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The purpose of this paper is to explore user leadership in peer support practice by reviewing existing evidence and models of delivery, investigating the recently developed term of “authentic” peer support and reflecting on challenges and opportunities for the future.

The paper presents and discusses views and evidence on peer support policy and practice, found in the current literature, grass roots peer support experts’ presentations and contributions to conferences, a national peer support network, key policy documents and the work of Together for Mental Wellbeing.

Peer support benefits are widely documented as is its history, rooted in user leadership. More recently, peer support is acknowledged in a number of key mental health policy documents as seen to be key in the response to current quality and cost agendas. There has been a simultaneous increase of “formal” peer support as practiced by large service providers and a gradual shift away from its “user led” origins. Against the background of the current economic climate and implications for mental health services, there seems to be a need to pause and reflect on current peer support practice and rethink the way forward.

This paper's emphasis on the authenticity of peer support covers new ground in relation to an important topical debate.

The purpose of this paper is to outline what peer support is, covering its history, variations and benefits, then goes on to discuss what the challenges have been to authenticity and what the future holds for peer support.

The authors argue for the necessity of service user leadership in peer support based on both the Service User Involvement Directorate’s (SUID’s) experience and UK-wide learning.

Peer support brings wellbeing and confidence benefits both to the supporter and the supported. However, the lack of understanding of what peer support is, the current climate of austerity and over-professionalisation can threaten the transformational power of genuine peer support.

Peer support is always evolving, and there are areas like the criminal justice service and secure services where more work needs to be done.

Commissioners/funders of mental health services should recognise the value of peer support and its potential for better wellbeing outcomes, while understanding the necessity of service user leadership to maximise its beneficial potential.

The paper looks at peer support at the point in time a decade after the formation of the SUID at Together and four years since the UK mental health strategy No Health Without Mental Health (Department of Health, 2011) and explores the challenges faced at a time when the value of peer support is generally accepted in legislation.

This paper aims to explore the extensive roots of peer support in mental health, and to identify the values and principles that the authors wish to hold onto as choices are made as to how and whether to engage with formal peer support within the National Health Service (NHS).

The authors attempt to cover the ground of three types of peer support, but with an emphasis on informal peer support and participation in consumer or peer‐run groups as providing the roots for the third more formal type, which is often known as intentional peer support (IPS).

Professionalisation of peer support may endanger the equality that lies at the root of peer support relationships. Independence may also be compromised if peer support becomes just another part of mainstream services. Whilst an individual/personalised approach to providing services has many strengths, one must be careful not to remove all opportunity for service users to meet together, support one another, plan and campaign.

The findings suggest that commissioners of services should aim for a plurality of peer support and be careful to ensure that informal peer support is flourishing as an essential basis for more formal peer support.

The paper shows that, with an increased interest in providing peer support as part of mainstream services, it is important to stress the basic values and principles that underpin informal service‐user led peer support.

This paper aims to explain how the CAPITAL Project Trust established an inpatient peer support project in West Sussex.

The paper sets the project within local and historical contexts, seeking to explain some of the reasons for the growing interest in formal peer support, before explaining the methodology used to set up the project and the learning along the way. The author draws on evidence from evaluations to demonstrate the added value offered by inpatient peer support and argues for a peer defined set of values to underpin all peer support projects.

Models of inpatient peer support need to be flexible to both the individual talents of peer support workers and the cultures of the different wards in which they work.

The paper shows that the project demonstrates the value that can be added by independent peer support workers being placed on acute inpatient wards and the importance for service users of peer support being peer led.

This paper aims to provide a summary of where peer support currently sits in the UK mental health services policy and practice. It presents an overview of models of peer support; the UK national policy on peer support; evidence of the benefits of peer support; case studies of recent and continuing peer support in action; challenges facing peer support; and suggestions for developing peer support in the future.

The paper selects and discusses evidence from academic literature and policy and practice on peer support within the UK.

The evidence base demonstrating the benefits of peer support in mental health across the UK is increasing. This has persuaded UK governmental bodies to encourage the development of peer support services, of which there is a number of models and examples, although the current economic climate poses challenges to their development.

Historically, peer support in mental health services across the UK has developed piecemeal. But at a time when policy-makers, health practitioners and people who use mental health services are increasingly recognising the benefits of peer support, this paper draws key evidence together and provides pointers towards the future development of such services.

The purpose of this paper is to explore what helped seven people in contact with secondary mental health services achieve their vocational goals, such as: employment, education, training and volunteering.

The authors used the practice of co-operative inquiry – staff and peer supporters co-designed an evaluation of vocational and peer support work with service users.

Service users experienced invalidating living conditions that caused serious distress. These life struggles included: isolation, trauma events and stigma. The impact involved distressing emotions such as: despair, fear, pain and confusion. In contrast, when service users experienced supportive validating conditions (trusting relationships, engaging in valued activity and peer support) they reported being able to learn, change and grow – finding their own way forward, to improve well-being and quality of life.

Qualitative analysis from in-depth interviews revealed a range of consistent themes that enabled the authors to visually represent these and “begin” developing a model of change – grounded in lived experience. Further research is required to develop this model.

The development of a model of change grounded in an invalidation/validation framework offers a different approach – in terms of how people are perceived and treated. This has relevance for Government policy development, clinical commissioning groups and practitioners.

The purpose of this paper is to report the experience and impact of paid staff who are employed to use their lived experience of mental health issues and service use within a secure mental health provider.

A qualitative approach using semi-structured interviews and thematic analysis was employed.

Results from this study suggest that employing lived experience workers (LEWs) in secure mental health settings is valuable to clinical staff, service users, the employing organisation and LEWs themselves. Findings emphasised the importance of support for LEWs to enable them to fulfil their role and maintain wellbeing, and the need to consider LEWs career progression within and beyond the role.

This study had a small sample size.

There is evidence to support LEWs in secure mental health settings and requirement for further understanding of their work in this environment. Specific recommendations include the need for training for clinical staff about the role of LEWs, specific LEWs role training, and regular supervision and mental health support for LEWs.

This is the first paper reporting the experience and impact of LEWs in a UK secure mental health service.

The purpose of this paper is to present findings from an evaluation of a community mental health resilience intervention for unemployed men aged 45-60. The focus is on examining the place of facilitated peer support within a multi-dimensional men’s mental health programme, and exploring implications for resilience building delivery approaches for men.

The paper draws on a mixed methodology design involving before and after survey data and qualitative interviews, to report results concerning effectiveness in changing men’s perceived resilience, to consider project processes concerning peer support, and to situate these within wider community environments.

The programme significantly raised the perceived resilience of participants. Project activities promoted trusting informal social connections, gains in social capital arose through trusting relations and skill-sharing, and peer-peer action-focused talk and planning enhanced men’s resilience.

The paper considers facilitated peer support on a programme, rather than on-going informal peer support or more formal peer support roles (a limitation reflecting the boundaries of the funded programme).

The paper discusses emerging considerations for resilience building, focusing on gender-sensitive approaches which can engage and retain men by focusing on doing and talking. It highlights the importance of peer support in community interventions which feature a social model of change. There is potential for encouraging further peer mentoring and peer led support beyond facilitated peer support in programme delivery.

Potential exists for gender-aware programmes to sustain salutogenic change, co-producing social assets of peer support, male-friendly activities, and context sensitive course provision.

The paper adds fresh evidence of gendered intervention approaches with a specific focus on facilitated community peer support, including effects on male resilience. Little previous resilience research is gendered, there is little gendered research on peer support, and unemployed middle-aged men are a significant risk group.

The purpose of this paper is to describe service user involvement, explain some of the key issues that define, affect or protect mental health in later life and show how involvement may contribute to better mental health in later life.

The paper reviews existing definitions of involvement and mental health in later life; provides a more detailed review of some examples of involvement at a range of levels and illustrates how these could have a positive impact on mental health.

Active involvement and engagement at all levels offers significant opportunities for older people to protect and improve their own mental health and the mental health of society as a whole.

This research does not set out to promote any particular intervention or involvement technique. The examples given have been evaluated in a variety of ways.

Service user involvement should be considered as an important potential contributor to mental health in later life.

The paper encourages people in later life to be considered as a community resource rather than a problem that needs to be solved.

This paper brings together existing research with a focus on the relationship between involvement and individual and collective mental health.

The purpose of this paper is to explore features of successful peer supported community support groups hosted by St Mungo’s and partners.

Literature review and theme construction.

Overall the review confirmed existing findings that successful support groups foster mutually supportive, reciprocal relationships capable of inspiring hope among group members. This paper will concentrate on findings that co-production was indicative of successful groups in terms of shared aims, negotiated agendas, clear communication, and engagement with the wider community.

A group’s success was seen in terms of growth in members’ self-esteem, empowerment, and optimism, which this paper proposes could become part of a conceptual framework of a learning organisational culture.

Developing understanding of a rapidly growing phenomenon in community-based mental health care and presenting this in terms of a particular organisational culture.