A Look Back: The History of Peer Support for Mental Health
By Jen Falco, ANAD Fundraising & Development Intern
Thanks to the vision and determination of peers and leaders like ANAD founder Vivian Meehan, peer support is available to millions of individuals struggling with mental health concerns each year. Join us now in a taking a look back at how we got here.
Peer Support: How it Started
Late 1700’s: The Beginning
The beginning of peer support arguably started in Paris, France in the 1700’s with Philippe Pinel, a physician, and Jean-Baptiste Pussin, a former patient turned hospital worker. Mrs. Pussin also worked alongside her husband. Pinel and Pussin witnessed inhumane treatment of men and women in asylums in Paris. Together they led the “moral treatment” movement, a shift in which those hospitalized due to mental health conditions were treated with dignity, respect, and compassion, rather than neglect and abuse. They quite literally unchained men and women patients. They did away with archaic methods and took a more patient-centered approach. What made their movement unique for the time was its use of having recovered patients work with the current ones because they were able to more compassionately connect given their lived experience. Peer support was born!
1935: Alcoholics Anonymous
Alcoholics Anonymous (AA) is derived from spirituality via the Oxford groups during this time. It began with Dr. Bob, a surgeon from Ohio, and Bill, a NY Stockbroker. Bill helped Dr. Bob get sober. And together the two of them led the first official group in a hospital setting after meeting Bill D., a lawyer, and patient at Akron City Hospital. The moment of their meeting is immortalized as the “man on the bed” (here as depicted in a painting by an A.A. member), Bill D. becomes the third member of what will eventually be called Alcoholics Anonymous. From there AA grew to a second group in NY and a third in Cleveland. In 1939, the textbook “Alcoholics Anonymous”, based on the 12 steps, was published and the rest is history.
1957: Peer Support in Schools
Rochester Psychologist Emory Cowen is known for his focus on preventative mental health care and the development of “Child associates” to help provide support and empathy for troubled and maladjusted youth in the school system. There was an understanding that children struggling in school were dealing with personal issues outside of school and simply needed a person to talk to who would be able to get on their level and understand. It is worth noting that a majority of the child associates were women with children of their own. Building that trust with the youth increased their self-esteem and thereby ability to learn. They became well-adjusted students once their confidence was improved thanks to a caring person who made an effort to understand them.
1963: The Community Mental Health Act
After The Joint Commission on Mental Illness and Health published its findings on the state of mental health treatment in America, the Community Mental Health Act was passed. Its goal was to de-institutionalize individuals and provide access to community mental health centers and funding to states to create and implement these. The passing of this act moved people out of state institutionalized care and into the community in the way of outpatient state funded programs. It changed what treatment looked like in America and helped open pathways for alternative programming.
1970’s: The Mental Health Consumer Movement
The peer movement took off in the 1970s! With the leadership of some incredible people advocating for patients’ rights. Following in the footsteps of the Civil Rights Movement, people such as Judi Chamberlin, Sally Zinman, Celia Brown and Howard Geld, “Howie the Harp” led the way. These survivors, peers, and activists led a groundbreaking peer movement which de-stigmatized those seeking treatment and fought to ensure dignified treatment for all. It was a movement towards alternative treatments such as drop-in centers and a focus on self-help and individual rights to choose. Additionally, their movement included combating racism and discrimination. These heroes spoke up for those who had been victimized by the institutionalized mental health system and championed a strong movement for change, giving power to the people.
A New Frontier: Peer Support for Eating Disorders
It was 1976 and times were still transitioning with regard to the mental health movement. Vivian Meehan, a nurse, found that not much was known about how to treat her daughter’s anorexia, and support was limited. She decided to create a program herself to help her daughter. She created a support group and referral hotline.
The response from others around the world showed that there was a strong need for this type of support and thus ANAD (National Association of Anorexia Nervosa and Associated Disorders) was born!
“The professional community at first resisted the idea of peer-led support. Many clinicians warned that peer-led groups would be harmful, teaching participants dangerous behaviors. To address this, ANAD always kept a professional “on call” in case concerns arose. Over time, professionals came to see ANAD’s seriousness and expertise….ANAD was different: it was grassroots, built by families, friends, and those with lived experience. We had a small circle of professionals as advisors, but our strength came from the community itself…What made ANAD unique was its responsiveness. If there was a new idea, treatment model, or research development, we were on it—and then shared it widely….From the beginning, ANAD was also about advocacy. We fought for insurance coverage and against managed care restrictions that denied treatment. Vivian and I both testified before Congress about the dangers of eating disorders and the urgent need for support and recognition. ANAD’s philosophy was simple yet radical: lived experience and community support matter. For 50 years, that spirit has guided us—filling gaps, challenging stigma, and standing alongside individuals and families as they navigate recovery.”
-Patricia Santucci, MD, FAED, FAPA, Vice President, Education Director of ANAD and board member since 1977
Thanks to such strong and dedicated founders, ANAD lives on today fulfilling its mission of providing support and education to those struggling with body image & disordered eating.
Evolution in the Mental Health Field: 1980’s-90’s
The Mental Health Systems Act of 1980, which provided grants to expand community mental health services, was signed into law.
In the early 1980’s Pat Risser was one of the first peers in the Consumer Case Manager Aide (CCMA) training program in Colorado. This was the first professional training in our nation’s history to train peers on a professional level (Risser, 2013). He set up dozens of peer-led groups around Colorado and trained constituents on how to start their own nonprofits. In one of Pat’s peer training classes, the WRAP program was formed. Pat focused on helping people re-discover their passions in life via a person-centered approach. Pat worked as an advocate and activist and inspired others to change their ways by finding their own strengths and voices.
Jacki McKinney had come a long way via her own personal experience and was an active advocate in the consumer/peer led movement. In 1991, she became director of a peer-led case management program funded by SAMHSA. This was a radical program and the first of its kind, as it was the first government funded peer support group. As a person of color and in recovery, she could relate to patients on a level that other mental health professionals could not. Jacki went on to co-found the National People of Color Consumer Survivor Network with the goal to see African-Americans in front of the room helping set the agenda, helping to talk about what the issues are. However, the goal shifted in 1996 to become trained as cultural competency experts. This way they can teach cultural competency. (In Honor and Memory of Jacki McKinney, 2021). Jacki was a renowned speaker and presented at numerous conferences and spoke from the heart to share about the power of peer support.
In 1997, the WRAP (Wellness Recovery Action Plan) program was born through Mary Ellen Copeland after the idea came about during a discussion in a peer support training class. Concepts came out of research done in the 1980s when recovery was not a word used when discussing mental health issues. The concept came to fruition in 1997. Mary’s goal was to develop an action plan to empower those struggling to take back control of their lives. The key concepts of WRAP are hope, personal responsibility, education, advocate for yourself, and support.
ANAD Expands Peer Support Offerings: 2000’s-Today
Over the past two decades, ANAD has continuously adapted, navigating technological shifts and global challenges to dramatically expand access to peer support. Our journey of growth includes:
2016: Launching our vital Peer Mentorship Program, connecting experienced recovery advocates with those just starting out.
2020: Pivoting all support groups online, which immediately amplified our reach and allowed us to serve thousands more annually.
2023: Adding a new Helpline line to meet the surging demand for peer support in the eating disorder community.
2025: Introducing our first dedicated Referral Team volunteers to bridge the gap between individuals and professional treatment providers.
None of this critical work—expanding programs and increasing accessibility—would be possible without the dedication of our incredible volunteers and your continued support.
Stay tuned as we prepare to celebrate 50 Years of Peer Support in 2026!
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