Peer support workers in mental health: win-win, not win-lose (updated)

There’s an excellent editorial in the latest Journal of Psychosocial Nursing (JPN), which reports on recent evidence concerning peer support workers and what this means for mental health professionals, especially nurses.

The evidence picks up a recent Cochrane Database systematic review, which has been brilliantly summarised by Mental Elf. The systematic review found:

• Outcomes for people with mental health problems are no different when interventions have been delivered by other people with mental health problems (i.e. peers) than when they’ve been delivered by professionals
• Peer support interventions for people with depression were better than typical interventions.

Put simply, peer support interventions are at least as good as professional interventions from a clinical point of view, quite aside from the additional, “softer” benefits that might accrue to both the user and the peer supporter.

Building on this, organisations like the Centre for Mental Health have published really useful documents, such as “Peer Support Workers: Theory and Practice” and “Peer support in mental health: is it good value for money?” (answer: yes).

But the JPN article also goes on to explore the implications of the positives of peer support for mental health professionals, especially nurses.

It makes an important point that often gets missed:

Studies evaluating the views of service users and carers show that mental health nursing has a lot to offer with skills, knowledgeable, caring clinicians providing a range of therapeutic interventions and organising and coordinating multi-disciplinary care… [Nurses] should recognise that our role can profit from collaborating with and listening to colleagues who have first-hand experience as services users.

The drive to include peer support workers, as well as more personalised approaches, in mental health, is often seen as a zero-sum, win/lose power game: power is taken away from professionals and given to users.

I think this is wrong: it’s a positive-sum, win/win game, where both professionals and users can both benefit.

It’s great to see this point being made, and I hope we can keep finding examples of where win-win is the case in practice rather than win-lose the worry in theory.

(Thanks to @teaandtalking and @coyle_mj for highlighting the Journal of Psychosocial Nursing that prompted this post.)

Update: Completely forgot to include the Centre for Mental Health’s “Peer Support Workers: Practical guide to implementation” in the resources above.

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DPULOs, peer support and Access to Work – Expression of Interest

Introduction

The Minister for Disabled People, Esther McVey MP, recently announced further measures to ensure disabled people can benefit from Access to Work.

The Government will also implement a package of measures recommended by the Access to Work expert panel, chaired by Mike Adams from the Essex Coalition of Disabled People (ecdp).

The full notice can be found in the DWP’s pressroom. Further information about Access to Work can be found on GOV.UK.

One of the measures recommended by the Access to Work expert panel is for “Grassroots disability organisations (Disabled People’s User Led Organisations) to look at what else can be done to provide one-to-one peer support to disabled people using the Access to Work scheme”.

This Expression of Interest outlines how you can get involved in this work.

DPULOs, peer support and Access to Work – background

DPULOs currently deliver peer support in areas such as social care and volunteering. Evidence from social care reports show people have more choice and control and flexibility over their care and support through peer-led approaches, including in assessment, care planning and implementation. Formal programmes in health – such as the Expert Patient Programme – are also built on principle of peer support.

We are now keen to look at how peer support can work for people using Access to Work in their local area.

There is a variety of options for DPULOs to deliver peer support activities in their local area which could both complement and supplement support provided through the Access to Work process. These include, but aren’t limited to, the following:

• Buddying scheme – pairing up individuals with similar impairments / conditions or employment situations who use Access to Work
• Advice – DPULOs can provide focussed and targeted advice on specific groups, eg people with learning disabilities or mental health conditions, or young disabled people
• Support – DPULOs could provide support to employers and encourage and up skill JCP advisers to support employers in their local area
• Workshops – DPULOs could arrange Access to Work workshops with groups of people in preparation for starting work or long-term sick employees returning to work. Workshops would be able to identify what help is available and enable employees to have an opportunity to share learning of what works
• Other forms of peer support – DPULOs can offer various other forms of peer support, such as one-to-one, on the telephone, or as mentoring in the workplace. Workplace peer support could also be used to enable disabled employees to progress in work and more importantly keep the job.

What we are going to do

Working through the Strengthening Disabled People’s User-Led Organisations programme, we are inviting local DPULOs to put forward their ideas for delivering innovative peer support for people using Access to Work. This can be either a new project, or build on something you are already doing.

We are aiming to start this work as soon as possible. Expressions of Interest are invited below, and will be marked according to the criteria highlighted.

Organisations that are successful at the Expression of Interest stage will be asked to write a full proposal for consideration at a special meeting of the Facilitation Fund Board, which will comprise members of the Access to Work Expert Panel and Ambassadors from the Strengthening DPULOs Programme.

We are looking for around 10 local DPULOs to deliver a project. We anticipate these projects beginning in January 2013 and running for approximately 12 months, including evaluation.

Please note: any DPULO is eligible to express an interest, even if you have already received funding from the Facilitation Fund. The normal Facilitation Fund financial limits will not apply to this work. For further information on this, please contact Rich Watts (details below).

Expressions of Interest

We would like DPULOs to submit a brief (no more than 4 sides A4) Expression of Interest to deliver an innovative peer support project for AtW in their local area.

Your Expression of Interest will be marked against the following criteria:

• The DPULO’s knowledge, understanding and expertise regarding Access to Work and the barriers individuals face
• The DPULO’s track record in delivering peer support approaches that result in tangible differences in their local area
• The DPULO’s idea for an innovative peer support project for Access to Work in their local area
• The scalability of the proposed innovative peer support project
• The DPULO’s approach to partnership work in delivering the project
• The DPULO’s approach to capturing learning and evaluating the effectiveness of the project
• The DPULO’s capacity to demonstrate the ability to deliver this work over the next 12 months
• The proposed cost for this project and its value for money.

Expressions of Interest will be considered and marked by the Strengthening DPULOs Programme and members of the Access to Work Expert panel. Shortlisted DPULOs will be chosen solely on the basis of the information provided.

Please submit your Expression of Interest to Richard.Watts1@dwp.gsi.gov.uk by 5pm on Friday 14 December.

If you have any questions, please get in touch with Rich above. Similarly, if you know a DPULO who may be interested in this opportunity, please pass this information on to them.

November 2012

#EssexUnite – a #dpulo peer-led employment programme

A few weeks ago, I wrote about Essex Unite – a peer-led employment programme run by ecdp (a DPULO based in Essex).

In partnership with Jobcentre Plus and the private sector group MITIE, Essex Uniteis a ground-breaking work experience training programme that offers unemployed disabled people the opportunity to participate in meaningful work placements.

What is unique about the programme is that it’s a peer-led programme: disabled individuals supporting other disabled individuals to achieve their aspirations and life goals.

The first week of Essex Unite has now taken place – a pre-placement week offering a number of training courses before the 16 people involved head off to 6 weeks of work experience with matched employers.

Full details of the first 5 days of the Essex Unite course can be found on ecdp’s website below:

• Essex Unite – day 1
• Essex Unite – day 2
• Essex Unite – day 3
• Essex Unite – day 4
• Essex Unite – day 5

There are a couple of things in particular to look out for. The first is this Audioboo of Leanne, one of the participants, talking about her experiences

The others are the interest that BBC Essex has taken in the programme. Dave Monk from BBC Essex will be following participants as they progress, and the first installment (in two parts) is below.

To keep up-to-date, you can follow the programme via www.ecdp.org.uk/essex-unite

*For info, I’m seconded from ecdp to the Strengthening DPULOs Programme.

Mutual Support: a #dpulo delivering a new model of care

Mark Baggley, one of our DPULO Ambassadors, recently visited Mutual Support in Sheffield, after they had recently been awarded a Facilitation Fund grant of £8,625 to develop their organisation through a number of areas including training, user forums, web site development, publicity, etc.

The aim of Mutual Support is to develop a new model of delivering social care. They are looking towards starting trading as a domiciliary care provider as a non-profit making organisation.

They have registered as an Industrial and Provident Society (IPS) and want to explore other areas of need as directed by their membership. Mutual Support is a co-operative, and is user-led, being controlled by members for members. Co-operative values and principles are built into the organisation so that members have influence and control over their care and support.

The organisation has started to develop both services and membership and has entered into a partnership with the Enable Group, who are currently funding the rent on a small office at The Burton Street Foundation (see http://www.burtonstreet.co.uk/) as a base for their project worker. Also, the on site is a cafe run by people with a learning disability and this could be a potential source of future members and users.

What makes Mutual Support interesting is their idea of users, carers and Personal Assistants as part of one organisation. They would agree that there are many barriers to overcome to this working effectively, not least some potential conflicts of interest! For example, if everyone has a vote, how would it be decided to re-invest any funding raised by providing services? Would it lead to the development of new services (for carers or users) or be used to increase the rate of pay to PAs?

Mark met with three of the trustees, plus their project worker and their enthusiasm for both their project and their success in obtaining an award from the Facilitation Fund was infectious. They are aware that they have lots to learn and are actively interested in developing with other groups who may have similar aims and objectives, or have experiences in the areas that they are trying to develop.

If organisations are interested in contacting Mutual Support, please initially contact Mark Baggley (Ambassador) on 01482 878778 or mark@choicesandrights.org.uk as Mutual Support are currently setting up their office and contact details.

Introducing Peer Support Workers into mental health

One of the shifts I think we’ll see in the provision of public services – particularly in social care and health – is the significant introduction of “Peer Support Workers”. I.e. people who have been through or are still in the social care / health systems formally and informally working with those currently going through the system.

There are lots of good reasons for this, including:

• It generally leads to better outcomes for the people being supported
• It generally leads to better outcomes for the people doing the supporting
• It’s an approach that works well in partnership with professionals
• It utilises the under-tapped capabilities of people who use services
• Evidence suggests it can be a more cost effective way of delivering services.

As with much innovation, mental health services are leading the way. Thus, this research work by St George’s, University of London is very much worth keeping an eye on.

The Peer Worker Research Project is set up to explore how Peer Worker roles are being introduced into mental health services nationally, in both NHS Mental Health Trusts and in the voluntary sector. We aim to assess what is already known from the existing evidence about introducing Peer Worker roles to see to what extent it applies in a range of mental health services in England.

We also aim to develop guidance and online resources about what supports Peer Workers to carry out their role effectively. We will do 12 case studies across England of initiatives that involve Peer Workers.

You can follow their progress and the case studies on the dedicated Peer Support Worker website. There is also a very interesting event on 28 April about this work and practice developed so far, details of which are here.

Social work practices: pilots, pioneers and DPULOs

I blogged a while ago on the Social Work Practice pilots that the Department of Health proposed last year. This was exciting for me, since the benefits of social work practices are almost exactly the same for the benefits that accrue from disabled people’s user-led organisations (DPULOs).

Indeed, I hoped that some DPULOs would be involved in the delivery of the Social Work Practice pilots.

And, indeed, they are. The document embedded at the bottom of this post is a summary I’ve created of all of the Social Work Practice pilots, and includes two in particular – Birmingham and North East Lincolnshire – that are explicitly working with DPULOs.

The good news doesn’t end there. SCIE has recently announced a further 10 Social Work “Pioneer” projects – essentially the same thing as Social Work Practices, but just starting a bit later.

The full press release is here. What’s particularly exciting about this is that a further two sites – another in Birmingham and one in York – are directly involving DPULOs.

This is fantastic, and I’ll share relevant learning and information as the Social Work Practices and Pioneers move forwards.

Social work practice pilots

View more documents from Rich Watts

Embedding peer support in the workforce

Last week, my colleague Andy from ecdp and me gave a talk at an Adult Social Care Workforce conference. The topic was on embedding peer support in the workforce, the slides for which are below.

Embedding peer support into the workforce, 23 September 2011

View more presentations from Rich Watts

There were 4 key points we wanted to convey:

1. Where services are developed and delivered by peers (i.e. disabled people / service users), the evidence suggests that these produce better outcomes for service users, and are more efficient than if provided by a local authority
2. Peer-led services are not only good in their own right, but they provide employment pathways for service users: the Personal Budget holders of today can be the peer advisers of tomorrow
3. Peer-led services can’t replace local authority-led or any other provider-led services: scale makes this impossible. However, they should be a part of the overall provider mix
4. Peer-led approaches aren’t just good at the level of supporting an individual to control their care and support: they also work at the level of the community, ensuring information and experience is shared quickly and appropriately, and at the collective level, enabling disabled people’s user-led organisations to understand how well the provider market is meeting service user demand and conveying this intelligence to commissioners.

My good Twitter friend @kmachin highlighted some other research and work going on around peer support – there is certainly a growing evidence base. I’ll post updates / comments on this post to share this info when I have it.