Building a Mental Health and Substance Use Disorder Care Career

Pathways, Pitfalls, and Progress

Peer Specialist

Peer Specialist

A peer specialist, also known as a peer support worker, peer recovery coach, or peer advocate, is a mental health professional who has personal experience with a mental health condition, substance use disorder, or both, and has been trained to help others with similar challenges.

Lived experience is a person’s understanding and representation of their own human experiences, choices, and options, and how these factors influence their perception of knowledge.

Potential Costs

Education$0-$2,000


ExperienceTypically, no direct cost


Field Experiential Training$500-$2,000


License/Certification$100-$300

Potential Return on
Educational Investment

Range of Total Cost$600-$4,300


Salary RangeNational Average:
$35,000 –
$45,000 

Timeline

EducationTypically, 4 years


ExperienceTypically, 0-2 years of relevant lived experience


Field Experiential trainingWeeks to months


License/Certification3-6 months

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Career Path

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Education

High SchoolHigh School

Challenge

Loan repayment programs often focus on the tax status of the employing institution, without considering other factors such as whether it is a critical provider in an underserved community.

Solutions

Expand eligibility for loan repayment programs.

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Expand eligible workers.

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Experience

High SchoolLived experience with mental health or substance use

Challenge

Individuals may have personal challenges related to MH/SUD recovery that impact their ability to pursue and achieve PSS certification.

Solution

Offer support groups.

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Field Experiential Training

High SchoolPSS Certification Training

Challenge

Minimal or inadequate training to properly prepare new employees for the peer specialist workforce.

Solutions

Fund Centers of Excellence.

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Establish a National Coordinator.

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License/Certification

National CertificationNational Certification

Challenge

Differences in provider credentialing requirements across states and across health insurers in the same state. Different and conflicting requirements can make it difficult to move states, provide telehealth across state lines, or serve populations covered by different kinds of insurance.

Solutions

Eliminate out-of-state licensure requirements.

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Convene a workgroup to identify barriers.

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Streamline enrollment of out-of-state providers in Medicaid.

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Potential Challenges Along the Path

Peer workers in the MH/SUD field face several challenges, including potential stigma and misunderstanding of their role within treatment teams and lower wages. They can deal with emotional fatigue from supporting others while managing their own recovery journeys, which may lead to burnout. Additionally, limited access to training, limited national standards, limited ability to bill for their services (in some states), and limited professional development opportunities may hinder their ability to advance in their careers and fully utilize their skills.

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Payment and reimbursement

Challenge

People in the MH/SUD workforce are often paid less than other areas of healthcare. These disparities in payment in part account for the workforce shortages.

Solutions

Build tools for reimbursement data.

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Implement reimbursement policies.

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Data and Technology

Challenge

Telehealth may not be covered by all insurers, which creates a service gap in rural communities and for those who are unable to attend MH/SUD care appointments in person.

Solutions

Maintain telehealth access post COVID-19.

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Develop telehealth data best practices.

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Expand EHR utilization in MH/SUD.

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Discover the Challenges and Solutions

The report “Policy Priorities for Advancing the Mental Health and Substance Use Disorder Workforce,” outlines essential policy recommendations focused on four key areas: payment and reimbursement, licensure and standardization, education and training, and data and technology.

Download The Report

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This tool is intended as a general example of a Peer Specialist career pathway, highlighting potential challenges and solutions. Please note that the information provided may not reflect the specific requirements, certifications, or licensing necessary in your state or region. Each state has its own regulations and standards for MH/SUD care careers, and it is essential to consult relevant state authorities or professional organizations for accurate and up-to-date information. This tool is not exhaustive and should not be considered a definitive guide. Users are encouraged to seek additional resources and professional advice tailored to their individual circumstances.