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This article describes the development of peer support roles and programmes in Scotland, and includes findings from an evaluation of a peer support worker pilot scheme. The evaluation assessed the impact of the pilot on service users, peer support workers and the wider service system, along with considering the issues involved in implementing peer support programmes.

The integration of peer support workers with lived experience of mental health problems into existing mental health services has been found beneficial in some ways. However, some peer support workers have experienced unique challenges in terms of role confusion and limited opportunities for networking and support. Qualitative research and evaluation regarding peer support worker integration is limited. This paper aims to address this issue.

The current paper presents a qualitative evaluation of the experiences of two peer support specialist (PSS) workers and their managers within one UK mental health trust. The PSS workers and managers were interviewed individually using a semi‐structured format. Thematic analysis was applied to the interview transcripts.

In agreement with prior research and evaluation, positive experiences and challenges were identified in relation to PSS employment, both for PSS workers and their teams. Overarching themes concern the PSS worker as “other”, the PSS worker as a “change agent”, and “readiness for PSS worker employment”.

The evaluation is limited by the small sample size but the findings could be used to inform the integration of PSS workers into other existing services. This evaluation begins to untangle some of the tensions around the integration process. Strategies to support PSS integration based on the recommendations of participants and the findings of the current evaluation are presented.

The purpose of this paper is to provide a perspective on peer work and insights from Flourish Australia’s journey in growing a thriving peer workforce. Flourish Australia is a large not-for-profit organisation that has been supporting people with their recovery journeys for over 60 years. The organisation provides, predominantly, non-clinical community-based support to enable people who live with a mental health issue and/or psychosocial disabilities to lead contributing lives in their community.

Flourish Australia developed and implemented a number of strategic directives in order to support the growth of a peer workforce. Central to these directives were policy positions that encouraged a shared understanding of the value and contribution that people with a lived experience of a mental health issue add to an organisation. From this policy foundation, the Why Not a Peer Worker? strategy and Transformation Peer Worker strategy were implemented and embraced by hiring managers across the organisation.

The “Why Not a Peer Worker?” campaign, coupled with the Transformation Peer Worker strategy, resulted in an increase in Flourish Australia’s peer workforce of almost 600 per cent over an 18-month period to now number 145 positions.

This paper provides organisations who are seeking to develop or grow their peer workforce with practical ideas that have been successfully implemented by Flourish Australia that can be discussed and debated when developing a peer workforce.

This paper provides unique insights into Flourish Australia’s peer workforce journey.

A pilot project commissioned to assess feasibility and impact of peer support in an Early Intervention in Psychosis (EIP) service highlighted the importance of team readiness. The purpose of this paper is to reflect on the lessons learned in recognising and facilitating team readiness in an NHS setting.

The literature suggests that mental health teams need to be ready to implement peer support, if this is to be done successfully. The authors describe the process of preparing for peer support, obstacles that arose and ways that the team found to address these.

The team had actively sought to develop peer support for some time, and negotiated with Trust managers to agree these roles in principle. However, initially unspoken concerns about duty of care emerged as a key obstacle. An arguably paternalistic desire to protect potential peer worker colleagues from stress and distress could have resulted in unnecessary risk aversion and a narrowing of the role. Willingness and opportunity to reflect on the change in relationship from service user/professionals to colleagues enabled these concerns to be aired, and practical solutions agreed.

Team enthusiasm is not the same as team readiness. The team’s willingness to identify and reflect on implicit concerns facilitated an acceptance of the change in relationship with peer workers, which in turn enabled the development of standard operating procedures to ensure safe and effective peer support as “business as usual.”

This paper considers the process of welcoming peer workers in an EIP team and offers practical suggestions that may be of value to other teams seeking to implement peer support in similar adult mental health settings.

The purpose of this study was to identify and understand the barriers and enablers to the implementation of youth peer support in a clinical mental health service. The development of a lived experience workforce in mental health is a key component of policy at both the state and the federal level in Australia. Implementing a peer workforce within existing clinical services, however, can be a challenging task. Furthermore, implementing peer support in a youth mental health setting involves a further degree of complexity, involving a degree of care for young people being invited to provide peer support when they may be still early in their own recovery journey.

This paper reports on a formative evaluation of the beginning stages of implementation of a youth peer workforce within an existing clinical mental health service in Melbourne.

The project found that it was feasible and beneficial to implement youth peer support; however, significant challenges remain, including lack of appropriate training for young people, uncertainty amongst clinical staff about the boundaries of the peer role and the potential for “tokenism” in the face of slow cultural change across the whole service.

Very little evaluation has yet been undertaken into the effectiveness of implementing peer support in youth mental health services. This paper offers an opportunity to investigate where services may need to identify strengths and address difficulties when undertaking future implementation efforts.

Peer support workers are becoming more involved in mental health services in Australia. Peer support workers have had to overcome challenges and dilemmas whilst embedding their role within mental health settings. This includes coping with scrutiny from fellow colleagues, supporting consumers and managing their own mental health. The paper aims to discuss these issues.

This paper will explore the author’s perspective and experience of working as a peer support worker in a psychiatric hospital and how the skills, knowledge and values she has developed during her recovery from mental illness have been essential in undertaking the daily activities with consumers and clinicians, overcoming the challenges and dilemmas, and managing her own wellness.

The paper provides insight into the experience of a peer support worker at a psychiatric hospital for adults.

The author’s personal experience of being a peer support worker in a mental health facility.

The aim of this study was to determine the effectiveness of promoting peer support to reduce depression, anxiety and stress among migrant construction workers in Singapore.

This longitudinal study drew participants from migrant workers of various nationalities in the construction sector in Singapore. Baseline data pertaining to depression, anxiety and stress was established using the DASS-21 questionnaire, and salient covariates such as demographic factors and work environment factors recorded using suitable questionnaires. Intervention was training of participants on peer support techniques, supplemented by episodic support by trained counsellors. At the end of 6 months, DASS-21 was again deployed to obtain the post-results. Comparison of baseline with post-results data was performed to evaluate effectiveness of the peer support intervention.

Statistically significant reduction was observed in measures of all the three parameters studied, namely, depression, anxiety and stress. A decrease of 3.3 (95% CI:2.3 to 4.3) points in mean depression score, a decrease of 2.6 (95% CI: 1.6 to 3.7) points in mean anxiety score and a decrease of 2.7 (with 95% CI: 1.6 to 4.0) points in mean stress scores on the DASS-21 scale were recorded. Conclusions: Peer support is effective in improving mental health of migrant workers in the construction sector in Singapore. This intervention should be considered among other measures to improve their welfare.

This is the first paper that talks about the mental health of migrant workers pre-COVID and hence would be a strong paper for the future comparative studies for pre-and post-COVID periods. This is the first paper that addresses the benefits of peer-support among migrant workers to improve their mental wellbeing.

Peer support is increasingly being introduced into mainstream mental health services internationally. The distinctiveness of peer support, compared to other mental health support, has been linked to values underpinning peer support. Evidence suggests that there are challenges to maintaining those values in the context of highly standardised organisational environments. The purpose of this paper is to describe a “principles-based” approach to developing and evaluating a new peer worker role in mental health services.

A set of peer support values was generated through systematic review of research about one-to-one peer support, and a second set produced by a UK National Expert Panel of people sharing, leading or researching peer support from a lived experience perspective. Value sets were integrated by the research team – including researchers working from a lived experience perspective – to produce a principles framework for developing and evaluating new peer worker roles.

Five principles referred in detail to: relationships based on shared lived experience; reciprocity and mutuality; validating experiential knowledge; leadership, choice and control; discovering strengths and making connections. Supporting the diversity of lived experience that people bring to peer support applied across principles.

The principles framework underpinned development of a handbook for a new peer worker role, and informed a fidelity index designed to measure the extent to which peer support values are maintained in practice. Given the diversity of peer support, the authors caution against prescriptive frameworks that might “codify” peer support and note that lived experience should be central to shaping and leading evaluation of peer support.

This paper adds to the literature on peer support in mental health by describing a systematic approach to understanding how principles and values underpin peer worker roles in the context of mental health services. This paper informs an innovative, principles-based approach to developing a handbook and fidelity index for a randomised controlled trial. Lived experiences of mental distress brought to the research by members of the research team and the expert advisors shaped the way this research was undertaken.

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.

The purpose of this study is to describe peer support work in a men’s mental health unit from a lived experience and service user’s perspective. The intertwining of process (a lived experience perspective) and subject (the therapeutic value of peer support) leads to greater knowledge and insight into peer support for people with mental health problems.

This service user narrative draws on the extracts from a reflective journal of interactions and conversations with people with mental health problems as well as feedback from service users and staff about the value of peer support. These methods allow a first-person, service user’s, reflective and narrative account of peer support work.

Peer support work, particularly hearing voices sessions, are found to be highly therapeutic and worthwhile. They promote insight and create feelings of safety and hope in what can sometimes be a frightening and hostile ward environment. Peer support provides emotional and practical support. Sharing stories and experiences of mental illness with people leads to trust, feelings of being valued, heard and accepted as well as better experiences of care and being seen as a person first. Due to their shared experiences, peer support workers are able to befriend people with mental health problems on the ward. Peer support work bridges the gap and vacuum of care between people with mental health problems and staff. It compensates for understaffing to provide more holistic and person-centred care and support.

Lived experience/ service user perspectives and narratives on peer support are rare, particularly in a hospital setting. This article provides a rich, perhaps overlooked and hidden narrative on the nature of peer support work. People with mental health problems, like Ben, are often excluded from society, health and social care, education, employment and research. This narrative opens up a pathway to understanding peer support from a service user perspective.