There is a growing trend in Massachusetts: Meetings and committees forming to regulate peer support roles where people who have substantive experience working in peer roles are either dramatically under represented or not represented at all. It’s not so much that it’s new that people who have no psychiatric history, and no peer support experience are having conversations about peer roles. Certainly, in a role that is commonly so devalued and impacted by systemic oppression, “about us without us” is pretty commonplace. However, this push to get policies that would have significant power to control the roles across the board is new… or at least far more apparent in 2021. And it has the potential to change the ‘face’ of peer support in the Commonwealth forever. What we’re talking about:
An Oversight Board for Certified Peer Specialists: In July, Bill. S.182, an ‘Act Establishing a Board of Registration of Peer Specialists’ went to public hearing. Before the notice of public hearing started circulating, peer leadership across the state knew nothing of it. It was sponsored by Senator Brendan P. Crighton who appeared to have no clear connections to the work. The language and terms of the Bill also reflected a clear lack of knowledge and understanding of the roles. And yet, if passed, it would stand to put into law regulations that would have serious impact, including solidifying the make-up of an oversight Board where people working in peer roles (or who have previously worked in those roles) would be underrepresented. Learn more about this Bill here: tiny.cc/S182
Guidelines for Supervision of Peer Supporters on ACCS Teams: Then in September, we learned of an ’ACCS Design Team’ committee that had formed and been meeting for several months that was looking to define standards and produce guidance for all organizations supervising peer roles on Adult Community Clinical Services (ACCS, what is essentially the residential system of care as funded by the Massachusetts Department of Mental Health [DMH]) teams. That committee started out with absolutely no representation from anyone in a peer role, let alone anyone who’d worked in a peer role and moved on to supervising peer supporters. Fortunately, at some point, there was a recommendation to add a couple of people who had that experience, and two people were added. That said, they remained outnumbered by people in clinical roles, and were both white men. (Those coordinating the committee acknowledged that there had been no process to ensure equitable representation of people coming from different backgrounds and experiences — including non-white people — at the point of the committee’s formation.)
Behavioral Health Workforce — Peers Standardization: Finally, in November, we learned about another committee that has reportedly been meeting for as long as a year to work on standardization of peer roles with the goal of (as best we could tell) obtaining Medicaid and other health insurance reimbursement for them. As a part of their process, they are considering ‘standardizing’ all peer roles (Peer Specialists and Recovery Coaches alike) by requiring them to go through some form of ‘Community Health Worker’ (a whole separate discipline) training to become certified. Once again, not only was there little to no representation of people working in peer roles (made up primarily of senior leadership from Medicaid, DMH, and so on), but many people in key peer leadership roles across the state had no idea the meetings were even happening. That meant that they only seemed to have a limited understanding of what peer support is about, and were receiving no real input on what peer supporters even thought about health insurance reimbursement. (There is much dispute within the peer support community across the state, as reimbursement of this nature has a long history of speeding co-optation, and changing the roles forever.)
Whether one agrees or disagrees with the goals of or materials produced by any of these initiatives, it is essential that we all stand together on at least one point: No Board, committee, think tank, group, or other gathering should be happening in any official manner to discuss (let alone develop guidance or legislation over) peer roles without a majority of those meetings being made up of people who’ve actually held those roles. People employed directly by the state—no matter what their role is (including anything ’peer’ related) deserve a voice, but should not be seen as meeting that requirement. Anything else is discriminatory. There would be no such group to discuss clinical guidance without majority membership held by people with clinical experience (and generally zero input from people in peer support roles). This practice needs to stop, and all groups of this nature that have already been meeting need to rewind, rebuild their membership, and start over. Have ideas on how to push back together? Let us know your thoughts!