Peer specialists can help close Sunset Park’s care gap

XY came into our offices at RaisingHealth alone, afraid, and uncertain. She is a recent immigrant to Sunset Park, immigrating to the United States alone. She found community in our ESOL and workforce development classes, which meet twice a week. However, the other days of the week, she is by herself, with her own thoughts, missing her family, and thinking back to the difficult moments she’s had — threats and violence from her former partner, traumas of trying to escape home with nowhere to go.

XY’s story is just one of hundreds of thousands of stories — some similar, some very different, some multiple layers more complex. We have seen time and time again a common thread from each of these stories: being alone, being stuck in one’s own thoughts, ruminating, not having a trusted confidant to turn to, not wanting to deal with these struggles. At the same time, this continues to cause feelings of continuous stress, anxiety, depression, mood fluctuations. It impacts the psychological, but also the physical. Blood pressure consistently increases, risks for stroke and heart conditions become more real. “When will this end? When will it stop? Will I actually feel like I can live freely at some point?” are questions being asked every day.

At RaisingHealth Partners, a Sunset Park-based public health nonprofit providing an integrated suite of social care, physical health, mental health, education and workforce training, community safety, emergency response, and community building services, we quickly realized that the traditional mental health system isn’t able to effectively address these needs. Especially in Brooklyn and in neighborhoods as culturally and linguistically centered as Sunset Park, we simply do not have enough capacity. Across the country, we already have a shortage of mental healthcare providers. We then add on the need for multi-lingual, culturally concordant providers with experience, training, and ability to work with immigration traumas, resulting in an even more serious workforce gap. Our community members have reported being on waitlists at mental health clinics for upwards of nine months to over a year, enough time for any mental health conditions to exacerbate significantly.

More often than not in healthcare, we hold the belief that any care — as long as it follows established standards to ensure safety and quality — is better than no care at all. That’s why we have been working to reduce these wait times through leveraging Peer Specialists at RaisingHealth. We hire community members who speak the same languages and dialects of those we serve, who live in the area, and who share similar life circumstances. This allows a foundational level of connection and inherent understanding to be made, which allows our community members to open up more comfortably. We then train our Peer Specialists in certain skills and evidence-based practices, such as motivational interviewing, problem-management modalities, mental health first aid, crisis intervention, among others, and provide them with regular case supervision.

We started noticing a difference. Community members were opening up more to us. They felt comfortable telling us about their major life stressors, inviting us into their lives and their minds and sharing stories that they have held onto for so long. We see community members bring up prior traumas in a way where they can process it, where they understand that these experiences don’t have to continue defining who they are, but once they understand how these experiences have caused them to think a certain way, they can find other helpful ways to handle these stressors.

Additionally, we noticed a difference in wait times. Community members no longer have to wait months to talk to someone. Even though they are not receiving a full course of psychotherapy, they can immediately have a trained peer to start processing and problem solving in the moment. Sometimes, this was all that was needed. Other times, this served as a necessary and effective bridge into therapy while being on a wait list. In a matter of two years, we were able to add a 400% increase to our capacity of providing mental health services with our Peer Specialists than with just therapists alone. Four times more community members under care, four times fewer community members waiting for months while their mental health conditions worsened.

At the end of the day, having someone who is from the same community, speaking the same language, having experienced similar situations, sharing similar lived experiences, who doesn’t necessarily need to have years of clinical training, makes mental health care more accessible, more comfortable. That’s how we can address mental health every day.