Peer-based mental health supports: a guide for incorporating best practices.

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Peer-led mental health supports continue to gain significant traction in Australia. The National Mental Health Commission has joined other government and non-government agencies in recognising the importance of the peer workforce in contributing to a more person-centred and recovery-focused mental health system[1]. As a result, there has been an increase in the number of dedicated peer support models, as well as peer roles more broadly within the mental health sector. Policy makers and funding agencies are increasingly recognising the value of a peer workforce in leveraging their lived experience to (a) address service access barriers and (b) strengthening a recovery focus.

Examples of Australian services offering peer-led mental health and/or service navigation supports include:

The Australian Government is actively promoting peer-based mental health support through initiatives such as the National Peer Workforce Support Program. It promotes the development of the peer workforce by providing funding for training and education, as well as supporting the establishment of peer workforce networks. These initiatives reflect a growing recognition of the valuable role that peer support workers can play in the mental health system and the need for ongoing support and investment in this area.

As support for peer-based mental health services continues to grow in Australia, it is crucial that we focus on implementing best practices and ensuring that individuals experiencing mental health challenges have access to the support they need to achieve their goals and live fulfilling lives. In this piece, we explore the key attributes of evidence based peer-based mental health support.

Using lived experience to promote person-centred care

One of the key attributes of peer-based mental health support is the recognition and valuing of the unique expertise and insights that peer workers bring through their lived experience of mental health challenges and recovery. This enables peer workers to ensure that client needs are fully considered while developing person-centred care plans in an empathic manner. To ensure this attribute is reflected, supporting actions such as meaningful codesign with consumers (via consumer advisory groups or lived experience advisory groups) can help empower peer workers and make this recognition more tangible.

Providing appropriate training and support

Comprehensive training and ongoing support should be provided to peer workers to ensure that they have the necessary skills, knowledge, and support to carry out their roles effectively. The National Mental Health Commission recommends a combination of formal training programs, peer-led training, peer networking and ongoing professional development opportunities[2]. This can help equip the peer workforce with the necessary competencies to provide effective support and advocacy, while ensuring their psychological safety and promoting resilience. We know that burnout and isolation are both common risks for some peer support roles.

To mitigate these risks, and to facilitate the successful integration of peer workers into broader health services, it is also important to prepare the existing organisational workforce for readiness. Key national policy and practice documents, such as the National Lived Experience Workforce Development Guidelines, recommend the implementation of comprehensive whole-of-organisation training. Organisational readiness training enhances understanding, acceptance, and perceived value of lived experience perspectives and roles, and in turn, fostering more authentic collaboration. It provides a platform for open discussions, promotes engagement and accountability, and challenges discriminatory beliefs. The training equips all staff with contextual information on the role of peer workers, boundaries, capabilities, and mutual support. It is, therefore, essential for cultivating a workplace culture that embraces and embeds lived experience work.

Promoting effective collaboration and integration

Effective collaboration and integration amongst peer workers, and the parent service organisation, as well as between peer workers and other mental health and relevant services is crucial to ensure that consumers experience seamless care. It encourages effective communication, mutual respect, and shared decision-making to ensure coordinated and person-centred care. Peer workers should be involved in the planning, delivery, and evaluation of services, including multidisciplinary team discussions, care planning, and service design and evaluation. Consideration must also be given to establishing and strengthening links with ‘non-health’ organisations such as housing support, employment support, legal aid, among others to provide recovery focused support that incorporates a social determinants lens.

Establishing clear ethical practice guidelines and boundaries

Establishing clear ethical guidelines and boundaries is crucial in ensuring the safety and wellbeing of both peer support workers and service consumers. The National Mental Health Commission’s Guide for Lived Experience Roles promotes best practice and provides guidance for peer workforce recruitment. This guide covers a range of topics, including maintaining confidentiality, informed consent, and professional conduct.

Clear guidelines not only help ensure the safety of both parties, but they also promote trust and mutual respect between peer support workers and service consumers. When individuals feel that their privacy and dignity are being respected and protected, they are more likely to engage in open and honest communication and to feel valued and heard. Establishing clear boundaries can also help prevent burnout and empathy fatigue for peer workers, who may be vulnerable to overstepping their role to provide additional support.

Establishing responsive evaluation and continuous improvement processes

Finally, ongoing evaluation and monitoring of the effectiveness of the peer workforce itself, and peer-led interventions are critical for continuous quality improvement, contributing to the evidence base, and recovery-focused service delivery. Collecting data and measuring outcomes can help inform future program development and improvement.

It is also important to ensure that evaluation and continuous improvement processes are responsive and flexible enough to adapt to changing needs and circumstances and align with peer values. Peer-based mental health support is a rapidly evolving area, and there is still much to learn about what works and what doesn’t. Contributing to this evidence base can help create a more responsive and person-centred mental health system in Australia.

We understand the unique challenges involved in implementing peer-based mental health support programs and can help guide you through the process, from designing and implementing effective interventions to evaluating outcomes and improving service quality over time, drawing on our extensive knowledge and expertise in this area.

Whether you are a mental health organisation, government agency, or community group, our team of experienced service planning, co-design, and evaluation consultants can provide guidance on best practices for establishing and evaluating peer-based mental health support services. Contact us for a conversation on 1800 527 837 or reach out at larter@larter.com.au.

[1] Byrne, L., Wang, L., Roennfeldt, H., Chapman, M., Darwin, L., Castles, C., Craze, L., Saunders, M. National Lived Experience Workforce Guidelines. 2021, National Mental Health Commission.

[2] Byrne, L., et al. National Lived Experience Workforce Guidelines. 2021, National Mental Health Commission.

[3] National Lived Experience Workforce Development Guidelines: Getting Started. 2023, National Mental Health Commission.