Skip to main content

Advertisement

SpringerLink
Log in

Documenting a Decade of Exponential Growth in Employer Demand for Peer Support Providers

  • Published:
The Journal of Behavioral Health Services & Research Aims and scope Submit manuscript

Abstract

The past decade has seen peer support providers increasingly incorporated as part of a recovery-oriented approach to behavioral health (BH) services for mental illness and substance use disorder. Despite this, there are few data sources to track this sector of the BH workforce, and understanding of peer support provider supply, demand, distribution, and associated factors is limited. In this retrospective, observational study, the authors analyzed job postings from 2010 to 2020 to assess employer demand for peer support providers and the factors associated with its growth, using a labor market data set from Emsi Burning Glass. The authors identified peer support job postings using a three-pronged, stepwise approach. Then, bivariate regression analyses using robust standard errors were conducted to examine state-level relationships between the number of peer support job postings per 100,000 population and Medicaid policies and indicators of states’ BH infrastructure. The authors identified approximately 35,000 unique postings, finding the number increased 17-fold between 2010 and 2020. Bivariate analysis found significant state-level associations between peer support job postings and Medicaid expansion, as well as states’ mean number of mental health facilities. This analysis represents the first to quantify employer demand for peer support providers, clearly demonstrating robust growth over time. Findings underscore the importance of continuing to develop data on this workforce to better understand factors driving its growth.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3
Figure 4

References

  1. Peers Rockville, MD: Substance Abuse and Mental Health Services Administration, 2022. Available at https://www.samhsa.gov/brss-tacs/recovery-support-tools/peers. Accessed 21 December, 2022.

  2. Gaiser MG, Buche JL, Wayment CC, et al. A systematic review of the roles and contributions of peer providers in the behavioral health workforce. Am. J. Prev. Med., 2021; 61, (4): e203-e210. Available at https://doi.org/10.1016/j.amepre.2021.03.025. .

    Article  PubMed  Google Scholar 

  3. Recovery support services for Medicaid beneficiaries with a Substance Use Disorder. Washington, DC: MACPAC, 2019. Available at https://www.macpac.gov/wp-content/uploads/2019/07/Recovery-Support-Services-for-Medicaid-Beneficiaries-with-a-Substance-Use-Disorder.pdf. Accessed 21 December, 2022.

  4. Rosenthal H, Schwartz E, Hill T, et al. Certified Community Behavioral Health Clinics, peer-delivered services And peer-operated agencies: Opportunities for collaboration and expansion. New York Association of Psychiatric Rehabilitation Services, Inc and National Council for Behavioral Health, 2019. Available at https://www.thenationalcouncil.org/wp-content/uploads/2022/03/110920_CCBHC_Peer_Services_Mtg_Toolkit-2.pdf. Accessed 21 December, 2022.

  5. Opioid Data Analysis and Resources. Atlanta, GA: Centers for Disease Control and Prevention, 2022. Available at https://www.cdc.gov/opioids/data/analysis-resources.html. Accessed 22 December, 2022.

  6. Twenge JM, Cooper AB, Joiner TE, et al. Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005-2017. J. Abnorm. Psychol. 2019; 128, (3):185-199. Available at https://doi.org/10.1037/abn0000410. .

    Article  PubMed  Google Scholar 

  7. U.S. Department of Health & Human Services. SMD #15-003 Re: New service delivery opportunities for individuals with a Substance Use Disorder. Centers for Medicare & Medicaid Services. July 27, 2015. Available at https://www.medicaid.gov/federal-policy-guidance/downloads/smd15003.pdf. Accessed 22 December, 2022.

  8. U.S. Department of Health & Human Services. SMD #17-003 RE: Strategies to address the opioid epidemic. Centers for Medicare & Medicaid Services. Centers for Medicare & Medicaid Services. November 1, 2017. Available at https://www.medicaid.gov/federal-policy-guidance/downloads/smd17003.pdf. Accessed 22 December, 2022.

  9. Mathematica Policy Research, Rand Corporation. Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2019. Washington, DC: Office of the Assistant Secretary for Planning and Evaluation, 2020. Available at https://aspe.hhs.gov/reports/certified-community-behavioral-health-clinics-demonstration-program-report-congress-2019-0. Accessed 22 December, 2022.

  10. Gagne CA, Finch WL, Myrick KJ, et al. Peer workers in the behavioral and integrated health workforce: opportunities and future directions. Am. J. Prev. Med. 2018; 54 (6, Supplement 3):S258-S266. Available at https://doi.org/10.1016/j.amepre.2018.03.010. .

    Article  PubMed  Google Scholar 

  11. Recovery Oriented Systems of Care (ROSC). Addiction Technology Transfer Center (ATTC) Network, 2022. Available at https://attcnetwork.org/centers/global-attc/recovery-oriented-systems-care-rosc. Accessed 22 December, 2022.

  12. Substance Abuse and Mental Health Services Administration. Core Competencies for Peer Workers in Behavioral Health Services. 2015. Available at https://www.samhsa.gov/sites/default/files/programs_campaigns/brss_tacs/core-competencies_508_12_13_18.pdf. .

  13. Cronise R, Teixeira C, Rogers ES, et al. The peer support workforce: results of a national survey. Psychiatr. Rehabil. J. 2016; 39, (3):211-221. Available at https://doi.org/10.1037/prj0000222. .

    Article  PubMed  Google Scholar 

  14. Evidence for Peer Support. Alexandria, VA: Mental Health America. Available at https://www.mhanational.org/sites/default/files/Evidence%20for%20Peer%20Support%20May%202019.pdf. .

  15. Pfeiffer PN, Heisler M, Piette JD, et al. Efficacy of peer support interventions for depression: a meta-analysis. Gen. Hosp. Psychiatry 2011; 33, (1):29-36. Available at https://doi.org/10.1016/j.genhosppsych.2010.10.002. .

    Article  PubMed  Google Scholar 

  16. Substance Abuse and Mental Health Services Administration. Peers Supporting Recovery from Substance Use Disorders. 2017. Available at https://www.samhsa.gov/sites/default/files/programs_campaigns/brss_tacs/peers-supporting-recovery-substance-use-disorders-2017.pdf. .

  17. Videka L, Neale J, Page C, et al. National Analysis of Peer Support Providers: Practice Settings, Requirements, Roles, and Reimbursement. Ann Arbor, MI: University of Michigan Behavioral Health Workforce Research Center. Available at http://www.behavioralhealthworkforce.org/wp-content/uploads/2019/10/BHWRC-Peer-Workforce-Full-Report.pdf. Accessed 22 December, 2022.

  18. Comparative Analysis of State Requirements for Peer Support Specialist Training and Certification in the United States. Kansas City, MO: Peer Recovery Center of Excellence. Available at https://8767e61b-c26e-4b0f-b872-d9e03c702a01.filesusr.com/ugd/8b1e4a_f28d6aec8310404e9cb2cf5da2d0c9fa.pdf. Accessed 22 December, 2022.

  19. National Certified Peer Specialist (NCPS) Certification-- Get certified! Alexandria, VA: Mental Health America, 2022. Available at https://www.mhanational.org/national-certified-peer-specialist-ncps-certification-get-certified. Accessed 22 December, 2022.

  20. Reinert M, Fritze D, Nguyen T. 2022 State of Mental Health in America. Alexandria, VA: Mental Health America. Available at https://mhanational.org/sites/default/files/2022%20State%20of%20Mental%20Health%20in%20America.pdf. .

  21. Han B, Compton WM, Blanco C, Colpe LJ. Prevalence, treatment, And unmet treatment needs Of US adults with mental health and substance use disorders. Health Affairs (Millwood) 2017; 36, (10):1739-1747. Available at https://doi.org/10.1377/hlthaff.2017.0584. .

    Article  Google Scholar 

  22. FACT SHEET: President Biden to Announce Strategy to Address Our National Mental Health Crisis, As Part of Unity Agenda in his First State of the Union. Washington, DC: The White House, 2022. Available at https://www.whitehouse.gov/briefing-room/statements-releases/2022/03/01/fact-sheet-president-biden-to-announce-strategy-to-address-our-national-mental-health-crisis-as-part-of-unity-agenda-in-his-first-state-of-the-union/. Accessed 22 December, 2022.

  23. Emsi Burning Glass. Labor Insight data. Retrieved March 31, 2021.

  24. Representativeness analysis of the Burning Glass job posting data – U.S. 2021. Boston, MA: Emsi Burning Glass.

  25. Status of State Medicaid Expansion Decisions: Interactive Map. San Francisco, CA: Kaiser Family Foundation, 2022. Available at https://www.kff.org/medicaid/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/. Accessed 22 December, 2022.

  26. U.S. Department of Health & Human Services. HHS awards up to $22.9 million in Planning Grants for Certified Community Behavioral Health Clinics. October 19, 2015. Available at https://www.nyaprs.org/e-news-bulletins/2015/hhs-funds-22-9-million-in-state-planning-grants-for-new-certified-community-bh-clinics. Accessed 22 December, 2022.

  27. Centers for Disease Control and Prevention. Drug Overdose Deaths in the United States, 1999–2019. National Center for Health Statistics. Data Brief 394, 2020. Available at https://www.cdc.gov/nchs/data/databriefs/db394-tables-508.pdf#3. Accessed 22 December, 2022.

  28. Lyons N, Cooper C, Lloyd-Evans B. A systematic review and meta-analysis of group peer support interventions for people experiencing mental health conditions. BMC Psychiatry 2021; 21 (1): 315. Available at https://doi.org/10.1186/s12888-021-03321-z. .

    Article  PubMed  PubMed Central  Google Scholar 

  29. Mutschler C, Bellamy C, Davidson L, et al. Implementation of peer support in mental health services: A systematic review of the literature. Psychological Services 2022; 19, (2):360-374. Available at https://doi.org/10.1037/ser0000531. .

    Article  PubMed  Google Scholar 

  30. Chien WT, Clifton AV, Zhao S, et al. Peer support for people with schizophrenia or other serious mental illness. Cochrane Database Syst. Rev. 2019; 4:CD010880. Available at https://doi.org/10.1002/14651858.CD010880.pub2. .

    Article  PubMed  Google Scholar 

  31. Kessler RC, Berglund P, Demler O, et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch. Gen. Psychiatry 2005; 62, (6):593-602. Available at https://doi.org/10.1001/archpsyc.62.6.593. .

    Article  PubMed  Google Scholar 

  32. Chapman SA, Blash LK, Mayer K, et al. Emerging roles for peer providers in mental health and substance use disorders. Am. J. Prev. Med. 2018; 54 (6 Suppl 3):S267-S274. Available at https://doi.org/10.1016/j.amepre.2018.02.019. .

    Article  PubMed  Google Scholar 

  33. Tracking Federal Funding to Combat the Opioid Crisis. Washington, DC: Bipartisan Policy Center. Available at https://bipartisanpolicy.org/download/?file=/wp-content/uploads/2019/03/Tracking-Federal-Funding-to-Combat-the-Opioid-Crisis.pdf. Accessed 22 December, 2022.

  34. Substance Abuse and Mental Health Services Administration. TI-17-014: State targeted response to the opioid crisis grants (Opioid STR) individual grant awards. 2017. Available at https://www.samhsa.gov/sites/default/files/grants/pdf/other/ti-17-014-opioid-str-abstracts.pdf. Accessed 22 December, 2022.

  35. SAMHSA Awards $123 Million in Grants for Multifront Approach to Combat the Nation’s Overdose Epidemic. Washington, DC: U.S. Department of Health and Human Services, 2021. Available at https://www.hhs.gov/about/news/2021/09/13/samhsa-awards-123-million-in-grants-for-multifront-approach-to-combat-the-nations-overdose-epidemic.html. Accessed 22 December, 2022.

  36. Alcohol and Drug Rehab Centers that Accept Access to Recovery Grants. All Treatment. Available at https://www.addicted.org/drug-alcohol-rehab-centers-with-access-to-recovery-programs-in-the-united-states.html. Accessed 22 December, 2022.

  37. Belnap D, de la Gueronniere G. Financing Recovery Support Services: Review and Analysis of Funding Recovery Support Services and Policy Recommendations. Substance Abuse and Mental Health Services Administration, March, 2010. Available at https://www.illinoismentalhealthcollaborative.com/consumers/crss/RSS_Financing_Report.pdf. Accessed 22 December, 2022.

  38. Reference Guide: State Medicaid Reimbursement for Peer Support Services. Gettysburg, PA: Open Minds. Available at https://static1.squarespace.com/static/56d5ca187da24ffed7378b40/t/5e4e2ecc21989a778bc3db5f/1582182093508/OMCircle_ReferenceGuide_PeerSupport.pdf. Accessed 22 December, 2022.

  39. Daniels AS, Ashenden P, Goodale L, et al. National Survey of Compensation among Peer Support Specialists. Mesa, AZ: The College for Behavioral Health Leadership. Available at https://www.leaders4health.org/wp-content/uploads/2020/03/PSS_Compensation_Report.pdf. Accessed 22 December, 2022.

  40. Myrick K, Del Vecchio P. Peer support services in the behavioral healthcare workforce: State of the field. Psychiatr. Rehabil. J. 2016; 39 (3):197-203. Available at https://doi.org/10.1037/prj0000188. .

    Article  PubMed  Google Scholar 

  41. Czeisler MÉ. Mental health, substance use, and suicidal ideation during the COVID-19 pandemic — United States, June 24–30, 2020. MMWR Morb Mortal Wkly Rep 2020; 69. Available at https://doi.org/10.15585/mmwr.mm6932a1. .

  42. Ahmad FB, Cisewski JA, Rossen LM, et al. Provisional drug overdose death counts. National Center for Health Statistics, 2022. Available at https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm. Accessed 22 December, 2022.

  43. Keating D, Bernstein L. 100,000 Americans died of drug overdoses in 12 months during the pandemic. Washington Post. November 17, 2021. Available at https://www.washingtonpost.com/health/2021/11/17/overdose-deaths-pandemic-fentanyl/. Accessed 22 December, 2022.

  44. Occupational Outlook Handbook: Health Education Specialists and Community Health Workers. Washington, DC: U.S. Bureau of Labor Statistics, 2022. Available at https://www.bls.gov/ooh/community-and-social-service/health-educators.htm. Accessed 22 December, 2022.

  45. Malcarney M, Pittman P, Quigley L, et al. The changing roles of community health workers. Health Serv. Res. 2017; 52, (Suppl 1):360-382. Available at https://doi.org/10.1111/1475-6773.12657. .

    Article  PubMed  PubMed Central  Google Scholar 

  46. Taxonomy Code 175T00000X: Peer Specialist. NPI Dashboard, 2022. Available at https://www.npidashboard.com/taxonomy/175t00000x. Accessed 22 December, 2022.

Download references

Funding

This project, including support for study authors’ work, was funded under grant number H79FG000028 from the Substance Abuse and Mental Health Services Administration (SAMHSA), US Department of Health and Human Services (HHS). The views, policies, and opinions expressed do not necessarily reflect those of SAMHSA or HHS, and should not be construed as such.

Author information

Authors and Affiliations

  1. Fitzhugh Mullan Institute for Health Workforce Equity, Milken Institute School of Public Health, The George Washington University, 2175 K Street NW, Suite 250, Washington, DC, 20037, USA

    Margaret P. Ziemann MPH, Randl B. Dent PhD, Ellen D. Schenk MPP & Clese E. Erikson MPAff

  2. DMA Health Strategies, Lexington, MA, USA

    Deborah Strod MA, MSW

  3. Milken Institute School of Public Health, The George Washington University, Washington, DC, USA

    Qian Luo PhD, MPSA

  4. Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA, USA

    Rachel A. Banawa MSPH

  5. University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Sara Westergaard MD, MPH

Authors
  1. Margaret P. Ziemann MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Randl B. Dent PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ellen D. Schenk MPP
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Deborah Strod MA, MSW
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Qian Luo PhD, MPSA
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Rachel A. Banawa MSPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sara Westergaard MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Clese E. Erikson MPAff
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Margaret P. Ziemann MPH.

Ethics declarations

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ziemann, M.P., Dent, R.B., Schenk, E.D. et al. Documenting a Decade of Exponential Growth in Employer Demand for Peer Support Providers. J Behav Health Serv Res 50, 413–424 (2023). https://doi.org/10.1007/s11414-023-09832-9

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11414-023-09832-9

Search

Navigation