Peer Support, Leadership and Service User Involvement

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Research and Practice
Videos and Presentations


Peer Support may be defined as the help and support that people with lived experience of a mental illness or a learning disability are able to give to one another. It may be social, emotional or practical support but importantly this support is mutually offered and reciprocal, allowing peers to benefit from the support whether they are giving or receiving it.
Key elements of Peer Support in mental health include that it is built on shared personal experience and empathy, it focuses on an individual’s strengths not weaknesses, and works towards the individual’s wellbeing and recovery.Though the language of peer support is relatively new in the UK, in practice self-help groups and mutual support has been around for many years. In Canada and the USA, Peer Support in its various forms has been a widely recognised and utilised resource that has been developing since the 1960s. In recent years there has been an increasing emphasis on the value of peer support in the UK.
Peer support offers many benefits, for example: shared identity and acceptance, increased self-confidence, the value of helping others, developing and sharing skills, improved mental health, emotional resilience and wellbeing, information and signposting, challenging stigma and discrimination. Peer support plays a role in building capacity within local communities and as a basis for campaigning and activism. It has also been shown to lead to cost savings, by reducing the use of inpatient beds.
Peer support is one of the ways of helping people recover from mental distress and its impact on their lives. Other people who have experienced mental health issues offer insight and understanding and can draw on their own experiences to help. They offer an effective complement to the professional support offered by trained mental health workers.

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Publications (date ordered)

2012 Survey of Peer-Run Organizations Lived Experience Research Network, 2012, USA The report is the result of the first national survey of peer-run mental health programs to be published in over a decade—the National Survey of Peer- Run Organizations. This report briefly describes the survey methods used and shed light on organizational operations of 380 peer-run programs which participated in the study.


  • The reach of peer-run services continues to grow nationwide, as does their need for more in-depth research.
  • Peer support workers fulfill a variety of essential roles within systems of mental health care.
  • Peer-run organizations are highly diverse, providing a variety of direct and non-direct support services.
  • Most organizations serve adults, engage in various advocacy activities, and provide classes in self-care and wellness.
  • Most organizations view some of their services as alternatives to traditional mental health services, while at the same time view other activities as complementary.
  •  The majority of peer-run organizations receive some sort of government funding, and report that governmental sources serve as their primary revenue source.

The Spiritual Gift of Madness: The Failure of Psychiatry and the Rise of the Mad Pride Movement (Hard copy and Google eBook), Seth Farber, Ph.D.Inner Traditions / Bear Co, 2012
A bold call for the “insane” to reclaim their rightful role as prophets of spiritual and cultural transformation
• Explains how many of those diagnosed as schizophrenic, bipolar, and other forms of “madness” are not ill but experiencing a spiritual awakening
• Explores the rise of Mad Pride and the mental patients’ liberation movement
• Reveals how those seen as “mad” must embrace their spiritual gifts to help the coming global spiritual transitionMany of the great prophets of the past experienced madness--a breakdown followed by a breakthrough, spiritual death followed by rebirth. With the advent of modern psychiatry, the budding prophets of today are captured and transformed into chronic mental patients before they can flower into the visionaries and mystics they were intended to become. As we approach the tipping point between extinction and global spiritual awakening, there is a deep need for these prophets to embrace their spiritual gifts. To make this happen, we must learn to respect the sanctity of madness. We need to cultivate Mad Pride.
Exploring the rise of Mad Pride and the mental patients’ liberation movement as well as building upon psychiatrist R. D. Laing’s revolutionary theories, Seth Farber, Ph.D., explains that diagnosing people as mad has more to do with social control than therapy. Many of those labeled as schizophrenic, bipolar, and other kinds of “mad” are not ill but simply experiencing different forms of spiritual awakening: they are seeing and feeling what is wrong with society and what needs to be done to change it. Farber shares his interviews with former schizophrenics who now lead successful and inspiring lives. He shows that it is impossible for society to change as long as the mad are suppressed because they are our catalysts of social change. By reclaiming their rightful role as prophets of spiritual and cultural revitalization, the mad--by seeding new visions for our future--can help humanity overcome the spiritual crisis that endangers our survival and lead us to a higher and long-awaited stage of spiritual development.

Mental Health, Service User Involvement and Recovery Edited by Jenny Weinstein, Jessica Kingsley Publisher, 2009
As the momentum for personalisation and recovery approaches grows, service users are increasingly participating as partners in all aspects of health and social care delivery, policy-making and professional training. This book provides an overview of service user involvement in mental health, its origins and current practice and policy.
Written cooperatively by service users and academics, this book conveys a vital connection between recovery and involvement, offering a framework of values and helpful strategies to promote meaningful user participation. By sharing their personal narratives and contributing their views, service user authors demonstrate how taking control of their own care facilitates a swifter and more satisfying recovery. The book further acknowledges the bilateral value of user involvement in the development of mental health services, student learning, collaborative research and challenging social stigma, providing examples and critical appraisal of how this is currently being implemented.
With a strong, positive emphasis on the benefits to all stakeholders, Service User Involvement and Recovery in Mental Health offers guidelines for good practice that will be relevant to health and social care practitioners, service users, students, researchers and educators.

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Research and Practice

Peer Respite Programs for Mental Health Crises: Research and Practice Initiatives in the United States Laysha Ostrow, Lived Experience Research Network, 2013  Background: context and review of the model; Existing and planned respites; Program design implications; Suggestions for research & evaluation.

Literature Review on the Mental Health Consumer Workforce Jamie McDonald (2010), Published by NSW Consumer Advisory Group. This literature review examines the research on mental health consumer workers in Australia.  The review includes the barrieers and challenges that exist in the employment of consumers as paid members of mental health services.  The literature review covers: history of consumer workforce; consumer workforce progress around both international and in Australia; benefits and barriers to consumer workforce.

Consumer Survivor Initiatives in Ontario: Building for an Equitable Future Mary O'Hagan, Heather McKee & Robyn Priest.  Published by Ontario Federation of Community Mental Health and Addiction Programs, 2009 CSIs (Consumer/Survivor Initiatives) are self help groups, alternative businesses or support services - run by people diagnosed with mental illness for people diagnosed with mental illness.  Canada led the world in 1991 with CSIs, since then other countries have developed CSI type initatives.  This report outlines research undertaken that includes an international literature review on legislation, policy and funding for peer run initatives in different parts of the world.   And Focus groups and interviews.  The report provides an overview of Peers Support Services in Canada and other parts of the world.

Pillars of Peer Support: Transforming Mental Health Systems of Care Through Peer Support Services: The Pillars of Peer Support Services Summit, The Carter Center Atlanta, GA, USA November 17-18, 2009
The findings of this report demonstrate that peer support has gained an important and effective role in state systems of mental health care. The goals and principles of peer support are consistent with contemporary policy reports including the New Freedom Commission, the Institute of Medicine, and others. The Pillars of Peer Support that are outlined in this report provide a framework for future services to be built upon.

The Service We Need: Mental Health service users' expectations for the future 2008 Published by Central Potential - Te Rito Māia
This document describes the non-government organisation, Central Potential that is run by mental health service users.  It provides a description of its current approach, philosophy and structure and then focuses on the wishes, needs and aspirations for the service in the future.  This paper is an inspiring description of how a peer support service exists.

Leadership for Empowerment and Equality: A paper on user/survivor leadership in mental health (2009) Mary O'Hagan Published in International Journal of Leadership in Public Services, Volume 5, Issue 4, December 2009 This paper looks at leadership in user/survivor movements and the challenges that come with this.  The paper argues that user/survivor leadership cannot grow unless services become democratized and genuinely implement the recovery philosophy, allowing personal empowerment and equality drive: helping systems; wider society responses to mental health issues; and the user/survivor movement.  The paper proposes a model and explanation for user/survivor movement, as a way forward.  It concludes the importance of genuine user/survivor movement to thrive. 

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Videos and Presentations

Mental health peer support worker Frances Skerritt gives a short speech describing her role in the mental health treatment team, and the opportunities and challenges she has faced therein.

Dr. Rachel Perkins OBE is Mind's Champion of the Year 2010. Her deep understanding of mental health issues come from both lived experience and professional training: Rachel was a clinical psychologist when she started suffering mental distress in the early 1990's. Since, she has tirelessly worked to help develop better services. Now a director of quality assurance at South West London and St George's Mental Health Trust, Rachel was invited by UK mental health Together to take part in the launch of a report resulting from research in peer support. The research involved community, statutory and academic experts Here, she stresses the importance of peer support in mental health, addressing her audience with humour and energy.

Peer Support in Mental Health Recovery

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Peer Support in Mental Health Recovery, Public Lecture Series: Lecture 3 Speakers: Dr Mike Watts Dr Tony Bate, Trinity College Dublin


HaVeN Dundee (Scotland) The Hearing Voices Network is a service user led registered charity which seeks to create acceptance that hearing voices is a valid experience. Based at 216 Hilltown Dundee under the banner 'HaVeN', a name chosen by members which utilises the initials of the Hearing Voices Network and incorporates the concept of it being a place of safety. It provides support to voice hearers through: Bridging the Gap Project (a befriending and mentoring service); various Self-help groups; activities; and volunteering, in order to promote independence and increase people’s confidence. These enable members to develop their personal and social skills as well as providing many opportunities for all members to access, promoting recovery from severe and enduring mental illness. The Haven also provides social activities which members and staff participate in. One of the first things that a person can lose when becoming mentally ill is their social skills and their ability to communicate. Therefore, social integration is fundamental in our members recovery. More information here

VOCAL (Virginia Organization of Consumers Asserting Leadership) (USA) VOCAL is a statewide community, support network, social change movement and self help education program.  Run as a nonprofit organisation of people in mental health recovery, VOCAL is created by and for people who have experienced emotional turbulence, mental health crisis or extreme states of consciousness.  VOCAL is currently 100% peer-run.  All staff and board members identify themselves as people in mental health recovery.  VOCAL focuses on creating broad-scale social change, as well as change in the lives of individuals.  Working to transform the mental health system and create alternatives to the system, VOCAL promotes mental health recovery, self-determination and peer leadership. 

Western Massachusetts Recovery Learning Community (RLC) (USA) Creates conditions that support recovery at both the individual and community level through trauma-sensitive peer supports and the development of a regional network.   They believe that human relationships are at the center of what heal people who have experienced extreme emotional states, trauma, mental health diagnoses and a variety of other challenges in life.  "Our lived experience and ‘humanness’ is what unites us.  Our stories, collective wisdom and strength are what guide us and our community to wellness". More information here

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Peer Support Fact Sheet from the Mental Health Foundation The Personal Helpers and Mentor Initiative. The Personal Helpers and Mentors Initiative aims to provide increased opportunities for recovery for people who have a severe functional limitation resulting from a severe mental illness by helping them to overcome social isolation and increasing their connections to the community. More information here

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