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Peer Support Helps People With Dual Diagnosis

Dec 26 2011 | Comments 11

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I’m always proud to tell people I’m a Certified Peer Specialist (CPS), but it isn’t something that’s well understood by people outside of the mental health community (and even by some inside). Explaining it is a little awkward: Phrases like “lived experience” aren’t familiar to most laypeople, so you actually do have to say, “I have been trained to help people who, like I do, have behavioral health challenges.” Then you get into the problem of the language: Is it appropriate to say challenges? It’s more politically correct to say “people who have been diagnosed with…” but many disavow those diagnoses and feel they’re inaccurate. Additionally, the phrase “behavioral health” doesn’t mean much to laypeople either. I either end up doing a weird self-deprecating thing (which jibes with my overall shtick) about being “crazy” or getting far too detailed about the history and successes of peer support in the United States, which frankly bores the crap out of people.

This is why it’s good that the media continues to cover peer support—so that it becomes more widely understood and accepted. The New York Times‘ Benedict Carey, who’s the best journalist covering the mental health beat, bar none, wrote about peer support in the last installment of his series “Lives Restored,” about people with severe mental illnesses living full lives in the open. In this final episode, Carey profiles Antonio Lambert, who deals with the challenge of dual diagnosis, which, as Carey points out, is a bitch (well, he puts it differently, but you know).

About peer support, Carey is a bit abbreviated:

The mental health care system has long made use of former patients as counselors and the practice has been controversial, in part because doctors and caseworkers have questioned their effectiveness. But recent research suggests that peer support can reduce costs, and in 2007, federal health officials ruled that states could bill for the services under Medicaid — if the state had a system in place to train and certify peer providers.

In the years since, “peer support has just exploded; I have been in this field for 25 years, and I have never seen anything happen so quickly,” said Larry Davidson, a mental health researcher at Yale. “Peers are living, breathing proof that recovery is possible, that it is real.”

One thing that struck me about the article is something I don’t hear people say enough: that peer specialists are willing to do things other traditional helpers are not. Lambert, now a successful recovery motivational speaker and counselor, started small but had a tremendous impact on the first place he worked as a peer specialist.

“He had the worst cases; he had to go into these high gang areas, places no one else would go,” said Sue Bethune, his boss at the time, who is now a mental health consultant in Greensboro. “He really opened the door for the program to be able to send people in there.”

When I managed peer specialists with dual diagnosis, in particular, that was something I saw again and again: fearlessness. There is nothing they haven’t been through and nothing they won’t do now to help someone else. That’s why it’s risky work for them, and why some, even Lambert, do relapse. But their ability to show up in dark places tells the person they’re working with: you’re important and I’m here and I’ll be here no matter where you go.

Lambert still struggles to believe he’s gotten to where he is. I’ve heard that a lot too. People who say, “I used to live on that grate and I’d score crack around that corner, and now I’m walking by in a suit and tie on my way to a meeting with city officials to talk about how to deal with people living on grates and scoring crack.” That disjunction can be a little overwhelming, and it’s a lot of pressure to be seen as a model for a community. What if you don’t measure up?

Read the rest of Lambert’s story and see a video of him here to see how he handles it all.


liz | 2:13 PM | dual diagnosis, peer support, antonio lambert, benedict carey, certified peer specialist, media coverage peer support, peer support programs

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