Embracing the challenge of developing the peer support worker role |
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| Tuesday, 20 September 2011 |
In this month's look at issues affecting those on their journey of recovery, mental health communicator Heidi Tweedi explores some of the barriers and supports to developing peer worker roles. “Peer Support what's not to love? Everyone benefits!” enthuses Belinda Jenkinson, former chartered librarian currently working as a peer support worker at Gartnavel Royal Hospital in Glasgow. “I find it helps keep me well, because it is meaningful and purposeful. The people I work alongside begin to rediscover their strengths and develop hope for their future. My colleagues in the work place gain greater knowledge of the possibilities of recovery in its widest sense, both for their ‘patients’ and themselves. I get to stay well, give something back to society and get paid for it.” Indeed, what’s not to love about the peer support worker role? The evidence from project evaluations, as well as word of mouth, is especially positive, and the development of this new role seems to intrigue and excite mental health professionals, service planners and those using services equally. But with an estimated twenty-five paid peer support worker roles across Scotland* the uptake and support of this emerging role is proving slow; something is holding people back. A key barrier to developing peer support workers becomes clear when you consider just how challenging creating and supporting this new role can be. “It’s such a valued role that we can’t underestimate it,” Graeme Mollon, senior social worker, coordinator of the Community Rehab team at the Royal Edinburgh Hospital and peer worker supervisor explains. “As professionals we are encouraging change but when it’s asked of us it’s a big challenge.”  Not so much a case of 'blame professionals' but rather recognising the sea change that is using paid lived experience in a professional mental health environment. “To change professional practice we need positive role modelling and healthy challenging of perceptions,” Linda Irvine, Strategic Programme Manager for mental health and wellbeing, NHS Lothian and chair of the Lothian Recovery Network, explains. “We need to understand that protecting boundaries is what professionals like consultants have been trained to do; it’s professional practice and takes time to deconstruct.” Clearly we are looking at a paradigm shift in the culture of mental health services. Add to this the time it takes to develop any new role in a service - especially statutory - with appropriate pay structures, practice standards and a job description, and you start to get a sense of the timescale that may be involved. To support this process, SRN in collaboration with SQA, have developed a ‘Professional Development Award’ in mental health peer support. Unfortunately the development of the accompanying learning materials has been significantly delayed and this may have contributed to the slow take-up as some employers wait for a nationally recognised award to be available.  However, support for peer support workers does move forward this September with SRN hosting its ‘Experts by Experience’ conference in Perth (21st September) and releasing guidelines designed to support the development of peer worker roles, informed by learning from the 2009 evaluation of the Delivering for Mental Health Peer Support Worker Pilot Scheme and international experience.Part of these guidelines deal with the crucial process of planning prior to creating a new peer worker role. Key to this is a need to explore the service’s initial motivation for developing the new role. This makes sense with any new development but in the case of peer working perhaps particularly important given some evidence that peer workers have been unreasonably seen as a quick route to improving non-recovery focused services. As the 2009 evaluation of the pilot scheme reports, “One key finding was that peer support works best when peers are based in settings that have a pre-existing commitment to the values and principles of recovery.” These values are vital for a peer worker to feel accepted in an existing team. “The challenge in my job is linking with ward staff, some of whom are not yet recovery focused and have a fear of ‘what if you get ill?’ I have to continually reassure them that I know my signs; get them to see you can be off ill and then come back,” explains Mandy Scott, peer support worker in the Community Rehab Team NHS Lothian, and one of the keynote speakers at Experts by Experience. “The eyebrows go up when they learn you have experience. One minute you’re working alongside a consultant in a professional capacity and the next you need to see them for your own mental health issues.”  Graeme Mollon, Mandy’s supervisor, has additional concerns: “The peer worker role can be isolating. You could be taking hope forward when others in your workforce are not.” He sees the supervisory challenge in balancing the autonomy of the role and its novel nature: “You can’t put too much pressure on the worker but equally they must not feel patronised - this person has a valued role and could be easily exploited and misused.” “It’s also very important that all managers buy in,” explains Fran McBride, an occupational therapist based in Kirkintilloch and peer worker supervisor. “My job is to be a buffer and clarify whether the service is suitable for a client to access; freeing the peer workers to move forward in their work.” Fran was selected by managers to support the development of a new peer support worker service due to their existing recovery orientated practice. Despite this background Fran took necessary time to research the role: “I liked the concept but was unsure how it would work; it took a while to work it out. I did a lot of homework, met with other peer support services and took on their learning. Case studies helped me to understand how it differed from a traditional support worker role; I understood the value of a peer and a support worker and I recognised it brought something unique, it sits alongside other components of the mental health team.” Embracing the necessity for thorough planning and research, Edinburgh Council is set to initiate three new peer support worker posts. Mental Health Officer, Carl Abernethy, explains why the initial plan of having workers attached to the MHO service was revised: “Much consideration has been given to potential conflicts and issues of confidentiality (i.e. tribunals and CTO applications). There has been a lengthy consultation process with service user-led groups and once the planning process began, it became apparent that it would be more appropriate if the workers were embedded within the Housing Support Service (Positive Steps) rather than with the MHO team itself.” Clearly creating and supporting new peer support worker roles in an effective and appropriate way is a task that should take time and reflection; we may all love the idea of peer support work but developing the practice, and getting it right, will take time. For those frustrated with the pace of development it’s important to remember that it’s not so much an 'if' but a 'when'; the positivity of peer workers, such as Mandy, is testimony to that: “I was told at one point that I was the most unwell person they had ever seen. When they see me in this role now it must give that team hope that recovery can happen.” *Estimate from SRN August 2011. Comments (2)
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written by Eileen Hay, November 06, 2011
Whilst my personal recovery journey has been enduring it has perversely given me a lease of life I would not otherwise have experienced. I feel priviliged and honoured to have met so many different people on my journey and from whom I have learnt the art of patience, humility and empathy. In my darkest days I could never envisage my wellness and supporting others to recognise their individual potential is therefore a two-way street that by default also assists my recovery.
... written by hugh mcfadden, September 27, 2011
This is an exciting time for people in recovery. I am at the early learning stages of being involved with Peer Support and that old saying "if you want to learn something, go out and teach it" comes to mind.
Because of what I get out of learning to become a Peer gives me more of an appetite for recovery. A great big thank you to E CLIPS (Cairscotland)and Theresa Clark who makes it fun to recover. Hugh Write comment
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