Peer services in behavioral health: A scoping review of Medicaid funding to inform policy and practice for refugee and newcomer populations in the U.S.

Refugee and other newcomer communities are at high risk for common mental health and psychosocial problems due to violence and trauma experienced in the country of origin and during migration, both of which are compounded by displacement stressors. Despite significant need, there are major gaps in the behavioral health service system available to refugee and newcomer communities in the U.S. Peer-delivered services have a potentially important role to play in promoting the behavioral health of refugee and newcomer communities domestically. To encourage model development and implementation, this scoping review examined Medicaid-financed peer services in the U.S in the fields of adult substance use, adult mental health, and child and adolescent mental health. Ten publications were included in the analysis. Most states provided Medicaid reimbursement for peer services in some fields but not others. The definition, credentialing processes, and reimbursement rates for peer providers varied across states. To better integrate peer services for refugee and newcomer communities, the findings indicate a need to expand the conceptualization of lived experience to include forced displacement, refine training approaches to empower refugee communities, and adapt and test evidence-based peer models that promote mental health during resettlement and integration. Policy attention will be needed to address low Medicaid reimbursement rates and expansion of Medicaid coverage for newcomers, to encourage and sustain growth in peer support services that enhance mental health after forced migration.