A new qualitative study published in the Community Mental Health Journal highlights the emotional and moral weight carried by peer support workers (PSWs) in Poland’s mental health system.
The study, led by Justyna Klingemann of the Institute of Psychiatry and Neurology, documents how PSWs experience distress when faced with service user suicidality, aggression, unforeseen crises, and institutional constraints that prevent them from acting according to their values.
“The PSWs participating in the study acknowledge that working with patients experiencing mental crises is undoubtedly emotionally demanding,” the authors write.
“They are exposed to situations where patients may have suicidal thoughts or attempts, or may become aggressive. Furthermore, working on a psychiatric ward is fraught with various unforeseen situations… A number of experiences that could be characterised as moral distress were identified in the narratives of those participating in the study, which can be understood as a combination of the individual’s values and the barriers they face in taking what they believe to be the right action.”
The study sheds light on how individuals with lived experience, employed to humanize mental health care, often encounter institutional constraints that replicate the very dynamics they were meant to challenge. It reveals how systems that valorize personal recovery may still marginalize peer workers through hierarchies, lack of support, and conflicting ethical demands.
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I saw this in a county meeting and the peer workers were earnest and trying hard in a wobbly maze. I was gobsmacked that they had just simple caretaking almost babysitting roles and also did not have a strong training component. I gave them books from my own library . One was Jin Kabat Zinn’s Full Catastrophic Living. Jon was involved in the Harvard
Mind and Body Project and has helpful ideas and thoughts. In fact, when I was parenting two severely ill children at the same time one of the heads of the Pediatric Departments saw me reading another of his books and said good you will be needing this.
Well what would have been helpful is peer parent support or a drop in from a medical pediatric social worker just to if nothing else check in. That is what I would have done when I had that type of position. The old question Is there anything I can to do to help ? You know simple human compassion.
A parent who had a child in the SICU would have been such a good support. This is what you should think about. These are the people who need to work with. Life experience can be invaluable.
The Child Life Worker was helpful but did not address my parental concerns.
A team approach for caretaking any human needs is always an expensive but best practice approach. The way societies treat not only those in need but those who try to help those in need is very telling. We have been failing and flailing for quite a while.
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If there is such concern for peer support workers, there might need to be even greater concern for school, education teachings that encourage children to look out for their classmates, friends, and provide support.
1. They look out only for their own friends
1. This is a form of parentification
1. The burden is placed in the minds of the young
1. Teachers rarely address concerns thoroughly and appropriately
1. Contagion may not show up for many years – when stress, stressors become less manageable
Education curriculums, policies, might need to change from causing harms, to actual active healthy engagement
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