A primary component of advocacy is linking clients with community resources that can assist in supporting the recovery process. Peer specialists can also help to identify resources that their employer agencies can include in partnership relationships to assist with a host of health, employment, financial, education, and other client needs.
Clients often have numerous social needs. Many are unemployed or under-employed, lacking job skills or work experience. Many do not have a high school diploma. Some are homeless, and those who have been incarcerated may face significant barriers in accessing safe and affordable housing. Many have alienated their families and friends or exhausted the capacity of these individuals to provide care and support. The peer specialist works to coordinate these many facets of care to assure that clients have the resources they need to support a successful life in recovery.
For some agencies and organizations, official formal referrals for services must be made. In these instances, the peer specialist may help the client request such a referral or may recommend to the treatment team that a referral for a specific service might be helpful. The counselor or case manager may actually complete the formal referral.
In other cases, the process is less formal and structured and is known as “resource linkage.” Linkage is more focused on providing information about services and how they can be obtained, whereas referral can involve engagement in specific, structured services where responsibility for client well-being is transferred or shared between agencies. Consider the following examples of each type of linkage.
Referral: Maricella is a client at the community addiction treatment agency. She is attending vocational classes that the agency also provides but is struggling to learn the material. The treatment team determines that Maricella needs to have an assessment for learning disabilities but your agency does not have a qualified professional for these services. Maricella’s Case Manager makes an appointment with a local psychologist and her peer specialist, Carmen, is tasked with taking her to the appointment.
Linkage: Dwayne is in a recovery support program and seems to be doing fairly well. Greg is Dwayne’s peer specialist. Greg notices that Dwayne is taking more snacks than usual at the recovery support groups lately. After a brief conversation, Dwayne tells Greg that he is in between jobs and does not have enough money for food. Greg shares information about two local food pantries where Dwayne can obtain food and offers to take him to one the next morning.
A peer support specialist should consider making a resource linkage or facilitating a referral when:
- they do not know how to help the client,
- the person’s needs can be best met elsewhere, and
- they feel judgmental or unable to be objective in a particular situation.
Dimensions for Resource Linkage
As you will recall from Module 2, SAMHSA has delineated four major dimensions that support a life in recovery. Peer specialists may be called on to make linkages for each of these domains:
- Health—overcoming or managing one’s disease(s) or symptoms—for example, abstaining from use of alcohol, illicit drugs, and non-prescribed medications if one has an addiction problem—and, for everyone in recovery, making informed, healthy choices that support physical and emotional well-being
- Home—having a stable and safe place to live
- Purpose—conducting meaningful daily activities, such as a job, school volunteerism, family caretaking, or creative endeavors, and the independence, income, and resources to participate in society
- Community—having relationships and social networks that provide support, friendship, love, and hope
Video: Community Advocates – Housing Inspires Hope (6:11 minutes)
In order to make effective linkages in each of the dimensions listed above, peer specialists should have the following knowledge and skills:
- understanding the range of relevant supports and services available in their community or region and understanding potential barriers to accessing community resources
- learning more about mental health, substance abuse and human rights laws in their state
- collaborating with community support resources and traditional care services
- how to explore options for services or resources with the client in a way that fosters empowerment
- interacting with other care and support providers in a manner that promotes partnership and teamwork
- resolving conflicts or differences of opinion when they may occur
Consent for Referral and Resource Linkage
One of the principles of client-centered services is that all of the choices belong to the client. The client may choose to participate or not participate in services and may select the providers from which s/he will receive services. In communities and service systems where there are multiple providers of services, the choice may be among providers, while in some communities there may be fewer options. Consenting to a service referral should never be used as a condition of receiving other needed services, unless failure to do so would put the client, the staff or other clients at risk (such as treatment for infectious disease).
Clients have the right to informed consent about the services they will receive and they have the right to privacy of their confidential health information. In order to make a formal referral from one agency to another, staff must obtain written consent from the client to make the referral and to release any confidential information required as part of the referral process. This release is a legal requirement under both federal law and most state statutes pertaining to behavioral health services.
When peer specialists are providing resource linkages – identifying appropriate community supports that the client may seek on their own or with the assistance of the peer support specialist – generally a written consent form is not required. However, the client may be asked to sign a “consent to services” form once they complete the linkage.