The Benefits of Peer Support for Mental Illness

Benefits of mental illness peer support, including reduced self-stigma

Self-stigma, which comes from public stigma that’s been internalized, can have a significant negative impact on those of us living with mental illness. Peer support can help to reduce self-stigma, and I wanted to explore that and some of the other benefits that research has shown.

Peer support can happen in a lot of different ways, including informally (e.g. in online communities), through stand-alone services (e.g. mutual support groups or peer support coaches), or as part of health care services. There seems to be a push towards traditional mental health services incorporating peer support specialists.

Characteristics of peer support programs

Before we look at what some of the benefits are, a good place to start is what kind of peer support models the research has been evaluating. It sounds like a lot of the research has looked at peer support services targeting people with severe mental illness.

The Mental Health Commission of Canada (MHCC) says:

“Peer support programs work by offering people support, encouragement, and hope that recovery is possible. Peer support considers the wellness of the whole person and focuses on health and recovery rather than illness and disability, in order to assist people in finding their own path to recovery.”

A briefing from the UK-based organization ImROC (Implementing Recovery Through Organizational Change) came up with eight core principles of peer support:

  • mutual (shared experience of mental illness)
  • reciprocal and non-hierarchical
  • non-directive
  • recovery-focused
  • strengths-based
  • inclusive
  • progressive
  • emotionally safe

Elements of effective peer support programs

A review of existing research conducted by the Centre for Addiction and Mental Health (CAMH) identified key characteristics of effective peer support programs. These include:

  • effective training and supervision (Mental Health America has developed a National Certified Peer Specialist certification program, and the MHCC has developed peer support training guidelines)
  • provision of social connection and support in ways that promotes empowerment rather than being directive
  • creation of a safe, respectful environment where people can feel heard
  • ongoing engagement with other peer support workers as well as proactive engagement of program participants
  • characteristics of effective peer support workers: good communicators, authentic, motivated, calm, good judgement, compassionate, optimistic, and accepting
  • peer support workers should be doing well in their recovery

Benefits of peer support

Research has identified a number of potential benefits of peer support. The CAMH review found that peer support workers (PSWs) are in a better position than health professionals to support improvements in several areas:

  • empowerment
  • self-esteem
  • self-efficacy (a sense of being capable of doing things)
  • social inclusion
  • belief that recovery is possible

Stigma researcher Patrick Corrigan has called empowerment an antidote to self-stigma (source). Accessing peer support can help to reduce self-stigma, and this may be related to how it affects the way we construct our identities in relation to mental illness (source).

Peer support can also help people to stay in treatment and promote self-confidence and greater functional ability.

ImROC identified other potential benefits, including improved problem-solving skills, improved access to work and education, and greater feelings of being accepted, understood, and liked.

A report from the Centre for Mental Health in the UK noted that PSWs can play a unique role in helping people to make sense of their illness and how it’s affected their lives. They’re able to move away from the focus on symptoms and dysfunction that’s common in the health care system. A couple of studies have shown that frequent contact with PSWs has improved people’s stability in employment, education, and training. Besides benefits to clients, PSWs themselves can also benefit in terms of feeling empowered, more confident, and less stigmatized.

Mental Health America has also weighed in on the value of peer support, concluding that it reduces inpatient days, re-hospitalization rates, and overall cost of health services. They also found evidence that peer support improves quality of life.

Potential benefits in health care services

The ImROC report noted that there’s some indication that incorporating PSWs on inpatient units can improve patient experiences and outcomes. I can see peer input being particularly valuable in initiatives to decrease the use of seclusion and restraint. I also see a lot of value in getting feedback from people with lived experience on whether services that claim to be recovery-oriented and trauma-informed actually look that way from a service user perspective.

The last nursing job I had was at a program that management said was all about recovery, but their policies and actions were completely contradictory to that. They employed PSWs, but those workers didn’t have any input into how the program was actually run. I think that patient voice in higher-up decision-making is a really important thing to have, although that doesn’t happen very often.

The recovery college model

The recovery college model was first implemented in the UK in 2007. It involves recovery-focused, strengths-based programming that promotes personal growth. It may involve providing information about mental illness and forms of treatment, teaching life skills, or developing strategies for living with mental illness. Courses are co-designed and co-delivered by health professionals and people with mental illness. They’re accessible to everyone, unlike mental health services that have specific mandates and require referrals. Participants have reported being able to achieve personal recovery goals, having increased hope, and experiencing less self-stigma. Peer leaders have also reported enhancement of their own well-being.

Here in Canada, the Canadian Mental Health Association (CMHA) has started implementing recovery colleges. They also use a co-production and co-delivery model. In a white paper on the topic, they say their courses focus on “empowering students and utilizing critical reflection to develop strengths and competencies. Examples of critical reflection include class discussion, reflective journaling, arts-based learning, and physical expressions such as dance or movement.” In a survey of students who had taken courses at the Calgary Recovery College, 96% felt more hopeful and 81% gained a skill or information to support personal wellness.

Examples of courses at the CMHA Calgary Recovery College include A Good Night’s Sleep, Adulting 101, Building Better Boundaries, Challenging Procrastination, Coping with Current Events, and Managing Your Inner Critic. It looks like courses range from 1-4 sessions.

The role of online communities

There’s been some research on peer support in social media communities, but I didn’t find anything that specifically addressed the topic of self-stigma. I think informal peer support in online communities is more accessible and can occur more organically than peer support services, but there are also inherent downsides to the online world, like trolling and fostering comparisons.

I’m sure it would have been harder in the pre-internet days to connect with peers dealing with mental illness, and that sounds very isolating. Having these kinds of online peer communities helps with feeling like part of an in-group, even if it’s not the mainstream in-group. I think my own life would be much more difficult without this supportive peer community.

Thoughts on the role peer support

I’ve never participated in any kind of formal peer support. A couple of places I’ve worked have had PSWs, but in my role, I didn’t work closely with them. I like the recovery college idea; in a way, it offers an in-person version of some of the things you can get out of blogging.

I don’t see peer support as being a replacement for professional treatment, but I can certainly see it placing a positive adjunct role. A key piece is that it shouldn’t just be a matter of tokenism on the part of health care providers; I see it working best if there’s genuine teamwork, and if the people at the top are actually listening.

I can also see why it can help to reduce self-stigma. In real life, a lot of us don’t have many people in our lives (that we know of) who are dealing with mental illness, and I think there’s a lot to be said for being able to share that insider perspective to help normalize mental illness experiences.

What are your thoughts on the potential benefits of peer support?

Peer support resources

Book cover: A Brief History of Stigma by Ashley L. Peterson

My latest book, A Brief History of Stigma, looks at the nature of stigma, the contexts in which it occurs, and how to challenge it most effectively.

You can find it on Amazon and Google Play.

There’s more on stigma on Mental Health @ Home’s Stop the Stigma page.

40 thoughts on “The Benefits of Peer Support for Mental Illness”

  1. Peer support is definitely a huge help for me, personally. It does help take the sting out of the stigma a bit. Even just connecting with people here and blogging has become a huge source of support for me, where I previously didn’t really have much peer support at all. It’s so important for people to have other people ❤️

      1. I had a long reply thanking you for leaving a comment after I lost my little fur angel but I lost the whole thing! You were my peer support (a stranger showing such kindness make me good cry) and I referred back to your comment often to get by. On a personal level you rock and on a professional level so astute and I can’t wait to explore more! Speaking of peer groups I want to know what you think about a research study…but I am sure you are busy:) I will leave a link if you have a chance (Research in Second Life)

  2. I dig the idea, but not the politics behind so many of these programs. It’s okay though. I’m satisfied with the community of people here. Plus, I am constantly challenging myself to do more. It’s tough stuff for sure, so whatever progress I realize, I take.

  3. We are suspicious of what “success” and “healing” mean as it would relate to us: it seems often tied to work/productivity/capitalism. We feel like sudden onset, such as depicted in the video, has a better chance of healing.

    Untrained peer support didn’t seem very useful for us in our hospitalizations. Peers often defaulted to caretaking and feelings each other’s feelings and co-dependence and reliving their trauma and acting as therapists for each other and recommending pharmaceuticals.

    We went to a sexual violence center for help and they had peer listeners. This we felt was effective as a bridge to keep us supported during a crisis.

    There are peer networks in our region and they speak at formal gatherings. If one is looking for inspiration, this sounds supportive but we’re too skeptical

    1. I believe in peer support! At times I wish I could be closer to my peers but I have met friends for life online. Peers help so much because we actually know what the other is going through. That is what we need is an affirmation from someone who truly gets us. Professionals who have not suffered just can’t identify what we are going through. Plus we have our moments and when one of us is okay and the other is in the darkness, we are able to encourage each other.

      1. Those online individual connections have been really meaningful for me too. Professionals provide an important perspective, but it’s nice to be able to access a different perspective from peers as well.

  4. I’ve heard the term Peer Support but I never actually knew about the groups and I’m not sure if there are any in Ireland. It sounds like a good idea and I imagine really beneficial.

  5. I agree, I think peer support can be a great thing. I also think the Internet can be a blessing here because despite the obvious potholes, it can also bring communities together, connect people to others going through something similar, raise awareness to enable those experiencing mental illness to feel less alone etc.

    “ongoing engagement with other peer support workers as well as proactive engagement of program participants” – I can see why the combo of professional worker and peers is more typically pushed because you get the best of both worlds. You also feel like it’s going to be more structured, reliable and effective if there’s a worker involved (as opposed to an ungoverned support group in person or FB group). I think peers can have a huge impact, especially when it comes to the sense of companionship, motivation and empowerment. xx

  6. I’d believe that the concept of peer support in being beneficial is pretty solid. As a husband, I know that there are many issues where a woman is better suited to talk to my wife. Likewise, what siblings draw from each other can be different from what they can draw from parents.

    There’s only so much one person can do. If your only support comes from an authority, we sometimes can’t help but wonder if they can empathise with what we’re going through. However, it’s far more difficult to make that argument, plus it feels a lot more relatable when the person we’re with is going through or has even been through much worse than what we have.

  7. Hi! I think that having the chance to share experiences with and get support from someone who has gone through similar stages is so powerful. There can be a real exchange. Thank you for your inputs and the short video about the Recovery College. I’m from Switzerland and I notice that these are coming more and more here, too! One thing I really like about Recovery that it’s spreading around the world and unifying people on a cause. Have a nice day!

  8. I think it’s important to talk to peers because not feeling alone can make such a difference. However there should probably be check-ins with a professional therapist to ensure the peer interactions don’t devolve into negativity and enabling. I’ve had issues with other people I talked to who were depressed and we just reinforced our problem. There should be an element of accountability to keep everyone safe.

  9. I wouldn’t even be halfway healthy without peer support I’ve received at LRC throughout the past four years. SHARING and sending to peer counselors at the Latah Recovery Center.

      1. I’ve noticed this. Also here in Idaho they have training to become a state qualified “recovery coach,” and “peer counselor” is a step along the way. The coach I like best at the Center was first a peer counselor and worked her way up. (There are several tiers.)

  10. I think I’m confused on terminology. By “peer support” do you mean formal counseling in a group setting, ie. a depression group or an anxiety group, with formal meeting times and facilitation? Or do you mean connecting informally like blogging about mental health topics and interacting with other bloggers?

    1. I was thinking of informal peer support as the kind of thing that happens in the blogging world, and peer support services can range from support groups to the recovery college model to one on one work as part of mental health care services.

  11. Yes, sometimes, the human connection from peer support, as ephemeral as it may, sends me positive charges that make the dark no longer dark. It’s magical. I will then bounce back and learn to live and work with the reality.

  12. Coming from a social service background I would have to agree peer support is every necessary. You know for me medication does work but not alone. I need that person to confide in and experiences to learn from. Hence peer support.

Leave a Reply