Can Peer Support Specialists Be Volunteers?

The term Peer Support Specialist is a vocational title referring to a paid position that can be either part-time or full-time.  I have seen some Peer Support Providers who are actually volunteers.  They were doing the same work as paid Peer Support Specialists.  Most importantly, they did not want to get paid. They found advantages to being a volunteer that they preferred.  Should this be an option or is this a risk to the field?

 First of all, let’s consider why these people wanted to volunteer to be a Peer Support Specialist? 

1.     They did not need the income.  Most were either retired or receiving disability income, and did not want or need the salary they could receive if they were hired.

 2.     They did not want some of the burdens and restrictions placed on employees.  Those volunteers I talked with wanted more flexibility in the time they devoted to being a peer, or more flexibility in how they did their job.  They were willing to do the job in an ethical professional manner, but they did not want the burdens that come with being an employee.

 3.     They did not want the reality or appearance of a conflict of interest. I had several volunteer Peer Support Specialists who loved the advocacy element of the work.  They wanted to help clients get the services and supports they needed and deserved.  They knew how important it was for clients to trust that their advocacy was motivated only by their interest in helping their clients.  They accurately pointed out that paid Peer Support Specialists can be seen by clients as having a dual relationship with the employer.  Those peers have to advocate with the organization that is paying them.  That could undermine their willingness to truly fight for their clients.  It could also undermine the appearance that they would truly fight for their clients.  Both are barriers to trust.  These volunteers did not want to give up that trust.

 4.     Some of the volunteers were people who were interested in trying the work of a Peer Support Specialist, but were not sure they would like it.  They did not want to do the work of applying for a paid position until they knew they wanted to do the work, and they felt they needed to try the work first.  By volunteering, they got a chance to see what the work was really like before they took steps toward employment.

 5.     Some had incentives for not being paid, and yet wanted to do the meaningful work of a Peer Support Specialist.  Most involved disability income that would be reduced if they were employed.  Social Security and VA disability income programs have developed rules to support employment, but there are people who still feel it is in their financial interest not to earn income.  At the same time, they want to do the work of a Peer Support Specialist, and so a volunteer option allowed them to spend time doing a meaningful activity while keeping their disability income.

So we can see why some people might be interested in Volunteer Peer Support Specialist roles, but why would healthcare and social service organizations be interested in volunteers?  These positions require time and energy to enroll and supervise.  They create risk if they don’t perform well.  What is the advantage?

• The reduced cost can allow these organizations to expand Peer Support Services more rapidly.  Volunteers do require administrative support and training.  The cost is reduced, and so a number of Peer Support Specialists can be added for a relatively small cost.

•  Volunteer Peer Specialists can allow healthcare organizations to expand the diversity of their Peer Support Specialists.  In particular, Peer Support Specialists can be strategically important for very specific roles that don’t require full-time positions. They can provide limited services for small populations such as people with relatively rare disorders or rare clinical needs.  They can represent client populations that are relatively rare in the organization but strategically important, either because of healthcare disparities (minority subgroups), or because of stigma associated with group membership.  The ability to have part-time peers in strategic roles to represent small subgroups can be strategically valuable.

•  The ability to include people who are seen as having no incentive to be dishonest is valuable.  Most healthcare organizations have patient advocacy services, but credibility is key to their effectiveness.  Paid employees in the advocate role will face skepticism by some clients.  The value of volunteer Peer Support Specialists in terms of their credibility and trust with clients can be attractive to healthcare organizations.

•  Entry positions for potential paid Peer Support Specialists.  Volunteer positions represent a chance for the organization to see if a new Peer Support Specialist will make a good employee.  Being a volunteer can serve as part of the recruitment process, allowing the employer to get to know them and their work, making it easier to decide on who to hire if the person becomes interested in a paid position.  Candidates who have volunteered first are often less likely to quit after they take a paid position, relative to someone who has not worked in the field.

To build the structure needed to support Volunteer Peer Support Specialist positions, several things are needed:

1.     Organizational Structure for Volunteer Positions.  This typically requires work from the Volunteer Department or Coordinator, to set up positions, including the training and guidelines, etc.  They already do this type of work for other positions, so the additional work is only to adapt their current volunteer positions to include Peer Support Specialists.

 2.     Organizational Structure in the Clinical Program.  It is important to not short-change Volunteer Peer Support Specialists in terms of the support they will need to do good work in the clinical setting they are assigned.  You will need to ensure they have good supervision, education, and on-going support so that they can become a real part of the organization and provide meaningful work.  Volunteers can feel that they are totally separate from clinicians with no meaningful communication or collaboration.  You’ll want to find ways to integrate Volunteer Peer Support Specialists with the clinical work and team.

 3.     Opportunities for the Volunteers to Collaborate with Other Peers.  Volunteer Peer Support Specialists will benefit from time spent with other Peer Support Specialists.  This will help them fully embrace the peer role and learn the range of skills that Peer Support Specialists use to provide their support.  The volunteers should be included in Peer Support Specialist meetings and educational offerings at the very least.

Whether it is possible to develop volunteer Peer Support Specialist positions will depend on your organization’s policies and support. It will also be important to ensure that any volunteer positions are created for the sole purpose of improving services and not primarily for saving money. In the right setting, volunteer Peer Support Specialists can help expand the development of an effective Peer Support team.

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