Background: The VHA is in the process of transforming its mental health care system. As part of this transformation significant resources have been committed to integrating peer providers into existing mental health services both as peer support technicians and as peer vocational rehabilitation specialists. Recovery models and specifically the helper therapy principle, postulate that employment as a peer specialist benefits not only the recipients of services, but also the providers themselves. A current randomized trial led by Dr. Eisen is examining the impact of participating in a peer support program on mental health recovery outcomes of participants. However, there is very little research examining the impact of being a peer provider on the mental health, functioning and community integration of veterans in peer provider positions. The existing literature focuses on outcomes of peer provider training programs, and on personal accounts of being a peer provider. There is currently no systematic empirical evidence regarding the impact of working as a peer specialist on their own recovery. This will be the first study to examine mental health recovery outcomes of peer specialists. The current employment of peer support technicians offers a unique opportunity to systematically examine the mental health and community functioning of veterans working in peer provider roles. Objectives: Objectives are to: 1) examine job functions, responsibilities, experiences, longevity, self- perceived job performance and satisfaction of peer specialists in VA: 2) examine mental health recovery including symptoms and functioning, housing and quality of life in peer specialists and compare them to a sample of CWT participants; 3) examine change in job performance and mental health/recovery over one-year; and 4) identify factors associated with job-related and mental health/recovery outcomes over a one-year period. Although we don't expect the veterans employed as peer support technicians and those hired as vocational rehabilitation counselors to differ in their outcomes, a fifth exploratory aim will be to determine whether there are differences in outcomes between those hired under these two initiatives. Methods: All currently employed peer support technicians and veterans hired as vocational rehab specialists under the Homeless Veterans initiative will be invited to participate in the study by email or by telephone, as will a comparison group of 300 Compensated Work Therapy (CWT) participants. The invitation to the study will provide basic information about the purposes and procedures, and will provide a link to the survey web site. In addition, an information sheet providing all the information that would be included in a written consent form will be included. We will use quantitative and qualitative methods including reliable and valid measures of mental health, recovery and job performance. Individual level data will be obtained by questionnaires to be administered via a secure website upon enrollment in the study and six months and one year later. Semi- structured telephone interviews will be conducted on a subsample of study participants to obtain in depth information about their jobs with specific emphasis on understanding how their skills and experience can be optimally used to contribute to the program in which they are working, and to maximize their impact on veterans' mental health (both those to whom they provide services, and to themselves). Anticipated Impacts: The proposed research will provide systematic information about 1) the impact of being a peer specialist on the mental health, recovery, functioning and community integration including housing stability of veterans serving as peer specialists; and 2) how to enhance the roles of peer specialists to maximize their value in the VA mental health care delivery system. The knowledge we gain will be helpful for guiding further implementation of peer support services in the VHA.
The proposed research is relevant to veterans because it supports two important VA goals: to implement recovery-oriented treatment approaches, particularly peer-support services, and to end veteran homelessness. There is currently no systematic empirical evidence regarding the impact of working as a peer specialist on their own recovery. This will be the first study to examine mental health recovery outcomes of peer specialists. Specifically, the proposed research will provide systematic information about 1) the impact of being a peer specialist on the mental health, recovery, self-identity, functioning and community integration including housing stability of veterans serving as peer specialists; and 2) how to enhance the roles of peer specialists to maximize their value in the VA mental health care delivery system. The knowledge we gain will be helpful for guiding further implementation of peer support services in the VHA.
