Abstract
Employment and deployment of peer support specialists in both clinical and non-clinical mental health settings has increased substantially since the 1990’s. Peer-run organizations are defined as those led and managed by individuals with self-disclosed lived experience of mental health conditions. Many peer-run organizations promoting advocacy and offering services have been established during the past 30 years. Some adherents assert the effectiveness of peer-run organizations over hybrid mental health service providers in which peer support workers are integrated or partnered with existing community mental health agency multidisciplinary clinical and treatment teams. Although research has indicated the positive contributions of peer-run organizations to service user recovery, the impact of peer-run organizations on system transformation is not well documented. This concept paper explores benefits, accomplishments, and challenges faced by a peer-run organization during its 30-year evolution in offering self-help groups, supported housing, peer support services, peer specialist training, and systems change projects in Los Angeles County, California. Future research topics and policy options are suggested, along with recommendations for the SAMHSA Office of Recovery.
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Notes
The term consumer/survivor/ex-patient was used frequently to refer to individuals who had received mental health services, often in-patient, and involuntary – against their will – and who thus referred to themselves as “survivors,” and “ex-patients,” who rejected coercive drugging and involuntary treatment by psychiatric institutions (Chamberlin, 1990). Many other terms have been used, including service user, client, patient, service recipient, program participant, individual and member. The term “peer” now may mean both someone with lived experience of mental health conditions who is also employed as a peer support worker or peer specialist; it can also be used to mean someone receiving mental health services. More generally, the term peer means someone in a similar situation, such as a colleague or classmate.
Informal reports suggest that some peers move from clinical positions to peer roles because as clinical providers, they were unable to seek care for their mental health concerns (personal correspondence). Clinical providers with lived experience of mental health conditions may not be comfortable, or allowed, to disclose. If stigma against people with lived experience of mental health conditions were reduced, the contradiction of self-disclosure as a requirement of peer support positions and prohibition from disclosing as a condition of clinician employment could be eliminated.
Information about SHARE! as well as SHARE at 30: Celebrating SHARE! Then and Now is Available at https://shareselfhelp.org/
The City of Los Angeles Controller noted the average per-person cost of constructing a housing unit in Los Angeles for unhoused people was almost $600,000 in 2021. Quintana (2022) “LA City Controller Report Shows Average Cost of Supportive Housing Unit Nearly $600,000. Brentwood News (March 5).
Information about the Supervision of Peer Workforce Project is Included in the SHARE! Guide to Best Practices in Supervising Mental Health Peer Services (2020), Submitted to the California Office of State Health Planning and Development in Fulfillment of RFA #17-1845
Information about this Grant was Provided by the SHARE! CEO as well as publicly posted online presentation recordings and information (www.shareselfhelp.org).
Ruth Hollman, SHARE! CEO, November 15, 2023.
In December 2023, the Board replaced the founding CEO, stating they intend to take the organization in a new direction. The former Board President was named CEO (Prenner, 2023). Senior leaders remain in place.
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Thank you to Ruth Hollman, SHARE! CEO, Libby Hartigan, Director of Training, and Jason Robison, Chief Program Officer; and Joanne Forbes, PhD, CPRP, and Louis Brown, PhD, for editorial assistance.
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Wolf, J. Changing the Game? Increasing the Impact of Peer-Run Organizations. Community Ment Health J (2024). https://doi.org/10.1007/s10597-024-01273-8
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DOI: https://doi.org/10.1007/s10597-024-01273-8