COVID-19 and the ensuing shutdown demonstrated to the world the impact that isolation, lack of community, and the absence of meaningful human interaction can have on a person’s mental health and wellness. The value and meaningfulness of each connection and encounter we have with one another throughout the course of a day have often been taken for granted. Only with the abrupt and unexpected loss of these interactions was the significance of having support systems in place broadly recognized and the consequences of their absence brought to the forefront of our attention. Loneliness is associated with higher anxiety, depression, and suicide rates in the general population. Marginalized groups are at even higher risk [1].
For individuals who already struggle with coping, mental wellness, and substance use challenges, the importance of having an established community of people who understand those challenges is magnified. Social networks and support systems may have been broken or never established in the first place, and are often insufficient or nonexistent as a result of stigma, shame, and lack of trust.
Substance use peer support specialists are individuals who have shared lived experiences of addiction and mental health challenges and are stable in their recovery journeys. They relate to people who are entering or are new in their recovery, in a nonclinical, mutually supportive way. Those still struggling benefit from having someone to help them navigate formal treatment systems or access informal community resources in a manner that is accepting, nonjudgmental, and inclusive. Research has shown that some people who survive a life-altering disorder or experience develop special sensitivities, insights, and skills that allow them to help others who are similarly afflicted and foster a sense of safety that eases trust among those struggling to engage [2]. Pairing someone who is new to recovery with a peer who has been in similar circumstances and managed the same struggles aids in building rapport and trust and increases engagement in support services.
COVID-19 changed the landscape of how peer support services have been traditionally provided. Typically, that one-on-one interaction is provided face to face and in the communities, homes, schools, and workplaces of persons engaging with peer specialists.
With the onset of social distancing at the beginning of the COVID-19 pandemic, peer support specialists had to become creative in how they provided services and support. The demand was higher than ever due not only to the impact of isolation on mental health, but also the lack of access to resources while so much was shut down. Encounters that initially began virtually quickly moved to outdoor, in-person, physically distanced meetings. Peer specialists assisted with access and delivery of food from local food banks. Resources for COVID-19 supports became paramount. Coaching on how to access services through various technological platforms became the norm as clinical services moved from face-to-face to virtual platforms. Relating on a mutual level to feelings of uncertainty about how to live, parent, and work in unfamiliar ways became a common topic of conversation. The mobility of community-based peer support specialists allowed them to serve as connectors in an entirely new way. The necessity of the support and connection they provided during these unprecedented events became a lifeline for many who were often already disconnected from their communities on some level. Peer-run warmlines opened up, providing 24-hour telephone access to someone to talk to or text with about how COVID-19 affected participants’ lives, creating new opportunities for peer connections in North Carolina that had not previously been established.
COVID-19 and the impact on every person’s life, not just the lives of people struggling with mental health and substance use challenges, has highlighted the need for acceptance, connection, and belonging within a community more than ever before. The loss of these staples of wellness that most take for granted was already a common theme for people dealing with stigma, lack of available resources, and access to services even prior to COVID-19—challenges often unseen by the general population. Peer support specialists exist to fill these needs. They stepped up their presence with proven resilience and continue to do so in the face of the ongoing challenges of the pandemic.
Acknowledgments
Disclosure of interests. No interests were disclosed.
- ©2021 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.
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