‘Nothing about us without us’
At 16 I was diagnosed with anorexia nervosa, something that would shape my life significantly over the next decade and I feel fortunate to have received support from NHS mental health services. But at times, although well intentioned I would often feel that this support felt like mismatch and that it wasn’t right for me. This continued until I met a team who asked me what I thought and what support I felt might be helpful. Suddenly my ideas were genuinely valued and I felt power was shared. Any decisions made were made together and it was at this point things started to change for me and I started to move forward.
As a Clinical Psychologist, it is incredibly encouraging that mental health and wellbeing is increasingly being prioritised within the workplace. However, only one in three employees believe their company wellbeing strategy is effective (WTW, 2022) and only 39% of HR decision-makers believe their current wellbeing strategy adequately meets the needs of their workforce (PIB Employee Benefits, 2024).
It is evident that there is more to be done to engage staff and I believe by harnessing the power of coproduction and peer support, we can create compassionate, more effective and sustainable wellbeing strategies.
An introduction to coproduction
Coproduction is a participatory and deliberative practice that is often juxtaposed against more top-down practices (Fung, 2015) and commonly begins because something is not working, missing or people don’t feel at the heart of initiatives. It is built on the principle that those who access a service are best placed to help design it and means people working together as equal partners and co-creators. Asking people what needs to change and what wellbeing outcomes do we want to achieve.
‘Coproduction is not just a word, it’s not just a concept, it is a meeting of minds coming together to find a shared solution. In practice, it involves people who use services being consulted, included and working together from the start to the end of any project that affects them’ (Social Care Institute for Excellence, 2023).
There are varying degrees of stakeholder involvement and the ladder of coproduction describes a series of stages where an organisation may find itself (Figure 1). From educating people to co-designing strategies in partnership, implementing this way of working will present challenges and real change may be difficult. However, in my career, I have witnessed how meeting those challenges can result in a transformational approach to the way wellbeing services are organised and the positive impact this can bring in engagement and outcomes.
Figure 1: The Ladder of Coproduction (Think Local Act Personal, 2021)
What is peer support?
One specific area of coproduction that benefits workplace mental health and wellbeing is peer support. Although definitions vary, peer support is typically defined as ‘offering and receiving help, based on shared understanding, respect and mutual empowerment between people in similar situations’ (Mead et al., 2001).
‘They know I’m not the expert… I said to her, ‘I’ve got my own experience’ and with that she sort of jumped up and gave me this huge hug’ (IMROC Theory & Practice, 2013).
Peer support is a safe space to speak with someone who is trained in providing support and who may have experienced a similar issue related to mental health. It provides a space for people to connect authentically through shared experience and aims to offer emotional and practical non-directive, strengths-based support which helps both move forward. Put simply, peer support aims to bring people together with shared experiences to help support each other.
Benefits of peer support
Successful across voluntary and statutory services, peer support is now gaining international traction and increasingly being adopted within corporate sectors. This is due largely to the evidence base for workplace peer support for mental health showing benefits across a number of perspectives.
Benefits to the person supported
Research indicates a number of benefits to the person supported including feeling more able to speak openly about their experiences alongside improvements to mental well-being, improved confidence and ability to cope with everyday workplace stressors (Agarwal et al., 2020).
Benefits to the peer supporter
Although there can be challenges to the role, evidence suggests that with effective training and support the benefits to the peer supporter themselves may include personal growth, greater confidence (Gillard., 2022) and empowerment in their own wellness or recovery journey (Bailie & Tickle, 2015).
Benefits to the organisation
Organisational culture may also be positively impacted by peer support through facilitating trusting and supportive colleague relationships, contributing to cultural change by reducing stigma (Agarwal et al., 2020), and reducing absenteeism (Cameroon et al., 2012; Odeen et al, 2013).
Embedding peer support in the workplace
For organisations considering embedding workplace peer supporters there are a number of key steps;
Preparing the organisation
Ensure there is leadership buy-in by demonstrating the value peer support brings, then build awareness, understanding and engagement across all levels as an important first step.
Developing the peer supporter role
Define what a voluntary peer supporter role entails including job descriptions, time commitments, modes of support (e.g. face-to-face or online, 1:1 or group), and how to communicate to employees about the opportunity to become a peer supporter. Be clear about the level of flexibility and the amount of time available to offer peer support during work hours. This is the time to clarify policies around peer support and identify a project coordinator to support roles.
Peer recruitment and selection
Determine how the organisation will recruit peer supporters, the selection process and how many roles are required. The peer supporters themselves are the most important resource for the success of the programme and the role won’t be right for everyone. Give consideration additionally to the orgainsation hierarchy as it isn’t advisable for example for an immediate manager or supervisor to be in an active peer support role for employees that report directly to them.
Peer training and support
Training (e.g. how to share lived experience safely, boundaries and self-care) and on-going support are vital for the success, impact and sustainability of any peer support programme. Support may include regular contact with the project coordinator and reflective spaces with other peer supporters to provide mutual support.
Ongoing evaluation & development
Finally, gathering data and evaluating your peer support programme’s impact will guide its continuous improvement ensuring it meets your workforce needs effectively. Set targets and measure success to understand help the value of peer support.
Summary
From my own personal and professional experience, I believe that those who access a service are central in shaping and building any wellbeing initiative. Shared problem solving and recognising power in others does not diminish power elsewhere and in fact organisations can become much stronger as a result of coproduction.
We see that peer support enhances engagement with wellbeing strategies and this can help deliver fundamental change for people and their organisations. Such wellbeing initiatives not only feel more genuine, and encourage people to bring their authentic selves to work but additionally can deliver a better return on investment and a more sustainable impact.
Peer support offers another option for people to choose the support that is right for them and I hope that by reading this it has inspired you to explore the power of peers within your workforce.
About the author:
Dr. Jessica Woolley is a Principal Clinical Psychologist with 20-years experience working in NHS mental health services and founder of workplace mental health training and consultancy, www.risementalhealth.co.uk
Jessica works as an innovation lead for developing peer support within NHS services and supports organisations to create co-produced mental health and wellbeing strategies.
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