"'Not just a job": Organizational Culture and the Sustainability of the Peer and Lived Experience Workforce.

Peer recovery support specialists represent one of the most rapidly expanding sectors of the behavioral health care workforce, yet organizational conditions that support or undermine this workforce remain underexplored. To better understand the experience of providing peer support and identify organizational factors that facilitate or hinder effective and sustainable peer work, we conducted semi-structured qualitative interviews with a convenience sample of 17 peer workers in Connecticut. Interviews were recorded, transcribed, and thematically analyzed. We identified five themes, reflecting both the profoundly meaningful roles of peer support workers and structural workplace conditions that impact workforce sustainability. Supportive supervision and a recovery-oriented workplace culture facilitated job satisfaction, while agency policies, a lack of role clarity, boundary expectations, and inequitable compensation created strain. Financial instability and a lack of organizational recognition were perceived as threats to long-term retention of the lived experience workforce. Peer work was consistently described as "not just a job," and peers' abilities to effectively do their jobs were facilitated or constrained by organizational factors. Community mental health agencies can strengthen and better retain the peer workforce by fostering effective peer-informed supervision, revisiting longstanding worker policies through a lived experience lens, promoting interdisciplinary understanding of lived experience roles, and addressing inequities in compensation. Reforming organizational culture is essential to effectively retain the peer recovery workforce within community behavioral healthcare systems and deliver important recovery support services at scale.