The Peer Support Solution: A community Based Model for Closing the Gap in Mental Health and Substance Use Disorder Workforce Shortages

Mental health and substance abuse in the United States is a pressing crisis of mental health. The crisis has only been exacerbated by the onset of the COVID-19 pandemic. As a result, the demand for mental health and substance abuse support resources has never been higher. Unfortunately, a nationwide labor force shortage in mental health and substance use support means the supply of resources to adequately treat and prevent severe instances of mental health and substance abuse cannot keep up with the demand. The labor force concerns with regards to behavioral health can be broken into three primary categories. First, access: there are not nearly enough clinicians to support the number of individuals who need their help. Second, cost: clinical support for mental health is extremely expensive. Third, asking for help: the formality of mental health care delivery in a clinical setting increases the barriers to asking for help. In this report, we outline how peer support solves these three key issues by improving access to care, decreasing cost of delivery, and decreasing the formality of care, increasing the ease with which individuals can feel comfortable asking for care.

In Section 2 of this paper, we discuss the federal and peer state efforts to combat rising levels of mental health and substance use disorder demand. Funding at the federal level seeks to enhance behavioral health research at universities and hospitals nationwide through the National Institute of  Mental Health. In addition, the Health Resources and Services Administration and the Substance Abuse and Mental Health Services Administration work in concert to partner with on-the-ground support programs, especially in rural areas, with demonstrated results in improving local mental health and substance abuse conditions. Public funding provides vital revenue streams for such efforts along with public partnerships that can be leveraged for acute care partnerships that integrate peer support with a patient's more general health care delivery plan.

Section 3 provides two key comparison states for the activation of the peer support labor force: Maine and Connecticut. Maine is a relevant comparison state given similar demographics and the rural nature of the state. Connecticut, while not necessarily facing the same geographic complexities as New Hampshire, has a particularly effective network of mental health and substance abuse support fueled by federal funding for non-profits and partnerships with hospital systems.

Section 4 of this paper assesses the existing situation for mental health peer support in New Hampshire, and Section 5 provides improvement options based on the assessment of the current landscape and infrastructure. In conclusion, an assessment on existing models of peer support across the country, built upon a robust literature, demonstrates three key features of an effective approach to building out peer support avenues for mental health delivery: leveraging the unique benefits of peer support, community-centric models, and grounding peer support in clinical guidelines and advice.