Tokenistic or genuinely effective? Exploring the views of voluntary sector staff regarding the emerging peer support worker role in mental health.

Emma Kilpatrick, Sinead Keeney, Claire Odile McCauley

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11 Citations (Scopus)
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AbstractAim: Peer Support Worker (PSW) roles are gaining recognition internationally as a valuable component in mental health service delivery. The aim of this study was to explore the views of mental health voluntary sector staff regarding the emergence of this role.Method: A qualitative research design was used. A purposive sample was employed. Semi-structured interviews were undertaken with 10 staff members in various positions in two voluntary mental health organisations. Interview transcripts were analysed thematically. Results: Views varied on the PSW role with some participants stating that it was tokenistic; whereas others highlighted the value of its contribution. Participants’ expressed concerns regarding professional boundaries and organisational cultural challenges that PSWs may encounter in their role. The provision of reasonable adjustments was recommended as an integral support mechanism.Conclusion: Successful integration of the PSW requires careful consideration of the role, the workplace environment and the unique needs of the peer, in order to prevent the role becoming constrained and diluted. Implications for practice: The PSW role may impact the traditional delivery of mental health nursing services. It is, therefore, essential that nurses are cognisant of these potential challenges to successfully facilitate the integration of PSWs in practice.
Original languageEnglish
Pages (from-to)503-512
JournalJournal of Psychiatric and Mental Health Nursing
Early online date19 Apr 2017
Publication statusE-pub ahead of print - 19 Apr 2017

Bibliographical note

Reference text: References

Barbour R. (2008) Introducing qualitative research: a student guide to the art of doing qualitative research. London: Sage

Basset T., Faulkner A., Repper J. & Stamou E. (2010) Lived experience leading the way: peer support in mental health. Together/University of Nottingham/NSUN: London

Bates A., Kemp V. & Isaac, M. (2008) Peer support shows promise in helping persons living with mental illness address their physical health needs. Canadian Journal of Community Mental Health 27, 21–36

Berry C., Hayward M.I. & Chandler R. (2011) Another rather than other: experiences of peer support specialist workers and their managers working in mental health services. Journal of Public Mental Health 10 (4) 238-249

Brown L., Shepherd M., Wituk, S. & Meissen G. (2007) Goal achievement and the accountability of consumer-run organizations. Journal of Behavioral Health Services and Research 34 (1) 73-82

Cabral L., Srother H., Muhr K., Sefton L. & Savageau J. (2014) Clarifying the role of the mental health peer specialist in Massachusettes, USA: insights from peer specialists, supervisors and clients. Health and Social Care in the Community 22(1) 104-112

Castelein S., Bruggeman R.J., van Busschbach J.T., van der Gaag M., Stant A.D., Knegtering H. & Wiersma D. (2008) The effectiveness of peer support groups in psychosis: a randomized controlled trial. Acta Psychiatrica Scandinavica 118, 64-72.

Chinman M., Shoai R. & Cohen A. (2010) Using organizational change strategies to guide peer support technician implementation in the veterans administration. Psychiatric Rehabilitation Journal 33(4) 269–77

Cooke J.A., Copeland M.E., Hamilton M.M., Jonikas J.A., Razzano L.A., Floyd C.B., Hudson W.B., MacFarlane R.T. & Grey D.D. (2009) Initial outcomes of a mental illness self-management program based on wellness recovery action planning. Psychiatric Services 60, 246–249
Crepaz-Keay D. & Cyhlarova E. (2012) A new self-management intervention for people with severe psychiatric diagnoses The Journal of Mental Health Training, Education and Practice 7 (2) 89-94

Creswell J.W. (2009) Research design: qualitative, quantitative and mixed methods approaches. 3rd ed. London: Sage.

Daniels A., Grant E., Filson B., Powell I., Fricks L. & Goodale L. (2010) Transforming mental health systems of care, through peer support services. Pillar of Peer Support.

Davidson L., Bellamy C., Guy K. & Miller R. (2012) Peer support among persons with severe mental illnesses: a review of evidence and experience. World Psychiatry, 11(2) 123–128.

Department of Health (2011) No health without mental health: delivering better mental health for people of all ages. London: Department of Health.

Department of Health, Social Services and Public Safety (2012) Delivering the Bamford vision: the response of Northern Ireland executive to the Bamford review of mental health and learning disability (2012-2015). Belfast, DHSSPS.

Doughty, C. & Tse, S. (2011) Can consumer-led mental health services be equally effective? An integrative review of CLMH services in high-income countries. Community Mental Health Journal 47, 252–266

Faulkner A. & Basset T. (2010) A helping hand: consultations with service users about peer support. Together, London.

Faulkner A. & Kalathil K. (2012) The freedom to be, the chance to dream: preserving user-led peer support in mental health. Together, London.

Franke C.C.D., Paton B.C. & Gassner L.A.J. (2010) Implementing mental health peer support: a South Australian experience. Australian Journal of Primary Health, 16, 179-186

Gillard S., Edwards C., Gibson S.L., Owen K. & Wright C. (2013) Introducing peer worker roles into UK mental health service teams: a qualitative analysis of the organisational benefits and challenges. BMC Health Services Research, 13(188), 1-13

Gillard S., Holley J., Gibson S., Larsen J., Lucock M., Oborn E., Rinaldi M. & Stamou E. (2014) Introducing new peer worker roles into mental health services in England: comparative case study research across a range of organisational contexts. Administration of Policy in Mental Health, 42, 682-694

Grant E.A., Swint N., Reinhart C. & Wituk S. (2010) The development and implementation of a stateside certified peer specialist programme. In: Brown, L. and Wituk, S. eds. Mental health self-help: consumer and family initiatives. New York: Springer, 193-209

Health Work Force Australia (2014) Mental health peer workforce literature scan Adelaide: Health Work Force Australia.

Holley J., Gillard S. & Gibson S. (2015) Peer worker roles and risk in mental health services: a qualitative comparative case study. Community Mental Health Journal, 51, 477-490

Houghton C., Casey D., Shaw D. & Murphy K. (2013) Rigour in qualitative case-study research. Nurse Researcher 20 (4) 12-17.

Jackson C. (2010). Critical Friends Openmind 161, 14–15.

Lawton-Smith S. (2013) Peer support in mental health: where are we today? Journal of Mental Health Training, Education and Practice 8(3) 152-158.

McLean J., Biggs H., Whitehead I., Pratt R. & Maxwell M. (2009) Evaluation of the delivering for mental health peer support worker pilot scheme. Available at: (accessed 20th October 2016).

Mancini M.A. & Lawson H.A. (2009) Facilitating positive emotional labor in peer-providers of mental health services Administration in Social Work 33, 3-22.
Mead S. & MacNeil C. (2006) Peer support: what makes it unique? International Journal of Psychological Rehabilitation 10(2) 97-37

Miles M.B. & Huberman A.M. (1984) Qualitative Data Analysis Newbury Park: Sage.

Moll, S., Jennifer, H., Geronimo, J. and Sherman, D. (2009) Work transitions for peer support providers in traditional mental health programs: unique challenges and opportunities. Work, 33(4), 449-458.

Moran G.S., Russinova Z., Gidugu V., Yim J.Y. & Sprague C. (2012) Benefits and mechanisms of recovery among peer providers with psychiatric illnesses Qualitative Health Research 22, 304–319

Nestor P. & Galletly C. (2008) The employment of consumers in mental health services: politically correct tokenism or genuinely useful? Australasian Psychiatry, 16(5) 344-347

O’Hagan M., Cyr C., McKee H. & Priest R. (2010) Making the Case for Peer Support: report to the mental health commission of Canada. Available at: (accessed 20th October 2016)

Ochocka J., Nelson G., Janzen R. & Trainor J. (2006) A longitudinal study of mental health consumer/survivor initiatives: a qualitative study of impacts of participation on new members Journal of Community Psychology 34(3) 273–283.

Pratt R., MacGregor A., Reid S. & Given L. (2012) Wellness recovery action planning (WRAP) in self-help and mutual support groups Psychiatric Rehabilitation Journal, 35(5) 403-405

Rebeiro Gruhl K.L., LaCarte S. & Calixte S. (2016) Authentic peer support work: challenges and opportunities for an evolving occupation Journal of Mental Health 25(1) 78-86
Resnick S.G. & Rosenheck R.A. (2008) Integrating peer-provided services: a quasi-experimental study of recovery orientation, confidence, and empowerment. Psychiatric Services 59(11) 1307–1317

Salzer M.S., Schwent E. & Brusilovskiy E. (2010) Certified peer specialists roles and activities: results from a national survey Psychiatric Services 61(5) 520-523

Scottish Government (2012) Mental Health Strategy for Scotland 2012-2015. Scottish Government, Edinburgh

Scott A., Doughty C. & Kahi H. (2011) Peer Support Practice in Aotearoa, New Zealand. Christchurch. New Zealand: University of Canterbury.

Skills for Health (2011) Peer support roles in the mental health workforce: examples of current practice. Skills for health: Bristol. Available at: (accessed 20th October 2016)

Tong, A., Sainsbury, P. & Craig, J. (2007) Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6):349-57.

Trachtenberg M., Parsonage M., Shepherd G. & Boardman J. (2013) Peer support in mental health care: is it good value for money? London: Centre for Mental Health.

van Vugt, M.D., Kroon, H., Delespaul, P., & Mulder, C.L. (2012). Consumer-providers in assertive community treatment programs: Associations with client outcomes. Psychiatric Services, 63, 477-481.

Watts M., Downes C. & Higgins A. (2014) Building capacity in mental health services to support recovery: an exploration of stakeholder perspectives pre and post intervention. Dublin: School of Nursing and Midwifery, Trinity College Dublin.

Welsh Government (2012) Together for Mental Health – A Mental Health and Wellbeing Strategy for Wales. Welsh Government, Cardiff

World Health Organisation (2013) Mental Health Action Plan 2013-2020. WHO, Geneva


  • Mental Health
  • Lived Experience
  • Peer Support
  • Interviews
  • Qualitative


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