Beyond the Medical Model with Neesa

Beyond the Medical Model with Neesa

A Column by Neesa Sunar, Peer Specialist, Transitional Services for New York, Inc.

The Vital Profession of the Peer Specialist

For the past couple of years, I have been employed as a “peer specialist.” A peer specialist is a mental health professional who has personal lived experience with mental illness. Because peers have suffered themselves, they are able to understand and empathize with the people they work with. This type of experience cannot be learned in university. Thus, peers have expertise that doctors and social workers do not.

I learned about the peer profession when I was in a psychiatric day program in 2012. Once I heard about it, I wanted to work as a peer myself. I applied to the peer specialist training program at Howie the Harp Advocacy Center (HTH) and was accepted. I attended classes at HTH five days a week for twenty weeks, totaling to 500 classroom hours. A 12-week internship followed.

Howie the Harp Advocacy Center is named after one of the first pioneers of the peer movement. Howard Geld was psychiatrically hospitalized as a teenager in the late 60s. At seventeen, he left New York and relocated to the west coast, where he became involved in the Insane Liberation Front. During his life, he was involved in mental health advocacy efforts on the east and west coasts. He earned his moniker of “Howie the Harp” because he was a street performer on the harmonica. In 1993, he became the Director of Advocacy for Community Access. He garnered funds to start a peer specialist training center, slated to open in 1995. Unfortunately, he passed away two weeks before the school opened. The school was named after him in his honor.

While at Howie, I learned about the Recovery Model, which is in stark contrast to the Medical Model. Typically, when one is physically ill, s/he will go to the doctor. The doctor prescribes a medication, and treatment is determined successful when the person’s symptoms are eradicated. Yet with mental health, absence of symptoms is not enough. Side effects can make the “cure” as bad as the mental illness.

The Recovery Model goes beyond this. Everyone is entitled to living a fulfilling life. People should be encouraged and supported to reach for complete wellness, no matter how “severe” their condition may seem. They do not have to submit to the limited expectations that standard providers have. In the past, I held jobs where I hid my diagnosis, only causing additional stress. Now as a peer, I can use my experiences as a strength which can help others. No longer do I feel “broken” and a “danger to society.” Instead, I have developed a sense of empowered pride. I have risen from the ashes of profound disability.

About two years ago, I began working full-time at Transitional Services for New York, Inc. We offer apartments in the community, as well as active case management services. Whenever I meet a new client, I immediately disclose myself.

“Hi, I’m Neesa! I am a peer specialist. Do you know what a peer is?”

Oftentimes, the client does not know. Thus I explain:

“A peer is a person who has mental illness themselves. I myself am diagnosed with schizoaffective disorder. I’ve been hospitalized seven times. I have been on disability since 2011. I know how this system can wear you down, trying to juggle public assistance and Medicaid and psychiatrists…I’ve lived it. I’m here so that I can relate to you. I know where you’re coming from.”

At this point, I always feel like this invisible wall melts between me and the client. My hope is always to strike a chord within the person, wherein s/he can feel safe and open. The greatest fulfillment I experience as a peer is developing that one-on-one relationship with the client. In this therapeutic partnership, I encourage them to determine their own path towards wellness instead of dictating to them how “I think how it should go.”

The peer movement specifically strives to create awareness about mental illness akin to a civil rights movement. So often, psychiatric clients are stripped of their rights, whether it be in institutions or with an outpatient psychiatrist. People are forced into treatments they don’t want for themselves, intimidated by doctors. And then there is also stigma, that pervasive societal attitude that discriminates against those who have a diagnosis.

My hope is that there soon will be widespread awareness about peer specialists. We are able to reach clients in ways that doctors and therapists cannot. We are able to stand as examples of recovery, and we inspire one another to reach higher and further than the negative prognoses from our providers. The work of peers is the future, and we must create awareness to make this happen.