Knowledge and expertise in care practices: the role of the peer worker in mental health teams

Abstract

Our research examines how different forms of knowledge and expertise are increasingly important in caring for people experiencing mental illness. We build on theoretical developments regarding multiple ontologies of knowing about illness. We examine how experiential knowledge of mental health problems, learned by being subject to illness rather than through objective study, is enacted in mental healthcare teams. We focus on Peer Workers (PW), individuals who have lived experience of mental health problems, and who contribute knowledge and expertise to mental health care within multidisciplinary healthcare teams. Our longitudinal study was undertaken over 2 years by a multidisciplinary team who conducted 91 interviews with PW and other stakeholders to peer support within a comparative case study design. We show how workers with tacit, experiential knowledge of mental ill health engaged in care practice. First, we show how subjective knowing is underpinned by unique socialisation that enables the development of shared interactional spaces. Second, we point to how the situated nature of subjective knowing is uniquely embedded in time and space and allows for the alignment of embodied knowledge with trajectories of care. Third, we provide insight into how subjective forms of expertise might be incorporated into multidisciplinary care.

Using peer workers with lived experience to support the treatment of borderline personality disorder: a qualitative study of consumer, carer and clinician perspectives

“…The shared view of consumers, carers, and mental health professionals regarding the importance of having a suitable match between consumers with BPD and consumer peer workers, including opportunities for consumers to choose their consumer peer worker, was consistent with research that shows that peer support is based on shared personal experiences [13,24]. Further, providing choice to consumers regarding who they enter a peer support relationship with upholds peer support principles [13,25,50].…”

“…Therefore, organizations may consider hiring multiple consumer peer workers to ensure consumers have options when choosing a consumer peer worker. In addition, the perspective of participants that consumer peer workers and mental health professionals are both necessary to provide optimal treatment demonstrates how both have unique knowledge and skills that can help consumers with BPD [24]. Consulting with consumers regarding the support they receive, and offering to include peer support in treatment plans is recommended [42].…”

“…Various models have been proposed which suggest ways of delivering peer support [22], such as peer supported Open Dialogue [23]. With any peer support role or model, experiential knowledge of consumer peer workers can be used to build rapport with consumers, and this characteristic differentiates consumer peer workers from mental health professionals [24]. The unique aspects of peer support may be maintained by peer support principles, including supporting safe relationships founded on shared lived experience, mutuality and reciprocity, promoting experiential knowledge, giving choice and control to peer workers regarding the way that support is provided and received, and empowering peer workers to use their strengths and find support through other peer workers and the community [13,25].…”

Peer support for discharge from inpatient to community mental health services

“…[ 25 ] In addition, qualitative research into the mechanisms of peer support indicates the potential role played by peer workers in enabling people to make and maintain wider social networks [ 26 , 27 ] and to act as a bridge between the services users they support and the clinical teams they work alongside. [ 28 , 29 ]…”

Peer Support in Coordination of Physical Health and Mental Health Services for People With Lived Experience of a Serious Mental Illness

“…Peer support specialists have been shown to help individuals with SMI to improve their self-management skills and to improve access to primary care (4). Peer support specialists are also being hired into traditional positions in mental health service organizations as members of integrated physical health and psychiatric teams (7,16). While peer support has been associated with a variety of benefits, little is known about how peer support services can facilitate the coordination of physical health and mental health services for individuals with SMI.…”