The role of the peer workforce

For the last two decades I have worked in mental health and addiction in a variety of roles that have personal experience of mental health needs and wellbeing at the heart. I love what I’ve been able to be part of. 

I’m using peer in this blog as a blanket term that includes lived experience, consumer, service user, peer and peer support workforce roles. The peer workforce consists of people who have lived experience of mental health and addiction needs, recovery and wellbeing who want to use our experiences and learning to create and be part of effective options and support for people like us. We want to change our landscapes into kinder, more understanding and effective healing places.

Mental health and addiction peers are the same but different.

Our treatment paths are different.

Mental health treatment traditionally starts under a medical model that includes medication, hospitalisation, symptom focus, risk management and can include forced treatment and restrictive practices. Many of our workforce roles started within a rights and social justice based paradigm.

Addiction treatment rarely starts with medication and most often begins with choices to do with self-exploration within therapy and therapeutic groups and self-selected rehabilitation options for recovery. The addiction workforce has historically included many people with their own lived experience of addiction and has a fine tradition of peer support. 

We both experience overwhelming distress and emotional pain, losses and rollercoasters, severe stigma and discrimination, loss of rights, navigating bewildering complex systems of support, being caught in justice systems, way too many self-ended lives and early death from treatable physical health problems. 

Currently the peer workforce fits within the ‘unregulated, unregistered and non-clinical’ mental health and addiction workforce. These all describe what we are not - clinical, regulated or registered. Surely it would be preferable to describe what we are - maybe the pro-wellbeing workforce? In this way we are part of the mental health and addiction support workforce. We are part of an assortment of options.

All peer workforce roles are defined and underpinned by values intrinsic to the consumer rights, self-help and recovery movements spanning mental health and addiction.  We have our own competencies, developed in 2014 by peers for peers - Competencies for the mental health and addiction consumer, peer and service user workforce (Te Pou o te Whakaaro Nui, 2014). Within the competencies there are six core values: 

• Mutuality – the authentic two-way relationships between people through ‘the kinship of common experience’.
• Experiential knowledge – the learning, knowledge and wisdom that comes from personal lived experience of mental health and addiction needs, recovery and wellbeing.
• Self-determination – the right for people to make free choices about their life, including what others may see as ‘poor choices’ and to be free from coercion on the basis of their mental health or addiction needs.
• Participation – the right for people to participate and lead in mental health and addiction services, in their own treatment and recovery and including in the development or running of services.
• Equity – the right of people who experience mental health and addiction needs to have fair and equal opportunities and to be free of discrimination.
• Recovery and hope – the belief that there is always hope and that resiliency, meaningful recovery and wellbeing is possible for everyone.

These values provide a strong foundation for peer work.

Peer workforce roles include, but are not limited to, the following:

• Peer support workers work alongside individuals and groups of people who experience addiction or mental health needs to help restore hope and personal power and to inspire them to move forward into wellbeing. Peer support worker is used here as an umbrella term for several other roles and job titles with similar functions, such as peer navigator, peer recovery coach, peer recovery guide, peer mentor, voice worker or peer support specialist.
• Consumer advocates work independently of the systems they advocate in with individuals to resolve their experiences of unfairness or injustice, or at a systemic level to resolve collective injustices.
• Consumer advisors work mainly within mental health and addiction organisations to provide operational and strategic advice based on peer values and recovery principles. They ensure the voices of people who experience mental health and addiction needs, influence the direction of the service. Consumer advisor is used here as an umbrella term for other roles and job titles with similar functions, such as consumer consultant, consumer leader and client engagement facilitator.
• Consumer, peer and service user educators provide education from a lived experience perspective for other peers, mental health and addiction workers or community members.
• Consumer, peer and service user researchers and evaluators do research and evaluation from a lived experience perspective in partnership with their peers.
• Consumer and service user auditors provide a service user perspective in teams that audit mental health and addiction services; amongst other areas they lead the audit of service user participation and leadership.
• Harm reduction peer workers from needle exchanges.
• Service user, consumer and peer supervisors provide coaching, mentoring or supervision to other peer workers or to clinicians using their lived experience perspective and peer expertise.

There is a huge variety of peer work resources, responses and services in New Zealand and around the world. Many of these are delivered by mainstream providers. The difference for the peer workforce lies in the values and the way peers work using their own experience.

I am often asked what is the difference between a peer support worker and other support workers that have their own lived experience?

• We are identified clearly and within our job titles as people who have lived experience of mental health and addiction needs, recovery and wellbeing.
• We are expected to, and trained to, use our own experiences within our work and with the people we support.
• We have our own competencies and values.
• We are trained to work within peer models and paradigms that align to our values and beliefs. They are different from support work models and training.

The support workforce is a mighty workforce that makes an enormous difference in people’s lives every day and often knows the people they support better than any other service provider. Thank you so much for what you do. Be proud - you are awesome and important.

In this blog I want to take a moment to honour the peer workforce that is a workforce of courage and generosity. 

It takes courage and strength to own and be ‘out’ with your lived experiences within a world that still sees us as different, potentially dangerous and as lesser people. As erroneous unwanted stereotypes. 

It takes courage to go back into the places we have been that have sometimes harmed and traumatised us. 

It takes strength to look at severe distress when your core being remembers exactly how that feels. 

It takes courage to say no, this isn’t right and push to inform, challenge and change our worlds. 

It takes generosity to turn all those experiences into sharing positive opportunities for other people.

I’m so proud to be part of such an extraordinary workforce.