People with Mental Health Symptoms ("Peers") Are Needed in Mental Health Work

One Mr DJ Jaffe, the self-styled Executive Director of Mental Illness Policy Org, “a non-partisan think-tank on serious mental illness funded by people with and families of the seriously mentally ill only,” had a startling opinion piece published online in Psychiatric Times on February 14, 2018.

Permit me to quote his final two paragraphs to show you his bias, ahem, there is no other word for his opinion.

The new Assistant Secretary [overseeing the Substance Abuse and Mental Health Services Administration of the US, known as SAMSHA] has spoken about requiring peer support specialists to work in concert with medical experts. She has also taken steps to eliminate non-evidence-based programs from SAMSHA and to focus it on evidence-based programs that help the seriously mentally ill. But the leadership of CMHS…is still putting out contracts that are burdened with the expensive requirement to hire peers without sufficient evidence they improve outcomes or do so better than non-peers.

Using scarce resources to support programs like paid peer support that lack evidence they help—while so many proven programs go unfunded—makes little sense.* Research should be conducted to determine if paid peer support improves meaningful metrics in people with serious mental illness and if provision of those services by paid peers is superior to provision of the same services by others. Paid peer support should not be expanded until that research is clear. If expanded, then steps should be taken to ensure that the peer support trade associations do not lobby to make treatment for the seriously mentally ill more difficult.

*Examples of programs proven to improve meaningful metrics in people with serious mental illness include appointments with psychiatrists, hospitalization, medications, electroconvulsive therapy, assisted outpatient treatment, clubhouses, assertive case management, intensive case management, supported housing, psycho-social rehabilitation, and others.

(I’ve even quoted his footnote to his conclusion to show that he has not heard of many contemporary treatments like transcranial magnetic stimulation (tCMS), and that his ideas about what works do not include meditation/prayer as second in line—but rather, hospitalization!) 

And notice how he is authoritarian enough to want “steps… [so] that the peer support trade associations do not lobby.” 

Why is he wrong? I can be briefer than he….

1. Peer employees of mental health agencies provide consumers/patients with self-esteem. They see that various forms of employment are possible for them.
2. Those who are peer employees themselves have jobs that bring them self-respect as well as income.
3.  “Patient-centered treatment” is required by the US Centers for Medicare & Medicaid Serrvices (known as CMS) under the rubric, “Partnerships for Patients.” 

Mr Jaffe is out in left field!

(C) Copyright Deborahmichelle Sanders 2018. All rights reserved.