by Jim Hajny, Executive Director
October 28, 2024
At the time of this article there are 210 certified behavioral health peer support specialists in Montana. Since the first peer supporter was certified by the Board of Behavioral Health in September of 2018, there have been a total of 400 peer supporters certified. Roughly half or 50% are still working today. The other way to look at it is 50% or half are not. Losing half of its workforce in just over 5 years is not a sign of a healthy workforce. Historically MPN trains around 100 peer supporters a year, half of those who complete Peer Support 101 will not go on to get certified, which is a topic for another article. Half of those who do complete training and are certified will not be for long. The CBHPSS workforce in Montana needs additional support.
Workforce development has been at the heart of our efforts since our inception in 2011, training peer supporters, the employers of peer supporters and advocating for funding to support peer services. MPN has been training peer supporters since 2015 when we facilitated the first 40-hour Peer Support 101 training. Three years before the first certified peer supporter. Right after certification was sign by then Governor Bullock we launched a peer supporter mentoring program to address the well-being of peer supporters regardless of employer. In 2019 we successfully advocated for peer support services to be a Medicaid billable service. ($6.25 million) In 2020, during the pandemic and shutdown, MPN continued to offer Peer Support 101 training in a virtual environment. In 2021 we advocated for and successfully secured a seat on the Board of Behavioral Health for CBHPSS and launched PS 102. In addition, we have been the technical assistance and training contractor for the state of Montana funded recovery Drop-in Centers for 4 years. Assisting in the development of the now 16 Drop-in Centers statewide. In June 2024 we launched an on-demand training platform for people in recovery, peer supporters and their employers. These are just a few of the workforce development efforts MPN has led.
Despite these efforts by MPN, collectively we still have a 50% turnover rate for CBHPSS in 2024. High turnover costs all of us. Replacing an employee costs employers and clients lose their support. Peer supporters lose their employment status and can often feel embarrassment or shame around losing their footing in recovery after relapse or crisis and are unable to seek the support they need to get back in balance. This plagues the peer support workforce. We hear this year after year and therefore list it as the number one cause of turnover. I have stood firm in my belief that encouraging recovery growth, and regular clinical supervision are the two best options for preventing CBHPSS turnover and increasing their mental well-being. The Board of Behavioral Health has identified a high number of ethics violations and peer supporter related grievances and are addressing these through the rules they enforce.
I have outlined some of the reasons for the turnover below.
- Relapse, Crisis, Mental well-being impacted, and emotional toll of the job
- Termination for ethics or policy violations
- Employers lack of planning, development and implementation of peer support services
- Not right fit, misaligned expectations, lack of recovery stability
- Replaced by other positions (Life Coach, Community Health Worker, Behavioral Health Tech, Care Coordinator, etc.)
- Financing peer support service (funding ends, low wages, financial incentives to switch careers)
- Professional Development/Growth (earning a degree and license such as LAC)
MPN does not have the answers to all the reasons on this list. It will take a combined effort to decrease turnover in the CBHPSS workforce. Some places to consider. The CBHPSS workforce needs to step up and begin to take responsibility for one another. If you see a colleague struggling, offer them support not isolation. We need employers to continue to grow their understanding of how to better support CBHPSS. Recovery is holistic and peer support thrives with flexibility. We need the funders of peer support services to include additional support and accountability in their funding. This may help create new avenues for the CBHPSS workforce. We need the Board of Behavioral Health to increase the required number of hours for certification training and audit clinical supervision hours. These are just a few ideas; others may have better ones. Improving the CBHPSS workforce is not a challenge MPN can take on alone. The healthier the peer support workforce is the more effective the support will be across communities.