Leveraging Lived Experience to Co-Produce the Ideal Peer Resource Center

Background and Purpose: Clinicians and policymakers are increasingly turning to peer specialists and people with lived experience of behavioral health conditions to deliver micro-level mental health and substance use treatment services. However, such individuals are rarely if ever invited to help co-produce and design mental health systems at the macro level. The purpose of the present study was to leverage the wisdom and expertise of peer specialists and other staff at a large county mental health department to inform the development and implementation of a new, publicly-funded service: peer resource centers.

Methods: This needs assessment examined the perceptions of peer resource centers according to individuals with direct experience of a behavioral health disorder and family members of those living with behavioral health disorders working as peer specialists at the Los Angeles County Department of Mental Health. The goal was to demonstrate the utility of group concept mapping as a community-based participatory research method that can be delivered by peer specialists to learn more about issues of concern to people with lived experience of mental illness, substance use concerns, and recovery. The focus prompt used for brainstorming was "the ideal peer resource center would include...". After cleaning the data and removing duplicates, participants returned to sort and rate ideas in terms of importance and feasibility.

Results: A total of 21 participants responded to the focus prompt, 76% of whom self-identified as having lived experience of a behavioral health condition or a family member who lives with one. Fifteen (79%) respondents returned to sort 173 statements into nine overarching themes in response to the focus prompt. The clusters include: 1) Programming, 2) Values, 3) Supplies, 4) Communications, 5) Partnerships, 6) Operations, 7) Administration, 8) Technology, and 9) Design. Operations and Design scored the highest on importance, with average ratings of importance between 4.99 and 5.29, whereas Programming and Technology scored the lowest, with average importance ratings between 3.81 and 4.10. Feasibility scores were highest for Communications and Design, for which scores ranged from 4.82 to 4.98, and lowest for Technology, on which feasibility scores varied from 4.19 to 4.35. A thematic spectrum of concepts, identified by participants as beneficial to peer resource centers, emerges visually from the clusters represented on the map, geographically, from left to right, as themes range from macro-level organizational issues to micro-level implementation concerns. The values cluster appeared at the center of the data visualization, suggesting that people with lived experience believed that recovery-oriented values are essential in planning for future peer resource center development.

Conclusions and Implications: Statements rated most important and most feasible appear to address issues of service accessibility, support for peer support providers, and the recovery-oriented values that are the foundation of all peer support interventions. These findings suggest that County resources should be directed toward ensuring that recovery values and concerns about accessibility are not undermined by the bureaucracy involved in establishing and administering peer service centers.