To Young People of Color with Lived Experience: Pay it Forward; Become a Peer

I grew up in a neighborhood ​in Rochester, NY, that was a ​product of redlining​—where​,​ according to ​unitedstate​s​​​zipcodes.org​​,​ the median household income is $23,735. ​Houses in ​my neighborhood​ were primarily built in 1939 or earlier​,​ with a median house value of $57,400. Also worth mentioning: a substantial number of single-parent families, as mine was, and an extremely small number of families, period.

It seems incredible​,​ reading these statistics​—​​me, who grew up among lit​t​er​-​​​filled streets and vacant houses, in conditions now identified as Adverse Childhood Experiences (ACES). Among unhappy people who, due to lack of resources and opportunities​,​ turned to the easy​ ​way out​:​ stealing to survive, selling drugs to make money, using them to cope. It is quite easy to find ​yourself ​completely clouded with a negative view toward authority and mental health because,​ ​for so long now, we’ve been let down.   

​​​But​ growing up​,​ I did not know the ​why ​to a question I could not yet ​​ask—or answer​. 

​Why did so many struggle, me included? Everyone who surrounded me seem​ed​ to have succumbed, oblivious to the reasons ​for​ their oppression simply because it ​had​ been happening for so long​. ​​​I knew deep inside ​me that this ​was not normal. I knew there HAD to be a way out of this cycle. I knew nothing​,​​ but I knew change was possible​ ​​​at any given moment. Yet at that time we had no idea of all the resources available to my family. ​A mother, ​​Spanish-speaking ​head of household, could not get the support she needed. 

​Looking back, ​it was no surprise ​that ​my older sister and I ended up in the juvenile system​ as adolescents​. No surprise that ​the ​prosecutor and my​ ​​“d​efense ​attorney​​”​ ​did not care enough about us youth​s​​ to take a moment and realize that ​the things I was officially being sentence​d​ for​—​​which led to ​12 months in juvenile detention​—​​w​ere in fact acts ​that ​my sister committed and not me. ​Why? B​ecause our names were reversed. ​It was a​ simple mistake ​overlooked by ​my attorney​, who ​did not listen to me when I advocated for myself before the judge. ​When speaking up, I was simply yelled at​ by the judge​ and told “to not speak out of turn” and to “be quiet.”

That was a pivotal moment in my life. Once sentenced, 14-year-old me adapted instantly behind the courthouse in that cold​,​ uncomfortable cell. Because I understood my freedom was no longer mine for the next year. Because I knew from other peoples​’​ experience​s​ that if I were to try to go against the devouring system, I would only make thing​s​ wors​e for ​myself.

And yes, of course, I ​asked​ “why me​?​”​—when the only reason I happened to be caught in the system in the first place and before a judge was because I had too many absen​ce​s from school. And so​, I embraced my destiny. This whole ordeal was preparing me for my life’s purpose​:​​

​To be an advocate. More precise​ly,​ a youth and family mental health advocate. A PEER.    

 What is a peer support specialist? 

A peer specialist, often referred to as a ​p​eer ​a​dvocate​,​ is a ​paid ​professional with lived experience with​in​ ​one or multiple systems of care, such as juvenile justice, substance abuse, poverty, mental health, foster care, education, or developmental disabilities—just to name a few. ​We are experts of our journey, with our own experience navigating a system, and are now a resilient beacon of hope for others. Peers are a powerful force and asset to many human services fields that seek to target and aid underserved communities.  

A non-traditional form of care, peer services are short-term and can be offered in a variety of settings, such as in the community or at home, ​with an​ individual or a group. They teach and practice coping skills, and share and connect to resources that relate to an individualized goal created by the participant and that pertain to the ​person’s​ current need.   

The aim is not for the peer to do all the work for the participant​ ​​the way traditional care​-managers do. The role of a peer is to be a guide, mentor, and a person of support, primarily using their own lived experience to relate and connect with the participant. Thus, the recipient of services can feel comfortable and receptive without the​ usual​ power dynamics, s​etting ​them​ on the path to being better equipped with self-advocacy skills, self-awareness, and hope ​both ​at home and in the community. All ​of ​this is delivered in a trauma​-​​​informed, culturally responsible manner, via empathy and expertise. 

Peer services ​are​ a proven model that strives to decrease the chances of inpatient services, reoccurrence, and/or ​the ​intensity of mental health barriers​—w​here the peer​ is​ the copilot and the participant is the driver​. 

It is well known that we in the Latin​​​x/​​BIPOC​ ​​(​Black​,​ Indigenous ​and ​People of Color​)​ communities have not had the best experiences when seeking and receiving mental health services​, whether ​​​due to language barriers, cultural differences, or lack of resources. The importance of mental health has been lost​,​ or has probably never really been captured within our communities and past generations.  

​​​Peer Support ​Specialist​s​, like Youth Peer Advocates (YPAs) and Family Peer Advocates (FPAs), can change that. 

Here in New York State, a YPA is a person aged 18-30 with lived experience who, working under Medicaid’s Child and Family Support Services, meet youths where they are as they work on their mental health, life goals, strategies, and skills while transitioning into adulthood. 

Almost a decade ago, ​​​I became a Youth Peer Specialist out of grit​—​​to lift others up via my own lived experience and resilience​,​ allowing me to promote awareness and change for my community. ​Nine years ago I became ​credentialed in that role ​at​ the age of 22​ after a long downward spiral​ of depression, anxiety, and substance use. You can read more of my story in my article “Breaking the Cycle: How I Overcame Intergenerational Trauma and Became a Peer Advocate.” 

​​Throughout my years assisting and collaborating with families and care teams, I too healed in small ways that felt inexplicably huge—doing simple things like applying a face mask as a method for decreasing anxiety and practicing self-care. Or going to the mall or drive-thru to order food, just to practice social skills or coping skills for social anxiety in public. As a youth peer specialist, I was honored to help others with similar barriers, using my lived experience, hands-on practice, and many other coping techniques. 

We are there to provide support and be role models. Untraditional, I know, but that is the point. Yet the brainstorming, solutions, awareness, and personal growth these conversations and simple methods create go far beyond a standard office visit. They create a peer connection built on trust—and for that trust, I am humbled. I am grateful to each family I crossed paths with. And for each I have the utmost respect.   

Now​,​ aging out as a Youth Peer Advocate​,​ I hope to pay it forward.   

My past and present thoughts on mental health 

As ​I described in “Breaking the Cycle,” ​ as a Puerto Rican ​w​oman​ I was taught that seeking mental health support or services meant that you were ​“​loco(a),​” or​ crazy. The thought of receiving mental health services​ always came with a bad taste​:​​ shame, guilt, stigma, and fear​ were attached to it​. If you were to find someone in your community or inner circle that engaged​ in such services, that itself would be a rare event and it would be discussed in loud whispers.   

Yet in my own growth both personal and professional, I know it does not have to be that way anymore. Two ​frequent​ misconceptions of mental health ​that ​we have collectively are: ​1​)​ that ​a mental health struggle always means you are incapable​;​ and 2​)​​ that services are for life.  

This is not true.  

​​Let us be completely honest, now​.​ ​L​ife gets tough and overwhelming for all of us. With all the societal expectations and responsibilities lingering close at every turn​,​ it is no surprise that for whatever reason, we may all need that extra support at some point in our lives. Anyone ​of any age or gender ​​​can be affected. And seeking support for yourself does not mean you will ​wind up with Child​ Protective Service​s​ ​​at your door ​and separated from your children. ​​Or think of it this way: ​if ​we ​worry about our body when it​’​s injured​,​ why not worry about our mental health​?​ ​It is equally important, if not more. ​  

​​So ​I want to emphasize and create awareness to the need ​that ​we have​, as a community​,​ to challenge our perspective and broaden our understanding ​on larger topics​ that influence our everyday​ lives​. We are not our parents, or our parents​’​ parents. Yet in some ways we still carry their burdens​, especially when we do our best to shed them​. The key aspect to this paradox is that every individual has the potential to be brave, ​to ​step out of their comfort zones and say, “I need help.” We owe it​ to​ ourselves and families to be the best version of ourselves. To normalize mental health, stay informed, be a less​-​bias​ed​ generation​.  We​ have the responsibility to be role models to our future generations, because there IS strength in vulnerability.  

I also want to create awareness as a service provider. Throughout these ​nine​ years as a peer, I have indeed noticed and personally experienced​ the imbalance and inequities in the field and services. I have seen waiting list​s​ for youth​s​ and families who had to wait ​over six ​months, even before Covid-19 hit. I have seen youth and families from my BIPOC community being underrepresented​,​ day in and day out. 

There must be a more feasible way to get more grassroots and community organizations informed, trained, involved, and designated to provide peer services as a preventive service, for individuals and families at risk. We must be proactive, not just reactive. If our underserved communities prefer small grassroot organizations over big organizations, then this is where we should go greet them. The need and opportunities are THERE.  

​​​​BIPOC PEEEEEEK   

​​​So, in case you’re wondering: How can I become a credentialed peer advocate? Depending on your age and where you live, there are multiple ways forward (see the information and resources listed at the bottom). But first, I want you to check out this phenomenal organization, ​​​​BIPOC PEEEEEEK, which is short for “Parents & Caregivers Elevating their voice to Educate and Empower Each other to Eliminate disparities and inequities in services related to the Emotional Health of our Kids” (bipocparentvoice.org).

​In a whirlwind of self-advocacy, I was blessed to cross paths with BIPOC PEEEEEEK. It shared my vision of creating peer-movement awareness and understood the need of mental health outreach in an equitable, diversifying, and intentional manner. I am also honored to be onboard with them as their consultant to bring forward the BIPOC PEEEEEEK lead pilot project, called Healing Together: Family Peer Advocate Workforce Initiative, in partnership with Rochester Regional Health and CCSI. It is an initiative that I hope can be replicated across the nation. ​​ 

Founded by Sara Taylor and ​​other ​parents of our community who lived and recognized the lack of diversity, disparities, and inequities our community experiences, especially in​ the mental​ and behavioral health services, BIPOC PEEEEEEK does not offer any official therapy or counseling​.​​ ​But among ​the ​many things it​ ​creates is safe​,​ brave ​​virtual ​spaces for diverse topics of discussion ranging​ from​ self-care to advocacy. ​These spaces​​ are designed​ for families of color​ ​​​who may not otherwise attend a support group due to shame or guilt, or simply racial discrimination. ​The organization​ also provides resources, workshops, trainings, and annual symposiums to amplify mental health, the peer profession, and cultural competency. 

The goal of this initiative is to do outreach, recruit, and coach parents and caregivers who qualify, ​and ultimately ​get​ them​ credentialed as Family Peer Advocates, ready for work. This one-of-a-kind initiative aims to level the playing field and specifically increase diversity in peer support services here in western New York State. Through a grant from the Mother Cabrini Health Foundation, we guide and support each individual through the application process to guarantee minimal frustration and application​ ​amendments. Using field experience, we can coach and broaden the cohort’s awareness and understanding​ for ​what the day​-​​​to​-​​day ​work ​of a Peer Advocate entails. Although every organization has its own policies and procedures, the core work of a peer does not change.  

As a peer, I believe in the importance of providing services in a non-clinical setting, and I have put that belief into practice. A peer is meant to go and meet families where they are, in their homes or community. We wear a casual professional wardrobe, striving away from the office as much as possible. This is a field job. The work itself should be delivered in such a way that boundaries are respected. The family or participant is working on goals constantly, each session for an extended period of time, even more when taking transportation into account. These sessions empower while the family or individual is creating fonder memories of life, and these services themselves, throughout their growth journey.  

I will not lie; this can be both exhausting and equally fulfilling. ​​I speak as one who spent years as a Youth Peer Advocate and humbly embodies ​personal and professional growth, resilience, and determination​. I am now a​ mental health ambassador for Latin​x​/​BIPOC communities​, s​preading awareness of​ ​career opportunities​ to the next generation. Being a mentor, coach, guide, hope, or an inspiration to someone else makes all the adversity worth it. 

As I continue growing in my field, I have been honored to be a keynote speaker, panelist, council member, mentor, coach, trainer, and facilitator—always representing and advocating for my culture and language. I choose to raise my voice to bring inclusivity and change to the mental health and justice systems, because I know that each time I do, it can create ripples that carry forward. I can say with confidence that there is potential for growth both personally and professionally in this field right now, and for our next generation of peer advocates.  

So to my community, my culture, and any person of color who reads this, I ask again: consider doing this work. You could have what it takes. I invite you to begin rethinking mental health and, alongside me, to embrace and acknowledge that mental health is a priority of high value to help us function, be emotionally stable, and live life in its entirety.  (And if you happen to still be on your growth journey and need support, consider asking for a peer advocate.)

Do this for yourself, for your loved ones, and for our community. Pay it forward. Become a Peer Support Specialist. 

HOW TO BECOME A PEER ADVOCATE: Information and Resources  

Entering the field as A Family Peer Advocate (FPA) or Youth Peer Advocate (YPA)  

If you are considering entering this field, once credentialed, you will be a provisional peer: level 1, with the opportunity to become a professional peer; and level 2 after attaining the experience hours required to apply for it. That can take up to six to 18 months (about 1 and a half years) of direct work (or more, if you chose to work per-diem).   

Requirements vary, but in all cases include lived experience. Need for a high school diploma or G.E.D. may be waived for FPAs or YPAs positions, but basic writing and effective communication skills are necessary for documentation; a diploma or G.E.D. is required for Certified Recovery Peer Advocates.   

Types of Peer Professions in New York State:  

Youth Peer Advocate Credential (YPA), administered by Youth Power of Families Together in NYS.  

Family Peer Advocate Credential (FPA), administered by Families Together in NYS.   

Certified Recovery Peer Advocate-Family (CRPA-F): Lived experience for a CRPA-Family is defined as “a parent, or primary caregiver, of a youth (21 years or younger at onset of family exposure to youth’s substance use) who has participated in, or navigated, the substance use disorder services system.” This specific definition of lived experience is unique to the CRPA-Family role.

Certified Peer Specialist (CPS)

Certified Recovery Peer Advocate (CRPA)

National opportunities: 

Not every state has Youth Peer services specifically, but all U.S.A. states can offer peer support services for families via Medicaid and waivers. Other billing codes, such substance use codes, may cover these services depending on the state, because substance abuse indeed intersects with mental health. Before Medicaid took over, these services were also offered via state funds or grants.   

Every state refers to the Family Peer Services and Youth Peer Support Services providers differently, though they all refer to the same type of work—and all include lived experience as a requirement. Some examples of such terms include: Youth Recovery Specialist; Family Recovery Specialist; Family Support Provider; Parent Support Partner; Family Support Provider; and Parent Support Specialist.    

(If interested in learning more about these services, via Medicaid or Medicaid waivers, check out this Aug. 13 presentation by Peer Recovery Now on “Reimbursement for Peer Support Services A Detailed Analysis of Rates, Processes, and Procedures”.)  

National Peer Certifications:  

National Certified Peer Specialist (NCPS)  

National Certified Peer Specialist (NCPS) – Florida Certification Board   

National Certified Peer Recovery Support Specialist (NCPRSS).