Happy World Mental Health Day! Given the topic we’re celebrating today, the basis of my project, and that I’ve made the decision to pursue my degree in social work, I feel like it’s a great day to talk about one way we can help the world improve mental health: peer support.
I recently read an article on peer support that I found fairly accessible to the average mental health consumer. Namely because it’s not a clinical paper written by doctors, it’s a theoretically-based paper written by educated people who have spent years working in the mental health community within the peer support space. That means you’re automatically spared the medical jargon in favor of more humanistic characterizations of the deeper levels upon which mental health recovery should be based, and why.
I’m going to be doing a lot of direct quoting from the article because I like the way they represent their perspectives, starting with their abstract, followed by a definition of peer support.
“This article offers one theoretical perspective of peer support and attempts to define the elements that, when reinforced through education and training, provide a new cultural context for healing and recovery. Persons labeled with psychiatric disability have become victims of social and cultural ostracism and consequently have developed a sense of self that re-enforces the “patient” identity. Enabling members of peer support to understand the nature and impact of these cultural forces leads individuals and peer communities toward a capacity for personal, relational and social change. It is our hope that consumers from all different types of programs (e.g. drop-in, social clubs, advocacy,support, outreach, respite), traditional providers, and policy makers will find this article helpful in stimulating dialogue about the role of peer programs in the development of a recovery based system.”
Definition of Peer Support
“Peer support is a system of giving and receiving help founded on key principles of respect respect, shared responsibility, and mutual agreement of what is helpful. Peer support is not based on psychiatric models and diagnostic criteria. It is about understanding another’s situation empathically through the shared experience of emotional and psychological pain.
When people find affiliation with others they feel are “like” them, they feel a connection. This connection, or affiliation, is a deep, holistic understanding based on mutual experience where people are able to “be” with each other without the constraints of traditional (expert/patient) relationships.
Further, as trust in the relationship builds, both people are able to respectfully challenge each other when they find themselves in conflict. This allows members of the peer community to try out new behaviors with one another and move beyond previously held self-concepts built on disability and diagnosis. The Stone Center refers to this as “mutual empowerment” (Stiver & Miller, 1998).
Peer support can offer a culture of health and ability as opposed to a culture of “illness”and disability. (Curtis, 1999) The primary goal is to responsibly challenge the assumptions about mental illnesses and at the same time to validate the individual for whom they really are and where the have come from. Peer support should attempt to think creatively and non-judgmentally about the way individuals experience and make meaning of their lives in contrast to having all actions and feelings diagnosed and labeled.
Many people have learned roles that build a strong sense of identity as “mental patient.” Because this becomes a primary identity we find affiliation with others who have also been labeled. Zinman (1998) refers to this as “client” culture. This “identity” leads us to the assumption that the rest of the community can’t understand us and creates an “us/them” split with others.
An imbalance of personal and social power lies at the heart of mental illness and is the cornerstone of the theory of recovery that we wish to present. Recovery lies in undoing the cultural process of developing careers as “mental patients.”
We undo this by practicing relationships in a different way. Peer support, therefore, becomes a natural extension and expansion of community rather than modeling professionalized caretaking of people defined as defective. As peers feel less forced into their roles as “patients,” they naturally come to understand their problems in the larger social and political context from which they emerge, rather than pathologizing themselves.
Peer support is a simultaneous movement towards autonomy and community building. It is not based in deficits model thinking. It is a model that encourages diversity rather than homogeneity, and recognizes individual strengths.”
Well put, right? Are we getting this out of our current mental health care system? Hardly.
Anyone who’s been processed through modern medicine’s modus operandi can clearly see the disparity between it’s approach to mental health treatment and recovery, and the peer-support approach. The former being a one-sided approach, and the latter being a two-way street of acquiring treatment and maintaining recovery.
Peer support creates an environment that allows consumers to dissociate the pejorative of clinical mental health patient, and identify it from a more human perspective that transverses across more planes of society and will basically fly under the stigma radar a little more easily given it’s peer-to-peer foundation.
I see it as reframing mental health care in a manner that allows for more accessibility, utilization, understanding, acceptance, safety, cost-effectiveness, hope, community, retention and recovery, and minimizes stigma, attrition, and relapse. I see it as a whole-person approach rather than a symptom-based approach.
I also believe that to have peer support in the role of advocate or liaison for a consumer of mental health care between their community and the clinical side of treatment makes the entire process, as I keep saying, more human. As it is in America, it feels like a machine; not easily navigable, approachable or very caring. Placing a human being in all those voids, one who can actually relate to the traumatic experience of the consumer, seems like an easy answer to me. A wise choice for the attempt to correct the imbalance between personal and social power, as the article states. I’ll go ahead and make the obvious statement that all of that, to me, adds up to more efficiently utilized health care with better outcomes for consumers.
Also, I couldn’t help myself with the image I used for this post 🙂
Peace, love, and wellness.