Peer Specialists as Educators for Recovery-Based Systems Transformation

With decreasing enthusiasm among consumers and consumer advocates for the traditional model of care that has dominated clinical practice for about a century, the recovery model has become the centerpiece of systems transformation.12 As articulated by former patients who are living a full and meaningful life beyond illness, the recovery model underscores hope, empowerment, independence, strengths, and the patient's ability to adapt.34 This notion of recovery stands in contrast to traditional views that focus on clinical outcomes such as symptom remission, an asymptomatic state, cure, and functional improvements maintained for a given duration.5 In the United States, the influence of this newer view of recovery is underscored in the 2003 President's New Freedom Commission on Mental Health, which endorses recovery as the guiding vision and framework for restructuring the national mental health service delivery system.6 In treatment settings, this recovery vision has guided innovations in mental health service delivery and includes7: * Reframing treatment goals, objectives, and outcome indicators from the traditional focus on symptom reduction to one centered on "the whole person," reclaiming a meaningful life, increasing hope, empowerment, and overall well-being * Reducing power differentials inherent in traditional care by promoting self-management, self-directed care, and shared decision making * Fostering a collaborative relationship among practitioners, consumers, relatives, community, advocates, and stakeholders As the recovery model has wielded its influence in mental health care systems worldwide, there has emerged a need to develop and implement curricula focused on increasing knowledge about the model and promoting attitudes consistent with recovery among patients, family members, practitioners, and the general public. After training and certification, Project GREAT CPSs: * Provide direct support and give voice to patients * Educate and provide feedback for residents and other trainees on how to listen, collaborate, empower, and foster a partnership with patients * Represent the efforts of Project GREAT in the larger community through membership on advisory boards There has been growing support among professionals for using CPSs to provide recovery-based services for patients with mental illness as well as recovery-based training for practitioners.214 The empirical support for such peer-led interventions is somewhat limited; however, studies of CPS-d