Multi-state survey of wages and financial well-being of mental health peer specialists

Abstract

BACKGROUND:

Certified peer specialists (CPS) serve a critical role in the behavioral health workforce, but little is known about their job quality or financial well-being.

OBJECTIVE:

Using cross-sectional analysis of baseline data from a three-year study of recently certified individuals, we examine the quality of peer specialist (PS) jobs in terms of wage, hours worked, and tenure, and CPS financial well-being (FWB). We also examine whether PS jobs are higher quality and enhance CPS FWB compared to non-PS jobs worked by CPS. Research on job quality and FWB can be used to enhance the peer specialist workforce.

METHODS:

A sample of 448 employed adults with a recently completed CPS credential participated in an online survey about job characteristics and FWB.

RESULTS:

Compared to Bureau of Labor Statistics data on comparable non-peer Community/Social Service occupations, PS jobs are lower wage and have shorter job tenure. Compared to the general workforce, PS jobs are more often part-time. Compared to a national survey of all adults in the United States, CPS report lower FWB regardless of job type and are at risk of financial hardship. In multivariable analyses and compared to non-PS jobs, PS jobs were not associated with significantly higher wages, more full-time status, longer tenure, or greater FWB. Higher wage jobs among CPS were associated with higher education, being a Veteran, and residence in an urban/suburban region rather than small town or rural setting. Full-time work was associated with not receiving federal disability benefits. CPS FWB was associated with higher hourly wage, older age, Latinx ethnicity, Veteran status, and better physical health.

CONCLUSION:

CPS are at risk of financial hardship. Among recently certified CPS, working in PS jobs was not associated with higher wages or greater financial wellbeing compared to CPS working in other jobs.

Keywords

Peer support employment financial wellbeing workforce development pay equity education and credentialing

Get full access to this article

View all access options for this article.

References

Adams,

W. E.

, Rogers,

E. S.

, Edwards,

J. P.

, Lord,

E. M.

, McKnight,

, & Barbone,

(2021). Impact of COVID-19 on peer support specialists in the United States: Findings from a cross-sectional online survey. Psychiatric Services, 1-9. https://doi-org.ucsf.idm.oclc.org/10.1176/appi.ps.202000915

Bouchery,

E. E.

, Barna,

, Babalola,

, Friend,

, Brown,

J. D.

, Blyler,

, & Ireys,

H. T.

(2018). The effectiveness of a peer-staffed crisis respite program as an alternative to hospitalization. Psychiatric Services, 69(10), 1069–1074.

Bureau of Health Workforce. (2021). Designated Health Professional Shortage Areas Statistics (Fourth Quarter of Fiscal Year 2021 Designated HPSA Quarterly Summary, Issue. H. R. a. S. Administration. https://data.hrsa.gov/topics/health-workforce/shortage-areas

Burke-Miller,

J. K.

, Swarbrick,

M. A.

, Carter,

T. M.

, Jonikas,

J. A.

, Zipple,

A. M.

, Fraser,

V. V.

, & Cook,

J. A.

(2010). Promoting self-determination and financial security through innovative asset building approaches. Psychiatric Rehabilitation Journal, 34(2), 104–112. https://doi-org.ucsf.idm.oclc.org/10.2975/34.2.2010.104.112

Chen,

(2017). Peer support specialist. Bureau of Labor Statistics, US Department of Labor. Retrieved January 1 from https://www.bls.gov/careeroutlook/2017/youre-a-what/mobile/peer-support-specialist.htm

Chinman,

, George,

, Dougherty,

R. H.

, Daniels,

A. S.

, Ghose,

S. S.

, Swift,

, & Delphin-Rittmon,

M. E.

(2014). Peer support services for individuals with serious mental illnesses: Assessing the evidence. Psychiatric Services.

Collins,

J. M.

, & Urban,

(2020). Measuring financial well-being over the lifecourse. The European Journal of Finance, 26(4-5), 341–359. https://doi.org/https://doi.org/10.1080/1351847X.2019.1682631

Consumer Financial Protection Bureau. (2017). Financial well-being in America (Consumer education and empowerment, Issue. https://files.consumerfinance.gov/f/documents/_cfpb_financial-well-being-in-America.pdf

Cook,

J. A.

, Jonikas,

J. A.

, Burke-Miller,

J. K.

, Hamilton,

, Powell,

I. G.

, Tucker,

S. J.

, Wolfgang,

J. B.

, Fricks,

, Weidenaar,

, Morris,

, & Powers,

D. L.

(2020). Whole Health Action Management: A randomized controlled trial of a peer-led health promotion intervention. Psychiatric Services, 71(10), 1039–1046. https://doi-org.ucsf.idm.oclc.org/10.1176/appi.ps.202000012

10.

Cook,

J. A.

, & Mueser,

K. T.

(2013). Economic security: An essential component of recovery. Psychiatric Rehabilitation Journal, 36(1), 1–3. https://doi.org/https://doi.org/10.1037/h0094739

11.

Cronise,

, Teixeira,

, Rogers,

E. S.

, & Harrington,

(2016). The peer support workforce: Results of a national survey. Psychiatric Rehabilitation Journal, 39(3), 211.

12.

Daniels,

A. S.

, Ashenden,

, Goodale,

, & Stevens,

(2016). National Survey of Compensation Among Peer Support Specialists. T. C. f. B. H. Leadership. www.leaders4health.org

13.

Daniels,

A. S.

, Bergeson,

, Ashenden,

, Fricks,

, & Powell,

(2012). Pillars of peer support: Advancing the role of peer support specialists in promoting recovery. Journal of Mental Health Training, Education and Practice, 7(2), 60–69. https://doi.org/https://doi.org/10.1108/17556221211236457

14.

Druss,

B. G.

, Singh,

, Von Esenwein,

S. A.

, Glick,

G. E.

, Tapscott,

, Jenkins Tucker,

, Lally,

C. A.

, & Sterling,

E. W.

(2018). Peer-led self-management of general medical conditions for patients with serious mental illnesses: A randomized trial. Psychiatric Services, 69(5), 529–535. https://doi.org/https://doi.org/10.1176/appi.ps.201700352

15.

Hawk,

(2013). Expenditures of urban and rural households in 2011. Beyond the Numbers: Prices & Spending, 2(5). Retrieved October 15, 2021, from https://www.bls.gov/opub/btn/volume-2/expenditures-of-urban-and-rural-households-in-2011.htm

16.

Iacurci,

(2021). Many Americans, especially families, can’t live on a $15 minimum wage. Personal Finance. https://www.cnbc.com/amp/2021/02/21/15-minimum-wage-wont-cover-living-costs-for-many-americans.html

17.

Jones,

(2021, March, 19 2021). 5 Facts about the state of the gender pay gap. U.S. Department of Labor Blog. https://blog.dol.gov/2021/03/19/5-facts-about-the-state-of-the-gender-pay-gap

18.

Jones,

, Niu,

, Thomas,

, Riano,

N. S.

, Hinshaw,

S. P.

, & Mangurian,

(2019). Peer specialists in community mental health: Ongoing challenges of inclusion. Psychiatric Services, 70(12), 1172–1175. https://doi.org/10.1176/appi.ps.201800552.

19.

Jonikas,

J. A.

, Cook,

J. A.

, Swarbrick,

, Nemec,

, Steigman,

P. J.

, Boss,

K. A.

, & Brice,

G. H.

Jr. (2021). The impact of the COVID-19 pandemic on the mental health and daily life of adults with behavioral health disorders. Translational Behavioral Medicine, 11(5), 1162–1171. https://doi.org/https://doi.org/10.1093/tbm/ibab013

20.

Lapidos,

, Jester,

, Ortquist,

, Werner,

, Ruffolo,

M. C.

, & Smith,

(2018). Survey of peer support specialists: Professional activities, self-rated skills, job satisfaction, and financial well-being. Psychiatric Services, 69(12), 1264–1267. https://doi.org/10.1176/appi.ps.201800251

21.

Liu,

C. Y.

, & Nazareno,

(2019). The changing quality of nonstandard work arrangements: Does skill matter?The Russell Sage Foundation Journal of the Social Sciences, 5(4), 104–128. https://doi.org/10.7758/RSF.2019.5.4.04

22.

Miles,

(2014). Tolerance and Variance Inflation Factor. In Wiley StatsRef: Statistics Reference Online. https://doi.org/https://doi.org/10.1002/9781118445112.stat06593

23.

Myrick,

, & del Vecchio,

(2016). Peer support services in the behavioral healthcare workforce: State of the field. Psychiatric Rehabilitation Journal, 39(3), 197–203. https://doi-org.ucsf.idm.oclc.org/10.1037/prj0000188

24.

Nanda,

A. P.

, & Banerjee,

(2021). Consumer’s subjective financial well-being: A systematic review and research agenda. International Journal of Consumer Studies, 45(4), 750–776. https://doi-org.ucsf.idm.oclc.org/10.1111/ijcs.12668

25.

National Association of Peer Specialists. (2007). Peer Specialist Compensation/Satisfaction 2007 Survey Report. https://papeersupportcoalition.org/wp-content/uploads/2015/09/PeerSpecialistCompensationandSatisfactionSurveyReport.pdf

26.

Optum. (2013). Innovations in Consumer-Centered Recovery-Oriented Care. https://www.optum.com/content/dam/optum/resources/productSheets/OptumConsumerCare.pdf

27.

Ostrow,

, Cook,

, Salzer,

M. S.

, Pelot,

, & Burke-Miller,

(2022). Employment outcomes after certification as a behavioral health peer specialist in four U.S. states. Psychiatric Services. https://doi.org/10.1176/appi.ps.202100651

28.

SAMHSA-HRSA Center for Integrated Solutions. (2014). Who are Peer Providers?. https://www.integration.samhsa.gov/workforce/team-members/peer-providers

29.

Substance Abuse and Mental Health Services Administration. (2019). Behavioral Health Workforce Report. https://annapoliscoalition.org/wp-content/uploads/2021/03/behavioral-health-workforce-report-SAMHSA-2.pdf

30.

U.S. Bureau of Labor Statistics. CPI Inflation Calculator Retrieved December 1, 2021 from https://www.bls.gov/data/inflationcalculator.htm

31.

U.S. Bureau of Labor Statistics. (2021a). Local Area Unemployment Statistics. https://www.bls.gov/lau/#tables

32.

U.S. Bureau of Labor Statistics. (2021b). May 2020 National Occupational Employment and Wage Estimates. https://www.bls.gov/oes/2020/may/oesnat.htm

33.

U.S. Department of Agriculture. (2021). USDA Economic Research Service https://www.ers.usda.gov/topics/ruraleconomy-population/rural-classifications/

34.

U.S. Department of Labor. (2019). Employment and Earnings by Occupation. Women’s Bureau. Retrieved November 1, 2021 from https://www.dol.gov/agencies/wb/data/occupations

35.

U.S. Government Accountability Office. (2021). Veterans’ Growing Demand for Mental Health Services (Health Care Capsule, Issue. https://www.gao.gov/assets/gao-21-545sp.pdfs

36.

University of Michigan Behavioral Health Workforce Research Center. (2019). National Analysis of Peer Support Providers: Practice Settings, Requirements, Roles, and Reimbursement. https://behavioralhealthworkforce.org/wp-content/uploads/2019/10/BHWRC-Peer-Workforce-Full-Report.pdf

37.

Yeo,

, & Lee,

Y. G.

(2019). Understanding the association between perceived financial well-being and life satisfaction among older adults: Does social capital play a role?Journal of Family and Economic Issues, 40, 592–608. https://doi-org.ucsf.idm.oclc.org/10.1007/s10834-019-09634-2