SRN blog: What is the role of peer support?

29th June 2017

‘It’s not what we do, it’s the way that we do it.’

Earlier this month I attended the ImRoc ‘Critical Debate in Peer Support’ event in Nottingham. The title of the event intrigued and amused me – as a young person growing up in the 80’s I just couldn’t shake Bananarama’s ‘It ain’t what you do, it’s the way that you do it’. It has taken residence in my headspace and taunts me to sing along whenever I think of the event!

The day kicked off with a lively debate.

Andy White (Peer worker) and Sue Williams (Senior Peer Trainer) set out their argument that in peer support ‘it’s not what you do but the way that you do it’ and that every interaction creates a recovery-focussed opportunity.

Steve Gillard (Reader, Social & Community Mental Health, St George’s University) and Anne Pledger (Recovery and Patient Experience Lead) advocated for distinct and dedicated peer roles to ensure the centrality of the peer relationship, strong value base and to resist co-option.

Strong arguments were presented based on people’s experiences and evidence. Closing the debate with questions and final statements we then had the opportunity to vote on what we felt was more important for peer working. The table below shows how people voted with the overall consensus being that peer support work should be a distinct and dedicated role.

 

What the debate highlighted for me is the challenge in developing peer roles.  ImROC has been transformational in supporting NHS Trusts in England, predominately, to become more recovery orientated. The scale of peer workers employed by NHS Trusts in England is much larger than in Scotland. I was reminded of how important it is to create roles as part of organisational change to recovery orientated practice. It’s more than replacing a vacant post with a peer role otherwise who completes the tasks that there are no longer staff for?

In Scotland, where services have drawn on Experts by Experience Guidelines and develop job descriptions grounded in the Values Framework for Peer Working, our experience is that we avoid the ‘fuzziness’ of understanding what peer workers do.

So quickly we can get into debates as to should peer workers be involved in restraint and whose job is it to make the beds! It’s not about the numbers but how peer workers are integrated and supported within the team with distinct roles and job descriptions. Shouldn’t every person working in services be focussed on ‘the way that you do it’? Relationships are at the heart of positive experiences of using services and key to recovery.

What struck me was just how many people in development roles as well as peer supporters were at the event. There was great passion and positivity of the value that peer workers bring to mental health services and it was a great opportunity to share learning. The infrastructure to peer support in many NHS Trusts is key and I think we have something to learn from this in Scotland.

It was heartening to also learn how people with lived experience are in leadership roles and helping to drive forward a co-produced recovery agenda. Emma Watson (Peer Support Development Lead) introduced her PhD peer support research and I was struck by how much we need to be mindful of the purpose of peer support.

Peer Support can offer a culture of health and ability as opposed to a culture of illness and disability.

(Curtis, 1999).

The primary goal is to responsibly challenge the assumptions about ‘mental illness; and at the same time to validate the individual for who they really are and where they have come from. Peer support should attempt to think creatively and non-judgementally about the way individuals experience and make meaning of their lives in contrast to having all actions and feelings diagnosed and labelled.

(Mead et al., 2001)

 

Emma’s ‘The Growing pains of peer Support’ can be downloaded free  – apparently we are in the teenage stage!

At the event we were also introduced to the inspiring work of  Dear Albert’, a peer support (substance misuse) social enterprise. They said:

Recovery is about networks of people coming together to share solutions. Linking up to challenge lifestyles and change identities, offering different culture and alternatives to ‘using’ rituals. It is about utilising the wisdom of community.

 

Manna to my soul was Michael Ryan (Service Development Lead, HSE Mental Health Division, Ireland) describing the peer support development he is leading in Ireland. He recognises the learning from others experiences in how to develop roles and is making sure the foundations are built around the development of peer roles. There was an incredulous gasp around the room when he mentioned the anticipated pay scale for peer workers!

The day included many opportunities for debate and discussion. We had a great discussion at our table of ‘How can we utilise the lived experiences of professional staff?’ and there were some great ideas. It was pointed out we had the bones of a great paper!

Will we bite…?

Lesley Smith