Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Jun 22, 2015; 5(2): 160-166
Published online Jun 22, 2015. doi: 10.5498/wjp.v5.i2.160
So if we like the idea of peer workers, why aren’t we seeing more?
Jacki Gordon, Simon Bradstreet
Jacki Gordon, Jacki Gordon + Associates, Glasgow G44 3TE, Scotland, United Kingdom
Simon Bradstreet, Scottish Recovery Network, Glasgow G2 6HJ, Scotland, United Kingdom
Author contributions: Gordon J was the lead author and was responsible for conducting and reporting the original research study described herein; Bradstreet S was responsible for describing progress in recovery thinking and practices within Scotland and internationally; the reflections and arguments were jointly developed by the authors.
Supported by The Scottish Recovery Network.
Conflict-of-interest: Simon Bradstreet is the Director of the Scottish Recovery Network who has a strategic interest in the promotion of peer working. Jacki Gordon is an independent researcher commissioned by the Scottish Recovery Network for this research.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jacki Gordon, BA (Hons), MSc, MPH, Jacki Gordon + Associates, 8 Williamwood Park West, Glasgow G44 3TE, Scotland, United Kingdom. jacki@jackigordon.net
Telephone: +44-141-5777077
Received: January 24, 2015
Peer-review started: February 1, 2015
First decision: March 6, 2015
Revised: April 2, 2015
Accepted: May 5, 2015
Article in press: May 6, 2015
Published online: June 22, 2015

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.