Considering Peer Support Sustainability: Survey of geographic differences in roles, skills, job satisfaction, and financial well-being

Abstract

Abstract Background The peer support workforce has become an established aspect of behavioral health care, with endorsement since 1999 as Medicaid reimbursable and with steady uptake of credentialing by 49 states and the District of Columbia. Yet sustainability issues due to wage and entry-level stagnation lacking advancement paths is a concern for the Certified Peer Support Specialists (CPSSs) workforce. Methods This analysis compared cross-regional survey data of employed CPPSs in Utah (U) to a prior Michigan (M) sample. The core areas of investigation were 1) health and well-being, 2) professional settings, activities, and opportunities, and 3) perceptions regarding professional practice. Results Over 85% of Utah peers expressed satisfaction with work hours, physical safety at work, and supportiveness of supervisors, similar to 75% Michigan sample satisfaction. Job security satisfaction differed at 87% in Utah and 67% in Michigan, with a higher average wage in Utah. Less satisfaction was reported for promotion opportunities (U-57%, M-41%) and coworker awareness of peer roles (U-34%, M-42%). Conclusions Results indicate similar workforce conditions across regions, but with higher pay and slightly higher satisfaction ratings in the Utah sample of mixed recovery and mental health peers. Both areas demonstrate a need for training non-peer staff on CPSS job roles, indicating a lack of clarity regarding the professional contributions of peers. Practical administrative steps to support sustainability include stigma-reducing workplace policies, trainings, career laddering with increased responsibility, sustainable wage and benefit packages consistent with career laddering, and reinforcing consensus around defined roles and competencies of peer support.