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What exactly does it mean to be a Peer?

What exactly does it mean to be a Peer?

The ‘peer’ world is divided


OK, so that’s not news. Neither is the mental health community’s divisions on how to best advocate and push for better healthcare reform and what best practices means in mental health treatment. I’ve said this before about new treatments, bold new ‘miracle modalities ‘that are so laden with buzz words that they say absolutely nothing about practicing mental health, therapy, or peer support.

I am now suggesting the same formula is valid the peer support realm of mental health advocacy.

Let’s take a closer look at this. So, we have peer specialists that are against using psychiatric labels. Throw away the diagnosis is being circulated in multiple intersections of mental health care. I have a real problem with this as a prosumer.

I am a therapist that relies heavily upon the use of the DSM-5. I don’t use the DSM to better understand my client’s condition, but for creating a language that allows me to communicate with my colleagues in real-time and use that same information to share why their symptoms meet specific criteria for medically necessary treatment.

The list of why someone should use codified and manualized mechanisms in clinical treatment is endless.

The list for continuing to decode adds multiple meanings to overused words, which can limit and restrict a patient’s experience. I get that, too. We need to continue to explore more liberal interpretations of a patient experience with a new language or language reconfigured in use and applied to clinical citations in altogether new contexts and applications.

The issue is that most people are polarised. It’s either we disband and deconstruct every manual out there in mental health, or we must only use the DSM-5 and other overly medicalized interpretations of justifying a disorder on paper.

The peer world is similar in its theorizing of what it means to be a peer and provide peer support. The going trend is that being a peer doesn’t suggest that the person carries a diagnosis. It should be based solely on the culture and behavior of the peer principle of providing mutual support. Well, this a giant leap from good practice.

Why would I ever want someone without a diagnosis, label, or identified (either self or through a care system) providing my services as a consumer receiving peer support? On a clinical level, which must work in a more extensive care system. With multiple professional attitudes, perceptions come ways of doing things.

Not to mention the medically solvent way of practicing, we need to consider all layers of treatment and the client experience before endorsing this camp’s limited understanding of best practices in mental health.

I say this because without having a peer in a mental health system identifying as having a condition, what service is this person providing other than their belief inequality.

Egalitarianism is terrific! I support it. But I am sorry, I am a person with schizophrenia who wants someone who also struggles, faces discrimination, and encounters daily obstacles because of their condition providing me services because there is value in shared experiences.

Doubly true for peer work. Being a peer is about bonding over shared experiences and deriving meaning from them, and knowing how to overcome life’s challenges given similar experiences. Sure, we don’t need to ‘have a label, ‘but there must be some sort of commonality besides a shared notion of equality we can bond over during sessions or time together as peers.

In the end, if peers are going to be genuinely savvy about providing services. Then we must get underneath the actual authentic experiences of people and not be afraid to utilize clinical intakes and manualized forms in delivering services. Sure, we must also construct new descriptive and holistic approaches to gathering information and providing services, but that’s a no brainer.

Let’s connect peers with similar challenges, either psychiatric conditions or environmental difficulties, so both people can benefit from learning how to take on life challenges together.

That’s what being a peer is!

Peers should utilize all information and perspectives out there, not picking and choosing ‘in’ language or approaches because it is hot in the mental health community. Instead, select strategies that connect all the dots, from medical necessity to wellness and beyond.

Just do it in a way that ensures all levels of care, treatment needs, and aspects of the person’s experience in the system benefit them at all times, not just in terms of the peer relationship.

J. Peters

J. Peters

Max Guttman '08, MSW '12, is the owner of Recovery Now, a private mental health practice. Through his work as a Licensed Clinical Social Worker, therapist and disability rights advocate, Max fights for those without a voice in various New York City care systems. He received a 2020 Bearcats of the Last Decade 10 Under 10 award from the Binghamton University Alumni Association. Guttman treats clients with anxiety and depression, but specializes in issues related to psychosis or schizoaffective spectrum disorders. He frequently writes on his lived experiences with schizophrenia. "I knew my illness was so complex that I’d need a professional understanding of its treatment to gain any real momentum in recovery," Guttman says. "After undergraduate school and the onset of my illness, I evaluated different graduate programs that could serve as a career and mechanism to guide and direct my self-care. After experiencing the helping hand of my social worker and therapist right after my 'break,' I chose social work education because of its robust skill set and foundation of knowledge I needed to heal and help others." "In a world of increasing tragedy, we should help people learn from our lived experiences. My experience brings humility, authenticity and candidness to my practice. People genuinely appreciate candidness when it comes to their health and recovery. Humility provides space for mistakes and appraisal of progress. I thank my lived experience for contributing to a more egalitarian therapeutic experience for my clients."

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