Authentic peer support work: challenges and opportunities for an evolving occupation.

Background: The peer support worker (PSW) belongs to the fastest growing occupation in the mental health sector, yet it is often under-valued and poorly understood. Despite an emerging evidence base, and strong support from mental health service users, the PSW remains on the periphery of mainstream services in northeastern Ontario.

Aims: To examine the role of the PSW, along with the challenges and benefits, and to understand why the PSW is not more integrated within mainstream services.

Methods: A sequential, exploratory, mixed-methods design was used to collect data on 52 survey and 33 focus group participants. Qualitative data were analyzed thematically.

Results: Peer support work was described by participants as being authentic when PSWs can draw upon lived experience, engage in mutually beneficial discussions, and be a role model. Authentic peer support was noted to be important to the recovery of mental health service users; yet, participants revealed that many positions continue to reflect more generic duties. Challenges to further integration include acceptance, training and credentialing, self-care, and voluntarism.

Conclusions: Future development and mainstream integration of peer support work must reconcile current tensions between standardization and loss of authenticity. Training in communicating the lived experience, setting boundaries and self-care are important steps forward.