Mental Health Peer Specialists Play Diverse Roles, But Need Essential Support

Peer specialists, mental health workers with lived experience, play diverse roles when supported with robust training.

Richard Sears

A recent study published in the Community Mental Health Journal discovered that peer specialists (PS) working with transition-age youth have diverse roles. These roles include providing emotional support, organizing group activities, conducting community outreach, and handling administrative tasks, among other responsibilities.

Christopher Magana from the University of California San Diego led the research and found that the diverse nature of the responsibilities of peer specialists requires them to receive extensive supervision, training, and support. This will help them to be successful in their roles. The study’s authors emphasize the need for proper guidance and support to ensure that peer specialists can serve the transition-age youth effectively.

Peer specialists are mental health workers who have lived experience of mental illness. Although the use of peer specialists has expanded considerably in recent years, there is little research on the training and supervision these specialists receive to prepare them for their roles in various mental health settings. The goal of the current study was to explore how program managers prepare peer specialists to work with transition-age youth (people between the ages of 16 and 24).

To accomplish this goal, the researchers recruited 11 program managers from San Diego and Las Angeles counties to participate in open-ended interviews. To be eligible for inclusion in the current study, the program managers had to head facilities that served 100 or more transition-age youth clients. These facilities also had to serve Black and Latino clients while employing three or more paid peer specialists. Interview questions asked about program manager perspectives on peer specialists’ roles, training needs, and organizational strategies for supporting peer specialists’ professional development. The interviews lasted between 60 and 90 minutes.

The authors organized themes in the interview data around four areas of inquiry: Peer specialists’ characteristics, roles/services provided by peer specialists, management’s support towards peer specialists’ responsibilities to the organization, and management’s support towards peer specialists’ responsibilities to the clients.

Program managers reported several characteristics that made peer specialists effective in their roles. According to management, peer specialists successfully building connections with clients depended on three factors: the lived experience of the peer specialist, the authentic/friendly/communicative personality of the peer specialist, and an empathetic/non-judgmental approach.

Managers also noted that compatibility in demographic traits and interests could make stronger connections between clients and peer specialists. This included being close in age and sharing special interests, as well as sharing race/ethnicity, language, and culture with the clients. Managers pointed to the organic, often less structured nature of the peer specialist/client relationship as fostering connection. This included peer specialists working in diverse settings depending on client needs and a more organic, less formal relationship that peer specialists often shared with clients.

Program managers reported varied roles and services provided by peer specialists. The roles of peer specialists encompass all stages of service utilization. This was exemplified in the current work through peer specialists conducting outreach to engage young people in recovery services and using their experience to make clients more comfortable seeking and maintaining service use. Peer specialists helped to address clients’ basic needs, such as assisting with finding transportation and adequate housing. Peer specialists also had the role of modeling recovery and independent living as well as leading social activities for clients.

The authors identified two themes around management support for peer specialists’ organizational responsibilities. First, managers noted that peer specialists could benefit from time management training and reviewing documentation practices. Second, managers also said supporting peer specialists in their relationships with their colleagues was essential. One example of this was scheduling staff meetings so that peer specialists could attend. This allowed for increased socialization and collaboration between peer specialists and other mental health staff.

Managers spoke about many ways they supported peer specialists in their responsibilities towards clients. As a result of their varied roles and responsibilities, peer specialists could benefit from many different training programs, including mental health training around approaches like cognitive behavioral therapy/trauma-informed care, training in cultural competency for minority groups most served by the program, and training for appropriate self-disclosure.

Managers also highlighted cultural competency around LGBTQ communities as crucial for peer specialists. Supervision was also mentioned as necessary for supporting peer specialists in their roles. This took the form of both individual meetings, where peer support specialists could get feedback on their work, as well as group meetings, where they could address things like safety concerns and caseloads.

The authors acknowledge several limitations to the current study. They explored management’s perception of peer specialists. The authors note that data was collected directly from peer specialists as well, but due to the extensive nature of the research, these findings will be published in a second article. The reliance on semi-structured interviews means the data was based on the participant’s recall of information. This kind of data is prone to recall bias. The onset of the COVID-19 pandemic limited the engagement of researchers with the participants. No demographic data was collected from participants. Data was collected from 2 urban communities in southern California, significantly limiting generalizability to other populations. The authors conclude:

Previous research has explored challenges that peer support specialists face, including unclear roles and professional development. Similar research cited organizational culture and training as tremendously influential in the work of peer specialists.

One study found that working as a peer support specialist can improve insight and resilience. Another author has asserted that while working as a peer support specialist can be transformative, it can also be exploitative.

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Magana, C., Gilmer, T. P., Munson, M. R.,  Jones, N., Burgos, J. L., Ojeda, V. D. (2023). Programmatic Support for Peer Specialists that Serve Transition Age Youth Living with Serious Mental Illness: Perspectives of Program Managers from Two Southern California Counties. Community Mental Health Journal, 59, 1498–1507. (Link)