A Longitudinal Qualitative Analysis of the Way Peer Support Specialist Roles Change Over Time in a Psychiatric Hospital Setting in Asia

Abstract

The current study seeks to determine how peer support roles change as peer support specialists’ positions within organizations and departments mature. We followed ten peer support specialists over the course of a year, interviewing them at three points, starting approximately three months after they began working as peer support specialists. We used an inductive process to analyze our data and followed guidelines on the structuring of longitudinal qualitative trajectories to divide the data into watershed moments. Our participants worked in a variety of departments in the hospital, and their service use experiences generally echo those of their service users. Participants appear to pass through four phases over the course of their employment as peers: early beginnings, establishing the role, role narrowing, and role sustainability. Services wishing to integrate new peers must be aware of the time required for integration. Having general job descriptions limited to specifying that peers are expected to use their lived experience to support current service users may lead to uncertainty amongst new and existing staff. Without role clarity, peers may struggle to find their place. Pairing new staff with mentors may limit this burden. As roles consolidate, boundaries may emerge. If these boundaries narrow the role of the PSS, they may no longer find the role appealing. They may then choose other caregiver roles with wider or different spheres of influence. Organizations may benefit by clearly indicating if they expect peer support positions to be static or transitionary.

Acceptability of Peer Support for People With Schizophrenia in Chennai, India: A Cross Sectional Study Amongst People With Lived Experience, Caregivers, and Mental Health Professionals

“…In keeping with earlier research ( 16 ) this study also shows that majority of the challenges perceived are concerning the PWS understanding of the role of the PSV and that PWS may have difficulty in transitioning from “PWS” to “peer,” although this transition is seen as a gradual process. While developing a programme for PSV, it is vital to ensure that PSV has role clarity and training and supervision to ensure PWS can positively transform into a PSV and maintain the integrity of peer support, such that peer support workers are seen as peers and not para-professionals ( 26 ).…”

“…This may have been due to poor confidence and lack of clarity on what being a PSV entails. Training and providing well-defined structure to roles of PSV may help the PSV get an understanding of the scope of their work ( 16 ) and provide them the confidence to take on this role.…”

The impact of peer support work on the mental health of peer support specialists

“…This study was part of a larger mixed-methods study designed to assess the global impact of peer support services [ 31 ]. To determine if the mental health of our Peer Support Specialists (PSS) changed over time, we chose to rely on self-reported experiences.…”

“…A loose job description at the institutional level was formulated to allow departments to tailor the duties of the peers to their department’s needs. This loose description also allowed their job scope to evolve [ 31 ]. Disclosure of lived experiences is left to the discretion of the PSS.…”

“…Prior to that time, the institute had yet to adopt a proactive policy of developing and integrating PSS into the workforce, and the experiences of PSS hired prior to this watershed might be different. Additional recruitment dispositions can be found in a previous project manuscript [ 31 ] and in the Additional file 1 .…”