Peer Specialists: Helping Veterans Battle Substance Abuse

Department of Veterans Affairs

Battling substance abuse or mental illness can be tough. Obstacles like feelings of hopelessness, loneliness and misunderstanding often get in the way of treatment. Very often, Veterans struggling with these problems feel that their doctors do not understand them.

However, for about a decade, VA has been breaking down these barriers using peer specialists to help guide patients through their treatment. These trained individuals can establish a bond and provide support in a way most providers cannot. Not only are peer specialists Veterans, but they have also overcome substance abuse or are successfully managing their life with a serious mental illness. They serve as role models, provide hope, engage patients in their care and help patients access supportive programs, peers and community resources.

"Peer specialists draw upon their lived experiences to share ‘been there' empathy, insights and skills", said Dr. Matthew Chinman a VA researcher from the VA Pittsburgh Healthcare System.

Chinman understands the importance of peer specialists in mental health care. He started his research on mental health peer specialists in 1995, as a psychology intern at the Yale School of Medicine and now currently leads the Peer Resource Center, where they have conducted the first clinical study evaluating the effectiveness of peer specialists in VA. The study revealed Veterans with the support of a peer specialist have an increased involvement in their care. This is a significant finding because patients who take an active role in their care often have better health outcomes. They also recently completed a review of research literature evaluating the impact of peer specialists.

"We did a review of all the studies that tested peer specialists' impact and found that a majority of studies did find some impact on issues like hospitalizations, quality of life, hopefulness, active participation in their own care and recovery, " he said.

In 2007, there were approximately 90 peer specialists working at the VA. In 2012, President Obama issued an executive order to enhance mental health services by hiring 800 peer specialists. VA has surpassed this goal, with about 1,100 peer specialists currently supporting other Veterans.

Fred Nardei is one of those peer specialists. He is a Veteran who shares his story to help other Veterans. He explains how he became addicted to pain medication after a car accident and later began trading his medication for stronger drugs, which led to a heroin addiction. After successful completion of therapy, he has been clean for six years. During that time, Fred completed a 40-hour training course to become a certified peer specialist.

The VA contracts with non-profit organizations to provide certification training for its peer support apprentices (those hired before completing training) and also accepts non-VA training that results in certification by states. The training ensures peer specialists have certain basic competencies in psychosocial rehabilitation and many other elements of patient care including communications skills, crisis management, problem-solving, and understanding various mental health and addiction conditions. Fred now works with other Veterans as a peer specialist within the VA Pittsburgh Healthcare System.

The VISN 4 Mental Illness Research, Education and Clinical Centers' Peer Resource Center within the Pittsburgh Healthcare System, plays a vital role in the effective utilization of peer specialists within the VA. They assisted in developing the proficiencies that each peer specialist must possess and are currently co-leading, along with the VISN 5 center, the evaluation of the White House's Executive Action of deploying peer specialists on patient aligned care teams at 25 medical centers.

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