The expansion of peer-delivered services is one of the most significant developments in behavioral health over the past decade. What was once a rare, little-known role has become mainstream. A 2024 report by the Peer Recovery Center of Excellence estimated that more than 100,000 individuals nationwide have been certified as peer providers in mental health or substance use dependence (SUD) services, and that number continues to grow.
Today, trained peer professionals work across crisis services, emergency departments, inpatient and outpatient programs, housing, outreach teams, community-based settings, and more. Their presence reflects a broader shift toward a recovery-oriented behavioral health system.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), peer staff foster hope, accelerate engagement and the development of trust between individuals and their treatment/support teams, and illuminate potential pathways to recovery. When well implemented, clinical providers and peer professionals complement one another, leading to a more responsive, person-centered approach to service delivery.
Despite this growth, many organizations continue to struggle with implementing peer services with fidelity. Challenges often include unclear role definitions, supervisors unfamiliar with peer practice, workplace cultures that misunderstand the peer function, and policies that were never designed with peer roles in mind. In addition, limited career pathways and advancement opportunities can contribute to turnover and workforce instability. This also affects agencies’ ability to find and recruit qualified peer professionals.
While most agencies approach peer integration with good intentions, many lack the infrastructure, training, or bandwidth to fully support the role. In some cases, peer positions are added to meet funding requirements without sufficient attention to organizational readiness.
The rapid expansion of the peer workforce presents additional challenges. Many peer professionals are new to the nonprofit workplace and must navigate unfamiliar organizational cultures. In programs where only one peer role exists, staff may experience professional isolation and lack opportunities for peer-to-peer learning and solidarity.
Maintaining fidelity to peer values can also be complex. Some staff experience “peer drift,” gradually taking on clinical tasks outside their scope. Others may become overly rigid in protecting role boundaries, straining team dynamics. Both patterns highlight the need for strong peer-informed supervision and organizational clarity.
While implementation challenges are real, traditional behavioral health agencies do not have to navigate them alone. Peer-run organizations represent a critical and often underutilized resource in building strong, sustainable peer services.
Led and staffed by individuals who openly disclose significant lived experience of trauma, mental health challenges, substance use, and other major life disruptions, including incarceration and housing instability, peer-run organizations bring both professional expertise and historical perspective to the field. Many were instrumental in shaping the early development of peer roles and continue to steward the values and practices that define the profession.
Beyond understanding the role conceptually, peer-run organizations have decades of practical experience delivering community-based services. They understand what has worked, what has not, and how to implement peer services in ways that remain faithful to core peer values.
Perhaps most importantly, their commitment to peer services is deeply personal. Peer-delivered services emerged in response to system failures that directly affected and sometimes harmed many of the individuals who built these models. That history continues to inform today’s peer leaders, driving efforts to create behavioral health systems that are more responsive, compassionate, and recovery oriented. At HALI, a peer-run organization serving Long Island for nearly four decades, we have seen firsthand how partnering with traditional providers strengthens workforce development and improves outcomes.
Peer-run organizations can support traditional behavioral health agencies in multiple ways. From strengthening workforce infrastructure to partnering directly in service delivery, the following strategies illustrate practical approaches that have been used successfully to enhance peer workforce development and implementation fidelity. These approaches are not exhaustive, but they illustrate how peer-run organizations can serve not only as service providers, but as workforce and systems partners.
Peer Recruitment Support: Peer-run organizations can help traditional agencies refine recruitment strategies to better attract qualified peer professionals. This may include reviewing job descriptions and other recruiting material to ensure alignment with peer role standards, strengthening onboarding practices, and advising on outreach methods that reach appropriate candidate pools. Because peer-run organizations are often deeply connected to peer networks and training communities, they can also serve as a direct pipeline for identifying strong candidates.
Supervision Support: Agencies that lack supervisors experienced or knowledgeable in peer practices may benefit from external supportive supervision. One effective model is co-supervision, in which a supervisor from a peer-run organization provides guidance to both the peer professional and their non-peer manager.
Meetings with managers often focus on education regarding peer values, role definition and standards, and effective team collaboration. Sessions with peer staff emphasize skill development, role clarity, self-advocacy, and strategies to prevent “peer drift.” When needed, joint meetings can facilitate shared problem-solving and strengthen team alignment.
Reflective Practice for Peer Staff: Reflective practice, sometimes described as group supervision, provides peer professionals with a structured space to share experiences, process challenges, and learn from one another. It functions as “peer support for peer supporters,” helping staff maintain role fidelity, strengthen skills, and reduce professional isolation. Peer-run organizations are well positioned to facilitate these sessions and can help agencies build internal capacity to sustain reflective practice over time.
Training for Non-peer Staff: A common barrier to successful peer service implementation is lack of understanding among non-peer team members. Targeted training can help clarify the peer role, strengthen collaboration, and reduce misconceptions that undermine integration. Since peer-run organizations have a deep and nuanced understanding of peer roles and often have multiple staff who are experienced in training on that topic, they are well positioned to educate staff and boards on how to meaningfully incorporate peer professionals into multidisciplinary teams.
Partnering in Direct Services: In certain circumstances, an organization may wish to offer peer services but lacks the time, resources, or infrastructure to hire, train, and supervise staff independently. In these situations, a peer-run organization can operate as a subcontractor, placing experienced peer professionals to fill roles in the programs that need them. Under this model, peer staff receive task supervision from the onsite manager but continue to be paid by and receive supportive supervision from the peer-run organization. Clear communication between agencies is key for these arrangements to succeed.
Program Design: As the evidence base for peer-delivered services has continued to grow, many behavioral health organizations have shown interest in adding them as a service option. However, they often are unsure where to begin or what elements are necessary to build an effective peer service model. Peer-run organizations are in an ideal position to assist in designing programs that maintain fidelity to peer values and practices. This may include helping to establish overall program structures, developing policies and procedures, defining staff roles, or planning supervisory frameworks.
Organizational Culture Development: A critical yet often overlooked element of successful peer service implementation is ensuring that an organization’s culture is prepared to incorporate them. Peer-run organizations understand the nuances of what a “peer-ready culture” looks like, including a person-centered orientation, belief that recovery is possible, trauma-informed practices, and a strong commitment to staff wellness. An agency may engage a peer-run organization to assess its readiness by reviewing policies, procedures, and program materials, as well as exploring staff attitudes and beliefs through qualitative discussions. When organizational culture becomes more welcoming and aligned with peer values, the benefits extend beyond peer staff to the entire workforce.
While the challenges of expanding peer services in behavioral health services are significant, they are not insurmountable, and the potential benefits are enormous. When traditional behavioral health agencies approach implementation with intention, care, and attention to detail, the entire system of care, especially those who participate in services, will benefit from it. Peer-run organizations, beyond the highly beneficial direct services they provide, are invaluable community partners who can play a key role in helping traditional providers realize that vision.
Jeremy Reuling, LCSW, NYCPS, CPRP, is Senior Director of Special Projects at Hands Across Long Island (HALI).
