Peer support workers

A good deal of discussion is taking place around the idea of peer support workers in mental health practice.  A recent Guardian article entitled 'Putting the lunatics in charge of the asylum' has highlighted the debate.

It's not just the 'asylum', hospital, day centre or residential setting where peer support working can take place.  Nor does a peer support or recovery worker have to be an official post, paid or voluntary within the NHS or any clinical setting.

Peer support in mental health is taking place informally all over the place.  Many peer supporters would not even give themselves such a title.  In many cases they are simply spending time with the friends they already know or with the peers who have accessed a setting or venue which attracts them too.

As a bridge builder who has signposted people with severe and enduring mental health diagnoses to mainstream settings of their own choice, I have witnessed this peer support happen over and again.

Four years ago I signposted a client to a mainstream recording studio.  With the help of direct payments he has been accessing this venue weekly ever since, practising guitar and collaborating with others in the studio.  He has also secured part-time employment as a studio assistant, getting the rehearsal rooms ready for bands and bookings.

What has happened as a result of this client's involvement is an informal cascading of peer support and group participation.  Again, this has occurred with very little prompting from the bridge builder.  As my client relishes working with other musicians, he is happy to have peers who also wish to participate i.e. start a band during his weekly studio sessions.  This has resulted in a drummer peer and a singer peer rehearsing regularly together with Bernie (not his real name).  Another peer also attends regularly - a long-term friend of Bernie who is learning guitar from him and who has previously been impossible to place by the bridge building team in any mainstream setting.

This is informal and highly effective peer support.  Above all, it is taking place in mainstream not in any clinical, residential or daycare setting.  Recovery that takes place in mainstream allows for hope, confidence, friendship, group projects and routes to employment.

Exposure to mainstream life

Mental health service users who live in residential care settings are often in danger of never being able to realise mainstream goals.  For various reasons it turns out that the initial exposure to mainstream life is the key factor in determining an individual's further progress into that milieu.

Residential care covers a range of bases.  It could be a residential home or a family setting, even the setting of a marriage or a personal relationship.  Carers and support workers do not always have their charges' independence as a key priority.  Sometimes carers or family members derive more support for themselves by living or being with the 'cared-for' member than vice versa.  Even staff within the clinical teams are often geared to providing support at the expense of encouraging mainstream development. What this can lead to is a form of unnecessary and intrusive over-protectiveness.

The results of enabling people to access mainstream are frequently nothing short of amazing. When this access is based entirely on clients' own choices the results can become formidable.