index.php.) “This role is not interchangeable with traditional staff that usually works from the perspective of their training and or their status as licensed health care providers. Certified Peer Specialists work from the perspective of "having been there." They lend unique insight into mental illness and what makes recovery possible.” People with psychiatric diagnosis, because of their experiences, bring different attitudes, motivations and insights to mental health services. The provision of mental health support services by persons who have experienced mental illnesses is the epitome of empathy, empowerment and, ultimately, recovery. (Executive Summary, President's New Freedom Commission on Mental Health, Achieving the Promise: Transforming Mental Health Care in America.)
WRAP Facilitator
A WRAP facilitator is a person with lived experience who has undergone training in the Mental Health Wellness & WRAP program® developed by Mary Ellen Copeland. In Massachusetts, MassWRAP offers a series of training that teach people the skills of training a WRAP course, as well as follow-up practicums to give trainees the opportunities to put their training into practice with supervision, feedback and support. In addition, MassWRAP has created a number of WRAP facilitator support groups for trainers in the state. (LINK HERE FOR WRAP).
Pact Peer Specialist
PACT (Program of Assertive Community Treatment) is a service-delivery model that provides comprehensive, community-based treatment to people with a mental health diagnosis. PACT recipients receive the multidisciplinary, round-the-clock staffing of a psychiatric unit, but within the comfort of their own home and community. The PACT team provides these necessary services 24 hours a day, seven days a week, 365 days a year.
To have the competencies and skills to meet a client's multiple treatment, rehabilitation, and support needs, PACT teams typically include people trained in the areas of psychiatry, social work, nursing, substance abuse, and vocational rehabilitation.
(http://www.nami.org/Template.cfm?Section=ACT-TA_Center&template=/ContentManagement/ContentDisplay.cfm&ContentID=49870). In Massachusetts, PACT teams must also include a peer recovery specialist. This is a person who uses their lived experience to bring insight to the PACT team members, and serve as a peer support to people getting services from the PACT team.
Other Peer Roles:
People with have experienced mental health diagnoses and services are an invaluable addition to the traditional mental health system. This is also a unique role, in that no training at any school or program can provide someone with the knowledge and insight provided by intimate, personal experience. Because of this, the roles for peers in services are endless.