The impact of context on mental health peer support work: ethnographic study

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Peer support workers (PSWs) are individuals with lived experience of mental health (MH) problems who are employed in a peer support capacity in public and voluntary sector MH settings. PSWs are a valuable part of the MH workforce (Department of Health, 2007). However, inflexibilities in highly standardised organisational environments can impose constraints on the PSW role limiting their ability to meaningfully impact MH systems (Gillard et al., 2014). This project will explore how the PSW role is implemented in two different MH settings with a particular focus on the relationship between PSW and organisational culture. Using structuration theory, I will explore how social structures (MH organisations, rules, resources) both constrain and shape individual agency (PSWs actions and behaviour), which in turn serve to (re)produce and shape structures. Through separating structure into three forms: Domination, Signification, and Legitimation, will allow for a better understanding of how PSWs negotiate complex mental health structural systems (Giddens, 1979). A comparative ethnographic case study approach will be employed to address the following two questions: (1) in what ways do the symbolic, legitimate, and dominant structures constrain or enable PSWs to carry out their role in different organisational settings? (2) How do PSWs re(create) or resist structures to support service users with MH problems?