Abstract

Introduction: This thesis explored National Health Service (NHS) Mental Health (MH) Peer Support Workers’ (PSWs) experiences of transitioning from their own lived experiences of MH difficulties to supporting other people with their MH problems. Existing literature is scarce, particularly in the United Kingdom (UK). When it is available it oversimplifies the transitional process by failing to offer more than general descriptions of benefits and challenges to enacting the role.
Aims: The purpose of the study was to explore how PSWs made sense of their experience of transitioning from their own lived experience of MH difficulties to providing a service to support others with their MH difficulties.
Methods: Single-site ethical approval was gained to conduct the study in one NHS Trust. All PSWs within the service were approached by the Peer Support project coordinator. Semi-structured interviews were conducted with seven
participants. Interviews were transcribed verbatim and analysed using an interpretative phenomenological analysis framework.
Results: Analysis of transcripts yielded three superordinate themes. They were interpreted as interdependent with interrelating subordinate themes. The superordinate themes loosely reflected a time dimension of preconceptions
before entering the role, actively making sense of the role in the here-and-now and future aspirations of the role. The first, fluctuating identities, detailed participants experience of a changing social self and a feeling of reconnecting,
recovering and taking control. What constrained this were the difficulties with managing multiple identities. The second, PSW role, specified the understanding of what provided certainty in the role and where there was role vagueness and difficulties. Participants also detailed the complexities around boundaries and disclosures. Finally, organisational culture, outlined participants desire to change the NHS system. Supporting attitudes and barriers were described, at an individual, service, organisational and societal level.
Discussion: The findings were compared to studies conducted in the areas of peer support, role transitions and identity. This research captured the complex and variable process of the transition, involving a number of inter-relating factors that impacted on an individual’s personal, interpersonal and collective identities. Participants highlighted the juxtaposition of the PSW identity being both emancipating and constraining whilst detailing the personal impact and
attempted resolutions.
Conclusion: The current research has clinical implications for the MH system, in that it has a role in practically supporting interprofessional working whilst addressing possible stigma attached to the PSW role. This research advocates for PSW training to be tailored to individual need, and flexible support offered throughout the process to both PSWs and the teams receiving PSWs. Finally, psychological interventions (e.g. self-narrative identity work), could help newly appointed PSWs to articulate and co-construct their identities during the transition; contextualising professional, personal and practice development. Methodological considerations are discussed, such as retrospective data collection, difficulty in recruiting a homogenous sample and the reliance on a specific transitional point. Suggestions for future research focus on the need for further longitudinal studies to better understand the enactment of the role. It may also be beneficial to explore the experiences of recipients of peer support and other professionals who work alongside PSWs.