Peers, or individuals who professionalize their lived experience to provide support for others, are significant in delivering effective behavioral healthcare. Here at COPA, we aim to continually improve the credentialing process for peers through our Colorado Peer and Family Specialist (CPFS) credential. Career development, equitable employment and emphasizing the value of peer to policy-makers and stakeholders are also big goals.
In December of 2024, COPA partnered with Unclouded Communications to develop a research report to better understand the concerns and goals of stakeholders regarding peer support programming. The report gathered opinions from a variety of stakeholders, including current peers, peer trainers and behavioral healthcare providers. This summary highlights key points, but please read the full report below if you are interested in learning more, as it provides far more details.
Value of Peers
“It’s evidence-based that someone with lived experience is sometimes the best support a person can get.” – Stakeholder
Lived experience is the unique perspective peers bring to those seeking recovery. That experience provides insight into the clinical and non-clinical recovery process. Lived experience allows peers to relate, advocate and develop individualized care for their client.
The report offers some ideas on how to better promote and advocate for peers, both in the workplace and the industry as a whole:
- promote their work through informational media,
- advocate for more peer career development and
- equip employers with the resources to meet peers’ needs.
Peer Management & Training
“If we want higher standards, then we have to look at the reasons why people aren’t getting the standard. And the reason is that they can make money not doing it. Money is the answer.”
Across the board, peer training and management are big concerns for stakeholders. There is confusion around which credential to pursue and which trainings to take. Several organizations offer approved trainings, but there is no one centralized location or singular path. While this is beneficial in providing peers with a flexible education so they can cater to their own needs/interests, it can also be a struggle to navigate. Additionally, there were discussions on whether there should be more detailed criteria for lived experience.
Stakeholders are also worried about the inconsistencies of quality in peer training and employment. Peer management ethics vary greatly, and may negatively impact a peer’s own recovery journey or training experience. Mental health support, professional development and grievance processes are all subject to the employer.
There are frustrations regarding the pay structure for peers too. There is neither a set standard for how much credentialed versus non-credentialed peers should be earning, nor a wage standard across agencies. Most surveyed peers make between $18 and $25 an hour across Colorado, and some are unpaid as interns or volunteers.
Additionally, the report listed several opportunities where COPA can improve in administering the CPFS credential. In the past year, the Credential Team revised the Approved Training List to identify which domains each training counts for, a landing page that explains the basics of the training list, and how trainings are approved.
Ideas for improving peers’ career progression include:
- Centralize training information (utilizing Certemy as a hub)
- Coach peer supervisors on how to manage peers and provide them with necessary resources
- Change pay structure to fit with the different stages of a peer’s career path, including entry-level, experienced and credentialed peers
Credential Attractiveness & Improvements
A benefit of the peer workforce is the flexibility to build one’s own career path. But, stakeholders expressed that there are some peers that do not see true career advancement after getting credentialed, and there are some that never get credentialed at all. The perceived value of completing the credential can be diminished whenever advancement is not correlated with higher wages.
Stakeholders do understand the benefit of achieving a credential like the CPFS. 93% of surveyed credentialed peers agreed that the resources and money was worth the investment, and 97% agreed the time and effort was worth it.
Stakeholders offered suggestions to aid these concerns:
- Promote credentials as an important part of peer career advancement through employer advocacy
- Initiate a peer-led mentorship program and tutoring session to address barriers
- Highlight the benefits of the credential, like skills from trainings and access to resources
Currently, COPA is revamping how we talk about the credential – nearly 700 (and counting!) peers are using their CPFS to do good for behavioral health and substance use care in Colorado. In the coming months, we’d love to share their stories with you, and highlight why becoming a CPFS is so much more than just a credential.
Discussions of Stronger Regulation
With the concerns of peer management, stakeholders are interested in improving workforce regulation. Stakeholders are generally in agreement that both agencies and peers operate with varying levels of integrity, with some prioritizing profit over quality support. Since there is not a standardized grievance policy in place, the way organizations deal with issues in the workplace differs.
Similarly, since the peer role is such a unique position that can stretch past personal limits, peers are vulnerable to exploitation. Because of concerns from this section and the previous, many stakeholders are in favor of a state-mandated peer credential to standardize the process.
Credentials are crucial to the effectiveness of the peer workforce, stakeholders agree. They believe that mandating the credential would validate the peer profession and create a more sustainable workforce for the future.
“Surveyed peers mostly agree that it is important for peer support specialists to be credentialed in order to perform the job effectively and maintain a code of ethics.” – Stakeholder Engagement Report, page 31
Developing a state-mandated credential would not come without challenges, like reshaping the peer industry and legislation around it, but it is a popular opinion to surveyed stakeholders, according to this report.
Systemic Challenges & Overcoming Them
“The fact that we have lived experience makes us a different type of employee than everybody else on the payroll. So we do need that community of support that comes from coworkers or at least being connected to other peer professionals.”
Stakeholders agreed that there are several issues the peer community is currently facing. Peers need personalized support in the workplace because of their own lived experience and recovery journey. There is a constant concern around funding, partly because funders do not understand the value of peer support.
The complexity of Medicaid billing is another barrier in the mix for peer compensation. These challenges are even more present in rural communities, which need extra attention because of lack of resources.
Systemic challenges are prevalent challenges to peers. If agencies structure their workplace as inclusive and safe, a diverse workforce will follow. Peer diversity is very important in providing equitable services to individuals facing behavioral health challenges. In order to support the peer workforce, there needs to be diverse voices in important decisions.
Stakeholders provided action items that can boost the effectiveness of the workforce:
- Structure agency workplaces as inclusive and safe in order to welcome a diverse workforce
- Engage employers in creating atypical workplaces for peers, like shorter workweeks and frequent mental health check-ins
- Allocate more resources to rural peers
Peers, employers, state departments and more are working hard to make the workforce a more equitable place. We are working with many other organizations to address inequitable working conditions, and to create more resources around how to effectively manage and implement peers and their depth of knowledge.
“Nothing about us without us.”
The peer workforce is an integral part of providing effective support to individuals facing behavioral health challenges. The team at COPA understands that not all of these goals are feasible at this time. The ultimate goal of this report is to facilitate conversations around present issues and improve the peer workforce experience for all parties.