Wellness-Oriented Peer Approaches

In the first installment of the integrated care column(PDF - 556 KB) in Psychiatric Services, Margaret A. Swarbrick, PhD, discusses the importance of wellness-oriented peer approaches. In peer-based approaches, individuals who have mental illness diagnoses and are current or former users of the mental health system offer aid and support to patients. Peer providers use their lived experiences with mental illness, plus skills learned in formal training, to deliver whole-health services to patients with mental health and substance use disorders.

The peer wellness movement began 40 years ago with the intention of providing support to patients with mental illness outside the traditional mental health system through advocacy and policy reform. Since then, the peer movement has also become a complement to the mental and medical health delivery systems. Because of the movement’s focus on whole-health, peers are an “important complement” to the integration of primary care and behavioral health. Peer providers can work alongside integrated primary care teams to provide support to patients who could benefit from lasting behavioral health changes and self-management techniques.

Peers serve in roles such as peer wellness coaches (PWCs) and peer whole health specialists (PWHSs). PWCs and PWHSs work with patients to address modifiable risk factors, such as diet, physical activity, and smoking. Peers emphasize self-management techniques that empower patients to be responsible and proactive in maintaining their health. In addition to what peers have to offer patients, peers can also teach medical professionals to “offer education, guidance, support, and informed shared decision making.”

Another benefit to using a peer approach is that they tend to be less expensive than nurses and social workers. Some states even provide Medicaid reimbursement for services provided by peer specialists.  There are, however, challenges to utilizing a peer wellness approach in integrated care. For example, collaboration between the patient, PWC, and medical care team may conflict with how medical care providers have been trained to practice. To overcome this barrier, “the team should be trained in creating a safe, non-judgmental environment in which the peer provider is an active participant on the team.”

Read the column: Wellness-Oriented Peer Approaches(PDF - 556 KB)

Learn more about peer providers in integrated care settings.