Overdose Measures Matter

Indicator Profile

Percent of peer workers who have been employed and retained by your organization for at least one year

Category: Peer Workforce Support

Audience: Program Implementer

Data Type: Quantitative

Indicator Overview

Description:

Percent of peer workers who have been employed and retained by your organization for at least one year. For this indicator, peer workers may include both full-time and part-time employees, but do not include volunteers.

This indicator measures peer worker retention in an organization to better understand employee turnover within this sector.

Rationale:

Employee wellbeing is important to the health of the organizations where they work. However, working in stressful and emotional environments, which can be common for peer workers, can lead to chronic stress and burnout.1 Organizations can adopt several strategies to support peer workers, such as offering fair wages and benefits, providing training and supervision, supporting workers’ recovery and providing opportunities for career advancement. Measuring the percent of peer workers who have been employed and retained by your organization is one way of assessing employee satisfaction and the health of your organization.

Related Indicators:

To understand the strategies your organization has adopted to support peer workers, consider monitoring efforts to support equitable treatment of peer workers employed by your organization.

Indicator Details

Definitions:

Peer workers, also known as peer support workers, peer navigators, peer recovery coaches, peer recovery support specialists or simply, peers, are people who have lived experience of recovery from a substance use disorder and have been hired by their organization to provide support to others experiencing similar challenges.2 Peer workers can provide a range of supports including, but not limited to, advocacy, resource sharing, skill-building and mentoring. They may also provide trainings and education, oversee programs and supervise other peer workers.

Employed and retained means that an individual has been hired by your organization and has since remained an employee of your organization, regardless of whether their current role differs from the one for which they were originally hired. They are still considered “employed and retained” as long as they continue working for your organization.

Numerator and Denominator:

Numerator: Number of individual peer workers in your organization who are or have been employed by your organization for at least one year

Denominator: Total number of individual peer workers who have ever been employed by your organization.

Note: To report retention for a specific time-period, you must specify this in both the numerator and denominator. For example, to report retention over the past 12 months, you would use the following:

  • Numerator: number of individual peer workers in your organization who have been employed by your organization for at least one year and who have been employed anytime in the last 12 months.
  • Denominator: total number of individual peer workers who have been employed at any time over the past 12 months

Ways to Examine the Data:

  1. Workforce demographics (e.g., age group, race, sex)
  2. Role or type of position (e.g., full-time vs. part-time; supervisory vs. non-supervisory, etc.)

Data Sources:

  • Employment records
  • Organizational staff
  • Peer workers

Note: Employment records will likely be the primary data source for this indicator. However, organizational staff and peer workers may provide you with additional contextual information related to this indicator, such as reasons why people may have left their roles.

Data Collection Methods:

  • Review of employment records
  • Surveys or interviews with organizational staff
  • Survey or interviews with peer workers

Application and Considerations

Suggested Use:

  • To assess peer worker satisfaction within your organization
  • To assess the effectiveness of organizational efforts to support peer workers
  • To assess staff capacity to serve clients

Health Access Considerations:

You may want to consider:

  • Are peer workers being paid fairly based on their experience, qualifications and workload? How does this compare to other employees within the organization?
  • Do peer workers have adequate time off, during which they are not on call?
  • Do peer workers have opportunities for career advancement through internal promotions or other opportunities such as mentoring programs, leadership development programs, training or continuing education?
  • How do the demographics of peer workers compare to that of other employees within the organization?
  • Are peer workers provided with all the supports they need to do their job? (E.g., provided with cell phone, laptop/tablet, on-boarding, training, etc.)
  • What role do peer workers have in decision-making? In informing and shaping their work processes and protocols? How does this compare with decision-making roles of other staff within the organization?
  • Are there additional state or regional-level policies that further support or hinder equitable treatment of peer workers? For example, are there institutional barriers to hiring people with criminal records or histories of substance use?
  • What processes are in place for peer workers to identify what additional supports they need to be successful? Are there opportunities for peer workers to provide feedback on program practices and policies to support them in their role?
  • What other barriers to equity might peer workers—and other organizational staff—face? And how might the organization provide supports to address these barriers? Consider race, ethnicity, culture, gender, age, sexual identity, language, etc.

Evaluation Considerations:

Limitations:

  • Does not track reasons why peer workers may choose to leave the organization
  • If an organization has had only a small number of peer worker positions, assessing percent retained may not be informative because there are not enough people to identify patterns or draw broader conclusions

Policy Considerations and Resources:

Additional Resources

Examples:

References:

  1. Howard, J., & Houry, D. (2024). Protecting the Mental Health and Well-Being of the Nation's Health Workforce. American journal of public health, 114(S2), 137–141.
    https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2023.307475
  2. Substance Abuse and Mental Health Services Administration. Peer Support Workers for Those in Recovery.
    https://www.samhsa.gov/technical-assistance/brss-tacs/peer-support-workers
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