Currently, around 47.6 million Americans are living with a mental illness and 20.3 million adults are living with a substance use disorder (SUD). In 2016, only 43% (20.6 million) of adults living with any mental illness received mental health (MH) care, and only 3.7 million adults (18.2%) living with an SUD received any treatment. Peer support specialists (PSSs) are one promising workforce that can help close this treatment gap. PSSs are individuals who use their lived experience of recovery from psychiatric traumatic or substance use challenges to assist and support another peer’s own personal recovery through modeling recovery behavior, building relationships, and encouraging resilience. Utilizing PSS services has clinical and economic advantages: Individuals enrolled in peer support crisis intervention cost Medicaid an average of $2,138 less than Medicaid-enrolled individuals who do not receive peer support. Despite these benefits, only 40 states offer statewide training and certification programs.

This report aims to understand the organizational settings and roles of peer providers in the behavioral health workforce and to build a profile of peer support specialists using statutes, administrative codes, state Medicaid plans, and national survey data.