In Reply: We appreciate the positive response from Peebles and Fenley to our discussion. They also noted that "LaBrie and colleagues also underestimate the ascendance of peer-support services in mental health care." Space limitations prevented us from fully addressing peer support services beyond urging that the care coordinator role be adapted to behavioral health services. The report by Davidson and colleagues that is cited by Peebles and Fenley offers this evaluation of the extant evidence for consumer-based and peer-supported services. As Davidson and colleagues note, "Consumer-run services and the use of consumers as providers promise to broaden the access of individuals with psychiatric disabilities to peer support, but research on these more recent developments is only preliminary and largely limited to demonstrations of their feasibility" (1).

We look forward to the report of the research by Peebles and Fenley and their group's empirical evidence, as well as other expansions of the evidence base on the efficacy of peer support. We hope the result will be to reduce the number of people who need behavioral health treatment but lack peer support funded by their treatment plans.

1.Davidson L, Chinman, M, Kloos, B, et al: Peer support among individuals with severe mental illness: a review of the evidence. Clinical Psychology: Science and Practice 6:165—187, 1999