It Started With a Lunch Shift
Early in a peer career, there can be a deep sense of gratitude. Grateful to have a job. Grateful to be trusted again after years of addiction. Grateful simply to be included.
So when asked to serve meals, clean common areas, or take on whatever extra task needed doing, the answer is often yes without hesitation. There is dignity in every task.
Over time, though, a pattern can begin to emerge. Peers are often the first called to fill gaps and the last invited into conversations about policy, programming, or clinical decision-making. Present in the building, but not always present in the strategy. That is often where the difference between inclusion and tokenism becomes clear.
What You’ll Learn
This piece explores:
• How tokenism can unintentionally show up in behavioral health systems
• What true inclusion looks like in practice
• The role of leadership and mentorship in peer workforce development
• How organizations and peers can work together to strengthen integration
When Presence is Not the Same as Inclusion
In behavioral health systems, inclusion is not just about being present. It is about being valued, heard, and trusted to contribute. Across behavioral health settings, peer roles can unintentionally become symbolic. Peers may be relied upon for logistical support or emotional labor while being left out of strategic conversations. Research has shown that without intentional design, peer roles can become more representational than influential (Piat & Sabetti, 2018).
There is dignity in every task. That is not the concern.
The concern is when peers are consistently utilized for support functions without being invited to apply their lived experience in ways that shape care. De-escalation, engagement, program development, and relationship-building are areas where peers bring unique expertise. Tokenism often shows up in subtle ways:
• Highlighting peer roles in workforce numbers but not in decision-making spaces
• Including lived experience in storytelling but not in system design
• Asking peers to support the work without shaping how the work is done
When lived experience is treated as a story instead of expertise, inclusion remains surface level.
Learning to See Inclusion Differently
Tokenism does not only exist at the organizational level. It can also take shape within team culture. When peer roles are viewed as task-based rather than influence-based, systems miss opportunities for deeper engagement. The full value of lived experience is not realized.
True inclusion requires a shift in perspective. Every interaction, even something as simple as sharing a meal, can be a moment of connection and trust-building. However, sustainable inclusion cannot rely on individual effort alone. It must be supported by structure.
Organizations that move toward true inclusion recognize lived experience as a professional expertise, create space for peer input in decision-making, and support peers in expanding their roles over time. Inclusion becomes meaningful when it is reflected not just in who is present, but in who has a voice.
The Role of Leadership and Mentorship
Leadership plays a critical role in determining whether peer integration is meaningful or symbolic. Research continues to reinforce the value of lived experience in shaping behavioral health systems (Rose et al., 2023). Organizations that integrate peers effectively create pathways for development rather than relying on informal growth.
These pathways often include structured mentorship, opportunities for skill development, and clear expectations for growth and leadership. Strong leadership also includes consistent conversations about development. When supervisors engage peers in discussions about goals and aspirations, it reinforces that peer roles are designed to evolve.
Mentorship supports this growth by creating space for skill-building, reflection, and professional identity development. Inclusion strengthens when learning is shared across roles. When leaders and peers engage in mutual learning, the workforce becomes more connected and more adaptive.
Building Systems that Support Peer Growth
If an organization identifies as peer-powered, that commitment must extend beyond hiring. The key question becomes how the peer workforce is supported to grow. True inclusion requires intentional investment in development. Organizations can strengthen peer workforce growth by:
• Asking about goals during and after annual reviews, even offering opportunities to shadow other roles that are relevant
• Support certification, training, and continuing education
• Creating clear and transparent career pathways
Without these supports, even strong peer professionals may begin to feel limited in their role. Over time, this can contribute to disengagement and burnout. Growth does not happen automatically. It must be built into the system.
What Happens When Peers are Integrated Well
When peers are fully integrated, the impact extends beyond workforce experience. Peer support has been associated with improved engagement, stronger relationships, and better outcomes across behavioral health settings. Programs that maintain strong alignment with peer principles have shown reductions in hospital readmissions and improved continuity of care (Leamy et al., 2024). Beyond measurable outcomes, there are meaningful shifts in how care is experienced.
Individuals feel more understood.
Teams operate with greater trust.
Systems become more responsive.
This is the difference between having peers present and building systems that truly include them.
About the Author
Marie Eddy is a project manager and peer professional at Recovery Innovations with experience across behavioral health care settings, including facility-based services, outpatient, and permanent supportive housing. She brings lived experience and a strong commitment to advancing peer roles as an essential part of behavioral health systems. Marie is passionate about workforce development, mentorship, and creating pathways for peers to grow, lead, and shape the future of behavioral health care.
Take Action: Truly Include Lived Experience
Behavioral health systems continue to evolve, and peer integration must evolve alongside them. Organizations should begin asking:
• Where are peers currently contributing, and where are they excluded?
• How are peer voices incorporated into decision-making?
• What pathways exist for growth, and are roles designed for long-term development or short-term need?
Strengthening peer integration requires intentional design, not incremental adjustment. For systems working to move beyond symbolic staffing, structured assessment of workforce models can help identify opportunities for alignment, growth, and sustainability.
Connect with us today to assess your workforce model, strengthen peer integration, and build sustainable pathways for growth across your behavioral health continuum.
