What's Recovery Got to Do with It? on Becoming a Peer Provider

Background and Purpose: Peer support services in mental health settings have produced benefits for the recipients of peer services, for the peer providers, and to the delivery of services within the mental health system. As interventions for persons with mental illnesses involved in the criminal justice system are expanded, there have been calls to incorporate peer support workers into these programs. Currently, few programs employ peer support workers with criminal justice histories and even less is known about peer support workers with these histories. This study examined how individuals with mental health and criminal justice histories become peer support workers and the impact of the training on their recovery and desistance from criminal activity.

Methods: Purposive sampling was used to recruit 13 participants who were graduates of a peer training program, had an Axis I diagnosis, spent at least 6 months incarcerated in jail or prison, and were working as peer provider. The sample is predominately male (85%), African-American or bi-racial (100%), on average have worked 2 years as a peer provider, received 12 years of mental health services, and have spent an average of 11 years incarcerated. Phenomenological life history interviews were conducted consisting of 1) a life history interview, 2) a phenomenological interview about their work experiences and, 3) a meaning making interview with each participant, resulting in 39 interviews. Interviews elicited life history narratives, focusing the turning points that led to them enrolling in a peer provider training program. Interviews were transcribed verbatim, entered into HyperResearch qualitative software, and coded thematically using grounded theory and phenomenological techniques.

Results: Data analysis showed that a combination of factors contributed to individuals seeking peer support training: a readiness to change, having tangible support like housing or treatment, and someone informing them of the peer training program. The commitment to change often occurred after an arrest or hospitalization or during incarceration and was critical to individuals’ seeking resources for tangible support once they returned to the community. Parole officers, other peer providers, and other treatment providers were crucial in informing individuals of the existence of peer providers and directing individuals to the peer training program. The training, while difficult for some, contributed to their recovery trajectories and desistance from crime as most undertook peer training within a 12 or 18 months of their latest incarceration.

Conclusions and Implications: Findings highlight the importance of others in directing individuals in the relatively early stages of recovery and desistance from crime to peer training once a commitment to change is expressed. Waiting until individuals have demonstrated a certain level of stability in their criminal offending and recovery process may undermine the role that peer training can provide in recovery and desistance from crime. Peer training programs should include individuals with criminal histories as they can address a potential gap in peer mental health services.