Where It Really Counts: Feasibility and Potential of the Peer Engaged Empowered Recovery Program for Substance-Dependent Jail Inmates.

Abstract

Objective: The Peer Engaged Empowered Recovery (PEER) program is a county collaboration between specialty behavioral health and probation departments to address substance use and related problems by providing team-based peer recovery specialist (PRS) services. The study aimed to assess the feasibility and potential effectiveness of PEER and propose recommendations.

Method: Eligible clients released from jail had suspected substance use disorder and were assigned to the local drug court, on pretrial probation, or considered of high risk of recidivism. Clients were offered PRS support for 6 months. Client-reported data, administrative data on services, and survey data from program stakeholders were assessed.

Result: The program successfully identified clients with substance use disorder who had high to very high levels of need for social determinants of health, comorbid mental illness and other chronic conditions, and a high recidivism risk. Clients were served predominantly by phone despite complex needs. The sustainability of the PEER program was rated as stable along many dimensions except funding stability.

Conclusion: The PEER pilot program was well targeted. The average level of health and social need among clients was high, and many were difficult for PRS to contact. PRS services, which are currently undifferentiated in the state, may need to be risk-stratified in the future to take into account health and social factors and to align caseloads, reimbursement, and training.