The National Collaborating Centre for Mental Health (NCCMH) developed the Competence Framework for Mental Health Peer Support Workers (MH PSWs) with UCLPartners and a specially convened expert reference group including peer support workers. It was commissioned by Health Education England as part of their ‘New Roles’ programme, ahead of a large expansion of PSW roles in statutory services around England.
The Competence Framework for MH PSWs outlines the knowledge, skills and attitudes required of the role. It aims to be flexible and adaptable, steering away from over-professionalising a role which, at its heart, is about human connection and relationships.
It outlines core skills for people starting out as MH PSWs, and includes optional skills for people who wish to develop further within the role, and competences for organisations to support PSWs. It is relevant to mental health care services, team members working with MH PSWs, their managers and commissioners, as well as voluntary community and social enterprise (VCSE) organisations that want to offer peer support.
The Competence Framework for MH PSWs comprises three parts:
Part 1: Supporting document – containing important background information and discussion that is intended to be read before the competence framework (PDF).
Peer support is an important element in an individual’s journey as they cope/manage/live with their mental health condition.
Although there is currently only a small research base on the value and effectiveness of peer support, this research is generally positive regarding its impact on the individual (Gillard et al., 2013; Gillard & Holley, 2018):
This article refers to peer support within the UK, and particularly Scotland (where I live).
Peer support roles are still relatively new in the UK and these exciting new(ish) roles have been developed specifically for individuals who have lived experience of recovery from mental distress.
“An increasing number of organisations and services are developing peer support roles. There are now around 80 paid posts in mental health services and a far higher number of unpaid roles.” (Christie, 2016, p.3).
Within the public sector (i.e. NHS), peer support is a paid role and within the third (charity) sector the role may be paid (i.e. member of staff) or unpaid (i.e. volunteer).
Titles vary also, for example peer worker, peer support worker, peer support specialist, and community support worker.
For administrative purposes, individuals are referred to as Service Users by charities and as Patients by the NHS.
The Role of Peer Support
The overarching purpose of the role is to provide support and assistance to individuals to promote independence and self responsibility. And, as such, you will work alongside existing mental health services to promote and deliver support which facilitates recovery for the individual (it is important to note that recovery means different things to different individuals, i.e. it is a unique process).
Within the role you may be expected to:
Use the knowledge gained through your own lived experience to inspire hope and belief that recovery is possible in others.
Work with a Community Mental Health Team alongside a clinical team to help patients/service users achieve their recovery goals.
To assist individuals to create their own outcomes focused recovery plans.
Work with people with complex psychological needs, meaning you will need to be emotionally and mentally resilient.
Provide 1:1 and/or group support, exploring the individual’s hopes for moving out of social isolation and towards meaningful opportunities, relationships and community engagement.
Draw upon your experiences of recovery and attend training on the most effective way to so this.
Be involved in contributing to the development of the peer support role, within mental health services.
Develop (and within) a relationship of mutuality and information sharing, promote recovery, self-management and opportunities for improved health and wellbeing.
Develop relationships with people based on the principals of peer support.
To share ideas about ways of achieving recovery goals, drawing on personal experiences and a range of coping, self help and self-management techniques.
Make a positive contribution to the reduction in stigma associated with mental health issues.
To model personal responsibility, self-awareness, self-belief, self advocacy and hopefulness.
Maintain a working knowledge of current trends in mental health, recovery and peer support through a variety of sources.
For example, by reading books, journals and accessing peer support networks.
Deal with sensitive and confidential information, and take account of safeguarding and child safety issues.
The peer supported should be wary of issues that may bring them into conflict with the patient/service user.
Maintain a positive therapeutic relationship and maintain child protection standards.
Work in partnership with other organisations.
Purpose of the Role
The exact provision of support will vary between organisations, and the following examples are for illustration only.
Building supportive and respectful relationships with patients on the ward/service users in the charity.
Supporting others using the personal experience and confidence you have gained having overcome similar challenges.
Assisting clinical/charity staff to help people identify their own recovery goals.
Providing information and support to family and friends of patients/service users.
Developing the peer support worker programme and role within organisation.
Modelling personal responsibility, self-awareness, self-belief, self-advocacy and hopefulness.
Wellbeing mentors will take a lead in delivering all one to one therapeutic and group work activity. They will also provide one to one support and key-working interventions using Wellness Recovery Action Plans.
Building and developing service users’ personal strengths, social networks and recovery capital (social, physical, human and cultural).
Provide practical support and supervision to volunteers/ Peer Workers as required.
Develop effective relationships with other groups and agencies in our area and take opportunities to promote mental health awareness in the wider community.
Effectively and proactively connecting service users into a range of health and social care services that support their recovery.
To assist the Lead Practitioner in addressing clients support needs and to review progress with clients at regular intervals.
To participate in effective team work and establish good channels of communication to all local organisations.
To promote peer and volunteering opportunities within the service.
To provide an efficient and welcoming reception service to visitors to the unit.
From the above two examples, we can see that peer support may offer a range of services that provide practical, emotional and social support. And, these services should be focused on improving health and wellbeing and aim to ensure that all the services are flexible, personalised and recovery focused.
What Attitude/Skills/Knowledge Do You Need for the Role of Peer Support?
A background of personally recovering from mental health issues.
Past and lived experience of using mental health services or awareness of mental health issues.
An understanding of the impact of mental health issues on individuals, families, and communities.
Resilience and to be able to know when to ask for help.
Demonstrate an awareness of mental health interventions and commitment to supporting recovery.
An understanding of factors which can affect recovery in mental health.
IT literacy including Microsoft Office and Internet or a willingness to learn.
Strong verbal and written communication skills.
The ability to work well in a multi-disciplinary team.
Empathy, good listening skills, approach-ability and common sense.
Enthusiastic, motivated, and positive in outlook.
Support for the Peer Support Role
For those in the NHS, they will receive formal/structured induction, training and on-going supervision, including a network of other peer support workers employed within the NHS.
Within the charity sector, induction, training, and ongoing supervision varies between organisations.
What is the Most Challenging/Difficult Part of the Role
Experience of what is challenging or difficult will depend on the background of the peer supporter, and below are some examples.
Aspects of the role can prove to be mentally demanding and stressful.
The peer supporter is required to provide mental effort and concentration due to confidentiality and the sensitivity of information, which is being given and sought.
There are emotional demands when communicating with distressed, anxious, worried individuals or relatives.
It is necessary to maintain a non-judgemental approach when discussing sensitive issues.
The peer supporter will have lived experience of mental health issues.
It is necessary for the peer supporter to demonstrate the ability to take personal responsibility with regards to their own personal recovery needs, limitations and support needs.
To assist members of staff/volunteers in providing comprehensive recovery focussed support to individuals who have a range of physical, mental and emotional issues and who may display verbal and/or physical aggression.
To work with individuals who may have negative preconceptions of health and social care, having had experience of discrimination from other services/organisations/people due to their mental health issue(s).
Responding to acute symptoms of relapse and challenging behaviour of individuals in isolated or public locations while unsupervised in the community.
Using initiative when alone with individuals in crisis and instigating emergency procedures in conjunction with trained staff.
There are a number of optional/mandatory courses which a potential peer supporter can attend.
Peer support is a system of giving and receiving help founded on key principles of respect, shared responsibility, and a mutual agreement of what is helpful.
Peer support is not based on psychiatric models and diagnostic criteria.
It is about understanding another’s situation with empathy through the shared experience of emotional and psychological pain where people are able to ‘be with each other’ without the constraints of traditional (expert/patient) relationships.