Supporting Peer Support Workers’ Professional Development and
Well-Being Through Organizational Changes
Write-up by IRIS team member: Yali Deng
Peer support workers (PSWs or peers) play an important role in behavioral health care. According to SAMHSA (2022), approximately 75% of all substance use treatment facilities offer peer services. Peers with lived experience in substance use and/or mental health recovery have unique core competencies that other professionals may not have to help people seeking recovery. PSWs meet people where they are and provide a wide spectrum of services, including harm reduction and recovery support services in a variety of settings, such as community recovery centers, hospital and emergency rooms, outpatient treatment settings, and schools. Peer support, as an evidence-based practice, has shown effectiveness in improving clients’ treatment engagement, social support, and reducing substance use (Mahon, 2025). Despite the fact that peers are a valuable workforce in substance use recovery, peers’ own work experience and well-being are often overlooked. Many behavioral health organizations face barriers to support peer workers’ unique needs, thus contributing to inadequate integration of peer support services, as well as burnout and turnover among peers.
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In this research corner, we introduce two articles. The first article reviews 20 studies on organizational and individual factors that contribute to peers’ job satisfaction and retention. We will mainly summarize organizational strategies that support peers’ work and well-being. Readers can use this recent systematic review as an anchor article to locate more research evidence (a good balance of quantitative and qualitative studies) to support peer workforce development. The second article is a qualitative study among 132 peer and non-peer workers in multidisciplinary organizations providing mental health and substance use recovery services. This article presents a best practice model for effective employment of peers in multidisciplinary organizations and offers a more in-depth exploration of peer workers’ experiences.
Article 1
"Workforce Outcomes Among Substance Use Peer Supports: A Scoping Review of Individual and Organizational Influences"
Bell, J. S., Watson, D. P., Griffin, T., Castedo De Martell, S., Kay, E. S., Hawk, M., Ray, B., & Hudson, M. (2025). Workforce Outcomes Among Substance use Peer Supports: A Scoping Review of individual and Organizational Influences. Frontiers in Public Health, 12, 1515264. https://doi.org/10.3389/fpubh.2024.1515264
Recognizing the research gap in studies speaking to substance use disorder (SUD) recovery peers’ work experience and well-being, this scoping review investigated the existing literature on peer workforce outcomes and individual and organizational contributors to these outcomes. Twenty studies were included in this review including nine quantitative, nine qualitative, and two mixed-methods studies.
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This review identified 11 organizational contributors to peer workforce outcomes and those were integrated into a framework for a supportive organizational culture represented by three attributes: recovery-oriented, collaborative, and sustainable. First, organizations are encouraged to adopt a recovery-oriented culture and policies that prioritize peers’ well-being and personal recovery. This can be achieved through supportive supervision, which was discussed in most studies as a vital factor in improving peers’ job satisfaction and reducing burnout and turnover. Peers appreciated supervisors who acknowledged their work achievements and who encouraged conversations about self-care and taking time off. To ensure peers’ well-being, authors also stressed the importance of ongoing conversation within supervisory meetings to address peers’ challenges and concerns.
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Second, creating a collaborative organizational culture where peers feel appreciated equally as their non-peer workers is important. This can be achieved by including non-peer staff in the hiring and onboarding process, educating non-peer workers about peers’ role, facilitating interaction between peers and non-peer workers through joint training, and team-building activities.
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Third, this review suggested organizations promote a culture of professional sustainability. To achieve this, providing opportunities for professional development and skill building is essential. These opportunities can include defining a clear career promotion pathway, providing tuition reimbursement for degree programs, as well as skill-building trainings such as public speaking and networking. Allowing for autonomy and creativity in peers’ role and advocating for peer wage increases are also important considerations for peer retention.
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In conclusion, this review highlighted the challenges and needs peers may have and synthesized organizational contributors to support peers. The article indicated that the path to organizational change is ensuring the voice of peer and non-peer workers are heard, and that all staff work collaboratively to generate peer-centered solutions to support optimal workforce outcomes.
Article 2
"Effective Peer Employment Within Multidisciplinary Organizations: Model for Best Practice"
Byrne, L., Roennfeldt, H., Wolf, J., Linfoot, A., Foglesong, D., Davidson, L., & Bellamy, C. (2022). Effective Peer Employment Within Multidisciplinary Organizations: Model for Best Practice. Administration and Policy in Mental Health and Mental Health Services Research, 49(2), 283–297. https://doi.org/10.1007/s10488-021-01162-2\
This second study used a qualitative method to explore perspectives of peers, non-peer staff, and managers from multidisciplinary teams on best practices in peer work and organizational change. A total of 132 people recruited from five U.S. multidisciplinary mental health and substance use recovery service organizations participated in focus groups and individual interviews. Based on the findings, this study developed a model of best practice including organizational commitment, culture, and strategies for peer employment (see Figure 1 from the study).
To avoid overlap, this summary will only discuss model components that were not mentioned in the first article. First, this study emphasized the importance of organizational commitment, which involves both philosophical and financial commitments to peer work. That is, the belief that peer work is essential to and central to organizations’ work, rather than optional. Organizational commitment also requires financial investment to ensure adequate numbers of peer staff and senior peer positions. In addition, organizations should cultivate a culture that is open to change and committed to working through and learning from challenges. They should also build mutual respect and meaningful collaborations between peers and other workers.
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This study discussed several organizational strategies to support effective peer employment. First, having peers in senior positions of authority is central to supporting peer workforce development and shaping organizational culture. A peer manager expressed that being involved in management and planning meetings enables them to share peers’ lived experience, plan services through the peer lens, and advocate for and remove systematic barriers to peer work.
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In addition, this study suggested an effective recruitment process by assessing applicants’ knowledge of the peer movement and recruiting non-peer staff who are supportive of peer work. As a non-peer worker shared in the focus group, “It has become most important that you match on a value level... We need you, if you are going to join our team, to understand that's the culture here. The culture is that peer services are extremely important, and we all believe in it”. Finally, this study indicated organizations should intentionally recruit peers with diverse cultural and linguistic backgrounds to provide culturally appropriate services and reduce barriers to services, especially among people of color.
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In conclusion, this qualitative study incorporated perspectives from a variety of peer and non-peer workers and highlighted the importance of a whole-of-workplace approach in which peer values are embedded in the organizational mission and every aspect of organizational practices, such as hiring, supervision, and training.
Conclusion
This research corner focuses on organizational strategies to support peer workers. To ensure these strategies are implemented, additional training, systems changes and united advocacy effort for peers and peer-led community organizations are needed. There are many national and state organizations working on supporting the peer workforce, such as Faces & Voice of Recovery, On Own Own of Maryland, and Maryland Peer Advisory Council. In addition, the IRIS Leadership Committee group has been meeting to plan coordinated actions to support peer workforce development. Readers can keep up with these developments through future IRIS newsletters. We also encourage you to reach out with any ideas for collaboration.
References
Mahon, D. (2025). Umbrella Review of Systematic Reviews of Peer Support in Substance Use settings. Mental Health and Social Inclusion.
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SAMHSA (2022). 2022 National Substance Use and Mental Health Services Survey (N-SUMHSS) Detailed Tables. Accessed via https://www.samhsa.gov/data/report/2022-n-sumhss-detailed-tables