Peer Workers in Co-production and Co-creation in Mental Health and Substance Use Services: A Scoping Review

Abstract

People with lived experience of mental health challenges are extensively employed as peer workers within mental health and substance use services worldwide. Research shows that peer workers benefit individuals using such services and can have essential roles in developing recovery-oriented services. However, understanding how peer workers’ contributions, by their role, functions, and input can be better used remains a critical challenge. Research on public sector innovation has focused on relevant actors collaborating to tackle complex demands. Co-production and co-creation are concepts used to describe this collaboration. Co-production refers to the collaboration between providers and users at the point of service delivery, whereas co-creation refers to collaboration starting in the early service cycle phases (e.g., in commissioning or design), including solution implementation. We overviewed research literature describing peer workers’ involvement in mental health and substance use services. The research question is as follows: How are peer workers involved in co-production and co-creation in mental health and substance use services, and what are the described outcomes? A literature search was performed in 10 different databases, and 13,178 articles were screened, of which 172 research articles describing peer workers’ roles or activities were included. The findings show that peer workers are involved in co-production and function as providers of pre-determined services or, most often, as providers of peer support. However, they are rarely engaged as partners in co-creation. We conclude that the identified peer worker roles have different potential to generate input and affect service delivery and development.

The effectiveness, implementation, and experiences of peer support approaches for mental health: a systematic umbrella review

“…The samples in the remaining reviews were PSWs and various stakeholders (e.g. non-peer staff, service users) [23,24,32,[57][58][59][60][61][62]. Most reviews included interventions involving any form of peer support, individual, group or combined, although three reviews looked at group peer support alone [34,37,47], and three reviews looked at individual peer support alone [2,36,42].…”

“…Perspective of mixed samples: PSWs were perceived to be role models, providing valuable support to service users and giving them hope of recovery [58,62]. Working as a PSW could enable service users to find a role in the community, beyond the identity of being a 'patient' [59].…”

“…However, there was the view that lived experience was not solely sufficient to work in interprofessional teams [62]. Despite this, supervision and support were often not offered to PSWs leading to risks [58,62].…”

“…Perspective of mixed samples: A final theme was the perception that service users should be able to choose among PSWs as service providers [58] PSWs [23,32,59]: PSWs experienced improved wellness and recovery. The role enabled them to reframe and accept their illness and kept them engaged in recovery.…”

“…They also experienced increased confidence, social networks, self-esteem, self-knowledge, and personal growth, through e.g., using their lived experience to help others, a sense of belonging, learning more about their own mental health and learning from service users. Challenge [33,53,58] [23] PSW [23,32]: the role could have a negative impact on PSW wellbeing and recovery, e.g., due to a heavy workload, the role could remind them of their illness and the 'sick' label could stay with PSWs. Service users could be a source of stress, e.g., service users who had a greater level of disturbance than the PSWs own experience.…”