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​A person's mental health recovery journey may include a therapist, counselor, social worker, psychiatrist, or other trained professionals. It can also include a peer support specialist, a certified behavioral health professional who has similar lived experiences with the people they serve.

The OSH Peer Recovery Services team includes peer support specialists who provide direct support to patients during their time at the hospital. Their role is focused on empowerment as the team helps patients navigate the challenges of being in an institutional setting and supports them in advocating for themselves and their care. The team also provides designated non-clinical spaces on both campuses where patients can experience a break from the hospital's structured environment. Peer support specialists also play an important role in preparing patients for discharge by connecting them to resources within the hospital and in the community.

“As a peer support specialist, I extend support to folks living with mental health and/or addiction issues through a shared lived experience," said Xenia Carone, an OSH peer support specialist. “What support looks like is unique and different from each individual to the next. From walks and meals, to games or a shared appreciation for arts – holding a safe space of understanding with empathy is the common ground that makes peer support exactly what it is. It's sitting in someone's discomfort with them. We do not instruct. We do not diagnose."

Carone shares more about her experiences as an OSH peer support specialist and the impact of peer support in recovery in a Q&A.

How would you explain to someone who has no idea what you do … what you do?  

As a peer support specialist, I extend support to folks living with mental health and/or addiction issues through a shared lived experience. What support looks like is unique and different from each individual to the next. From walks and meals, to games or a shared appreciation for arts – holding a safe space of understanding with empathy is the common ground that makes peer support exactly what it is. It's sitting in someone's discomfort with them. We do not instruct. We do not diagnose. Most of my meets with my peers look like a walk through our plazas ending in a game of cards. For some, it is sharing a meal and moments of culture. Our discussions range from our favorite jokes and music to our deepest fears and wonders. When we part from each other, our peers feel they can continue on in their day with a bit less weight, and trust that their vulnerabilities are safe and validated and never to be used against them. For me, to feel seen and heard was crucial to my recovery, for without it how do I trust? And without trust, how do we recover?

Is there anything you'd like to share about why you decided to become a peer support specialist and why you chose OSH as the place to support peers?  

My father lives with addiction and schizophrenia. He spent most my life within the California prison system, while my mother always made sure to only install a kind understanding within me of what it is like to live with these things, and what can happen if we do not have support though them. I never knew my father as a “criminal." I knew him as a man with trauma who never received support. Upon leaving Los Angeles and moving to Oregon in 2005, my father was sentenced to 15 years in prison. I wanted to extend my understanding of his experiences and my own, so I applied and started my employment at OSH with Food Service in 2016. For the first 5 years of my employment, I was still battling my own addiction and mental health issues. This resulted in a leave from work due to psychosis and two stays in rehab during 2018 and 2019.

My wife and I are now both four years clean, and I have held different positions here at OSH since my times in treatment. Peer support has been my goal and is now a blessed reality. 

Working at OSH is more than a job or title for me. By working at OSH, I have the honored opportunity to offer a safe trusted space of no judgement. I get the chance to support people in seeing themselves in an empowered light, where we are often made to feel a number or a label being pushed through statistics.

I am a peer support to extend the hope and courage that gives a sense visibility and voice to individuals who, much like my father, were seen for what they may have done rather than the roots of why.

We are people supporting people. We are equal.

What do you think the patient experience at OSH would be like if there was not a peer support program?  

With peer support offering a connection based off one's similar shared lived experiences, I do believe the experience of our residents at OSH would be extremely different without our peer supports here. Having things to look forward to that may offer a sense of “normalcy" while between appointments, meetings, and treatment plans are so very important. While many may see a side of fries or someone's favorite song as “small," these are the things we have instant access to outside of these walls. These “small" things are quite magnificent, as they are things that connect our peers in here to gentle reminders and joys of what they still have outside these walls. They also serve as a connector between one another. One second, we are playing cards, the next we are exchanging conversation of what things bring us joy in moments of pain and how we hold onto them. 

I am here today due to a collection of “small" considerations people made for me in times of need.

​Did you have access to a peer support specialist during your own journey? If yes, how was it beneficial? If no, how do you think it could have benefitted you? 

I did not have a peer support during my journey, though I want to acknowledge I did have the immense support of my family which I know is not something many folks have. If I picture myself having had peer support, I may have felt less alone in the dark experiences and paranoid cycles I was living in. As someone who fell rebellious and distrusting to authority and clinicians while in the deepest parts of my illness, someone who had walked my similar walk and talked my similar talk would offered a different journey for myself. A quicker road to healing? Possibly. I stand thankful today though, for had my story been written any differently I may not be in the position I am being welcomed in to offer support to so many wonderful individuals. 

What do you find difficult or challenging about your work as a peer support specialist?  

For me the most difficult part of peer support runs beyond these walls, but into the crevices of society. I cannot watch TV or walk into a store without noticing someone struggling and thinking about what they were experiencing at five, six, 10 years old. I also cannot help but notice others who are noticing them and wanting to advocate against their judgement. In a way it's beautiful, I am no longer angry and resentful to society. Seeing these things though serves as motivation to always only extend kind and safe intent. We never know what someone is living through, even with a sharp-dressed smile. And those who cast judgements have their own stories to tell. 

What do you find rewarding about it?  

Peer support is rewarding in so many ways. Honestly though, the fact alone that someone can look at me and think “Hey, she seems safe and cool to talk to," is already rewarding. Having the opportunity to live up to that, to support someone's trust being built again or assist in establishing a sense of self confidence that will take them through the many waves of this life is an honor. I don't think too many people understand how meaningful and special it is so have someone see you as a place of comfort when everything around them feels as if it is seemingly crumbling. I think of the people who were my safe spots when I didn't know what reality to believe. They may not remember me, but they are imprinted in my experience.

I cannot build the house, but I can absolutely show someone the blueprints.

Is there anything you think people would find surprising about the work you do?  

The greatest surprise when people learn of my job is the fact that we offer a peer support program and what it consists of. For some it is such an unfamiliar concept, which while this too saddens me it also serves as a motivator to extend peer support as far as clinical support reaches, in all spaces possible. Whether or not my peers and I see it in the nearest future, we know our connections and experiences together are not only contributing to their recovery, but it is paving the way for those who follow behind us. May their road be paved even smoother and with a solid foundation, a greater understanding of what it is that we do.

How did you become a peer support specialist – was it training through a nonprofit? OHA training? Was it easy to find this training? 

I obtained my peer support training locally through a nonprofit. The training was easy to find, and there are scholarships often available for those who find themselves wanting to become a peer support but may only be held back due to money. There are resources, and there should be no shame in accepting them!

Any advice you would give someone who is interested in becoming a peer support specialist?  

Please show up in honesty. There will be times you will have to tell someone you are not capable of something, or you may find yourself unsure at times of what to say or do. Hey, that's part of it. Sometimes, the most trusted foundations are built on our ability to show someone we are able to admit where we are powerless, offer explanation, and speak on what it is we CAN do, or we DO know.

I have found trust is not built based on the amount of things we are capable of, but how we follow through with the things in which we are capable. The safe follow through that we bring is what is instilling courage, strength, and hope within our peers.

You are worthy. You are needed. You are wanted.

Interested in becoming a peer support specialist?

Oregon Health Authority offers certification for people interested in becoming a peer support specialist. Learn more on OHA's Peer Support Specialist webpage.