Behavioral Health Service Utilization for Users of Peer Support Services Versus Matched Controls

Certified Peer Specialists provide optional peer support services (PSS) to individuals with mental health disorders. In this effectiveness study, we describe changes in behavioral health service utilization in Medicaid-enrolled adults receiving PSS compared to propensity-score matched controls. Individuals receiving PSS (n = 2,156) in 2021-2024 were successfully matched 1:2 to individuals receiving outpatient mental health services without PSS (comparison; n = 4,312). Service rates were compared between groups over time (90 days before, during, and 90 days following the PSS or outpatient episode of care. Rates of services were higher for PSS; utilization for the majority of services declined over time. PSS versus the Comparison was associated with a steeper decline in psychiatric hospitalization, β = -.0190, t(2,932) = -2.61, p = .0090, and crisis service, β = -.0269, t(2,932) = -3.49, p = .0005 following discharge from the episode of care. PSS may successfully maintain recovery-oriented care through diversion from psychiatric hospitalization and increase community tenure resulting in a utilization pattern that is not observed with outpatient mental health service alone.