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The purpose of this service user narrative and viewpoint article is to describe interprofessional and interpersonal barriers to peer support on a men’s mental health ward over the course of a year from a lived experience perspective.

A reflective journal was kept and participant observation was conducted over the course of the year.

There is sometimes a fissure and binary of “Us” and “Them” on the ward. In other words, staff can sometimes perceive peer support workers to be “one of us” (a member of staff) or “one of them” (a service user). For service users, the opposite is sometimes true: “one of us” (a service user) or “one of them” (a member of staff). Peer support workers must bridge this gap and strive to be “one of us” with both these groups, which is no easy task. A good ward manager or peer team leader can smooth over interprofessional differences and support the peer worker in their efforts of care towards the recovery of people with mental health problems.

Little has been written on this topic in a mental health inpatient setting as most papers address community peer support work, which is very different from peer support in hospital. This paper addresses one of the first peer support pilot projects in hospital of its kind in NHS England so is quite innovative and perhaps even unique.

The purpose of this service user paper and narrative is to highlight that peer support is not a continuous, easy or uniform process but given to disruption, fragmentation, breakdowns in relationships and hurdles. This is illustrated in a summary of the case of “Christopher”.

A reflective journal was kept, and participant observation was conducted for just under a year on the ward where Christopher was under Section.

Peer support can be given to fissure, breakages in relationships and discontinuity. This can negatively impact the mental health of peer support workers. With this in mind, it is vitally important to ensure that the people who take up this role are appropriately trained, supported and supervised. There needs to be a focus on “restorative” supervision and supervision by someone with experience of the peer support role as well as buddying between peer workers.

There is an abundance of literature and research on peer support in the community but little in the inpatient setting, making this paper novel and a contribution to understanding peer support on mental health wards.

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.

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 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 purpose of this paper is to review current perspectives on peer support in mental health informed by service user perspectives.

The paper is informed by a literature review and consultations with five groups of service users engaged in different forms of peer support.

The findings suggest that there are many benefits to service users from engaging in peer support. These include: shared identity; development and sharing of skills; increased confidence; improved mental health and wellbeing; and the potential for challenging stigma and discrimination. Most difficulties encountered were associated with “intentional peer support”, where service users are employed as peer support workers – these included role conflict, setting boundaries, and ensuring adequate training and support. A key theme that divided opinion was the degree to which peer support should be “professionalised” as part of statutory services.

The findings suggest that it is vital to acknowledge the different views about peer support that arise in different service user and voluntary sector groups: views about such core issues as payment, equality, and professionalisation. Ultimately, peer support arises from people wanting to create their own support networks; any plans to formalise it from within statutory services need to acknowledge that pre‐existing grassroots expertise.

Recent developments mean that peer support, which originated from the grassroots of service user experience, has taken a new direction through becoming incorporated into statutory services. This paper looks at some of the benefits and pitfalls of these developments informed by the views of service users.

The purpose of this paper is to provide an overview of the implementation of a peer support volunteer scheme in a high secure setting and to explore the peer support volunteer’s experiences conducting this role, based predominantly on an assertive rehabilitation ward.

This paper has outlined the implementation of the peer support volunteer scheme in a high secure setting and has explored the peer support volunteer’s experiences conducting this role and has explored the views of newly transferred patients who have accessed this scheme. The peer support scheme is based predominantly on an assertive rehabilitation ward. The data have been collected through the completion of detailed questionnaires that have been disseminated to participants through the clinical team.

This paper has outlined the implementation of a peer support scheme on an assertive rehabilitation ward within a high secure forensic mental health setting. This paper has explored the role and experiences of a peer support volunteer on an assertive rehabilitation ward and has explored the experience from a service recipient’s perspective also through the completion of questionnaires. This paper has explored the overall benefits of peer support within mental health services to both the volunteer, staff members and to a patient newly admitted to the ward, and has identified the skills that the volunteer is able to develop following contribution in to the peer support scheme.

This paper has acknowledged that there have been challenges introducing this particular scheme into mental health service teams. Challenges have included establishing appropriate boundaries and dilution of the role due to power imbalances, both between the peer support volunteer and the service recipient, but also between the clinical team that supervises the overall peer support scheme (Christie, 2016). The clinical team within this particular ward have been mindful with regards to the approach that has been utilised and has therefore, included the service users within the overall development of the scheme to encompass the recovery principles, but have continued to review the progression as a team and have taken into consideration all aspects of relational security.

The paper relating to the implementation of the peer support volunteer scheme in a high secure setting has not been published before and is not under consideration for publication with another journal.

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.

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.

Lived experience has increasingly been incorporated into service delivery across health and social care settings. One of the methods used to do this is through the provision of peer support work. While many people will have lived experience of an issue, condition and may even work in services, peers are markedly different insofar as they are employed specifically because they are using this lived experience to explicitly inform their way of providing an intervention. As we will see throughout this book, peers are not a homogenous group; however, they do use some of the same processes to engage and offer support to people with a variety of health and social vulnerabilities. This chapter contextualises these issues before delving into further chapters authored and co-authored by those with lived experience across multiple areas of peer support work.