Hearing Their Voices: Engaging Certified Peer Specialists in Dialogues About Racism and Recovery

The Racism and Recovery series consisted of six events, held monthly from September 2020 to February 2021: a listening session, a webinar to share findings from the listening session, and four facilitated conversations. All sessions were delivered by Zoom videoconferencing software and facilitated by two CPSs from GMHCN (R.H. and C.J.). (Table S1 in the online supplement to this column provides additional details about each event.)

The first event, “Hearing the Truth About Racism in Recovery: A Listening Session,” was run in a town hall format, which allowed CPSs to share their personal experiences of racism in the behavioral health system. The full group was asked questions about the presence of racism in the behavioral health system, whether participants had witnessed racism, and how empowered they feel in their workplace to address racism. Participants then went into virtual breakout rooms facilitated by representatives from GMHCN. After the breakout session, a participant from each group presented a brief summary of their group’s discussion.

The second event, “Race and Recovery in the Peer Support Workforce,” was a direct follow-up to the listening session. This webinar equipped participants with language to better describe racism in the behavioral health system and discussed how racism creates barriers to wellness and recovery. The facilitators also shared a summary of the information gathered from the listening session. The webinar ended with a discussion about immediate actions that CPSs could take to recognize and remedy barriers to recovery created by racism.

The next four events were 90-minute peer-led dialogues titled “Continuing Conversations: Race and Recovery in the Peer Support Workforce.” Each conversation provided a supportive environment for discussing the effects of and solutions to racism in the workplace and focused on a specific topic. The topics, in order, were how racism affects recovery supports in the community and the behavioral health system; what efforts are being made to address racism in two state departments of mental health, featuring speakers from the departments; how racial disparities in health care affect recovery and wellness; and how to build the resiliency to face racism in the peer support workforce.

After each event, participants were asked to complete the online Government Performance and Results Act survey required by the Substance Abuse and Mental Health Services Administration (overall response rate=67%, N=239 of 356 total participants) and specific Southeast MHTTC questions with Qualtrics (overall response rate=60%, N=213). Descriptive analyses were conducted for the quantitative items (e.g., demographic characteristics, satisfaction with the event). Responses to the open-ended questions were coded by a public health graduate student on the basis of common topics under each question (e.g., what was most useful, suggestions for improvement, ways information could be used). Themes within and across events were identified from the coded segments by the coder (L.H.) and Southeast MHTTC evaluator (E.R.W.). The Emory University Institutional Review Board determined that this evaluation did not need a protocol review.

A total of 356 participants took part in the Racism and Recovery events (listening session, N=31; webinar, N=162; conversations, N=20–53 each, with total N=163). Participants included CPSs (N=77 of 239, 32%) and other mental health care professionals, who attended from 31 states and the District of Columbia. Participants mainly identified as Black (24%–36% across the listening session, webinar, and conversations) or White (48%–76%) (see Table S2 in the online supplement for demographic characteristics of participants by event). In the evaluation surveys, most participants reported high satisfaction with the events, that the events enhanced their knowledge and skills, and that they would use the information to change their current practice.

The Racism and Recovery event series provided a space for CPSs and other mental health professionals to discuss experiences with racism in the behavioral health system. Participants appreciated the opportunity to connect with each other; to feel seen, heard, and valued; and to hear about different experiences. This approach appears to be a feasible and well-received model for engaging diverse CPSs and other stakeholders and for facilitating conversations about racism in the behavioral health system.

One aim of the series was to prompt CPSs and other mental health care providers to think about actions they could take within their organizations to combat racism. Participants expressed greater awareness of structural racism, examined their own biases, and stated their intentions to apply what they learned to better serve the peers with whom they work. Therefore, the series may have prompted participants to take initial steps to integrate antiracist approaches in their work (12, 13). However, the series was not designed to provide in-depth training in the organizational changes needed to address institutionalized racism in the behavioral health system; thus, further training sessions on this topic are important. Additional efforts are necessary to diversify the mental health workforce, amplify the voices of peers who have been historically marginalized, and advocate for policies that will enhance mental health equity (10, 12, 13). Peers must be a part of these changes, but engaging clinic administrators, mental health care providers, and staff in the process is crucial. The main responsibility for addressing racism at a systemic level belongs with leaders in the behavioral health system rather than those with less power, such as CPSs and other providers.

Participants reported experiencing and witnessing racism within their workplaces, but the evaluation data provide only a glimpse of those experiences. In future iterations, follow-up data could provide insight into the degree to which participation in the series spurred action. Most participants identified as White, indicating a need for continued outreach and engagement of individuals of color and other marginalized identities to fully understand their perspectives and experiences. Further work is needed to better understand how the intersectionality of race and mental health affects the lived experiences and recovery of CPSs of color, how antiracist approaches can be infused into peer support activities, and how behavioral health organizations can best support peers of color and foster equitable environments.

This pilot of the Racism and Recovery series facilitated conversations on racism and could be used for further discussions to promote equitable participation in the behavioral health system. Lessons learned from the series may also inform future training sessions for CPSs, other mental health care providers, and clinic leadership on integrating antiracist and equitable approaches to behavioral health care.