When you’re in crisis, the task of telling someone can feel monumental. That dread grows when the person you’re talking to is in a position of power over you, like a doctor or a psychiatrist, or when your life experiences have cultivated mistrust in medical professionals. That’s where peers come in. A peer support specialist is a person who has direct lived experience of a behavioral health disorder, including addiction or mental illness, and who is trained in techniques like deescalation, motivational interviewing, and crisis response. Their approach is guided by both evidence-based behavioral health practices and their firsthand knowledge of navigating the same issues they’re now helping others overcome.

Peer support specialists are quickly becoming a pillar of behavioral health care in California. In 2020, SB 803 (Beall) instituted a framework for a peer support specialist certification, making it possible for peer support to become a Medi-Cal reimbursable service. With the passage of Proposition 1, which requires counties to bill services through Medi-Cal in order to reduce direct costs, peer support specialists are increasingly relied upon to staff mobile crisis units, perform outreach to people experiencing or at risk of homelessness, and support individuals as they work to recover from a behavioral health challenge. Peers seeking certification may specialize in areas including justice involvement, homelessness, crisis services, and parent, family, and caregiver support. Working as a peer support specialist can also provide a person newly in recovery with the stability they need to maintain their health while utilizing their unique skill set to help others.

However, challenges remain to establish peer support specialists as a long-term pillar of California behavioral health. Chief among these is the pay scale. Certified peer support specialists, despite their immense contributions to behavioral health services, frequently make under $40,000 per year—a fraction of the standard livable wage in California for a single adult, much less for someone with children. This rate boxes out people who support their families and those who do not have alternative forms of income or generational wealth, resulting in a less diverse workforce with high levels of burnout and turnover. It also impedes peers’ ability to care for their own wellbeing and invest in their recovery through resources like adequate housing, healthy food, and community engagement.

Developing a strong peer workforce is a critical investment in a resilient behavioral health system. Instituting higher wages, employment incentives, and opportunities for professional advancement can help to ensure that peer support specialists have the resources to care for their clients and themselves.