I lost my personality on a train once. It got on the train
that day and left me behind. I waited for hours on the platform, but it didn’t
come back. It was the Transport Police who moved me on and out of the station.
I was telling this story to my hairdresser Vicky last week.
Well, it beats talking about my holiday plans. Yet, it has taken me years to
get to a point where I have processed that terrifying episode and can talk
about it at all, let alone laugh; that terrible time when I fell apart, not
knowing what was illusion and reality, sleep or dreaming.
As well as being my hairdresser Vicky actually has her own
mental health stories to share. She is my peer, and just one of many precious
people who helped me back on my feet.
Mental illness is no respecter of ethnic, religious or
gender fault lines. It affects black people, Jewish, young, old, rich, lesbian,
atheist and believer. And some decide to convert their experiences into a
positive; supporting others to get back and stay on their feet. They are peer
supporters: role models, leaders, and my heroes.
The benefits of peer support are well known and proven. It has
evolved over decades, in many cases as an antidote to the ‘system’ which many
people with mental health issues have experienced as dispassionate, undermining,
even abusive. For marginalised groups who have traditionally found it difficult
to access mainstream services, local user-led peer support groups have provided
a vital lifeline against isolation and despair.
Of course, there are times when someone in distress needs
the support of specialist professionals, but the ability of peer supporters to
speak from the ‘I know because I have been there’ perspective provides comfort
and hope in a way that is unique and special. Peers act like a guide, with
their insight as the compass, travelling with you and providing you with simple
practical support, but also the confidence, humour, common sense which are
signposts to wellbeing.
Its use in formal mental health settings originated in the US and has gained
a foothold over here, possibly accelerated by the current pressure to find
money-saving ways of delivering health and social care services.
This recognition of the value of peer support is to be
welcomed, and could revolutionise mental health services. Indeed, we learnt of
many positive and collaborative partnerships being forged in the voluntary
sector and between user-led peer support groups. However, in a report we
commissioned recently ‘Freedom
to be, the chance to dream’ we discovered disturbing testimonies which
could emerge into a dangerous trend: the ‘professionalisation’ of peer support;
where the distinctive roles and tasks of peer supporter and paid staff becomes
blurred. This, we warn, dilutes the unique power of peer support and can
engender mistrust and suspicion from the people who would normally benefit from
it.
For instance, I was horrified to hear a peer supporter
talking at a conference about being taught how to physically restrain and
control patients in a hospital before working on an acute ward. Others I have
spoken to have been used as low paid nursing assistants, or being asked to
serve meals and go shopping.
Disturbingly, some respondents in the report alluded to
resistance and suspicion from some staff in formal health settings, perhaps
mistrustful of the autonomous and organic nature of peer support and wanting to
shoe-horn it into the ‘medical model’ with its rigid policies and procedures.
Clearly, being asked to come into contact with vulnerable
people in formal settings requires creating certain procedures to create a safe
and protective environment for service users. Indeed our report advocates the
need for peer supporters to receive training in important things like listening
skills, and equality and diversity. But,
there is also clearly work to be done to create mutual respect for two very
different ways of working which, when done well, can be complementary and
ultimately beneficial for the user.
This also applies to the charity sector. At Together, we are
in the process of putting peer support at the heart of the transformation of
services. Admittedly we are faced with the same professional and philosophical
dilemma: how to balance the need to preserve the informal, organic nature of
the peer support relationship with our duty of care to service users to ensure
their safety
We believe that the
peer support ‘movement’ is at a crossroads, and that the creation of a
framework which enshrines the user-led element of peer support, values its
heritage, and offers good practice guidelines is essential to ensure its
survival and maintain its distinctness and integrity. Naturally, this work
needs to be done from the grassroots up to have real meaning.
And, at a time when funding is driven by the need to deliver
on hard outcomes, it is vital that more work is carried out to consolidate the
evidence for the effectiveness and benefits of peer support if we are to
preserve the existence and growth of those thousands of groups and organisations
who are a critical and innovative part of the future of the voluntary sector.
In the worst case scenario peer support could be used as a
cheap form of labour rather than an alternative or complementary resource of
choice, pulling people into giving their experience without any investment
around building capacity or infrastructure, or regard for the peer supporter’s
own wellbeing. This would be to ride roughshod over the values of peer support,
and ultimately nullify its power.
We need to stop the erosion of this unique and valuable
work. Without it, I would still be waiting at Platform 5 for my mind to return.
Anne Beales
No comments:
Post a Comment