Improve standardization and data of peer support

More than half of all U.S. counties do not have a mental health or substance use disorder (MH/SUD) provider. While many MH/SUD services can be provided via telehealth, much more needs to be done to expand the MH/SUD workforce, including peer support specialists. These critical providers are formally trained and offer peer support, using their lived experience with a MH/SUD to promote recovery in other individuals. Peer support specialists are cost-effective and provide critical support that helps individuals build stronger support systems, engage with treatment, and manage both MH//SUD and physical health conditions. Increasing utilization of peer support specialists (including through telehealth) is a critical way to alleviate shortages of MH/SUD professionals, particularly in rural and other underserved areas. By helping individuals get the support and care they need, peer support specialists help prevent costly negative outcomes, including disability, hospitalization, incarceration, and even homelessness.[1] Indeed, research has shown that peer support services were associated with 2.9 fewer hospital admissions each year, and Medicaid programs saved an average of over $2,000 per month.[2]

Unfortunately, barriers remain in expanding the peer support specialist workforce. One critical barrier is insufficient standardization. For example, credentialing of peer support specialists is not standardized across states. The Substance Abuse and Mental Health Services Administration (SAMHSA) and the Health Resources & Services Administration (HRSA) should take steps to standardize credentialing. Additionally, the U.S. Bureau of Labor Statistics’ Standard Occupational Classification (SOC) system does not have a separate classification for peer support specialists.[3] Instead, peer support specialists are lumped in with “Social and Human Services Assistants.” The SOC system is how federal agencies classify workers in order to collect, calculate, and disseminate data. Congress should direct SAMHSA and HRSA to take steps to standardize credentialing of peer support specialists and the Office of Management and Budget to revise the SOC Manual to include a definition of peer support specialists.

Another barrier is that HRSA does not publish data on peer support specialists.[4] Such data is collected and published for psychiatrists, psychologists, and social workers – and includes information on the number of professionals and their location. Having data on peer support specialists would help identify gaps across the country, including where peer support specialists could fill gaps in available clinicians. HRSA collects much of this data through the Behavioral Health Workforce Education and Training (BWHET) program, but this data is not published. Congress should direct HRSA to add peer support specialists to its Workforce Bureau dashboard.

Finally, in 2022, the Senate Finance Committee’s Task Force on Workforce released draft legislation, which included a Medicaid workforce demonstration project modeled after a previous demonstration project.[5] Unfortunately, peer support specialists were not named within the draft. It is critical that any new workforce demonstration projects explicitly authorize peer support services so that these projects cover the range of provider types.