Are there times in your life that you would categorize as “extreme low points”? Times when you were struggling and felt utterly alone?
For me, my first real low as an adult was when I was in my 20s and had just been dumped. I had had relationships end before, but this time it was different. I was in a well of grief that I couldn’t get out of. At the same time, I began to have a crisis of identity: who am I? Why do I exist? Does living matter? And then childhood trauma flashbacks began. I couldn’t sleep, and I couldn’t find any relief.
Fortunately, someone gave me a 12-step meeting list. I do not remember who, when, or where. And I do not know how I found any courage or even energy to actually find a meeting and go, but when I entered the rooms, I was blown away at how many people were telling my story. I kept going back like a thirsty person to a jug of water. And I started to feel grounded again in myself and in my body.
My problems did not miraculously disappear. But I was not alone. And I began to see a way forward.
That is one example of peer support at work.
We have all experienced some version of peer support. You know that feeling of immediate connection and understanding because the person you are talking to has walked in your shoes? It is the feeling when your mother is dying of cancer and your friend whose mom just died of cancer hugs you. Or when you spend years trying to get pregnant and you randomly encounter someone else experiencing the same emotional roller coaster and you instantly bond. Or when you sit down in a group of (insert here: voice-hearers, single parents, suicide survivors, Veterans…) and feel suddenly not alone.
Peer support can be happenstance and informal or planned and come with training and competencies.
The Substance Abuse and Mental Health Services Administration (SAMHSA) defines a peer specialist as “a person who uses his or her lived experience of recovery from mental illness and/or addiction, plus skills learned in formal training, to deliver services in behavioral health settings to promote mind-body recovery and resiliency.” It also defines the role of a peer specialist as “offering and receiving help, based on shared understanding, respect and mutual empowerment between people in similar situations.”
Today 48 states and the District of Columbia all have formalized peer certification programs and Medicaid-funded peer support services. Vermont is not one of these states. From Georgia to California to Pennsylvania, peer support services reduce emergency room visits and save those states money.
Where there are peer support workers in Vermont currently, there are no statewide standards of experience and training, no competency standards, and no ethical standards. Vermont’s peer support workforce is underdeveloped and the state is not tapping into all available Medicaid funding to expand community-based, recovery-oriented mental health services in Vermont.
The Department of Mental Health funds Pathways Vermont to coordinate the Peer Workforce Development Initiative, whose purpose is to improve consistency, infrastructure, communication, and resource sharing among the peer-workforce community. As part of our charge, we commissioned a research report entitled Peer Specialist Certification: An analysis of U.S. and Canadian Efforts to Promote and Expand Mental Health Peer Specialist Workforce Capacity. The research highlights the efficacy and effectiveness of peer support services to any system of care, and the cost savings and lower emergency room usage in states that embrace a well-resourced peer support workforce.
That Vermont’s current mental health care system is strained goes almost without saying. Where we look to find solutions needs to be informed by best practices, proven solutions, and the voices of people who use the services.
Today before the state legislature, there are two pieces of legislation supported by four of Vermont’s peer-led organizations: Alyssum, Another Way, Vermont Psychiatric Survivors, and Pathways Vermont. The legislation is S.194 and S.195, acts relating to peer-operated respite centers, and certification of mental health peer support specialists. I urge Vermonters to consider and support this best practice that will help Vermont provide effective and beneficial support in the community.
An investment in peer services will strengthen our system of care, and at the same time, it will save us money and free up emergency rooms and hospital beds. An investment in peer support will develop community and build relationships, and it will create much-needed jobs for people often discriminated against for employment. Finally, and perhaps most importantly, it will ensure that everyone in the throes of their extreme lows in life will not be alone.