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State Lawmakers Eye Federal Dollars To Boost Mental Health Counseling By Peers

Reach Out Program Manager Charlie Jones, right, and volunteer Lee Frierson take a short break after leading a game of bingo with mental health patients at an Oakland, Calif., board-and-care home. (Rob Waters for California Healthline)

It’s 1 p.m. on a balmy Oakland afternoon as residents of Great Expectations Residential Care, a home for people with mental illness, gather in an activity room for a game of bingo.

Lee Frierson, an unpaid volunteer, introduces himself as he and his team leader, Charlie Jones, unpack chips, soda, batteries and shampoo that they will hand out as prizes.

“I’m Lee with Reach Out,” Frierson says. “I’m a peer. I suffer from depression. It helps me to help you guys.”

“And I’m Charlie the angel,” Jones says. “We go to board-and-cares and psychiatric and wellness facilities to inspire hope and model recovery.”

A few rounds into the game, Frierson calls B-5, and a dark-haired man shouts, “Bingo!”

“Winner, winner, chicken dinner!” Frierson calls back, prompting chuckles.

What unfolds in this room is not exactly therapy, but it is something that mental health advocates and research suggest can be healing in its own right: people who have struggled with mental illness helping others who are experiencing similar struggles. Frierson and Jones are former mental health patients who now work with the Reach Out program, part of the nonprofit Alameda County Network of Mental Health Clients, which provides what is called peer support.

The value of peer support is recognized by Medicaid, the health insurance program for people with low incomes, and it funds such services. That money is available for certified peer-support workers in states that have a formal certification process.

California does not, and that means it is “leaving money on the table,” said Keris Myrick, chief of peer services at the Los Angeles County Department of Mental Health. South Dakota is the only other state with no peer certification program.

But a bill pending in Sacramento, SB-10, would direct the State Department of Health Care Services to create a process for certifying peer support workers and establish a set of core aptitudes and ethics guidelines for the job. The legislation passed the state Senate unanimously in May and will move to the Assembly Health Committee on Tuesday.

More than 6,000 peer support specialists already work in wellness programs, hospitals and clinics across California, according to SB-10’s sponsor, Sen. Jim Beall (D-San Jose). They help mental health patients navigate bureaucracies, find housing or locate services.

“They’re sharing their experiences: ‘Been there, done that, now I’m going to help another person,’” said Myrick, who has been diagnosed with schizoaffective disorder, was hospitalized several times and spent 10 years running a peer support program in Los Angeles.

Last year, the legislature unanimously passed a bill to certify peer support workers, but then-Gov. Jerry Brown vetoed it, saying it was costly and unnecessary.

Legislative analysts estimate the state would spend hundreds of thousands of dollars to set up a certification process and millions more a year to implement it. Advocates say the new federal money would help offset those costs. And, they say, the legislation would cement the bona fides of peer mentoring as an occupation.

Gov. Gavin Newsom has not declared his position on the current bill, but he has said that addressing the state’s mental health crisis is a top priority for his administration. During his campaign for governor, he endorsed “expanded roles for nurse practitioners and peer providers.”

Dr. Thomas Insel, a former director of the National Institute of Mental Health whom Newsom named in May as a key mental health adviser, told California Healthline he supports the peer certification bill.

“For many people, having a connection to someone else who’s had this experience proves vital,” Insel said. “There may be nothing more healing than giving people an opportunity to help others.”

Peer programs grew out of a movement in the 1970s opposing coercive psychiatric treatment, led by people who’d been treated against their will and felt they would receive better care from those who personally identified with their experiences.

Many peer-run groups already offer training in peer support techniques to current or former mental health clients. The Alameda County Network of Mental Health Clients runs a training program called BestNow!, which graduates 18 to 20 people a year. Fifteen of the network’s 25 staff members graduated from that program.

Among them is Charlie Jones, the program manager for Reach Out who coordinates the teams of peers that visit residential programs. Jones, 43, experienced nervous breakdowns in her 20s and 30s and was hospitalized several times. She eventually enrolled in college and is completing a degree in human development at California State University-East Bay.

Jones was a mentor to Frierson before he volunteered for her team. They met several months ago when Jones and her colleagues organized a bingo game at a board-and-care home where Frierson was recovering from severe depression.

“We talked and I listened to people who’d been in a similar situation,” Frierson said. “It really pumped me up.”

Now Frierson plans to enroll in BestNow! and become a peer specialist. He said he hopes he’ll eventually be certified by the state of California.

This story was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

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Medicaid Mental Health