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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.

Describes a pilot peer education project based at Fife Health Promotion Department, which began in April 1993. The project had funding for three years and was supported by Fife Health Care, Fife Health Board and the Health Education Board for Scotland. Describes how the project team devised a model to clarify the aims and objectives of the project, given that there is no affiliated body to provide guidelines, and that there is a lack of documentation concerning thorough evaluation and the plethora of meanings associated with peer‐led work. The model will make it easier to document the processes involved for the purposes of evaluation. Outlines the rationale behind the model and describes how the model provides a core framework for other peer work.

Peer support work is increasingly becoming part of the delivery of health and social care services. However, in an Irish context, there is a paucity of research in this area. This study aims to investigate the experiences of peers and other key stakeholders across four sectors in Ireland.

Qualitative interviews (N = 35) were conducted with key respondents in mental health, substance use, migrant health and homelessness sectors. Data were analysed using thematic analysis and reported using an ecological framework.

Peer work is a slowly emerging area of practice, although mental health is further ahead in this journey. Findings suggest that peers are important additions to service delivery but also have various support and development needs. Organisations can encourage and support peers into employment through enacting human resource policy and practices, effective supervision, management and maintaining a positive working culture. Helping other professionals to understand the peer role and how it can function within the wider team is highlighted. National policy and governance structures can also support the emergence of the peer role, which exists in a highly complex arena.

Peers can play a meaningful role in supporting service users in four sectors of health and social care in Ireland. Structures and processes to help embed these roles into systems are encouraged across micro, meso and macro levels. Implications and limitations are discussed for moving forward with peer work.

To the best of the authors’ knowledge, this is the first study to include these four areas of practice simultaneously.

There has been a significant growth in the employment of peer workers over the past decade in youth and adult mental health settings. Peer work in mental health services for older people is less developed, and there are no existing peer work models for specialist mental health services for older people in Australia. The authors developed and implemented a peer work model for older consumers and carers of a specialist mental health service. The purpose of this paper is to describe the model, outline the implementation barriers experienced and lesson learned and comment on the acceptability of the model from the perspective of stakeholders.

To ensure the development of the peer work model met the needs of key stakeholders, the authors adopted an evaluation process that occurred alongside the development of the model, informed by action research principles. To identify stakeholder preferences, implementation barriers and potential solutions, and gain insight into the acceptability and perceived effectiveness of the model, a range of methods were used, including focus groups with the peer workers, clinicians and steering committee, consumer and carer surveys, field notes and examination of project documentation.

While the model was overall well received by stakeholders, the authors experienced a range of challenges and implementation barriers, in particular around governance, integrating the model into existing systems, and initial resistance to peer work from clinical staff.

Older peer workers provide a valuable contribution to the mental health sector through the unique combination of lived experience and ageing. The authors recommend that models of care are developed prior to implementation so that there is clarity around governance, management, reporting lines and management of confidentiality issues.

The employment of mental health consumers as peer support workers (PSWs) to provide support to other consumers is gaining momentum around the world. The purpose of this paper is to explore the tensions and dilemmas for a social worker in developing a peer support programme at an inpatient psychiatric service in Australia. The author draws on her experience of embedding a peer support programme providing an insight into the difficulties experienced and strategies used which supported the embedding of PSWs. The discipline of social work has complimentary values to the philosophy of peer support as well as the skills to manage the broad range of activities and tasks associated with developing a new programme. Due to the profession’s underlying knowledges and values social work is able to act as a bridge between mental health professionals such as doctors and nurses and PSWs giving social workers the ability to “interpret” the divergent languages, values, beliefs and practices.

A retrospective analysis of peer support programme implementation using social work values as a point of reference.

The author draws on her experience of embedding a peer support programme providing an insight into the difficulties experienced and strategies used which supported the embedding of PSWs. Due to the profession’s underlying knowledges and values social work is able to act as a bridge between mental health professionals such as doctors and nurses and PSWs giving social workers the ability to “interpret” the divergent languages, values, beliefs and practices.

This paper arose out of a conference presentation and author’s Master’s Dissertation, for which she received honours marks. During the period she was implementing the peer support programme, there was a dearth of local (Australian) literature about peer support programme development; this paper is a response to that need as the author would have greatly appreciated some local wisdom about embedding peer support programmes.

The authors believe this is a unique approach to a journal paper; certainly the authors have not discovered anything of its ilk previously. There is a lot of material available now about peer support, its benefits and challenges, and many are written by social work, psychology, psychiatric and nursing academics but without overt statement of the professional values which inform their practice.

In April 2010, Nottinghamshire Healthcare NHS trust won Regional Innovation Funding to recruit, train and employ six peer support workers in community mental health teams. At the time, practical examples of the employment of peer support workers were lacking in England. An earlier paper focuses on the lessons learned in this first year of peer support. The aim of this paper is to examine the nature and dynamics of peer support: what the peers did with clients and what difference this made.

The project was evaluated using a simple evaluation model reflecting service structure, processes and outcomes, collected through qualitative methods: documentary analysis, semi‐structured interviews and a focus group.

The six peers worked with 83 clients over the six month period. They offered emotional, practical, social support, support specific to care and support specific to recovery. They felt that the shared knowledge that they too had experienced mental health challenges was critical in engaging with clients in a trusting relationship and in informing their work.

In the absence of English service models for peer support workers, this paper provides some guidance for new peer support teams, and some evidence to support the helpful nature of peer support work.

This paper aims to present a working model for using experiential knowledge in the work of lived experience practitioners within the mental health field.

The working model is constructed from three key elements, namely, components of lived experience, the Library of Life Experiences and the NISE technique for sharing experiential knowledge (NISE: need identification; inner identification; sharing experiential knowledge and interpersonal encounter).

The model will be described, followed by central themes that emerged from a pilot course that was taught in Israel in 2019 to a group of peers working in the mental health system. The central themes were: developing peer identity; sharing peer language; internalizing the working model; understanding the peer role; and awakening social consciousness.

The original working model and training course were co-produced and co-conducted by peer specialists and mental health professionals, for the use of lived experience practitioners.

In the previous chapters, I set out a conceptual model of trauma-informed servant leadership and discussed servant leadership supervision for working with burnout, compassion fatigue and secondary trauma in employees within trauma related health and social care settings. In this chapter, I further extend servant leadership to the peer support principle in trauma-informed approaches (Substance Abuse and Mental Health Services Administration, 2014). The first part of this chapter will examine peer support work (PSW) and report on the outcomes associated with it. Then, servant leadership will be discussed and used to operationalise the principle of peer support as set out in trauma-informed approaches. A servant leadership peer support approach is put forward with a theoretical basis. This theoretical model has been slightly changed from the previous servant leadership approaches discussed, in order to represent the PSW role more accurately. However, as discussed previously, it is not the characteristics of the Servant leadership (SL) model that define the approach, rather the philosophy and desire to serve first. In the last section of this chapter, Martha Griffin brings the characteristics of this model to life using her vast experience and discusses some of the potential challenges faced by peers in training and practice.

In April 2010, Nottinghamshire Healthcare NHS trust won Regional Innovation Funding to recruit, train and employ six peer support workers in community mental health teams. At the time, practical examples of the employment of peer support workers were lacking in England. The aim of this paper is to communicate the key lessons learned in this first year of peer support in the hope that these will provide a foundation for other services to build upon.

The project was evaluated using a simple evaluation model reflecting service structure, processes and outcomes, collected through qualitative methods: documentary analysis, semi‐structured interviews and a focus group.

The peer support employment process has been broken down into its fundamental components (selection, recruitment, training, supervision relationships, recovery approach and discharge of clients) and within each of these sections a brief narrative is provided to explain some of the challenges faced. Each section ends with recommendations based on the lessons learned as a result of the pilot study.

A second paper will examine the nature of peer support: what the peers did with clients and what difference this made.

At present many mental health services are planning to employ peer support workers and this paper provides some early guidance for implementing this process in the NHS.

Peer harm reduction programmes engage service users in service delivery and may help peers to develop employment skills, better health, greater stability, and new goals. Thus far, peer work has not been discussed as an intervention to promote recovery. The purpose of this paper is to provide findings related to two research questions: first,do low-threshold employment programmes have the potential to contribute to positive recovery capital, and if so, how? Second, how are such programmes designed and what challenges do they face in supporting the recovery process?

Using a community-based research approach, data were collected at a Toronto, Canada community health centre using in-depth interviews with peer workers (n=5), staff (n=5), and programme clients (n=4) and two focus groups with peer workers (n=12). A thematic analysis was undertaken to describe the programme model and to explore the mechanisms by which participation contributes to the development of recovery capital.

The design of the Regent Park Community Health Centre peer work model demonstrates how opportunities for participation in community activities may spark cumulative growth in positive recovery capital within the community of PUDs. However, the recovery contagion of peer work may lose momentum with insufficient opportunities for new and experienced peer workers.

Using the concept of recovery capital, the authors demonstrate how low-threshold employment interventions have the potential to contribute to the development of positive recovery capital.