“There is a gorgeous wisdom that can only be gained by surviving and thriving… When we offer it to the world, real change occurs.” – Cherene Caraco

Survivors of trauma have long relied on their peers as part of their journey toward recovery and wellness. Talking about shared experiences can help foster a deep sense of empathy, compassion, and community – factors that contribute to resilience and empowerment. In 2007, the Centers for Medicare & Medicaid Services recognized peer support models as an emerging best practice as part of the Medicaid program, following in the footsteps of Canada, the United Kingdom, New Zealand, and other countries with peer-led behavioral health care models. Peer-led care models promote mutual and reciprocal healing through the giving and receiving of help and support based on shared experiences. Throughout the United States, peers are embedded into a variety of settings as paid employees and there are several organizations focused exclusively on the peer support model.

Promise Resource Network

Promise Resource Network started as a collective of individuals who had experienced mental health issues working alongside allies and service providers. Under the leadership of founder and Chief Executive Officer, Cherene Caraco who is also a Pathways to Resilience Expert Advisory Committee member, the Promise Resource Network grew into the first mental health organization led and staffed exclusively by people with lived experience. Located in Charlotte, North Carolina the team is comprised of more than 60 individuals with an array of lived experiences and unique perspectives. PRN’s mission is to “disrupt illness-based approaches to mental health and substance use, by understanding impacts of trauma and supporting healing, wellness, and recovery.”

“What if “help” was defined by people experiencing distress and that is what gets funded, measured, and expected? What if continued funding of services was dependent upon the experiences of people receiving them, not only the ones providing them?” – Cherene Caraco

Promise Resource Network provides immediate support and resources to people in crisis. Their peer-run respite, Retreat@ The Plaza, serves as an alternative to emergency department visits, in-patient mental health services, and/or involuntary commitment. As a trauma-informed, survivor-led organization, PRN does not use force or coercion to get people into care. As such, their respite is completely voluntary and is located in a home near downtown Charlotte. Peer Supporters with shared experience in trauma healing and recovery are available 24/7 and offer opportunities for people to explore their experiences without judgment or fear of involuntary commitment. This allows people to maintain their connections to family and community and continue to attend work or school while prioritizing their mental health and healing. The respite –complete with flowers, water features, and firepits – offers a calming environment, activities to reduce stress such as yoga and meditation, and connections to resources, if desired.

Other PRN programs include free self-referred trauma informed one-on-one peer support and support groups; a 24/7 peer-run “warm line” for problem solving, resource sharing, and emotional support; Homeless to Housing initiatives that help people experiencing houselessness to consider being in a home, adjusting to living in a home, and moving toward home ownership if they desire. There is also a hybrid in person and virtual Recovery Hub offering more than 95 classes, support groups, and activities each month. As part of PRN’s commitment to offering no- and low-barrier healing opportunities and ensuring access and equity, all of their programs and resources are available to people with and without insurance. Most of the programs do not require a referral and none of them require assessments, authorizations, screenings, or other traditional systemic barriers. Additionally, PRN works to diversify and increase peer-led recovery options by providing start-up incubation for peer-run projects and organizations, including administrative support, shared health insurance, and mentorship.

“Trauma in the name of treatment is unacceptable; meaningfully engaging individuals with lived experience is essential for effective policy and practice reform.” – Cherene Caraco

Meaningful Engagement is the Key to Effective Policymaking

As part of their growth as an independent survivor-led organization, PRN recognized the need for capacity-building of similar organizations across the state. With support from the Substance Abuse and Mental Health Services Administration (SAMHSA), PRN created Peer Voice North Carolina (PVNC) to champion policies and programs across sectors and invest in emerging leaders to organize and mobilize around issues that directly impact them – created by survivors, for survivors.

In 2019, PRN became one of 16 grantees to receive funding from SAMHSA to incubate Statewide Consumer Networks, which provide insight and guidance to policymakers regarding mental health and trauma-informed policy. PVNC is designed to ensure that people with lived experience emerge as leaders in the movement for policy reforms. Their goal is to reimagine the reaction to and treatment of mental health, substance use, homelessness, incarceration, domestic violence, and trauma in North Carolina. PVNC has leveraged the unique perspectives of peoples with lived experience to identify inequities in policies, programs, and funding processes. During their first year, PVNC coalitions and commissions lead in the writing of four bills in North Carolina, all with bi-partisan support:

Peer Support Specialist Certification Act (HB 732): Established the North Carolina Peer Support Specialist Oversight Board to create certification for Peer Support Specialists and improve oversight within the profession.

Enhance Local Response to Mental Health Crises (HB 786): Created an emergency mental health response model that blends community organizing, peer support, and recovery practices as an alternative to police intervention.

Improved Data on Involuntary Commitments (HB 787): Established guidelines for data collection around involuntary commitments in response to a lack of cohesive data.

Achieve Better Mental Health Recovery Results (HB 788): Provides appropriations for PRN to establish four peer-run wellness centers in North Carolina.

What’s Next for Peer Voice North Carolina?

After a successful legislative session, PRN received additional funding from SAMHSA to expand the reach of PVNC and sustain the momentum of their coalitions. They will continue to advocate for and implement peer-led services in the criminal justice and health care systems, provide training and technical assistance to support peer-led organizations and leaders, and create innovative programming and policies by and for survivors.

About Pathways to Resilience

Pathways to Resilience supports the leadership of people with lived experience and believes that individuals who have experienced trauma should have the agency to create and inform the practices, programs, and policies that directly impact their ability to heal and thrive.

On November 30, 2023, Pathways hosted a Learning Network Session featuring Cherene Caraco alongside William Kellibrew, an international advocate for trauma survivors. Each experienced traumatic life events as children that changed the trajectory of their lives and helped inform careers dedicated to helping others heal and thrive. Cherene and William are working with policymakers and people with lived experience to develop and advocate for trauma-responsive policies across sectors and systems. Watch this session to learn about concrete and actionable strategies to effectively involve people with lived experience in policymaking and program implementation. You can view a recording of the Learning Network session on our website.

View our Pathways to Resilience Tip Sheet, “Nothing about us without us: Tips for involving people with lived experience in policymaking and program design,” informed by takeaways from our Learning Network Session.