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New charity report reveals: adoption of ‘peer support’ by mental health services poses threat to grassroots ethos and survival

Posted on 25, September 2012

Good practice guidelines are needed to prevent the ‘professionalisation’ of peer support and preserve its grassroots, user-led ethos, says a new report published today by Together for Mental Wellbeing.

Peer supporters have become increasingly valued in formal health settings for their positive role in mental health recovery. However, warns the report, “The Freedom to be; The Chance to Dream”, there is a real risk that the role might become diluted or lost within a statutory setting facing cuts and staff redundancies. This threatens the unique relationship of mutuality and trust upon which peer support is built and is the essence of its proven effectiveness.

Peer supporters interviewed spoke specifically about their experience or fears of:

  • Resistance from staff wary of the autonomous, user-led way of working.
  • The expectation to comply with staff policies and procedures such as control and restraint and risk assessments.
  • Being viewed as ‘cheap labour’ only there to assist professional staff.
  • Smaller, user-led, community, peer support groups being subsumed by these newer formal models, especially as community support structures are already affected by cuts in public spending.

A member of a user-led peer group, commenting on the challenges of undertaking the role of peer supporter in a formal setting said he found:

Resistance from professionals to work in partnership, not having the same power, resources or influence of professionals and professionals trying to take over or thinking that we are their to assist them”

Peer support has existed amongst service users for many years but grew in strength as an antidote to the mental health system which many had experienced as negative and restrictive.1 It has also become a lifeline for people from marginalised groups who have traditionally found it difficult to access mainstream services.

The acknowledgement of the value and efficacy of peer support by the health system is to be welcomed and the report highlights many examples of positive collaborations within formal settings. However, the report argues that as peer support becomes more embedded as a model in mental health services, it is vital a framework is developed that supports its grassroots ethos and preserves its user-led heritage.

These ’good practice’ guidelines, it contests, should also facilitate increased partnership work with local user-led groups and ensure peer supporters have access to appropriate support, supervision and training.

Anne Beales at Together said: “As a service user, having tried all different kinds of services, I can testify first hand as to the incontrovertible benefits of peer support.

It’s introduction into formal mental health services could prove revolutionary but we need to find a way to preserve its autonomous and organic nature – the very values that deem it effective – even in an environment that follows a predominantly ‘medical model’ witih its strict policies and procedures”

To spearhead and facilitate this good practice work, Together has set up the Peer Led Collaboration, a membership group that brings together research bodies, user-led groups and voluntary sector organisations committed to working in partnership to establish user-led peer support as a leading force in mental health.

David Crepaz-Keay, Head of Patient and Public Involvement at the Mental Health Foundation, who are a member of the Peer Led Collaboration, said:

“Peer support is far too important for it go the same way as recovery, which has become little more than an NHS slogan. People have been supporting themselves and each other for many years, peer support has developed both organically as part of the self-advocacy movement and in a more structured way as a part of focussed projects. This report gives a flavour of the breadth of peer support already happening and also some of the blocks and threats to its development.

By working in partnership, we can ensure that the future of peer support is safe, that it continues to mean something to the people who benefit from it and that when someone experiences peer support their life is better for it.”

The Freedom to be The Chance to dream Executive Summary

The Freedom to be The Chance to dream Full Report


1.     Mead, S. & MacNeil, C. (2005, May/June). Peer support : A systematic approach. Family Therapy Magazine, 4(5), 28-31.