The bottom line: Language is not neutral in peer support and the continued use of medical model terms quietly reshapes it into something it was never meant to be. When peers adopt diagnostic and institutional language, mutuality is weakened and roles drift towards surveillance, compliance, and hierarchy, with real consequences for mental health and well-being. Reclaiming a values led, experience based vocabulary is not cosmetic but essential if peer support is to remain ethically distinct and protected in policy, funding, and practice.
If peer support is to be taken seriously as its own discipline, then its language matters. Words do not simply describe practice. They shape it. They signal values, power, and allegiance. For that reason, I argue that peer support must decisively move away from medical model language and reclaim a vocabulary that reflects its original purpose and history.
At a keynote address during the Alliance for Rights and Recovery Conference held at the Villa Roma Resort in Callicoon, New York, in September 2025, I challenged attendees to reconsider how deeply medicalised language has become embedded in peer spaces. Terms such as “community is therapy”, “serious mental illness”, “triggers”, “low functioning”, and “high functioning” are now routinely used, often without reflection. Yet these phrases were not part of the peer support movement that emerged in the 1960s. They originate from clinical and institutional frameworks that peer support was explicitly created to resist.
This linguistic drift has consequences. When peer support adopts the language of diagnosis, treatment, and pathology, it risks losing its ethical and political grounding. The co-optation of peer roles into systems driven by surveillance, compliance, and risk management is not accidental. Language has been one of the entry points. When peers are described using medical model terms, their role is subtly reshaped to fit professional hierarchies rather than mutuality.
There are alternatives. Instead of “community is therapy”, we might say “community is healing” or “community supports recovery”. Rather than defining people by diagnoses, we can speak of people living with mental health or substance use challenges, or people with lived experience. “Stressors” communicates far more accurately than “triggers”, which carries clinical assumptions about pathology and control. Asking “what happened to you” recognises context and history, whereas “what is wrong with you” centres deficit. These shifts are not cosmetic. They reflect a different understanding of distress, one rooted in experience rather than classification.
Some terms should be abandoned altogether. The use of “client”, “patient”, “consumer”, or “recipient” has no place in peer support. These words position people as passive, transactional, or dependent. Peer relationships are none of these. Equally troubling is the continued use of the term “collateral” within policy and administrative language, including references in the Center for Medicare and Medicaid Services. Peers are not bargaining tools, assets, or leverage. The term itself carries a long and violent history tied to enslavement, racial capitalism, and systemic harm. Its presence in peer contexts is indefensible.
Even seemingly neutral words deserve scrutiny. “Medication” and “pharmaceutical” reinforce medical dominance in conversations where peers are meant to support autonomy and choice. “Medicine” is often less loaded. Likewise, “helping” and “fixing” imply hierarchy and correction, whereas “support”, “assistance”, and “guidance” better reflect mutual respect.
It is also important to reject phrases such as “community is the cure”. This framing assumes sickness and implies treatment. Many people involved in peer support are responding to trauma, exclusion, poverty, violence, and loss. These are not illnesses. They are lived realities shaped by social conditions. Language that frames people as broken simply reinscribes harm, even when offered with good intentions.
None of this is an argument against collaboration with clinical services. Bridges can and should exist. But bridges require two distinct sides. Peer support and the medical model are not the same, and they should not be forced into uniformity. Each must remain free to operate within its own values, without fear of retaliation or erasure.
This is a question of willingness. The word “can” reminds us that change is possible. We have the capacity to act differently, to speak differently, and to embody the principles we claim to uphold. Whether we choose to do so is a collective responsibility. Peer support was never meant to replicate existing systems. It was meant to offer something fundamentally different. The task now is to decide whether we are prepared to live up to that legacy.
Rev. Dr Phillip Fleming is the chief executive officer and director of the division of peer support services at Mindful Living. He holds credentials in peer support, EFIT, and an honorary Doctor of Divinity.