“Once a peer always a peer”: A qualitative study of peer specialist experiences with employment following state certification.

Abstract

Objective: Peer specialists are people with lived experience of a mental health or substance use disorder who are certified to deliver peer support services under state training programs. This qualitative study explored recently certified peer specialist (CPS) experiences navigating the job market to find postcertification employment, experiences with employment once in the workforce, and reflections on CPS training. Method: Qualitative data were collected as part of a multistate, 3-year observational prospective cohort study of CPS graduate employment trajectories. We conducted 25 in-depth, semistructured interviews with a subsample of recent CPS graduates who indicated a range of employment experiences in a survey as part of the parent study. Interviews focused on their current employment and satisfaction with the position and experiences looking for work. Data were analyzed using constant comparative methods informed by grounded theory. Results: Participants described factors that supported or undermined securing employment, which included a shortage of CPS positions, their professional networking skills, financial considerations, and a position’s alignment with CPS values. Once employed, participants described how relationships with supervisors and coworkers, which ranged from supportive to confused about the value of the peer specialist role, impacted their work. In general, participants held their CPS training and certification in high regard. Conclusions and Implications for Practice: Our findings highlight policy, employment, and practice opportunities to strengthen CPS training to improve their work readiness of graduates and expand their role, while preparing organizations and their staff to hire and work inclusively with CPSs.