While most states use SAMHSA grants and state general funds to  develop and sustain their peer support programs, as of 2016, 41 states  and the District of Columbia were receiving federal Medicaid  reimbursement for the services provided by peer support specialists. Mental health experience. Certification renewal. State Officials Generally Cited Six Leading Practices for Certifying Peer Support Specialists

Officials from peer support specialist programs in selected states  generally cited six leading practices for certifying peer support specialists. One stakeholder commented that peer support programs have  a responsibility not to contribute to barriers in the workplace for  individuals with mental illnesses. Our review shows that some of the peer support specialist programs in  the six selected states are taking steps to address these barriers. Program officials from five of the  six selected states cited the importance of emphasizing to peer support  specialists that they should help others manage their physical health—in  addition to their mental health—during core training or continuing  education as a leading practice. Agency Comments

We provided a draft of this report to HHS for review and comment. The  Department did not have any comments. We are sending copies of this report to the appropriate congressional  committees, the Secretary of the Department of Health and Human  Services, the Secretary of the Department of Defense, and other  interested parties. Appendix I: List of Organizations and Individuals Interviewed

	State peer support specialist programs

	Stakeholders

Appendix II: Summary of Peer Support Specialist Program Screening, Training, and Certification Requirements in Selected States

Recovery experience   Must have lived  experience with a  mental illness or  substance use disorder  and have been in  recovery for a minimum  of 2 years. For the purposes of this report, we use the term “peer support specialist” to describe individuals who  use their own lived experience recovering from mental illnesses to support others in their recovery;  however, each state may have different titles in place for the certified role achieved through their peer  support specialist programs.
Why GAO Did This Study

As the peer support workforce has grown, there has been increased attention to standardizing the competencies of peer support specialists through certification.
The 21st Century Cures Act included a provision for GAO to conduct a study to identify best practices related to training and certification in peer support programs in selected states that receive funding from SAMHSA. This report, among other things, describes leading practices for certifying peer support specialists identified by program officials in selected states.
GAO interviewed state program officials in six selected states and reviewed online, publicly available information about their peer support programs. GAO selected the states in part based on the state's certification program being well-established (at least 2 years old), use of SAMHSA funding for peer support, and stakeholder recommendations. The six selected states—Florida, Georgia, Michigan, Oregon, Pennsylvania, and Texas--are among the 41 states and the District of Columbia that, as of July 2016, had programs to certify peer support specialists. In addition to the state program officials, GAO interviewed SAMHSA officials and 10 stakeholders familiar with peer support specialist certification, including mental health researchers and officials from training organizations, among others.
GAO provided a draft of this report to HHS for review and comment. The Department did not have any comments.

What GAO Found

According to officials from the Substance Abuse and Mental Health Services Administration (SAMHSA) within the Department of Health and Human Services (HHS), shortages in the behavioral health workforce are a key reason that individuals with mental illnesses do not receive needed treatment. In recent years, there has been an increased focus on using peer support specialists—individuals who use their own experience recovering from mental illness to support others—to help address these shortages. Program officials GAO interviewed in selected states generally cited six leading practices for certifying that peer support specialists have a basic set of competencies and have demonstrated the ability to support others.