Beyond Twelve Steps, Peer-Supported Mental Health Care

Abstract

Georgia is the state at the heart of the groundbreaking Supreme Court case, Olmstead v L.C., brought by two women with mental illness and developmental disabilities. In 1999 Olmstead established the right of people with disabilities to receive state-funded services in the community. In that same year Georgia became the first state to receive Medicaid reimbursement for services delivered by "peers," or people who use their personal experience with mental illness to help others. The role of nonclinical peer support is now a core part of the behavioral health workforce nationally, as fortyeight states and the District of Columbia have or are developing a system of certifying peer specialists. Peers join care teams in varied settings, from emergency departments and crisis centers to community programs. Unlike twelve-step group-support programs such as Alcoholics Anonymous that rely on volunteers, peer programs are built on a set of professional competencies, ethical standards, and continuing education. Peer mentors assist people with practical matters, such as finding housing or adjusting to life outside an institution, and they share their own recovery stories to help people learn new coping skills. While the pay varies, they earn, on average, about $15 an hour.