In the summer of 2004, New York City Health and Hospital Corp.'s (HHC) Bellevue Hospital Center provided behavioral health consumers with a new service: peer counseling.

Senior leadership in Bellevue's Department of Psychiatry firmly believes people who have been there can offer the most relevant perspective on how systems fail and what meaningful alternatives should be in place.

In 2003, the New Freedom Commission Report on Mental Health suggested transforming the mental health system with a stronger focus on recovery-oriented and evidence-based practices on psychiatric rehabilitation, supported work, illness and wellness self-management.

As Bellevue's former associate executive director of nursing, I took the first step in hiring the first 10 peer counselors in its inpatient psychiatry units. Having been trained on trauma-informed care through Substance Abuse Mental Health Services Administration, I am familiar with recovery, rehabilitation and empowerment as issues that form as core elements in the concept of person-centered care.

Introduction of peer counseling required a lot of buy-in of the multidisciplinary team (psychiatrists, nurses, social workers, and other clinicians), human resources and other leadership staff.

Looking back at the whole experience of this worthwhile clinical move, there are three categories that contribute as ingredients when employing consumers as providers.

Recruiting Consumers

A strong buy-in from the unit clinical team works wonders. They should be engaged from the first time a change in philosophy in moving from a medical model to a recovery-focused is to begin. Having behavioral health consumers participate in dialogues with clinical staff in issues such as recovery, treatment and medication opened the eyes of numerous clinicians and patients that indeed, recovery is possible for mental health consumers.

When preparing to interview potential candidates for positions as peer counselors, it is necessary to include in the interview process all members of the clinical staff who are to work with these counselors.

It is imperative to have change champions among the professional disciplines where the peer counselors will report to. These champions are staff members who believe in recovery, rehabilitation and empowerment and are knowledgeable with issues related to American Disabilities Act and acceptance on certain levels of applicants with histories of substance use and incarceration.

It is important to look for applicants who are consumers in their advance stage of recovery themselves and who may have possible experience in the field. There are advocacy training centers in New York that provide extensive training to become peer specialists.