By Caroline Grueskin
When Tyler Auck was recovering from his opiate addiction several years ago, a guy volunteered to help him.
“He took me out to eat, did stuff with me, took me golfing,” Auck said. “I didn’t have a lot of experience with that.”
And Auck said that was important in helping him get better.
“Treatment centers, they take care of you when you’re in there. They give you aftercare, which helps you get back into society. But they’re not there for you when you go home,” Auck said. “To have somebody that will teach you how to go out and eat and sit with somebody and have a conversation …. To say, hey, I’m having a hard time, what would you do in that situation. To look at their life and say, I want part of that.”
The friend was helping him for free, and Auck said that happens a lot in the treatment community. But around the country, peers are often trained and paid to work with addicts and people with mental illness.
Seen by experts as an important piece in drug and mental health treatment, peer coaches are rare in North Dakota, where there is no common certification process. But new funding sources and a growing interest in making them more available could bring them to cities around the state, potentially adding manpower to a thin treatment workforce.
A peer coach is someone recovering from an addiction or mental health issue who is trained to work with people while they get sober or participate in therapy. They can work within treatment centers alongside psychologists and addiction counselors or in recovery-focused groups.
Armed with 40 to 80 hours of training, coaches help people during their recovery by encouraging them to stay sober, involving them in activities or finding them housing. They can also do outreach on the front end to people who may be considering treatment.
Pam Sagness, director of the behavioral health division of the Department of Human Services, said a standardized peer coach program could be key to improving services.
“By investing in these programs, we will be reducing relapse, which is high-cost down the road,” Sagness said.
It has been presented as a “primary need” in the interim Human Services Committee this year, with support from many stakeholders, she said.
“What we want to do is provide training across the state so that people working in this realm would be given the tools they need,” Sagness said.
Steve Allen, a senior policy associate at the Council of State Governments, has also recommended them to the Incarceration Issues Committee as a way of improving treatment with the long-term goal of keeping people out of jail.
“Use of peer support specialists is an emerging best practice,” Allen said, noting that Medicaid supports these roles to the extent of funding them in 31 states.
Allen also has said peer coaches and other paraprofessional workers, such as someone who coordinates between the multiple systems — behavioral health, criminal justice — that often affect the same group of people, could bolster workforces in areas with few treatment options. People who become peer coaches also may be inspired to continue their schooling and become clinicians.
Allen said hiring of coaches, who would be paid about $50,000 annually, could start within a year, though it may take several to build a full program.
“It is one thing the state could do fairly quickly,” Allen said.
The few formal peer coaching programs in North Dakota have largely withered away for lack of funding. What exists today is mainly for youth.
For example, in 2012, Heartview Foundation in Bismarck had a two-year grant to train peer coaches to work with recovering addicts.
Auck was one of them.
He got paid to take people kayaking, Frisbee golfing and mountain biking. He worked with them on job resumes and finding housing.
But after the grant ended, there wasn’t funding to continue paying people and it was costing the organization to coordinate.
“We tried to sustain those coaches on a volunteer basis, but these are folks that are active and engaged in the community,” said Executive Director Kurt Snyder. “Without the support of the grant, it fizzled away.”
If a process to train and certify coaches were put in place, funding from the state and federal governments could make these services more available.
Peer coaches are recognized by Medicaid in many states. If the state renegotiated its contract with the health care provider, local treatment centers could be reimbursed for offering certified peer services, Sagness said.
Additionally, a new state-funded voucher program for people with substance use disorders is just getting started, Sagness said. Recovery coaching is one of the services it is designed to reimburse.
In the meantime, a couple of initiatives are opening up to offer recovery coaching in both realms.
An organization called Face it Together is starting in Bismarck and Fargo. The idea is to recruit and train volunteer coaches, who would be available at all times to people struggling with addiction, said interim executive director Marnie Walth. The group, which intends to get funding from businesses, is on track to recruit volunteers in the fall.
Also, Mental Health America of North Dakota got a grant from the federal government for its executive director to become a mental health peer coach trainer.
Carlotta McCleary said she will be traveling soon to Connecticut for the training, which she hopes to bring back and teach to people in North Dakota as funding becomes available.
“We’re trying to get that infrastructure in place,” McCleary said. “That can’t be one of the reasons we can’t move forward.”