Peer specialists, or trained paraprofessionals who are current or former consumers of behavioral health services, are part of a paradigm shift in behavioral health: They embody the recovery model and, as they participate in greater numbers, act as the foot soldiers of system transformation, contributing to positive outcomes among those they serve. (1) Typically, peer specialists:
* Teach skills needed to facilitate self-advocacy and recovery;
* Explain available service options;
* Promote the use of natural supports in the community; and
* Encourage wellness and a sense of self-worth in consumers.
While widely accepted in many areas of behavioral health, peer specialists have not yet played a significant role in suicide prevention, postvention, or aftercare (for attempters), despite the fact that this area has been under-resourced and underserved. A growing body of research, opinion, and experience demonstrates that trained peer specialists, equipped with their own suicide-related experiences as well as learned recovery and support skills, can play a role in suicide prevention among consumers living with serious mental illnesses. It's time they did so.
Mental illness is a major risk factor for suicide. (2) According to the CDC, 45 percent of some 9,000 suicide victims in 16 states (2007) had a psychiatric diagnosis. (3) Mental illness can trigger or aggravate other risk factors including low self-esteem, poor coping or problem-solving skills, substance use, financial and employment problems, and more. At the same time, it weakens protective factors such as interpersonal relationships and adherence to treatment. Thus, it is no surprise that suicidality is more prevalent among those with serious mental illness than among the general population, with mental health consumers showing higher rates of suicidal ideation, attempts, and suicides. In fact, suicidality is a factor in most psychiatric hospitalizations and in many readmissions. (4)
The need for suicide prevention programs is clear, and there's a role for peer specialists in these efforts. In 2004, Kathryn Power, director of the Center for Mental Health Services, predicted this role: "In a transformed system, consumers ... will...