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Initiated by the service user movement, recovery-oriented practices are one of the keystones of modern mental health care. Over the past two decades, substantial gains have been made with introducing recovery-oriented practice in many areas of mental health practice, but there remain areas where progress is delayed, notably, the psychiatric inpatient environment. The peer support workforce can play a pivotal role in progressing recovery-oriented practices. The purpose of this paper is to provide a pragmatic consideration of how occupational therapists can influence mental health systems to work proactively with a peer workforce.

The authors reviewed current literature and considered practical approaches to building a peer workforce in collaboration with occupational therapists.

It is suggested that the peer support workforce should be consciously enhanced in the inpatient setting to support culture change as a matter of priority. Occupational therapists working on inpatient units should play a key role in promoting and supporting the growth in the peer support workforce. Doing so will enrich the Occupational Therapy profession as well as improving service user outcomes.

This paper seeks to provide a pragmatic consideration of how occupational therapists can influence mental health systems to work proactively with a peer workforce.

A novel integrated staffing model for community-based residential rehabilitation services is described. The purpose of this paper is to achieve synergistic gains through meaningful integration of peer support and clinical workers within rehabilitation teams. Key features include the majority of roles within the team being held by persons with a lived experience of mental illness, the active collaboration between peer and clinical workers throughout all stages of a consumer’s rehabilitation journey, and an organizational structure that legitimizes and emphasizes the importance of peer work within public mental health service delivery. This staffing model is not anticipated to alter the core rehabilitation function and service models.

The emergence of the integrated staffing model is described with reference to the policy and planning context, the evidence base for peer support, and the organizational setting. A conceptual and contextualized description of the staffing model in practice as compared to a traditional clinical staffing model is provided.

There is a potential for synergistic benefits through the direct collaboration between horizontally integrated peer and clinical specialists within a unified team working toward a common goal. This staffing model is novel and untested, and will be subjected to ongoing evaluation.

The integrated staffing model may provide a pathway to achieving valued and valuable roles for peer workers working alongside clinical staff in providing rehabilitation support to people affected by serious mental illness.