Wardipedia – 11. Peer supporters

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He ain’t heavy


What’s one of the best kinds of therapy for aiding recovery from mental health problems? We think it’s peer support. Peer supporters provide a first-hand insight into the impact of the issues patients experience. Drawing on their own experience they can provide reassurance and support and point to light at the end of the tunnel. Peer supporters are able to complement professional support

Peer support is the latest term for when people with similar experiences help each other. It can be as informal as the crucial daily sharing among inpatients, or a structured as having trained peer supporters working alongside ward staff. Forchuk et al (2005) found that service users, who received peer support, were discharged from hospital an average of 116 days earlier per person.

As well as the long history of people with mental illness providing mutual support, the value of more formalised peer support has been strongly endorsed over recent years, including:

  • National Service Framework for Mental Health (Department of Health 1999)
  • New Horizons: a shared vision for mental health (Department of Health 2009)
  • Putting People First (Department of Health 2010)

According to Together UK, the principles of Peer Support are:

  • Mutuality
  • Solidarity
  • Synergy
  • Sharing with safety
  • and trust
  • Companionship
  • Hopefulness
  • Focus on strengths
  • and potential
  • Equality and
  • empowerment
  • Being yourself
  • Independence
  • Reduction of stigma
  • Respect and inclusiveness

Twelve-step programs for overcoming substance misuse and other addiction recovery groups are often based on peer support. (See Idea #73 Addiction Support.) Alcoholics Anonymous promotes peer support between new members and their sponsors: “The process of sponsorship is this: an alcoholic who has made some progress in the recovery program shares that experience on a continuous, individual basis with another alcoholic who is attempting to attain or maintain sobriety through AA. ” Other addiction recovery programs rely on peer support without following the twelve-step model.


Ward examples

  • The Trust has a major project of training and employing peer supporters.
  • A mental health charity run the hospital’s social centre for patients, held in a large hall which was previously a ‘portable chapel’! (Collapsible, clapboard sides for bunging onto the roof of your Mini.)
  • During Occupational Therapy sessions, every effort is made to ensure that  ‘buddies’ can attend the same sessions where appropriate and offer support  to each other.
  • Mutual support groups are arranged regularly, service users are encouraged to take the lead in running some of the support groups.  Mutual support is encouraged in the ‘come dine with me’ sessions when service users have the opportunity to give as well as receive.
  • Mental health empowerment worker from the voluntary sector council comes in weekly, to talk with patients about their experiences,
  • Rethink go to each ward’s Start the Day meeting once a week and then see individual patients who want their advice or support.
  • The service-user rep co-ordinates the weekly community meetings and also regularly visits wards.
  • Ex service users visit the ward regularly.
  • The patient rep for the ward is encouraged to provide a brief ‘induction’ to the ward and offer advice.
  • An ex-patient attends the ward on a Thursday morning and attends to the ward garden and stays for lunch.
  • The unit receives input from Involvement Workers who are former patients.
  • “Peer support offers something that can go beyond the professional support and therapy offered to people during crisis. Seeing a person who has been there, and is able to tell the tale of their own recovery, offers real hope to individuals who may not have any at that particular point in their life. The feedback from the peer support project that has been running in [our Trust]…has been extremely positive and patients have welcomed the input that has been offered. The peer volunteer is now well integrated with the ward staff and the patient group, and all look forward to her visit”.
  • “Patients on the ward get to know me through the regular art exercises and in time they talk to me about their issues and problems. I help them tune back into reality. They know I have been a patient too and we speak the same language. I have also been able to talk with staff and give them some insight into what it is like to be a patient on an acute ward. I would rather be working alongside staff than working against them. I think I can sometimes be a bridge between patients and staff. I believe that peer support is exciting and opens things up”.
  • We have managed to get a “peer” for our dual diagnosis group and this has made a huge difference.
  • On admission all patients are introduced to a peer who is able to encourage and support them to orientate to the unit and develop relationships. This support often continues with patients being offered the opportunity to remain in contact after discharge.
  • Patients are encouraged to utilise peer support where possible.
  • All patients are encouraged to help each other, as the length of stay is, on average, eighteen months this process takes place over a period of time.

Patient Examples

  • We learnt how to read one another without using words. It is a very special feeling to be that connected to people.
  • There was always one other patient who could see your distress through the smiles and acknowledge that it hurt like hell.
  • Using the e-community of Bipolar UK kept me in touch with the outside world and I got great support from other s who had the same experiences.
  • I enjoyed being on the ward because I had company. I realised I needed to make more of an effort to get to know more people in the outside world.
  • I met some wonderful characters on my ward with really interesting life stories, which helped me understand myself.
  • Myself and another girl painted each other’s nails. Not only did my nails look great but I made a new friend too.
  • I found talking to others on the same medication really helpful. Especially when they would describe how much the medication had helped them.
  • I read a story that someone had written about their journey to good health – it gave me courage and hope to carry on.
  • I felt so overwhelmed when I first came in but got chatting to someone who was leaving that day. She reassured me that I would get better given time and seeing her well gave me hope.
  • I felt like this hurt would never end but I found talking to other patients on the ward who had been where I had been but now felt much happier let me see that things could get better
  • I don’t feel like a responsible person towards myself but I can look after others really well. I am trying to find the balance. I am starting off small.
  • Being ill was horrendous but I made some amazing friends and we still continue to support one another.
  • Peer support was vital in helping those who struggled to assert themselves in having a voice.
  • We had an ex-patient come back and join our tea and biscuit morning. She was such an inspiration.
  • It is a real privilege to go on such an arduous, personal journey with others. A very unique bond is formed.
  • We all used to talk about our dreams and I don’t think any of us really believed we would ever get there….we might not be where we thought we would be but we the majority of us are somewhere equally as excellent.
  • It takes a while to get used to how the ward works which is why it is nice to have someone nominated to talk to about it in the first few days.
  • In the outside world it is often hard to get to know the ‘real person’ underneath. In hospital there is no getting away from it. At times that can be excruciating but mostly it is intensely supportive.
  • We weren’t very good at being kind to ourselves but we were fantastic at being kind to others. We acted as mirrors for one another – and it helped each of us to see that we were loved.
  • We all had our little ways of doing things, and we each respected that.
  • There is no bigger responsibility than holding another’s fragile sense of self and helping them heal.
  • Collectively we were a force to be reckoned with. Mostly a positive one!
  • In one of the group work rooms they had all these pictures on the wall of famous people who have a mental health condition. That made me feel like I wasn’t some weirdo and that it can happen to anyone.
  • Helping others to commit to recovery actually helped me to do the same.
  • I met some really wise people on the ward who’d dealt with mental health problems all their life. That’s one of the best things about being in hospital; you can learn a lot from other patients.
  • I am a true believer in momentum. Moving forward. Accepting that commitment isn’t always linear and that when you can’t see the light at the end of the tunnel, others can be there to hold your hand in the darkness.
  • It is much easier to commit to the idea of change when others do so too. It is a journey best shared.
  • I have made the best of friends in hospital. There is a connection and level of understanding that is precious and unique.
  • Just chatting with other patients gave me a lot of reassurance and made me feel safe. When I first came to the other ward other patients scared me but through talking I realised that we had a lot in common.
  • The other patients are really supportive but we all know not to overload each other with our problems. You have to know when to change the conversation to Eastenders, or the weather or something.
  • I joined an outpatient support group and eventually helped run it.
  • What helped the most was the other patients. Whatever their diagnosis or problem, we’re all the same.
  • Prior to coming into hospital I thought I was the only one with these experiences. It’s good to know there’s others out there and you’re not on your own.
  • You have an idea in your head about what mental patients are like, you know from movies and that. But when you come in and meet them for yourself it’s surprising. We’re all just human struggling with the same things.
  • As a group we used to get together and plan an activity in the evenings and I think we all felt that bit less shackled to the ward and to the difficulties we had.
  • We used to plan our leave, as patients, together and go out as a group without staff. It was brilliant fun, supportive and extremely beneficial.
  • As patients we can all bring each other down, but equally we can carry one another’s hope when things are tough. I take that responsibility seriously and it feels like a privilege.
  • I felt like this hurt would never end but I found talking to other patients on the ward who had been where I had been but now felt much happier let me see that things could get better
  • Hearing other people’s recovery stories is motivating and reassuring.
  • Reading poems written by other service users – positive or negative – comforted me.
  • I can’t function without responsibility. It is such an important part of my life. On the ward I started off by being in charge of mealtime calls. Now I lead the peer support programme.



An A-Z of patient mutual support

Authenticity – able to be oneself
Belonging and group identity
Confidence and self-esteem
Coping strategies
Cost – from none to modest
Flexibility of contact e.g. time and place
Equality of power and status
Guilt in ‘burdening’ friends who don’t have this experience or need is relieved
Identity shared and improved
Information sharing
Isolation reduced
Increased knowledge
Men can be more self-disclosing and vulnerable than gender stereotyping or conditioning usually allow
Mental health improvements, sustainably
Monitoring progress and set-backs
Non-hierarchical – reduces sense of inferiority and disempowerment
Normalises what is seen to be ‘pathological’ or at least unusual
Personal change
Professional help is enhanced, not replaced
Range of experiences, views and coping strategies
Recommendations for local services
Role models
Self-efficacy – feel effective, skilled, valued, appreciated by helping someone else
Stigma reduced
Strengths and potential built on
Valued for their contributions


Categories: Imagination, Wardipedia