Peer support working: a question of ontology and epistemology?

Abstract

Mental health services are currently undergoing immense cultural, philosophical, and organisational change. One such mechanism involved in this change has been the recognition of lived experience as a knowledge subset in its own right. Within five Community Health Care Organisations [CHOs] in the Irish mental health services, 2017 marked a new era as the traditional statutory mental health service hired a total of 30 Peer Support Workers. Since then, additional Peer Support Workers were recruited along with the added addition of Family Peer Support Work. The purpose of such positions is to use their lived experiences and the knowledge subset within it to normalise experiences, break down hierarchical barriers and facilitate candid conversations that will allow the service user to progress on their own, self-defined recovery journey. Since it's inception into Irish mental health services, peer support has been line managed by a non-peer discipline. It is this where this paper highlights a potential problem. The paper raises concerns that the supervision conducted by these non-peer professionals could tamper, mutate and destroy the essence of peer support—the transfer and use of lived experience between service users. As such, a recommendation is suggested that the literature pauses discussions as to the mechanism by which lived experience is delivered and instead focus energies on identifying the ontological and epistemological position that underpins the experiences.One potential position to examine is that of constructionism as such knowledge is created or constructed through the fusion of life experiences and sub-concious thoughts and emotions experienced at a particular moment in time which are then entangled together with current information to create a narrative or story that can be therapeutic. It is through this philosophical exercise involviong/including existential themes that the essence of lived experience can be identified, protected, and nourished within mental health discourse.

Transcending technology boundaries and maintaining sense of community in virtual mental health peer support: a qualitative study with service providers and users

“…Norton (2023) points out that “ mental health services are currently undergoing immense cultural, philosophical, and organizational change. One such mechanism involved in this change has been the recognition of lived experience as a knowledge subset in its own right ” [ 54 , p.1]. The trends of peer support gaining in importance and being delivered in virtual as well as in-person spaces are poised to continue in the future.…”

Using Autoethnography to Reflect on Peer Support Supervision in an Irish Context

“…The peer profession [those who utilise lived experience as their knowledge subset] is a discipline in itself albeit at an early stage of development and thus warrants nurturing and protection as a different way of working. Discussions regarding protecting lived experience is just now beginning, with Norton (2023) commentary suggesting that the academic community needs to step back and understand lived experience from a philosophical perspective first before discussing how peers can apply it to practise. All of which is carried out in an attempt to protect the knowledge that is attained and therapeutically transferred through lived experience (Norton 2023).…”

“…Discussions regarding protecting lived experience is just now beginning, with Norton (2023) commentary suggesting that the academic community needs to step back and understand lived experience from a philosophical perspective first before discussing how peers can apply it to practise. All of which is carried out in an attempt to protect the knowledge that is attained and therapeutically transferred through lived experience (Norton 2023). This is the first examination of this in an Irish context, but similar findings are evident in the literature in other jurisdictions, building on the World Health Organisation's preference for a supervisor having worked in a peer role.…”

“…It is this quality that very much sets the Peer Support Worker apart from other disciplines. It also demonstrates the creation of a new knowledge subsetexperiential knowledge -which if protected and nurtured can become an asset to the wider mental health system (Norton 2023). At the first recorded evaluation of Peer Support Workers in the Health Service Executive, there were 26 Peer Support Workers employed directly from statutory services (Hunt & Byrne 2019).…”

“…Some Peer Support Workers have a very positive experience while for others it is less so. From the authors' training and experience in this area, we suggest that Peer Support Workers should be supervised by their own profession/philosophical position (Norton 2023). The rationale behind this idea is that peer support supervision works best when the practitioner understands their unique experiences and role within mental health systems, along with the emotional toll spent during day-to-day interaction with those they support (Francis & van der Veere 2011).…”