Peer Support Workforce Shortages Anticipated: What You Can Do

Imagine this: You are the manager in a behavioral health agency that has decided to hire peer support providers in your workforce. This position can give the agency a boost in revenue, additional help in needed areas with personnel shortages, and hope and practical help to service participants. You have posted the peer support provider positions on all major job search sites. Crickets. You quickly find out there are no qualified peer providers available to hire.

Why? Quite simply, there is more demand for peer support providers than supply.

Diverse group of peers sitting in circle holding hands at group therapy

Where are all the Qualified Peer Support Providers?

Peer support providers are increasingly being hired not only for their unique ability to use their personal lived (and living) experience but also to cover gaps left by the shortage of other mental healthcare professionals, particularly in underserved communities (Bipartisan Policy Center, 2023; Ostrow, 2023).

Policymakers are creating pathways for federal and state governments to cover peer support services through Medicaid and Medicare (The White House, 2022; Bipartisan Policy Center, 2023). In New York State, outpatient programs were recently reclassified from clinic to rehab through a Medicaid State Plan Amendment. With 500 of these programs now able to bill Medicaid for peer support services, the competition for qualified peer support providers is growing.

Outpatient clinics are just one example. Peer support providers provide services in crisis settings, safe options support (SOS) for people experiencing homelessness, emergency departments (CPEP), inpatient units, forensic units, jails and prisons, partial hospitalization, bridge programs, Assertive Community Treatment (ACT), Intensive and Sustained Engagement Team (INSET), continuing day treatment, adult homes, re-entry programs, housing programs, care coordination programs, Community Oriented Recovery and Empowerment (CORE), Personalized Recovery Oriented Service (PROS) programs, OnTrack, supported education, supported employment, geriatric advocacy and support programs, recovery and wellness centers, drop-in centers, and community inclusion programs. Family support services also employ peer and family advocates who provide services in school-based clinics, special education programs, foster care, juvenile justice, vocational services, and various settings addressing complex child healthcare needs (PeerTAC, 2023).

What Can Be Done?

As the number of positions in the workforce has increased, the number of available peer support candidates has decreased. To get ahead of this expected shortfall, we encourage you to talk to people you know who are in recovery – whether you are an agency leader, provider, family member, peer provider, supporter, or someone whom the magic of peer support has touched; your voice can be a powerful agent of change. By encouraging people you know to consider becoming a peer support provider, you can make a difference not only in that person’s life but also in the lives of those who will be changed through the person’s support. Personal experience is the first step. Certified or credentialed peer support providers complete training to inspire hope, build trust, and let people know they are not alone in their journey to mental wellness. In addition to the rewards of helping others, those in a peer support role also experience their transformation from service recipient to service provider (Shalaby, 2020).

As you encourage people to consider the role, share the descriptions of different types of peer support providers below. Each description contains links to learn more about becoming certified or credentialed.

New York State Qualified Peer Support Providers

Academy of Peer Services (APS) Peer Support Services Technical Assistance Center (PeerTAC) New York Peer Specialist Certification Board
National Association of Peer Supporters, New York Peer Advancement Network (NY-PAN) New York Certification Board at ASAP Families Together in New York State

Mental Health – Adult Certified Peer Specialists (NYCPS)

New York Certified Peer Specialists are adults over 18 years of age with lived (or living) experience of a life disrupting mental health challenges who have completed specialized training and are certified to deliver peer support services under a state-approved training program (Siantz et al., 2023; NYPSCB, 2020). In New York State, training and testing are provided by the online Academy of Peer Services (APS), and the certification is approved through the New York Peer Specialist Certification Board (PeerTAC, 2023).

Learn more:

Mental Health – Youth Peer Advocates (YPA-C)

Credentialed Youth Peer Advocates are young adults (18-30 years of age) with first-hand experience of a social, emotional, medical, developmental, substance use, or behavioral challenge and/or received services in a child-serving system (juvenile justice, foster care, special education, or addiction recovery). YPAs promote resiliency, recovery, wellness, and self-efficacy in young people and promote the practice of youth-guided and family-driven approaches (PeerTAC, 2023).

Learn more: Families Together in New York State: www.ftnys.org/yp-ypa-credential or email YPACredential@ftnys.org or call (518) 432-0333 ext. 18.

Mental Health – Family Peer Advocates (FPA-C)

Credentialed Family Peer Advocates do not necessarily have first-hand experience but instead count their ‘lived experience’ as the parent (biological, foster, adoptive) or primary caregiver of a child/youth with a social, emotional, behavioral, mental health, or developmental disability. Family Peer Advocates often have experience navigating multiple systems to support their children (i.e., educational, mental health, judicial). In addition, these family advocates receive training to develop skills and strategies to empower and support other families. They nurture effective collaborative parent-professional partnerships and promote the practice of family-driven and youth-guided approaches. (PeerTAC, 2023).

Learn more: Families Together in New York State: www.ftnys.org/workforce/family-peer-advocate-credential or email FPACredential@ftnys.org or call (518) 432-0333 ext. 18.

Addiction (Substance Use) Treatment – Adult Certified Recovery Peer Advocates (CRPA)

Certified Recovery Peer Advocates are adults who are in recovery from or have supported someone who is in recovery from a substance use disorder. CRPA-F is a designation for family members. In New York State, these peer advocates have completed training and testing recognized by the Office of Addiction Services and Supports (OASAS).

Learn more: New York Certification Board (ASAP)

We hope you will be looking for people who could use their lived experience to help others by becoming certified or credentialed to join the peer support workforce. It is a very rewarding role!

Help Wanted, Right Now!

That’s all good, you say, but suppose you are an employer seeking to fill one or more peer support provider positions right now? You are in luck. Families Together has a job board where you can post FPA and YPA positions: www.ftnys.org/workforce/jobboard/. The National Association of Peer Supporters (NAPS) has also established the New York Peer Advancement Network (NY-PAN), creating opportunities for peer support providers to develop the workforce further. They have a self-serve job bank where you can post openings.

Learn more: www.peersupportworks.org/jobs

I’ve Hired a Peer Provider, Now What?

Suppose you have successfully hired a peer support provider despite the shortage of qualified candidates. While this role is becoming increasingly popular in clinical service settings, peer support providers have unique values and scope of practice. The continuous use of their experiential knowledge means they are not duplicating the efforts of other providers. Instead, they offer something new and practical. Something unique rather than a duplication of what other providers have to offer.

To assist agencies with including peer support providers in ways that meet billable requirements while remaining true to the values and fidelity of peer support, OMH funded a Peer Support Services Technical Assistance Center (PeerTAC) to provide training and consultation to organizations and agencies.

What Now?

While there may be shortages on the horizon, you can actively let more people know about this rewarding role. Share this article with people receiving treatment, families, or anyone with experiential knowledge and willingness to help others. The process to become credentialed or certified is (except for CRPA) completely free of charge. If you know people seeking peer support providers, share the links to the Families Together and NAPS NY-PAN Job Banks or the PeerTAC website.

Rita Cronise is Co-Director of Peer Support Services Technical Assistance Center (PeerTAC) and Faculty at Rutgers University Academy of Peer Services.

References

Bipartisan Policy Center (2023, January). Filling the Gaps in the Behavioral Health Workforce. Available at: bipartisanpolicy.org/download/?file=/wp-content/uploads/2023/01/BPC_2022_Behavioral-Health-Integration-Report_RV3.pdf

Families Together in New York State: www.ftnys.org/

National Association of Peer Supporters (NAPS): www.peersupportworks.org/

Ostrow, L., Cook, J., Salzer, M., Pelot, M., Burke-Miller, J. (2023, Oct. 30). Employment of Certified Peer Specialists in Mental Health Professional Shortage Areas (MHPSAs). Administration and Policy in Mental Health and Mental Health Services Research. doi.org/10.1007/s10488-023-01318-2

Peer Support Services Technical Assistance Center (PeerTAC): peertac.org/

PeerTAC (2023). MCTAC and PeerTAC Regional Events for Mental Health Outpatient Treatment and Rehabilitative Services (MHOTRS). Presentation Slides: peertac.org/resources/

Shalaby R. & Agyapong VIO. (2020, June). Peer Support in Mental Health: Literature Review. JMIR Ment Health.7(6):e15572. doi: 10.2196/15572. PMID: 32357127; PMCID: PMC7312261

Siantz, E., Pelot, M., & Ostrow, L. (2023). “Once a peer always a peer”: A qualitative study of peer specialist experiences with employment following state certification. Psychiatric Rehabilitation Journal, 46(3), 216–222. doi.org/10.1037/prj0000569

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