Peer Support Workers: Exploring Rethink Mental Illness’s Practice

A peer support worker is someone with lived experience of a mental health problem who uses their experience to support other people in mental health services. 

It is a crucial role within a number of Rethink Mental Illness services.

In early 2023, we launched our Learning and Insights project to find out more about the experiences of our peer support workers (PSW), so we could:

• Give staff a chance to pause and reflect on the value and contribution of PSWs within Rethink Mental Illness services
• Reflect on Rethink Mental Illness’s practice with regards to recruiting, embedding and supporting PSWs
• To explore how some of the themes and topics in the literature are playing out with Rethink Mental Illness’s particular context
• Consider how things could be improved or adapted moving forwards

The findings of this project are presented in our Peer Support Workers: Exploring Rethink Mental Illness's Practice report and demonstrate how the role of a PSW contributes significantly to our services.

The peer support worker role in practice

The majority of people involved in the review were positive about their experience of either undertaking their PSW role or managing PSWs. However, a lot is being learnt about the uniqueness of the role and what this means for our practice.

1. Recruitment and induction

Very often, the PSW role was someone’s first role in the mental health sector. Being mindful about this in the recruitment process, both in terms of where the role is advertised and the interview process itself, was felt to be important.

2. Knowledge, skills and experience

In addition to lived experience, there are range of qualities and skills that staff feel are important in these roles including:

• Being open minded, kind and compassionate
• Being patient, sympathetic and empathetic
• Being adaptable, self-aware and reflective
• Being fairly resilient and having an element of self-confidence
• Having good communication and interpersonal skills
• Having good organisational skills and the ability to work as a team
• Able to work independently, remain calm and have an element of life experience to
  bring to the role.

3. Management, supervision and support

The majority of PSWs feel well supported in their role, especially when they are part of a team with other PSWs (*this aligns with existing literature). However, people felt that PSWs’ internal support networks could be extended. Managers themselves are very thoughtful about how to balance their traditional supervisory role with a more supportive, “hands on” role, which is having an impact on managers’ time and capacity.

4. Training and development

Staff are positive about the peer support training PSWs receive, however, a number of additional training needs were identified. There is also felt to be a gap in the progression and development opportunities for these
roles.

5. Boundaries of the role

The difference between PSWs and other roles (e.g. Wellbeing Practitioners) was articulated by managers in terms of their duties, with PSWs not usually responding to initial referrals or getting involved in case or risk management decisions. Whilst the majority of PSWs are comfortable with the range of duties associated with their role, a couple of people questioned the appropriateness of their role in solely crisis-based services as well as working on a mental health phoneline.

6. Feeling valued

The majority of PSWs feel valued by Rethink Mental Illness and external partners, and services are actively taking steps to ensure this is the case. However, the level of seniority, salary and perception of the role are leading some to feel undervalued.

7. Drawing on lived experience

Interviewees were clear about when and how it was appropriate to share their lived experience, and the majority did not feel under pressure to share on every occasion.

8. What makes someone a peer

Interviewees were thoughtful about what makes someone a peer (including factors such as mental health diagnosis, age, cultural background, personal interests etc) and deliberate choices are being made about matching PSWs with service users (where this is possible). A discussion arose, however, about how central someone’s mental health diagnosis should be in this decision making process.

Ideas for improvement

There were six main areas where improvements were identified by respondents, including:

• Reviewing where PSW roles are advertised as well as adapting the interview process
• Providing a variety of training opportunities, not just training in peer support
• Increasing the internal support networks available for PSWs and their managers
• Identifying development and progression opportunities for PSWs to ensure the principle of reciprocity features in the peer support role
• Developing a more consistent approach across services that are employing PSWs both in terms of the training offer as well as the expectations of the role
• Respecting the value of the peer support relationship by taking care to end someone’s support with a PSW sensitively

The review provided important insights into the significant value of PSWs. It documented the passion service managers have for embedding PSWs within their services and drawn attention to the uniqueness of the role and the implications this has on all stages of the employment journey.

For more information, email rebecca.moran@rethink.org