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Peer work

The Commission feels strongly that the peer workforce must:

  • be an essential component, not an ‘add on’ to any support team, with equal status to their team colleagues
  • be remunerated appropriately at a level commensurate with their skills and training – a good and willing volunteer is just that, not a peer worker
  • be supported and sustained into and in the role with high-quality, ongoing training and supervision
  • be supported by national competencies and standards, and
  • have a clear career trajectory.

Mental health peer workers are in paid roles that require them to bring expertise to their position based on their lived experience of mental illness, either personally or as a family member or supporter.

Peer work can take many forms; from giving hope and modelling recovery to contributing to the recovery of people and their families, by providing social support, advocacy, and one‑to‑one mentoring.154, 155 Approaches are flexible and peer workers can address aspirations and personal goals, rather than focusing on medical treatment. Family peer workers play a crucial role in offering others support and advice to navigate through the mental health system and advocate for change.

Evidence on the major benefits of the peer workforce to mental health outcomes and recovery has developed rapidly in the last decade, with some seeing their employment as “one of the single most effective ways to develop and sustain a culture that stays focused on recovery practices.”156 They can influence and change service culture and practice, and bridge gaps between supports provided by other professionals. The benefits of having a peer workforce include reduced social isolation, increased service access for substance use and health difficulties, improvements in social functioning, enhanced empathy and acceptance, reduced stigma and an increased feeling of hope.157

 

Figure 6: Mental health peer workers by service type

Figure 6: Mental health peer workers by service type pie chart

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Peer workers can bring about positive change in the culture and recovery focus of the organisation in which they work; for example, with colleagues becoming more aware of the language they use.158, 159 Evidence suggests that peer workers can also help to reduce the use of seclusion and restraint.156

The peer workforce can provide a meaningful career option for some people living with mental health difficulties.160 The available research evidence indicates that peer workers perform at least as well as other staff in areas such as reducing hospitalisation rates, accessing hard-to-reach clients and reducing levels of substance use.157, 160-162

While the benefits of peer work have long been recognised in the addiction field, the peer workforce is now the most rapidly growing workforce in the mental health sector in Australia, with many working in the non‑government sector (refer Figure 6).

Recent research undertaken by Health Workforce Australia included a small-scale survey of 305 people who identified as peer workers. Of this sample, 18 per cent worked casually, 29 per cent full-time and 53 per cent part-time.163 About half of the sample worked for non-government organisations, while 17 per cent worked in public hospitals, 11 per cent in a Commonwealth-funded mental health service or program and ten per cent in a state or territory funded public mental health service or program.

 

Figure 7: Consumer and carer peer workers as a proportion of the direct care mental health workforce

Figure 7: Consumer and carer peer workers as a proportion of the direct care mental health workforce line graph

As peer workers can be employed under various titles and awards, further research is needed before we can have a complete picture of the numbers and characteristics of the Australian peer workforce.

Although these professionals have been employed in some Australian states for many years, the actual numbers of full-time positions in public health services remains very small and has increased very little over time (Figure 7). In practice, many are employed for just a few hours a week, and misunderstandings about the role and value of peer work still prevail.

 

Figure 8: The concept of recovery

Figure 8: The concept of recovery diagram

The endorsement of the Certificate IV in Mental Health Peer Work by the National Skills Standards Council provides a solid foundation on which to expand the peer workforce across all domains of a contributing life. The Commission is sponsoring Community Mental Health Australia to undertake the Peer Work Qualification Development Project164 to develop training and assessment resources for both the consumer and carer peer worker streams.

The study by Health Workforce Australia gives us more information about the profession.

We now need to build upon the evidence and this momentum with some real action. The Commission calls upon all governments to together develop a National Mental Health Peer Workforce Development Framework and include peer work approaches as a key performance indicator for service contracts and programs.

We also endorse the call for a national target for peer workers in mental healthrelated support services. This target aims for 50 per cent of services employing peer workers in four years and 100 per cent in ten years. These actions will help to improve outcomes, and employment rates of people with mental illness and their families and supporters.

 

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