Peer support- someone who knows?

In my reading on the net I came across Peer support a term that I have always associated with friends rather than as a tool that the medical profession might want to capitalise on but then I am rather a cynic and my rather narrow ideas don’t really allow for very much. http://www.together-uk.org/new-charity-report-reveals-adoption-of-peer-support-by-mental-health-services-poses-threat-to-grassroots-ethos-and-survival/

For me peer support is just the support of ones friends and therefore would not include the likes of strangers who would like to help me. It seems a ludicrous distinction in light of what I have now read but still one that I had held. At first I wondered what these services were, where did you find the peer support the internet said was becoming rife within the health service. Silly me I’ve been taking support from my peers for a very long time it just wasn’t called that. And yes in the strictest sense peer support is just gaining support from your peers as defined by the person, not their elders or their betters but just those that they see are like them.

I find it strange that I should not think of peer support services as existing especially since I’ve spent a lot of time using NHS services.

So what is peer support in this sense?

Well it is just services provided by those who have personal experience of poor mental health; they may be paid, but often are not. They provide a range of services from befriending, to information and advice. This article gives a better idea of what the services can do, (http://www.together-uk.org/wp-content/uploads/2012/09/The-Freedom-to-be-The-Chance-to-dream-Full-Report1.pdf) however it does show that these services are not universally available in the uk. American and Canada do seem to have more comprehensive services see here for more information http://schizophreniabulletin.oxfordjournals.org/content/32/3/443.full

The fact is that peer support services have been around so long that many of us may have completely overlooked them when we were thinking about what they were. I guess the most well known is AA, but I wouldn’t’ have though it but then would that be because I don’t see alcoholism as a mental health problem rather than the service not being peer support. I guess it’s all in the severity of mental health problem.

So getting back to severe mental health problems since this is what the current articles are dealing with. http://www.mentalhealth.org.uk/our-news/blog/12-09-25/ and particularly do these services help and really are they any better than those run by people who’s mental health history is unknown?

It seems the jury is out on that one when it comes to mental health http://schizophreniabulletin.oxfordjournals.org/content/32/3/443.full as this review found no significant advantage to using peer services rather than non peer. And somehow I’m not surprised, I’ve used both and gotten a lot from both but then my ideas of who my peers are fluctuates and changes depending on many things, not just my mental health diagnosis. And for me that’s the key, to feel comfortable with people and feel they are my peers is not just about a shared past although it helps a lot. It’s not just about my ethnicity or my educational status either, although again I know it all helps.

A peer is someone you consider you’re equal and I’m not sure I could define what that is, there are so many factors and I’m not sure that just having that one thing in common or even all of the ones I’ve stated would be enough but then again maybe it is, if it is felt that it is biggest barrier to understanding each other.

What I’m trying to say here in a very round about kind of a way is that recovery is a long road and all the way your changing and redefining yourself and along with that you’re also redefining your peers and your needs and at some point that shared past becomes less of a problem to communicating and trusting others. And at that point peer supported services are nice but not necessary and the greater rates of improvement will not be seen. I guess this is typified in that I have friends who are mentally ill and I still need their support and often go to them with things that I don’t to my friends who aren’t because I know they will understand but I don’t need it desperately and I can talk to most people about most things now but it wasn't that long ago that I couldn't, wouldn't.

I do believe that the reason the benefits are not being seen is because of the way people are assessing the services, not because they are not giving a benefit. In fact I find myself convinced that the real problem in the assessment process is about the clients attitudes to people, officialdom, paid staff, the government/ health services, hospital staff, friends, family, community etc. and the matching process to them. Our beliefs about whether something will help are formed from our experiences and sadly for most of us with severe mental health problems these have been extremely limited and not positive. We are not going to trust just anybody and that mutual understanding of the problems will forge a bond but only with someone who gets our problems and that is as much about the persons personality as their experiences. Don’t forget most of the problems were caused by how people lived and how they felt about it and people who appear to be similar in attitude, even physically could affect whether someone will bond. It’s a very difficult process and very hit miss.

 If my theory is correct then peer support services will be most important for the most stigmatized, most victimised, most neglected and least supported, and these people are not likely to report to anyone about how a service is helping them or go through repeated follow up from any one because they won’t even want people to know that they are engaging with service.

If you want to know if peer support schemes work then look at AA!

If it works it’ll take off and spread and the best thing to do is to leave it well enough alone to do just that. And I don’t’ mean don’t monitor it in terms of the law, or consider training or anything I just mean let it evolve in it’s own good time and if training is needed, if people find it important then it will happen.

I think the biggest thing is that peer support only really works when it comes from the heart, when openness and trust are applied with freedom.