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In September 2023, U.S. Sens. Tim Kaine (Va.) and Mike Braun (Ind.) introduced the Providing Empathetic and Effective Recovery (PEER) Support Act. This bipartisan legislation aims to improve support for people with mental health and substance use disorders.

The proposed bill would make the role of peer support specialists stronger. It would make the field bigger by removing barriers to entry. These barriers often include criminal offenses.

“It’s critical that we have high-quality providers who are adequately trained to help individuals in recovery,” Kaine said. “Through their own experiences, peer support specialists play an important role in the recovery process.

“The PEER Support Act would better support these experts and expand access to care by identifying best practices, providing support for training, and addressing barriers facing prospective peer support specialists.”

What Are Peer Support Specialists?

Peer support specialists have experience living with mental health and/or substance use disorders and the recovery process. They are progressed in their own recovery.

They speak out for and support others who are recovering from similar issues. They also connect them with the resources they need.

Examples of peer support specialists include:

• Individuals who had a mental health or substance use disorder.
• Parents or caregivers of people who had a mental health or substance use disorder. They offer support to families of people who have mental health or substance use disorders.

“We meet individuals where they’re at,” says Chekesha Campbell, program supervisor, Peer Support Program, UPMC Western Behavioral Health. “That could be in the home, the community, in the street, anywhere they need assistance. We are with them on their journey, so they don’t feel alone in the challenges that they’re facing.”

Lindsay Smith, program director, Psychiatric Rehabilitation and Peer Support, UPMC Western Behavioral Health, says peers are an important part of recovery. They’re there for people when they’re not visiting with clinicians.

“We’re there to help people work on building their recovery toolkit or building their recovery capital,” Smith says. “We’re helping people with things like budgeting, meal planning, building connections within their community, whether that’s through support groups, whether that’s through community organizations or events.

“We’re helping people learn how to ride the bus. We’re helping people look for employment. Or maybe they don’t like the apartment they’re living in and they want a different apartment.

“The service is very people-driven. Whatever people want to work on, that is what we support them with. It is their choice what their recovery looks like, and we’re just there to really support them in making that vision a reality.”

What the PEER Support Act Would Do

The PEER Support Act would make the role of peer support specialists in recovery stronger. It would remove barriers to make top-quality care easier to reach for people with mental health and substance use disorders.

Among other things, the bill would:

• Create an Office of Recovery in the Substance Abuse and Mental Health Services Administration (SAMHSA) to:
  • Train peer support specialists.
  • Help peer support specialists learn best practices.
  • Recommend career paths for peer support specialists.
• Teach the Department of Health and Human Services and the Justice Department to study states’ background screening methods for peer support specialists. The goal is to identify any unnecessary barriers and give evidence-based recommendations for overcoming them.
• Require the Office of Management and Budget to update the Standard Occupational Classification system. The aim of this is to recognize peer support specialists as an official profession.

Ken Nash, MD, chief, Clinical Services, UPMC Western Psychiatric Hospital, believes there’s great value in legislative support for these specialists.

“It gives it validity,” he says.

“It’s a very important part of the behavioral health system. There’s a lot of stigma about behavioral health in general. It’s nice to see support because that’s not always been the experience of a peer going through the mental health system.”

How the PEER Support Act Can Improve Care for Mental Health and Substance Use

According to research by Open Minds, a market intelligence and management firm that focuses on the health care sector, peer support services:

• Increase the use of outpatient medical services.
• Reduce hospital admissions and readmissions.
• Reduce the number of days spent in the hospital.

Improved outcomes for those facing mental health and substance use disorder challenges include:

• Confidence that the treatment is responsive.
• An overall better quality of life.
• A sense of empowerment.
• Social support and functioning.

A 2019 Frontiers in Psychology report reviewed several studies on peer support’s effect on substance use recovery. It found that peer support could help people with substance use disorders get treatment faster. It can also make some more likely to stick with their treatments.

Why UPMC Supports the PEER Support Act

Millions of Americans deal with mental health and/or substance use disorders challenges. However, help is always available.

At UPMC, we strongly support this effort. It would expand the workforce. And it would help people reach others who know the complexities and challenges of mental health and substance use issues well.

Navigating such a space can feel lonely and overwhelming. But the support of someone who has been on that same journey can make all the difference.

In May 2023, UPMC Western Behavioral Health leaders met with the Bipartisan Policy Center (BPC). They discussed how peers are responding to community needs.

They also looked over BPC’s policy recommendations. These recommendations would strengthen the role of the nonclinical workforce. The nonclinical workforce includes peers.

BPC worked with sponsors of the PEER Support Act to develop the bill. They aligned it with their report Filling the Gaps in the Behavioral Health Workforce.

“Everybody wants data. Everybody wants evidence-based practice. The value [of peer support] is, ‘I am the evidence,'” says Keirston Parham, lead recovery and peer services coordinator, UPMC Western Psychiatric Hospital.

“For every clinician, every doctor, every social worker, every therapist, every person that meets, greets, and supports an individual in the behavioral health realm, if it gets hard, if you’re seeing people relapse, you see people come back again — if you feel like we’re not getting anywhere, I am the living, breathing proof,” he says.

“I am the fruit of your labor. I’m the reason you should not give up. I’m the reason you should keep going. Because we do make it, and we get better.”