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Models – Peer Responders

Designing a Reimagined System

Peer responders – sometimes referred to as peer specialists or credible messengers – are individuals who share lived experience with the people they serve, having confronted personal challenges related to substance use, mental health, homelessness, or incarceration. Several jurisdictions incorporate peer specialists in the teams deployed to respond to relevant community needs. Because of their personal histories, peers often are able to support and connect with individuals seeking service in ways that are deeply meaningful and likely inaccessible to providers lacking shared experiences.

Research demonstrates that peer support can help achieve positive outcomes for individuals dealing with a mental health or substance use issue, as evidenced through metrics such as reduced hospital admissions and better crisis stabilization.1 The Substance Abuse and Mental Health Services Administration (SAMHSA) describes best practices and the benefits of employing peer workers in supporting individuals in recovery.

The following are three real world models.

  • Formal Peer Responders.  San Francisco’s Street Crisis Response Team (SCRT) responds to residents experiencing homelessness, substance use, or mental health challenges. Each unit consists of a paramedic, mental health clinician, and peer specialist. Peer specialists have similar lived experience and build trust with clients to connect them with services and care.
  • Reentry Advocacy.  The Anti-Recidivism Coalition (ARC) – a reentry advocacy non-profit in Los Angeles, California – employs formal, paid credible messengers to work directly with individuals in custody and prioritizes hiring formerly incarcerated individuals throughout the agency.
  • General Peer Incorporation. Eugene, Oregon’s widely-discussed CAHOOTS (Crisis Assistance Helping Out On The Streets) program deploys a paramedic and crisis worker to non-emergent calls related to mental health or social service issues, such as homelessness or welfare checks. Seventy-five percent of CAHOOTS responders identify as an individual with lived experience in housing insecurity, incarceration, substance use, or neurodivergence.


  1. Davidson, Larry. (2018). Revisiting the Rationale and Evidence for Peer Support. Psychiatric Times, 35(6).