Legal Fellow Sophia House Co-Authors Paper on Shared Experience in Peer-Delivered Services

April 5th 2019

NYU Furman Center Legal Fellow Sophia House and colleagues recently published What We Have in Common’: A Qualitative Analysis of Shared Experience in Peer-Delivered Services in the Community Mental Health Journal. The paper examines the role of “shared experience” in peer-delivered mental health services and addresses a gap in existing research about the role of shared experience in peer provider-client relationships. To explore this issue, in-depth qualitative interviews were conducted with peer specialists and supervisors working in a Peer Wellness Program within a Housing First Agency. The Housing First model provides individuals who have experienced homelessness and serious mental illness with permanent scatter-site housing, and connects clients with a wide range of supportive services without conditioning housing on particular outcomes.

Peer specialists exist in many fields, but within mental health services are typically defined as “individuals who have personal experiences of successfully living with serious mental illness (SMI e.g. schizophrenia), and who can tap into these experiences, often in combination with specialized training, to provide services to others with severe mental illness.” Peer-delivered services have shown effectiveness in improving outcomes for clients with a variety of mental health conditions; however, questions remain as to which aspects of peer-delivery are most important and effective for improving outcomes for Housing First clients.

In this study, the authors conducted interviews with eight peer specialists and two supervisors from a Peer Wellness Program within a Housing First Agency. The organization created a peer wellness program to supplement the organization’s standard support services, with a particular focus on assisting clients with their long-term goals. The agency’s peer specialists assisted newly-housed formerly homeless clients with a variety of issues including employment, education, social connections, family reunification, criminal justice issues, and healthier lifestyles. In addition to working one-on-one with peer specialists, clients could also attend groups on topics such as nutrition, computer skills, art, photography, harm reduction, and current events.

The findings revealed that having “peer” status allowed for higher levels of trust, empathy, and open communication with clients. Despite their qualifications through training, peers primarily established credibility by being able to express to clients that they have “been there”. However, those interviewed claimed they rarely disclosed their specific experiences with mental illness, substance abuse, or treatment to clients. Peer specialists relied on the “peer” moniker and chose to focus more on shared common life experiences (such as the death of a loved one) or cultural similarities to build relationships with clients.

Peer specialists also focused on more intangible signs of progress and placed increased emphasis on their clients’ engaging in the process of changing their perceptions, rather than focusing narrowly on outcomes. Supervisors interviewed relied more on the setting and achievement of concrete goals for their clients, such as reaching out to a parent or keeping appointments.

Overall, the results affirmed that shared experience is a vital component of mental health services from peer specialists, but pushed back on the perception that the sharing of specific encounters with mental illness held a primary function in the peer/client relationship. Instead, the results indicate that shared experiences contribute to a shared perspective, which influences the ways that peer specialists deliver services. These findings shed light on how peer wellness services supported and facilitated formerly homeless clients’ transition into housing, and how peer wellness can be integrated into housing organizations’ service delivery models.

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