Confronting the Covert Double Standard: A Critical Look at Peer Specialist Treatment in Mental Health

In the field of mental health, there is a stark and often unspoken double standard affecting peer specialists. This covert discrimination is entrenched deeply in the culture of mental health agencies, permeating through various organizational levels. As a professional with extensive experience in this field, I’ve witnessed firsthand the depths of this bias, affecting everything from Human Resources to clinical operations and peer-run departments. It’s a pervasive issue that unfairly colors perceptions and expectations of peer work, overshadowing the mental health “agency” environment with misguided beliefs.

The Culture of Medicalization and Its Effects

At the heart of this double standard lies a culture of mental health medicalization. The DSM-5, a cornerstone of clinical diagnosis, codifies symptoms of mental illness. Yet, these symptoms are inherently subjective. In a typical setting, complaints like insomnia or feeling low are not cause for alarm. However, when a peer specialist who has disclosed a mental illness expresses similar concerns, these experiences are suddenly viewed as “symptoms” of a deeper issue. This skewed interpretation leads to unjust scrutiny and questions about the peer’s competency, undermining their professional standing.

The Complexities of Self-Disclosure

Peer specialists, by virtue of their role, often share their lived experiences with colleagues, including clinicians, psychiatrists, and social workers. This act of self-disclosure, meant to foster understanding and empathy, ironically subjects them to a narrow and biased perspective of mental health. The irony is that while interdisciplinary teams, such as Assertive Community Treatment (ACT) teams, are designed to be non-hierarchical, the reality is often different. Peers are not seen on an equal footing with their clinical counterparts, leading to a skewed workplace dynamic where their health and abilities are constantly under a microscope.

Persistent Evaluation and Unfair Comparison

In every mental health agency I’ve been a part of, the informal yet constant evaluation of peers’ job performance and health was a recurring theme. This scrutiny starkly contrasts with the treatment of colleagues without disclosed diagnoses, who are generally assumed competent until proven otherwise. For peers, the presumption is the reverse—their work quality and health are perpetually in doubt, leading to an oppressive work environment where they must continuously prove their worth.

The Misapplication of ‘Functioning’

Although considered outdated in many clinical circles, the concept of’ functioning’ has been repurposed as a tool against peers. Questions about a peer’s work readiness and ability to perform, given their mental health history, are relentless and often baseless. This misuse of the term creates an environment where peers are always seen as potential liabilities, with their every action and behavior scrutinized for signs of relapse or incompetence.

Bias in Response to Normal Behaviors

Everyday life events, such as calling in sick or a change in demeanor, become grounds for speculation about a peer’s mental health status. This biased reaction starkly contrasts how similar behaviors are perceived when exhibited by non-peer professionals. There’s a disturbing disparity in how peers and non-peers are judged, with the former always under the lens of their mental health diagnosis.

Discrimination and Its Traumatic Impact

Working as a peer specialist comes with unique challenges, intensified by the constant judgment and scrutiny from colleagues. This discrimination isn’t just harmful—it’s traumatic. The continuous assessment of a peer’s education, demeanor, and general ability to perform their role reinforces harmful stereotypes and biases. It creates an atmosphere where peers are seen as perpetually recovering or in need of treatment, never fully capable or reliable.

Recovery and Healthiness: A Skewed Perception

In the mental health field, a peer’s recovery and ‘healthiness’ are often assessed in narrow, clinical terms. Colleagues and supervisors tend to discuss a peer’s recovery as a clinical case study rather than a human journey. This clinical detachment dehumanizes the peer experience, reducing it to a set of symptoms or a recovery status to be evaluated and discussed.

The Absurdity of the ‘Healthy’ Standard

The standard by which peers are judged is both arbitrary and absurd. There’s no clinical basis for determining a peer’s ‘healthiness,’ yet their perceived well-being becomes a yardstick for their professional capabilities. This standard is unrealistic and discriminatory, as it holds peers to a level of scrutiny not applied to their non-peer colleagues.

The Double Standard in Practice

This double standard demands that peers demonstrate their ability to help others heal and be openly comfortable with their issues, all while working alongside social workers and other professionals. However, when it comes to managing their own challenges and practicing self-care, peers are often viewed as less capable—this unfair bias privileges clinicians over peers, creating an unequal and oppressive working environment.

Conclusion

The discrimination faced by peer specialists must be acknowledged and addressed at every level of the mental health sector. Readers and advocates must take this information and actively work to dismantle these biases within individual agencies and the broader mental health landscape. Only by confronting and challenging these issues in larger forums can we hope to eradicate this double standard and foster a more equitable and respectful environment for all mental health professionals.