Peer specialist-led interventions in primary care at the Veterans Health Administration: An integrative review

Abstract

The Veterans Health Administration (VHA) currently employs over 1,300 peer specialists-veterans with lived experience of mental illness who are in recovery and have been trained to provide support to other veterans experiencing these issues. VHA peer specialists have largely been employed in behavioral health settings. In 2014, VHA began to employ peer specialists in primary care settings via the peers in Patient Aligned Care Team (PACT) program, and congressional legislation was passed to expand this program in 2022. In light of this expansion, it is important to evaluate the effectiveness of interventions provided in the Peers in PACT program. This integrative review of studies of peer specialist-led interventions in VHA primary care includes 13 articles with 11 unique studies represented in these articles. These studies targeted mental health symptoms, substance use, health/well-being, and health/treatment engagement. Seven described single-arm studies, three described two-arm studies with a treatment as usual control group, and three described two-arm studies with an active control group. The majority of these studies demonstrated statistically significant improvements on at least one main outcome. Seven studies also included qualitative interviews with veterans; several common themes emerged, including the importance of working with a veteran peer with shared lived experiences, and finding peers helpful in providing accountability, motivation, encouragement, emotional support, resources, and assistance navigating VA health care. Recommendations for future research on the peers in PACT program are discussed, including a need for more RCTs with active controls. (PsycInfo Database Record (c) 2025 APA, all rights reserved).