People Do Not Live in Service Silos, But Our Differences Still Matter

Recovery Walk, Rock Hill, South Carolina, September 27, 2024.

On September 27, 2024, we walked together in Rock Hill, South Carolina, to celebrate recovery.

Two years later, I look at these pictures differently.

I know more of the stories that came after the walk.

People I love who walked with us have returned to use.

People I love have returned to recovery.

Some have continued moving forward in recovery while navigating mental health, trauma, family challenges, housing, relationships, employment, and everything else that comes with being a human being.

And some people I have loved have lost their lives after a lifelong battle with substance use disorder.

Their absence matters.

In 2024, 79,384 people in the United States died from a drug overdose. The overdose death rate declined significantly from the year before, and that progress deserves to be recognized.

But 79,384 people still died.

Every one of those empty chairs has a name.

Some of them were names that I knew.

After nine years of active substance misuse and now 22 years in recovery, I have known too many of those names. I have watched people find recovery, return to use, return to recovery, build families, rebuild lives, and sometimes lose their lives.

That history does not make me believe we need to abandon the recovery systems we have built.

It makes me believe we need to elevate the way we think about them.

As our understanding of recovery grows, our systems have to grow with it.

We have to become better at recognizing the whole person while protecting the value of the individual supports, specialties, pathways, and forms of lived experience that person may choose.

As our work and relationships have expanded across the Southeast, from Virginia to Florida and west through Kentucky, Tennessee, Alabama, and Mississippi, I keep coming back to two things that may sound contradictory, but I believe both have to be true.

People do not live in service silos.

And:

The individual pieces of lived experience still matter.

I Know This From More Than One Side

I have lived experience of human trafficking and exploitation.

I have lived experience of mental health challenges.

I have lived experience of substance use disorder and long term recovery.

I am also a family member of people whose lives include these experiences individually and in combination.

And that part of lived experience matters too.

I know what it feels like to be the child of parents with substance use disorder.

I know what it feels like to love people who are struggling with substance use disorder.

I have sat up at night crying over babies who would not be held by their parents.

I have been afraid to reach out to a friend because part of me was terrified that this would be the time I discovered they were no longer here to watch their children grow up.

And I have grieved people I loved who did not survive their lifelong battle with substance use disorder.

Those experiences do not make me an expert on every family, every survivor, or every person experiencing substance use disorder.

But they make it impossible for me to believe that recovery happens to one isolated individual.

Substance use disorder does touch children.

It does touch parents.

It does touch partners, friends, workplaces, and communities.

It does affect families.

So do mental health challenges, trauma, exploitation, and the systems people encounter while trying to recover.

Fear can move through families.

Grief can move through families.

Trauma can move through families.

But so can hope.

So can healing.

So can recovery.

The Numbers Tell Us People Do Not Fit Into One Box

My own experience is personal. It should not be used to generalize everyone else’s experience.

But national data make it clear that overlapping needs are not unusual.

In 2024, 46.3 million American adults had a substance use disorder. Of those adults, 21.2 million also had a mental illness.

That is 45.8 percent.

Among adults experiencing both a substance use disorder and mental illness, only 14.5 percent received both substance use treatment and mental health treatment that year. More than 41 percent received neither.

Those numbers do not tell us why.

Availability, cost, workforce capacity, geography, readiness, eligibility, personal choice, stigma, and many other factors can affect whether someone receives services.

But they should cause us to ask:

What happens in the spaces between our systems?

Trauma complicates that picture further.

CDC research using data from adults across all 50 states and Washington, D.C., found that 63.9 percent reported at least one adverse childhood experience. More than one in six reported four or more.

Human trafficking can add still another layer. Research has documented relationships among trafficking, substance use, coercion, trauma, and mental health. Substance use may exist before exploitation, develop during it, be used as a means of coercion or control, or become connected to how someone copes with what has happened to them.

People do not arrive at our doors divided into our funding categories.

They arrive as whole people.

Recovery happens in communities, not in silos. Building bridges between specialized supports gives people more choices about who walks beside them.

Whole Person Cannot Become Generic Person

This is where I believe we need to be extremely careful.

Recognizing that people’s experiences overlap does not mean those experiences are interchangeable.

And it certainly does not mean our services should become interchangeable.

As systems increasingly recognize co occurring needs and fund integrated approaches, we cannot allow integration to become erasure.

The lived experience of recovering from substance use disorder has value.

The lived experience of navigating mental health recovery has value.

The lived experience of surviving trafficking and exploitation has value.

The lived experience of homelessness has value.

The lived experience of justice involvement has value.

The lived experience of being a family member has value.

The lived experience of being a child affected by a parent’s substance use disorder has value.

Sometimes several of those experiences exist within the same person.

They do within me.

But having one form of lived experience does not automatically give someone expertise in another.

Being a person in recovery is not the same lived experience as being the child of a parent with substance use disorder.

Being a family member is not the same lived experience as surviving exploitation.

Surviving trafficking is not the same lived experience as navigating a mental health condition.

We should not have to erase those distinctions in order to recognize the whole person.

In fact, recognizing those distinctions may be part of what allows us to truly see them.

If we say lived experience is valuable, then we have to be willing to ask:

Which lived experience does this person want beside them right now?

A person navigating substance use recovery may find tremendous value in connecting with someone who understands that experience from the inside.

A survivor of trafficking may want someone who understands exploitation.

A person navigating mental health recovery may value someone who has walked a similar road.

A parent, spouse, or child may need another family member who understands the complicated experience of loving someone while also learning how to care for themselves.

Those forms of support can complement one another without becoming interchangeable.

That is not fragmentation.

That is choice.

Funding Should Build Bridges, Not Collapse Them

This is where systems and funding decisions become incredibly important.

Funding helps determine which services exist, which positions organizations can hire, which credentials are recognized, and which types of lived experience remain available to people seeking support.

Efficiency matters.

Coordination matters.

Responsible stewardship matters.

But efficiency cannot be the only measure.

If combining services saves money while eliminating meaningful choices, we need to ask what was actually saved.

If one broadly defined peer role replaces access to several distinct forms of lived experience, we need to ask what disappeared in the process.

And if we create an integrated system that offers a person fewer choices about who walks beside them, we should be willing to ask whether we actually created a more person centered system.

The alternative is not returning to isolated silos.

It is building bridges.

A substance use peer can recognize that trauma may be part of someone’s story without becoming a trauma therapist.

A mental health peer can recognize the role substance use may play in someone’s life without becoming a substance use specialist.

Someone supporting survivors of trafficking can understand the relationship that may exist between exploitation and substance use without assuming every survivor has the same experience.

A housing professional can understand that stable housing may be essential to recovery without becoming someone’s recovery provider.

A clinician can bring clinical expertise.

A family peer can bring family lived experience.

Each person brings something different to the table.

The table becomes stronger because those differences remain.

We should know enough about one another’s work to be able to say:

There is someone else who may have something valuable to bring to this table. Would you like us to bring them in?

Not instead of me.

With me.

And, importantly, only if the person wants them there.

That is where whole person support and person centered support meet.

The Person Has to Remain at the Center

We can build a beautifully coordinated system and still get this wrong if we forget whose recovery it is.

Someone may need housing before they are ready to address trauma.

Someone may want to rebuild a relationship with their children.

Someone may choose medication as part of recovery.

Someone may want a particular kind of peer support.

Someone may want several kinds.

Someone may decline a service that everyone around the table believes would help.

Person centered recovery has to leave room for that too.

Otherwise, we have simply built a more sophisticated system for making decisions about people instead of with them.

There is another number I want us to remember.

In 2024, 23.5 million American adults who reported ever having a problem with alcohol or drug use considered themselves in recovery or recovered.

Millions of people are recovering.

People return to recovery.

Families recover.

People build lives they once could not imagine.

I am one of them.

Looking Back at the Walk

So when I look back at September 27, 2024, I think about much more than a Recovery Walk.

I think about the people in those pictures.

I think about the people I love who returned to use.

I think about the people who returned to recovery.

I think about the people who are still figuring out what recovery looks like for them.

I think about children growing up affected by the substance use of people they love.

I think about families waiting for phone calls.

I think about the people who will not be there for the next walk.

I think about their families.

I think about my own family.

I think about my own life.

The people we have lost did not live in service silos.

Neither do the people who are recovering today.

They are whole people.

Seeing someone as a whole person does not require us to pretend that the individual pieces of their story do not matter.

They do.

So as our relationships continue to grow across the Southeast, I do not want us to choose between isolated services and one collapsed recovery system.

I want something harder.

I want connected systems that preserve specialization.

I want peers valued for the specific lived experience they bring.

I want professionals respected for the expertise they have developed.

I want organizations confident enough in what they do well to also recognize when someone else needs to come to the table.

I want funding that makes collaboration possible without requiring everyone to become the same thing.

And most importantly, I want the person seeking recovery support to have meaningful choices about who walks beside them.

People do not live in service silos.

But that does not mean every service should become the same service.

A bridge connects two things.

It does not require either of them to disappear.

Maybe that is what I hope we are walking toward.

Read the Research and Data

SAMHSA: 2024 National Survey on Drug Use and Health

National data on substance use disorder, mental illness, co occurring conditions, treatment, and recovery.

Read the 2024 National Survey on Drug Use and Health

SAMHSA: Co Occurring Disorders

Information about the intersection of mental health conditions and substance use disorders.

Read about co occurring disorders from SAMHSA

CDC National Center for Health Statistics: Drug Overdose Deaths in the United States, 2023 to 2024

Final national overdose mortality data, including the decline in the overdose death rate during 2024.

Read the CDC overdose mortality report

CDC: Prevalence of Adverse Childhood Experiences Among U.S. Adults

Research examining adverse childhood experiences using data collected across all 50 states and Washington, D.C.

Read the CDC research on adverse childhood experiences

Substance Use and Trauma Bonding Among Survivors of Sex Trafficking

Research examining relationships among substance use, coercion, trauma bonding, and sex trafficking.

Read the trafficking and substance use research on PubMed

Substance Use Disorders Among Human Trafficking Victims

Research examining substance use disorders among human trafficking survivors receiving emergency department care.

Read the study on PubMed

The Economic Value of a Community That Fully Utilizes Lived Experience

People with lived experience should not be viewed only as recipients of services.

They are employees, neighbors, parents, business owners, trainers, volunteers, advocates and community leaders. And when their experience is intentionally incorporated into the systems a community uses to help people become and remain stable, lived experience can become an economic asset as well as a human one.

That distinction matters.

The argument for peer support is sometimes framed primarily around representation: people with lived experience deserve a seat at the table.

They do.

But communities should also be asking another question:

What happens when we fully utilize the peer-support network already available to us?

Caption: Community connection at the 2026 Pathways Community Luncheon in Rock Hill, South Carolina. Photo courtesy of Visions by Vanessa.

Peer Support as Community Infrastructure

A community may have hospitals, behavioral-health providers, treatment programs, housing organizations, food resources, benefits programs, workforce services, nonprofits, faith communities and government agencies.

Having those resources does not necessarily mean people successfully move between them.

There is an important space between:

“Here is the resource you need.”

and

“I connected with it, received what I needed, and became more stable.”

People fall through that space every day.

Peer support can help strengthen the net underneath it.

Peers don’t replace clinicians, social workers, case managers, housing professionals or other community providers. Their value is different. They can help people navigate systems, understand options, overcome barriers, maintain engagement and make the transition from one part of the service system to another.

When that happens effectively, the impact can extend well beyond a peer-support program.

The Economic Impact Is Measurable

Research is beginning to demonstrate what that can look like.

In one study of a community-based peer-support program serving Medicaid members in Detroit, researchers compared 738 peer-support recipients with 738 matched individuals. Healthcare costs among peer-support recipients were approximately $115 lower per member per month. Participants also demonstrated better retention in their health plan and improvement in a measure of access to preventive and ambulatory healthcare.

In another study, researchers examined a peer-staffed crisis respite program as an alternative to psychiatric hospitalization. During the first year, participants averaged 2.9 fewer hospitalizations, while Medicaid expenditures averaged approximately $2,138 less per enrolled month than researchers estimated would have occurred without the intervention.

Research involving peer recovery coaches in emergency departments has also found reductions in repeat emergency-department utilization among some populations—particularly people who had already been cycling repeatedly through emergency care.

That matters economically because a crisis rarely produces a cost in only one system.

A hospitalization can mean missed work.

Missed work can mean lost income.

Lost income can threaten transportation, food security, childcare and housing.

An interrupted treatment connection can contribute to another crisis.

Another crisis can mean another ambulance, another emergency-department visit, another hospitalization or another interaction with an already strained community system.

The cost of instability compounds.

The Goal Isn’t Simply to Use Fewer Services

There is an important caution in the research.

Not every peer-support program has reduced overall healthcare spending or emergency utilization.

And that shouldn’t necessarily be the only goal.

In one study of recovery coaching, hospitalization and emergency-department use decreased while outpatient healthcare utilization increased substantially.

That can be a positive outcome.

Someone who begins attending primary-care appointments, accessing behavioral-health treatment, filling prescriptions or receiving preventive care may actually use more services in the short term.

But they may be using the right services earlier, rather than waiting until another crisis requires the most expensive level of care.

So perhaps the economic question shouldn’t simply be:

Did peer support make services cheaper?

We should also ask:

Did someone get connected earlier?

Did they remain engaged?

Was an interruption addressed before it became a crisis?

Did someone successfully move from one service to the next?

Did they have support while rebuilding the stability necessary to work, maintain housing and participate in their community?

And did we prevent people from disappearing into the gaps between otherwise good programs?

This Is Why Collaboration Matters

Caption: Community organizations, leaders and partners gathered for the 2026 Pathways Community Luncheon in Rock Hill. Photo courtesy of Visions by Vanessa.

I thought about this recently while attending the 2026 Pathways Community Luncheon in Rock Hill, South Carolina—not only as the founder of Bring Freedom, but as a member of the Pathways Board.

Pathways brings multiple community organizations and resources together in one location.

That matters because people’s lives don’t divide themselves according to our organizational charts.

A behavioral-health challenge can affect employment.

Employment affects income.

Income affects housing.

Housing affects health.

Transportation can determine whether someone gets to an appointment.

A missed appointment can interrupt treatment.

And one interruption can begin another cycle of instability.

Strong communities therefore need excellent individual services.

But they also need strong connections between those services.

Fully Utilizing the Peer Network

This is where I believe communities have an opportunity.

The goal should not simply be to create a few peer-support positions and consider the work finished.

Imagine instead a community in which its peer-support network is intentionally connected across behavioral health, substance-use recovery, hospitals, housing, homelessness response, workforce development, reentry, family services and community organizations.

A hospital discharge doesn’t simply end with a piece of paper containing a phone number.

A referral doesn’t end when it is entered into a database.

A person doesn’t become someone else’s responsibility simply because they crossed an organizational boundary.

Peers can become part of the connective tissue between those systems.

That doesn’t mean promising that peer support will eliminate every hospitalization, prevent every crisis or save money in every program.

The research doesn’t support those claims.

It means recognizing something much more practical:

Fragmentation is expensive.

And when trained people with lived experience can help individuals navigate that fragmentation, maintain connection and move toward stabilization, communities should be measuring the value created—not simply the cost of employing the peer.

Lived Experience Belongs Upstream, Too

Fully utilizing lived experience also means looking beyond direct peer services.

People with lived experience belong on advisory councils, committees and boards.

They belong in program development, quality improvement, workforce development, training and community planning.

Their stories matter.

But their value does not end with their stories.

Sometimes the person who can show us where the safety net has a hole is someone who once fell through it.

Sometimes that person eventually becomes the peer helping someone else navigate it.

Sometimes they become the employee designing a better process.

Sometimes they become the trainer teaching organizations what they have learned.

And sometimes they become the board member helping determine what happens next.

That is why investment in lived experience is bigger than representation.

A fully utilized peer-support network is an investment in a community’s capacity to connect people earlier, reduce fragmentation, support stabilization and make better use of the resources that community is already paying for.

The question isn’t simply what it costs to employ peers.

We also need to start measuring what fragmentation costs us when we don’t.

Caption: Zona Garrett, Bring Freedom founder and Pathways Community Center board member, at the 2026 Pathways Community Luncheon.

References available.

What Comes After the Uncomfortable Part?

Recently, I was leading a group for a local drug court. We were working toward something that can be surprisingly difficult when you're rebuilding your life: dreaming about the future.

But before we could really talk about what people wanted their lives to look like, we had to talk about the things that made those possibilities feel out of reach.

One participant shared a very real worry about having a felony on their record. Even if they were eventually eligible for expungement, they worried that it could still show up on some background checks.

What happens when an employer asks about it?

What about an eviction you have to explain to a future landlord?

What do you say about the gaps in your work history?

These weren't excuses. They were uncomfortable realities.

And I didn't want to tell them those things wouldn't matter, because sometimes they will.

Instead, I asked the group a question.

"Where do you think is the most unlikely place you would find a felon?"

They started thinking about it.

Then I told them: the White House.

That got their attention.

The current president has a felony conviction.

I wasn't bringing politics into the room to debate politics. I wanted them to challenge an assumption.

So I asked another question:

"If someone with a felony conviction can become president of the United States, have you stopped to think about what you might still be able to do?"

The point wasn't that a felony doesn't create barriers.

It can.

The point was that we sometimes decide what the barrier means before we ever get to it.

We imagine the background check, the interview, the housing application or the uncomfortable question—and then build our lives around avoiding that moment.

But what if instead of asking, "How do I make sure I never have to face this?" we asked, "What skills do I need so that I'm prepared when I do?"

That's where coping skills become incredibly practical.

If I know someone may ask about the gap in my employment history, I can practice my response.

If I know talking about my conviction makes me anxious, I can decide ahead of time how I will ground myself before an interview.

If I'm applying for housing after an eviction, I can gather documentation, practice explaining what happened and identify someone I can call afterward if the conversation doesn't go the way I hoped.

If rejection is something I struggle with, I can make a plan for rejection before I ever submit the application.

Coping doesn't mean pretending the uncomfortable situation isn't coming.

Sometimes coping means deciding what you're going to do when it gets here.

And while I was having this conversation with the group, I was thinking about something I have come to understand through my own recovery.

This Recovery Month, I have 22 years.

For so many of the beginning years, I remember feeling like I was a completely different person every year.

I couldn't have told you who I would be 22 years later.

I couldn't see this entire journey.

I didn't need to.

I needed to deal with what was directly in front of me.

That's one of the things I love about people who have fought for their recovery.

There is a particular kind of confidence that can develop when you've had to learn how to take the next step without knowing exactly where the entire road leads.

Not confidence that says:

"Nothing bad is going to happen."

Not even:

"I know this is going to work."

It's something closer to:

"I've handled the step in front of me before. I can figure out what to do with this one."

And that is what I wanted the people sitting in that room to recognize about themselves.

They didn't need to know how they would handle every background check for the rest of their lives.

We could prepare for the next one.

They didn't have to solve every possible housing barrier.

We could talk about how to approach the next application.

They didn't have to know what their careers would look like ten years from now.

They could decide what opportunity they were willing to pursue next.

And maybe that's where dreaming and coping skills meet.

Dreaming gives us something on the other side of the uncomfortable thing that is worth reaching for.

Coping skills help us get through the uncomfortable thing when we reach it.

Recovery has taught me that we don't always need to see the whole journey.

Sometimes we just need to stop letting the possibility of an uncomfortable moment convince us not to take the next step.

Recovery is Economic Development : A Recovery Month Perspective on the Value of Behavioral Health Peer Support

September marks Recovery Month a time when we celebrate the millions of people living in recovery and recognize the families, communities, professionals, and systems that help make recovery possible.

As we begin Recovery Month, I want to ask a different question.

We spend a great deal of time calculating what mental-health and substance-use challenges cost our communities.

What do our communities gain when people recover?

A person who achieves greater stability does not simply disappear from a healthcare expenditure column. They may return to work or remain employed. Maintain housing. Continue their education. Support their children. Purchase goods and services. Pay taxes. Volunteer. Start a business. Become a caregiver—or even use their lived experience to become a trained peer support professional helping someone else find their own path forward.

Recovery doesn't only change individual lives.

Recovery can restore economic capacity to families and communities.

On the first day of Recovery Month, that deserves to be part of our conversation.

Recovery Is More Common Than Many People Realize

Behavioral-health challenges touch a substantial portion of the American population. So does recovery.

According to the Substance Abuse and Mental Health Services Administration's 2024 National Survey on Drug Use and Health, approximately 23.5 million U.S. adults considered themselves in recovery or recovered from an alcohol or drug problem.

Approximately 45 million adults considered themselves in recovery or recovered from a mental-health problem.

Those populations overlap, so they should not simply be added together. But they illustrate something important:

Recovery is not a marginal experience in the American economy.

People in recovery are workers, parents, caregivers, consumers, students, taxpayers, entrepreneurs, professionals, volunteers, and community leaders.

That means recovery has implications extending far beyond the behavioral-health system.

The South Carolina Opportunity

SAMHSA's state-level estimates demonstrate that South Carolina has a substantial population experiencing mental-health conditions, substance-use disorders, or both.

That matters economically.

Behavioral-health instability can intersect with employment, housing, healthcare utilization, food security, education, family stability, and criminal-justice involvement.

But it would be a mistake to look at people experiencing these challenges primarily as costs to public systems.

The more important economic-development question is:

What human and economic capacity is suppressed when people cannot achieve stability—and what becomes possible when they can?

That's where recovery changes the equation.

Where Peer Support Fits

Peer support professionals are trained and credentialed behavioral-health workers whose lived experience of mental-health recovery, substance-use recovery, or both is an essential component of their professional role.

Their expertise is distinct from that of licensed clinicians, case managers, or other behavioral-health professionals.

Depending on the setting and role, peer professionals may help people engage with services, navigate complicated systems, identify recovery goals, strengthen recovery capital, build community connections, develop self-advocacy skills, and sustain hope during periods when progress can feel impossible.

Peer support is also no longer simply an informal addition to behavioral healthcare.

SAMHSA reports that approximately 4.1 million U.S. adults received services from a peer support specialist or recovery coach for mental-health purposes in 2024 alone.

Peer professionals are increasingly part of the behavioral-health workforce.

That makes investment in the quality and sustainability of this workforce important—not only to behavioral-health systems, but to communities.

What Does the Research Tell Us?

Research on peer support continues to develop.

Systematic reviews have found evidence of improvements in outcomes such as personal recovery, clinical recovery, self-efficacy, engagement, and other recovery-related measures. Results vary by intervention, population, and study design, and not every measured outcome demonstrates a significant effect.

The economic evidence specific to peer support is even newer.

A systematic review examining the peer recovery workforce and economic evaluation of peer recovery support services found evidence useful for evaluating healthcare and service utilization, but researchers also identified substantial gaps in the economic literature.

That distinction is important.

We should not claim that every dollar invested in peer support automatically produces a predetermined financial return.

We also shouldn't take the well-known economic returns associated with addiction treatment generally and relabel them as the ROI of peer support.

The research does support a broader proposition:

Peer support is part of a recovery-oriented behavioral-health infrastructure, and successful behavioral-health recovery and stability can produce outcomes with significant economic consequences.

Stability Has Economic Value

Consider what can change when behavioral-health stability improves.

A person may become better positioned to remain employed.

Someone repeatedly cycling through crisis services may become more consistently connected to community-based support.

A person returning from incarceration may have additional assistance navigating recovery, employment, housing, and community reintegration.

Someone experiencing housing instability may become better positioned to maintain housing.

A parent may become more capable of creating stability for their family.

None of those outcomes belongs exclusively to peer support.

Behavioral-health recovery is supported by an ecosystem that can include treatment, medication, healthcare, housing, employment, transportation, families, community organizations, peer services, and many other resources.

But the economic consequences of successful stabilization are real.

Employment Changes Both Sides of the Equation

Employment provides one of the clearest examples.

Suppose improved behavioral-health stability allows someone to obtain or maintain a job earning $30,000 annually.

That $30,000 isn't simply a potential reduction in public spending.

It is $30,000 in household economic capacity.

Those earnings can pay rent or a mortgage, utilities, transportation, groceries, childcare, and other household expenses.

They create consumer spending.

They generate payroll taxes and potentially state income-tax revenue.

And they represent labor and talent participating in the economy.

Now imagine that outcome occurring across a community.

Thirty people earning $30,000 annually represent:

$900,000 in household earnings each year.

This is why relatively small improvements in behavioral-health stability can become economically significant at scale.

Instability Is Already Expensive

There is another side of the economic equation: communities already absorb significant costs associated with instability.

Consider incarceration.

The South Carolina Department of Corrections reported a FY2025 state-funded annual cost of approximately $34,673 per incarcerated person.

That does not mean preventing one incarceration immediately returns $34,673 to the state treasury. Correctional systems have substantial fixed expenses.

But the figure demonstrates the magnitude of public resources associated with incarceration.

Mental-health crisis care provides another example.

South Carolina Medicaid established reimbursement of $800 per member per day for acute stays in stand-alone inpatient psychiatric hospitals.

A seven-day acute psychiatric hospitalization therefore represents approximately $5,600 in Medicaid reimbursement.

That doesn't mean hospitalization is inherently negative. Appropriate psychiatric hospitalization can be necessary and lifesaving.

The economic concern is repeated crisis cycling that might potentially be reduced when people have access to effective treatment, community support, housing, recovery resources, and other stabilizing services.

Behavioral-health instability can touch multiple expensive systems simultaneously:

Healthcare.

Emergency response.

Hospitals.

Homelessness services.

Courts.

Corrections.

Communities are already investing enormous resources in behavioral health.

The question is where in the cycle we choose to invest those resources.

A Conservative South Carolina Thought Experiment

We don't have to assume dramatic outcomes to understand the potential economic significance of greater behavioral-health stability.

Consider a hypothetical population of 1,000 South Carolinians experiencing mental-health and/or substance-use challenges.

Suppose just 3%—30 people—obtain or maintain employment associated with improved stability and each earns $30,000 annually.

That represents:

$900,000 in annual household earnings.

Now suppose just 1%—10 people—avoid the equivalent of one year of incarceration.

Using South Carolina's FY2025 state-funded incarceration cost as a benchmark, that represents approximately:

$346,730 in gross public-cost equivalent.

Together, those two outcomes represent approximately:

$1.25 million in economic activity and public-cost-equivalent value.

And that deliberately excludes potential economic effects associated with healthcare utilization, housing stability, consumer spending, state income taxes, payroll taxes, sales taxes, food security, family stability, and intergenerational outcomes.

There is an important limitation:

This is not a claim that peer support independently creates $1.25 million in savings or economic activity.

It is a conservative scenario demonstrating the economic significance of relatively small changes in behavioral-health stability.

Peer support is one component of the larger infrastructure that can help people achieve and sustain that stability.

The Broader Recovery System Already Shows Economic Returns

The broader addiction-treatment literature helps demonstrate why recovery should be part of economic-development conversations.

The National Institute on Drug Abuse has reported conservative estimates suggesting that every dollar invested in addiction treatment can produce $4 to $7 in reductions in drug-related crime, criminal-justice costs, and theft.

When healthcare savings are included, total savings can exceed treatment costs by substantially more.

Those figures apply to addiction treatment generally—not peer support specifically.

That distinction matters.

But the research demonstrates something larger: successful intervention in substance-use disorders can create societal benefits extending beyond the treatment system, including workplace productivity and reduced public-system costs.

Other recovery-oriented interventions provide additional evidence.

Research examining recovery housing, for example, has identified improvements in economically significant outcomes including employment, income, abstinence, criminal charges, and, to a lesser extent, incarceration.

Again, recovery housing is not peer support.

Together, however, these findings demonstrate why recovery infrastructure should be viewed through an economic lens as well as a healthcare one.

The Peer Workforce Needs Investment Too

There is an irony in the way we sometimes build peer-support systems.

We ask people whose professional expertise includes their own lived experience of behavioral-health recovery to spend their careers helping other people navigate trauma, crisis, substance use, mental-health challenges, homelessness, family disruption, and complicated service systems.

Then we sometimes treat investment in that workforce as optional.

Research examining implementation of peer-support programs repeatedly identifies the importance of training, appropriate supervision, role clarity, organizational support, leadership, and recovery-oriented workplace cultures.

In other words:

Hiring peer professionals is not enough.

We need environments in which peer professionals can remain skilled, healthy, connected, and sustainable in their work.

Continuing education matters.

Quality supervision matters.

Professional connection matters.

Workforce resilience matters.

Opportunities for leadership and advancement matter.

And the wellbeing of the peer workforce matters.

If we want peer professionals to help other people sustain recovery, we also need to think seriously about what helps peer professionals sustain careers.

Recovery Is Human-Capital Development

Perhaps we need to change the question.

Instead of asking only:

How much does behavioral health cost our communities?

we should also ask:

What economic capacity becomes possible when more people can achieve and sustain recovery?

That reframes behavioral health from simply an expenditure to an investment in human capital.

The pathway is not perfectly linear, but it is increasingly clear:

Behavioral-health and peer-support infrastructure

→ engagement, connection, navigation, and recovery support

→ greater stability

→ stronger health, housing, recovery, and community participation

→ greater opportunity for employment and education

→ household income, consumer spending, and tax participation

while potentially reducing exposure to

→ hospitalization, homelessness, incarceration, and other high-cost crisis systems.

That isn't simply a behavioral-health conversation.

It is an economic-development conversation.

What We Need to Measure Next

Peer support should not be expected to solve every structural problem affecting people with mental-health and substance-use challenges.

Housing matters.

Healthcare matters.

Treatment matters.

Transportation matters.

Employment opportunities matter.

Families and communities matter.

Public policy matters.

Peer support belongs within that ecosystem.

And if we want to understand its full return on investment, our evaluation needs to become more sophisticated.

We should be asking:

Did people become more stable?

Did recovery capital increase?

Did people remain engaged in recovery?

Did housing stability improve?

Did employment or earned income change?

Did crisis-system utilization change?

Did justice-system involvement change?

And did the peer professionals themselves remain in the behavioral-health workforce?

Those measures can help us build a stronger evidence base for the economic value of peer support over time.

This Recovery Month, Let's Recognize What Recovery Gives Back

As Recovery Month begins, celebrating recovery should mean more than celebrating individual transformation.

We should recognize what recovery gives back.

Every person who becomes more stable carries possibilities that cannot be completely captured on a balance sheet: restored relationships, stronger families, creativity, leadership, community connection, purpose, and hope.

But there are economic consequences too.

Recovery can mean employment.

Income.

Housing.

Education.

Purchasing power.

Tax participation.

Reduced crisis-system involvement.

And another South Carolinian able to contribute more fully to the community around them.

Recovery is personal. Recovery is community. And recovery is economic development.

This Recovery Month, perhaps it's time we started investing—and measuring—as though all three are true.

Sources & Further Reading

Substance Abuse and Mental Health Services Administration (SAMHSA). 2024 National Survey on Drug Use and Health. National estimates regarding mental health, substance use, recovery, and peer-support services.
SAMHSA — 2024 National Survey on Drug Use and Health

Substance Abuse and Mental Health Services Administration (SAMHSA). 2023–2024 NSDUH State Estimates of Substance Use and Mental Health. State-level estimates for mental illness, substance-use disorder, and co-occurring conditions.
SAMHSA — State Estimates of Substance Use and Mental Health

Castedo de Martell, S., et al. What We Know About the Peer Workforce and Economic Evaluation for Peer Recovery Support Services: A Systematic Review. Review of the peer recovery workforce and evidence available for economic evaluation of peer recovery support services.
PubMed — Peer Recovery Support Economic Evaluation Review

White, S., et al. Systematic review and meta-analysis examining peer-support interventions and mental-health recovery outcomes.
National Library of Medicine — Mental Health Peer Support Review

Systematic Umbrella Review of Peer Support. Review examining effectiveness, implementation, and experiences of peer support in mental-health services, including workforce conditions such as training, supervision, leadership, and organizational support.
National Library of Medicine — Peer Support Umbrella Review

National Institute on Drug Abuse (NIDA). Principles of Drug Addiction Treatment: A Research-Based Guide. Evidence concerning the broader societal and economic benefits of effective addiction treatment. The treatment ROI figures cited in this article should not be interpreted as peer-support-specific ROI.
NIDA — Principles of Drug Addiction Treatment

Recovery Housing for Substance Use Disorder: A Systematic Review. Research examining recovery housing outcomes including abstinence, employment, income, criminal charges, and incarceration.
PubMed — Recovery Housing Systematic Review

South Carolina Department of Corrections. FY2025 system statistics, including annual state-funded and all-funds cost per incarcerated individual.
South Carolina Department of Corrections — System Statistics

South Carolina Department of Health and Human Services. Acute inpatient psychiatric hospital reimbursement methodology, including the $800 per-member-per-day Medicaid reimbursement benchmark referenced in this article.
SCDHHS — Inpatient Psychiatric Hospital Reimbursement

Bring Freedom | Recovery. Resilience. Community.

This article is intended to advance discussion about the economic implications of behavioral-health recovery and investment in the peer-support workforce. Economic scenarios presented are illustrative and should not be interpreted as causal estimates of savings produced solely by peer-support services.

Building Resilience After Trauma with the WRAP Program

Building Resilience After Trauma with the WRAP Program

Honoring World Day Against Trafficking in Persons

On this World Day Against Trafficking in Persons, we recognize the profound strength and resilience of survivors. At Carolina Peers, we are committed to supporting individuals on their journey to recovery and wellness. One of the most effective tools we offer is the Wellness Recovery Action Plan (WRAP), a powerful program that helps survivors of trauma rebuild their lives and develop lasting resilience.

Understanding Resilience

Resilience is the ability to adapt and recover from difficult life events. For survivors of human trafficking, building resilience is a crucial part of the healing process. It involves recognizing personal strengths, developing coping strategies, and creating a supportive network.

How WRAP Supports Resilience

The WRAP program, developed by Mary Ellen Copeland and a group of people with lived experience, is designed to help individuals take control of their wellness and recovery. Here’s how WRAP can support resilience after trauma:

1. Personalized Wellness Toolkit:

   • WRAP encourages participants to create a wellness toolkit filled with activities and resources that promote well-being. This can include practices like journaling, exercise, meditation, and connecting with supportive friends and family.

2. Daily Maintenance Plan:

   • Participants develop a daily plan to maintain their wellness. This includes identifying activities that help them feel their best and incorporating them into their daily routine.

3. Identifying Triggers:

   • Understanding what triggers stress and anxiety is crucial for managing these responses. WRAP helps individuals identify their triggers and develop strategies to mitigate their impact.

4. Early Warning Signs:

   • Recognizing early warning signs of distress allows for timely intervention. WRAP guides participants in identifying these signs and taking proactive steps to address them.

5. Crisis Plan:

   • In the event of a crisis, having a plan in place can provide a sense of control and stability. WRAP includes a crisis plan that outlines how to manage severe distress, including who to contact and what steps to take.

6. Post-Crisis Plan:

   • Recovery continues even after a crisis has passed. The post-crisis plan helps individuals transition back to their daily routine and refine their WRAP based on what they learned during the crisis.

Real-Life Impact of WRAP

Testimonial:

"WRAP has truly changed my life. I was introduced to WRAP in 2001, and it has been the primary tool I have used to facilitate my ongoing recovery from trauma. I no longer experience the trauma of my symptoms on a daily basis."

• Helen Nilon (Source: Wellness Recovery Action Plan)

Example:

Steve Tathata says:
“Something amazing happens with WRAP. People wake up. They wake up to the reality of recovery and to the reality of the part they play in making things happen. WRAP is the spark that ignites the flame of potential and possibility inherent within every individual.”
(Source: Wellness Recovery Action Plan)

Join Us in Building Resilience

At Carolina Peers, we offer WRAP meetings and support groups to help you build resilience and take charge of your wellness journey. On this World Day Against Trafficking in Persons, we stand with survivors and commit to providing the resources and support needed to heal and thrive.

Upcoming WRAP Meetings:

• Start Date: August 12, 2024

• Schedule: Every Monday, 5:00 PM - 7:00 PM

• Location: 526 John Ross Pkwy Suite #101, Rock Hill, SC 29730

Register Online: Sign Up Here
Contact Us: zona.garrett@favorpiedmont.org
Follow Us: Zona Recovery Coach CPSS on Tiktok

Conclusion

Building resilience after trauma is a journey, but you don’t have to do it alone. With the support of the WRAP program and the Carolina Peers community, you can develop the tools and strategies needed to thrive. Join us and take the first step towards a brighter, more resilient future.

For more information about our WRAP program and to sign up for our newsletter, visit here.

Thank you for being a part of Carolina Peers. Together, we can make a lasting impact on our lives and the world

Harnessing Strengths-Based Conversations in Peer Support and WRAP Planning

Harnessing Strengths-Based Conversations in Peer Support and WRAP Planning

Embracing Strengths-Based Conversations for Empowerment

At Carolina Peers, we believe in the transformative power of strengths-based conversations. These dialogues focus on identifying and leveraging individual strengths to foster empowerment, resilience, and a sense of agency. Whether you’re engaging in peer support or creating a personalized Wellness Recovery Action Plan (WRAP), strengths-based conversations can be a cornerstone of your wellness journey.

What Are Strengths-Based Conversations?

Strengths-based conversations shift the focus from deficits and problems to strengths and solutions. Instead of asking "What's wrong?" we ask "What's right?" This approach helps individuals recognize their inherent strengths, fostering a positive self-image and motivating them to use these strengths to overcome challenges.

The Power of Strengths in WRAP Planning

In the context of WRAP, strengths-based conversations play a crucial role in developing a personalized plan that works. By identifying and building on personal strengths, individuals can create more effective and sustainable wellness strategies. Here are some examples of strengths that can be highlighted during these conversations:

1. Resilience:

   • The ability to bounce back from setbacks and keep moving forward. Recognizing resilience can help individuals see their capacity to overcome challenges and maintain their wellness.

2. Creativity:

   • Using creative outlets like art, music, or writing to express emotions and manage stress. Incorporating creative activities into a WRAP can provide powerful tools for emotional regulation and self-expression.

3. Empathy:

   • Understanding and sharing the feelings of others. Empathy can enhance peer support interactions, fostering deeper connections and mutual understanding.

4. Problem-Solving Skills:

   • The ability to find solutions to difficult situations. Highlighting problem-solving skills can empower individuals to tackle challenges head-on and develop effective strategies within their WRAP.

5. Positive Relationships:

   • Building and maintaining supportive relationships. Identifying key relationships can ensure that individuals have a strong support network to rely on during difficult times.

6. Self-Awareness:

   • Understanding one’s own emotions, triggers, and needs. Self-awareness is critical in developing a WRAP that truly reflects an individual’s unique wellness needs.

How to Facilitate Strengths-Based Conversations

1. Active Listening:

• Listen attentively without judgment. Show empathy and validate the individual’s experiences and emotions.

2. Positive Inquiry:

• Ask open-ended questions that encourage reflection on strengths and successes. For example, "Can you tell me about a time when you overcame a challenge?"

3. Affirmation:

• Acknowledge and affirm the individual’s strengths and achievements. Reinforce positive behaviors and attitudes.

4. Collaborative Exploration:

• Work together to identify strengths and explore how they can be used to achieve wellness goals. Make the individual an active participant in the conversation.

5. Strengths Mapping:

• Create a visual map of the individual’s strengths. This can serve as a powerful reminder of their capabilities and a tool for developing their WRAP.

Example Strengths for Download

To support your journey, we have created a downloadable list of example strengths that can be used in strengths-based conversations and WRAP planning. This list includes a variety of personal strengths and practical examples of how to incorporate them into your wellness strategies.

Strengths Based Skills List

Conclusion

Strengths-based conversations are a vital part of the WRAP process and peer support. By focusing on what’s strong rather than what’s wrong, we can empower individuals to take control of their wellness journey and build a life that reflects their true potential. At Carolina Peers, we are here to support you every step of the way.

For more information about our WRAP program and upcoming meetings, visit our List Here.

Carolina Peers LLC Partnership with FAVOR Piedmont Dawns New Local Pathway to Recovery

FAVOR Piedmont: Pioneering Free Individual and Family Peer Support for Substance Use Disorder Recovery

Rock Hill, SC – July 19, 2024 – FAVOR Piedmont, with a rich history dating back to 2004, continues to be a beacon of hope and support for individuals seeking recovery from Substance Use Disorder (SUD) and their loved ones. Committed to fostering communities of recovery, FAVOR Piedmont has been instrumental in expanding Peer Support for SUD across South Carolina.

Vision Statement: "Our goal is for individuals to improve their health and wellness, live a self-directed life, and strive to reach their full potential."

Mission Statement: "FAVOR Piedmont promotes long-term recovery from substance use disorder through education, advocacy, and recovery support services, resulting in healthier individuals, families, and communities."

New Path to Local Recovery Opportunities: We are excited to announce the availability of the Wellness Recovery Action Plan (WRAP) in tandem with FAVOR Piedmont on Monday Nights in Rock Hill, SC.

For more information, please contact:

Zona Garrett
CPRS
Carolina Peers LLC
9104933527
zona.garrett@favorpiedmont.org
Carolinapeers.org

About FAVOR Piedmont: FAVOR Piedmont is dedicated to providing free individual and family peer support for those interested in recovery or supporting a friend or loved one in their recovery journey. Since 2004, FAVOR Piedmont has been at the forefront of the Peer Support movement for Substance Use Disorder in South Carolina, committed to building healthier communities through education, advocacy, and support services.

Introducing the Wellness Recovery Action Plan (WRAP): A New Path to Wellness and Recovery

We are thrilled to announce the launch of our Wellness Recovery Action Plan (WRAP) program, a transformative tool designed to support individuals on their journey to wellness and sustained recovery. As someone who has personally navigated the challenges of familial trafficking and maintained a 20-year journey of recovery, I understand the importance of having a structured, supportive approach to overcoming life's obstacles.

What is WRAP?

The Wellness Recovery Action Plan (WRAP) is a personalized wellness and recovery system created by the Copeland Center. It helps individuals monitor their wellness, identify early warning signs of distress, and develop action plans for times when they face challenges. This program is ideal for those dealing with Substance Use Disorder (SUD), Alcohol Use Disorder (AUD), and mental health issues stemming from trauma such as human trafficking, domestic violence, and more.

Key Features of WRAP

• Personalized Wellness Toolkit: Each participant creates a unique set of tools and strategies that help them maintain their wellness.

• Daily Maintenance Plan: A plan that outlines what the individual needs to do daily to stay well.

• Identifying Triggers: Helps individuals recognize and manage external events that could lead to distress.

• Early Warning Signs: Identifies subtle signs that things are getting worse, allowing for early intervention.

• Crisis Plan: Details how to manage situations when the individual is unable to care for themselves, ensuring their safety and well-being.

• Post-Crisis Plan: A strategy to regain wellness after a crisis, preventing future occurrences.

Why Choose WRAP?

Unlike traditional 12-step programs, WRAP is non-religious and can be used alongside other recovery methods. It focuses on holistic health, incorporating mental, emotional, and physical well-being. WRAP empowers participants by promoting hope, personal responsibility, and self-advocacy, leading to a more balanced and fulfilling life.

Who Can Benefit from WRAP?

Our primary audience includes individuals with SUD, AUD, and mental health challenges following trauma. This program is designed for those who are no longer in immediate danger and are looking to rebuild their lives in a supportive, small-group setting.

Join Us on This Journey

We invite you to be part of this exciting journey towards wellness and recovery. Whether you’re seeking support for yourself or a loved one, or looking to contribute to our mission, there are many ways to get involved.

• Sign Up for WRAP: Here

• Learn More: Here

• Follow Us on Social Media: Stay updated with our latest news and events.

Conclusion

The Wellness Recovery Action Plan (WRAP) is more than just a program; it’s a pathway to a healthier, more balanced life. By joining our WRAP community, you are taking a vital step towards reclaiming your wellness and building a future filled with hope and resilience.

For more information, visit our website or contact us directly. Together, we can make a difference.