Person-Centered Care and the Value of Peer Support

Melissa Hensley at Augsburg University in Minneapolis. Photo Sarah Whiting

I am a person in long-term recovery. I am also a social worker and educator in Minneapolis.

When I was hospitalized in February 1989 for bipolar disorder and concurrent binge drinking, my roommate in the psych ward read to me each night from the Narcotics Anonymous Basic Text. That relationship was my first experience with the power of peer support, and it influenced the start of my own recovery.

Eventually I became a faculty member at Augsburg University in Minneapolis and began studying peer specialists in Minnesota. My interest grew in “person-centered care,” meaning health care that centers the perspective and lived experiences of the person using the service, rather than a top-down, provider-patient approach. Peer supporters, who use their own experiences with addiction or mental health to help guide others, are an example of person-centered care.

Peer supporters fill gaps in traditional mental health services by providing essential knowledge about the recovery process, such as how to cope with symptoms, develop healthy relationships, and balance employment.

To put it simply, peers offer credibility because they have been through the recovery process. A person living with a mental health condition is more likely to accept feedback from a peer rather than a professional with no lived experience.

It is also true that medical providers and social workers sometimes label or make judgments about a person’s capabilities, which creates a barrier to recovery.

As a part of research I undertook on behalf of the Saint Louis, Missouri Mental Health Board in the early 2000s, I conducted in-depth interviews to study interactions of people with mental illnesses within service systems.

I saw how people experienced more stigma from professionals in mental health organizations than from any others, including friends and family.

Prejudice and stigma against people with mental illnesses in the broader community filter into social services. One way this shows up is lowered expectations. Mental health and social service providers might not believe that people can truly get better, so they do not support people’s goals and dreams. A person’s desire to pursue employment or higher levels of community involvement may be ignored or not taken seriously. When people feel discriminated against by professionals, they stay away from resources that are lifesaving. In that way, stigma kills.

I also have seen many people originally labeled by social workers as “hopeless” achieve their dreams in spite of negative interactions with the system.

People Do the Healing

As an educator of social workers, I believe social work students need exposure to more information about the benefits of peer support. The use of peers in service settings continues to increase — and they are a powerful tool social workers can learn from to better understand their own profession.

Social workers like myself need to understand that our role is not to “fix what is wrong.” People do their own healing, and our job is to offer tools and resources.

Understanding a person’s unique culture and perspective can also aid in healing. Although peer supporters will not necessarily come from the same cultural background as the person they are supporting, they are closer to that person’s experience of struggle.

Professionals who do not have personal experience with substance use or mental health conditions need to understand that every person we work with has their own wisdom about dealing with painful emotional situations. Skills that people have learned in order to survive may seem dysfunctional, but often can be transformed into positive traits.

An important aspect of stigma reduction is civic engagement. Studies have shown that voting rates among people with mental illness are low in the U.S. for a variety of reasons, one of them being that when people do not feel valued by their community, they are more likely to be disengaged and unmotivated to try making a difference. It is important that those of us who have survived mental health or addiction treatment systems have a voice in policy processes. When that happens, true change can occur.

  • Depression and Bipolar Support Alliance promotes the work of peers.
  • Wellness in the Woods, a Minnesota-based peer-led organization, connects people with lived experience through the Virtual Peer Support Network.
  • NAMI Minnesota is a resource for advocacy and support among peers and support persons.
  • Start Your Recovery is a national resource for identifying issues and exploring treatment options