"for Us to Help Someone Else, First We Have to be Okay Ourselves": Supervision As a Strategy for Implementing Culturally Responsive Peer Support in a Latinx Serving Peer-Run Organization

Background: Latinx and Spanish speaking persons with mental illness and behavioral health needs encounter many barriers to accessing care. Culturally responsive services delivered by certified peer specialists (CPSs) capitalize on commonalities between CPSs and consumers who share similar cultural and linguistic backgrounds and recovery experiences. However, little is known about implementing culturally responsive peer support in a Spanish-speaking peer-run organization that serves a Latinx immigrant client community. This qualitative study used the Consolidated Framework for Implementation Research (CFIR) and asked: What are the requirements for implementing a culturally responsive peer support program; and What strategies does the organization use to promote successful implementation?

Methods. Fifteen stakeholders participated in a semi-structured interview, including organizational leadership (n=3), Spanish-speaking or bilingual Certified Peer Specialists (n = 9), and bilingual supervisors (n = 3). Interview guides were developed according to the domains of the CFIR; Interviews were audio-recorded, transcribed. Thematic analysis was used to analyze qualitative data, and results were organized according to the CFIR.

Results. Key CFIR elements emerged as follows: 1) ‘Innovation.’ Peer support services integrated with mental health services were delivered by bilingual Latinx community members in recovery, which alleviated stigma and celebrated ‘Latinx and peer culture.’ The partnering organization also developed and implemented a robust model of CPS supervision. Supervision consisted of weekly individual meetings with bilingual/bicultural CPS-certified supervisors and emphasized CPS self-care and recovery, in addition to job performance. CPSs also received monthly group supervision, which focused on group problem solving; 2) Outer setting: Spanish-language professional development opportunities for CPS were unavailable elsewhere in the community, and the peer support program responded to cultural and linguistic barriers to accessing community mental health services elsewhere by cultivating a bilingual and bicultural peer support staff. 3) Inner setting: To develop their peer support staff, the organization developed and delivered a CPS state certification training to educate their workforce and build community capacity. The organization’s built environment also contributed to mutual support and collaboration, and facilitated team building and mutual support among the peer support staff; 4) Individuals involved: The supervision model strengthened CPS knowledge and skills to deliver peer support; 5) Implementation Process: Despite organizational supports, CPSs described their work as emotionally draining.

Discussion. A thriving peer support staff that was state certified along with a robust model of supervision delivered by bilingual, CPS-certified supervisor and focused on CPS recovery were essential to implementing the culturally responsive peer support program. Culturally responsive supervision builds capacity within this organization’s multicultural workforce and appears to be an effective strategy for supporting the implementation of culturally responsive peer support, while buffering against burnout. Findings can be used by organizations and service systems who wish to support a multicultural peer support workforce. Future studies should explore a larger-scale delivery of this supervision strategy, using a culturally responsive lens.