So if we like the idea of peer workers, why aren’t we seeing more?

Abstract

The employment of peer support workers is widely encouraged in recovery-oriented mental health systems and services, providing a tangible example of how to translate recovery values and principles into actions. In Scotland, despite a long-term policy commitment to recovery approaches, the creation of peer worker roles has been slow and patchy. This paper describes findings from a study on the levers and barriers to the development of peer worker roles in two Scottish health board areas. Findings suggest that new evidence on effective implementation and cost effectiveness should be prioritised to support potentially complex role development in times of reduced resources. We argue that additional evidence on effectiveness is unlikely, by itself, to lead to country-wide employment of peer workers. We therefore suggest that a policy commitment to peer working would be reinforced by not only a strengthened evidence base but also strengthened accountability mechanisms. In the absence of such accountability, decision-makers and planners might reasonably continue to ask “why bother”?

Keywords: Peer support, Recovery, Mental health policy, Role adoption, Workforce development

Core tip: Recovery approaches are widely and increasingly promoted internationally in mental health policy and services. Peer support working is a new professional role in mental health services and provides a tangible example of recovery principles being applied within the context of these services. As a consequence, there is a great deal of interest in emerging evidence around this role, and whether/how evidence might support increased and more effective involvement of peer workers. Our editorial presents findings from research in Scotland and on the basis of these, poses some “big questions” concerning what needs to happen to accelerate progress in not only the employment of peer workers but also in mental health services’ recovery approaches more generally.