There is an unspoken, covert, and arbitrary standard for working in the mental health community as a peer. Within this landscape, discrimination goes without question sometimes. In the world of the modern mental health diagnosis and diagnostic therapies in social work, mental health, and medicine it becomes even more difficult to think and live outside this world of biases and stigma. 

The standard I am talking about exists in the mental health professional helping realm. Peers disclose their lived experience more than any other discipline in behavioural health. For whatever reason, I am here to talk about how Peers are constantly evaluated and informally assessed by their colleagues for the quality of their health and their level of so-called level of ‘functioning’. In doing so, our work readiness is constantly under question.

In every agency I have worked for exists a secret conversation, an informal meeting, and ongoing dialogue about a particular peer’s mental health status when an incident or unexpected event occurred. For example, if a peer called out sick, or there was a new and unusual behaviour in the peer’s day-to-day disposition, all of a sudden, that peer competency was under question. The aetiology of this discrimination runs deep. Therapists and psychologists without any lived experience are somehow above reproach, outside, and between the rules for social norms, healthy attitudes, and people’s perception of healthy living and interpersonal rules of engagement. 

I knew plenty of professionals that would talk about: ‘fucked up marriages’ or ‘explosive’ behaviours at personal social functions or work. Somehow, someway, these professionals are not considered sick or in need of treatment. Striking me as bizarre and unfair, these behaviours are very common. What is not so common is the license for peers to mimic this behaviour. Peers who want to feel comfortable in their shoes being themselves without fear of losing their jobs or respect from their colleagues can’t behave like this without fear of being called ‘sick’. 

This disparity was so visible and yet so brazenly discriminatory in the jobs I have had that I have suffered trauma from the entire experience working as a peer with lived experience. As a peer, my education, my disposition, and all my experiences were and always will be under the radar. Given we live in a world of stereotypes, and discrimination, and labels, peers are always judged by other team members when working in mental health or on interdisciplinary teams. We are judged as not quite healed yet, or still in need of further recovery to be successful or ready to work. 

I know this because I have openly disclosed my lived experience, and worked as a clinician. I have heard the comments from colleagues, the smirks, the language thrown around the watercolour regarding their fellow peers, and the peer’s abilities as if their skills are somehow calculated and a general summary of their perceived progress and status of their recovery from a diagnosis.

My point is a peers’ worth and abilities seem to be summarized as a general accounting of their level of so-called functioning. Let me be very clear about how this myth operates in the mental health system. A peer’s ability is determined by clinicians and their colleagues in the system to be only as good as their ability to come across and seem healthy to their fellow team members or agency members. The standard is courageously absurd as it is arbitrary. Since there is no clinical determination or way of assessing seeming healthy, the peers are trapped in a world of illusion, discrimination, and an altogether unnatural mode of living.

The standard requires peers to demonstrate their skills and talents to help people heal, be publicly comfortable with their problems, and work alongside social workers and others in the helping profession. In doing so we handle the same or even more serious issues but are regarded as less able to compartmentalize our issues and engage in self-care?

In my opinion, this is evidence of a standard and attitude that favours and privileges one side of the binary in the mental health system and is the most decisive absurd division between clinicians and peers in the helping profession. Our peers are no different from the clinicians with the same problems and issues. We all have lived experience. We need to ask: are we managing enough to meet our expectations for ourselves and health and wellness?

Ultimately, our self-awareness, use of self-disclosure, and authenticity as helping professionals, regardless of our roles in the mental health system, will trump the issues of systemic and cultural oppression interfering with peers being comfortable with their history. I am suggesting honesty is very much a part of the healing process. As a culture, we need to learn from lived experience. We must never lose sight of our mission to share the message and learned lessons from others who have walked in the same path in their recovery. 

People may not always agree with you or like your personality. However, once we start actively listening to everyone involved in the helping process mutually, we can begin disempowering the arbitrary and misleading images of peer professionalism disguised as the phoney standard for peer work.

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Image credit: Freepik

Max E. Guttman, LCSW  is a psychotherapist and owner of Recovery Now, a mental health private practice in New York City.

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