As the demand for behavioral health treatment skyrockets alongside rising staff vacancy rates, behavioral health agencies are facing a true crisis in building enough capacity to meet the need. After an extensive literature review and working with more than a dozen behavioral health agencies, Third Sector believes one of the most strategic shifts agencies can make to confront this crisis is to invest heavily in roles for individuals with lived experience, known as peers. 

Increasing peer positions and expanding peer responsibilities not only provides necessary staffing capacity, but is also an investment in client recovery as peer support has been proven to strengthen client interactions and improve overall outcomes. 

Benefits of Increasing Peer Positions & Expanding Peer Roles

Creative approaches to staffing, such as filling existing non-peer staff vacancies with peer staff, and expanding the current roles of peers, eases the workforce crisis while expanding the peer-informed approach to recovery throughout the behavioral health service delivery model. Effective peer integration in behavioral health systems has three primary benefits:

• Strengthened Team & Client Interactions: Peers bring their lived experience and wisdom in navigating the journey of recovery to their work, and research shows that peers are highly effective in supporting client recovery. Peer support is proven to increase client trust and retention in services, thus improving client-provider relationships and team collaboration overall. 
• Reduced System Costs: Peer support lowers costs throughout the system of care by increasing medication initiation, reducing emergency department visits, decreasing the number and length of inpatient stays, and increasing the use of outpatient services. 
• Improved Client Outcomes: All of these benefits ultimately drive a higher quality of life for individuals receiving services and improved client outcomes, including better mental health, decreased substance use, enhanced social interaction, and increased patient activation. 

Strategies to Successfully Integrate Peers Into Teams & Organizations

Third Sector recommends the following strategies to successfully increase peer support positions and expand peer roles:

• Strategy #1: Address Professional Stigma: In our experience working with the peer community, we have heard that the majority of peers still experience stigma in the workplace from other staff on their team or program unit. One strategy to begin tackling professional stigma is to provide specific training designed to educate non-peer staff on the value of peers, their positive impact on client outcomes and engagement, and the efficacy of the recovery model. 
• Strategy #2: Integrate Lived Experience into Hiring, Promotion, & Compensation Frameworks: Peers are often more representative of the communities being served than other staff, and yet remain some of the lowest paid employees across behavioral health agencies. Organizations can communicate the value of peers by working to establish equity in pay across years of education and years of lived experience. Agencies can also provide peers with advancement options into non-clinical roles, such as a peer coordinator, trainer, supervisor, or manager roles, instead of only offering promotions that require clinical training or approaches. 
• Strategy #3:  Ensure Peer Representation Throughout the System of Care: Peers have expressed their desire to be better represented throughout the system of care, especially in decisionmaking processes that impact peer staff and clients directly. One way to tangibly incorporate peers is to create a Peer Advisory Council that weighs in on service delivery design, quality and continuous improvement processes, outcomes and evaluation, and peer specific initiatives such as improving the peer certification process. Advisory councils create a structured platform for peers to support their organizations in improving services and provide leadership in creatively co-solving challenges.

Increasing the number of peer positions, expanding peer roles, and successfully integrating peers throughout the system of care better enables behavioral health organizations to respond to the workforce crisis holistically and with a recovery-centered approach that uplifts the crucial role that peers play in staff, client, and community wellness. 

To learn more about strategies to address the behavioral health workforce crisis, read our brief on "Addressing the Behavioral Health Workforce Crisis: Five Strategies to Shift Organizational Culture to Center Client & Staff Experience".