This week Mad in America examines three studies related to peer support work in mental healthcare. The first finds positive results for a program that trains involuntary patients to be peer support workers. The second investigates the value, impact, defining features, and tensions associated with peer support work. The third reports that organizational support is an important factor in avoiding burnout for peer support workers.
Peer Support Training Program Shows Promise in Transitioning Involuntary Patients into Peer Support Specialists
A new study published in the Community Mental Health Journal reports success for a California-based pilot program designed to train people under involuntary conservatorship receiving treatment in a locked mental health facility to work as Peer Support Specialists (PSS) in the same facility where they receive treatment. This research, led by Lori Ashcraft, founder of Resilience Inc., finds that all enrolled patients completed the peer support training program and more than half were hired as part-time Peer Support Specialists.
The goal of the current work was to examine the Peer Employment Learning Center pilot program. This program involved 80 hours of peer support training and a 100 hour supervised internship for peer support candidates, recovery-oriented workshops for staff and managers, and weekly development meetings for peer support specialists hired after completing the program.
The authors wanted to know if the program was feasible and if staff and leadership involvement shifted attitudes towards a more recovery-oriented culture. The authors collected quantitative data on knowledge acquisition of peer support and recovery-oriented care, organizational culture, and program completion rates. They also collected qualitative data through open ended interview questions. In total, the authors collected data from 18 peer support candidates, 15 facility managers, 221 mental health workers, and 187 patients.
All 18 peer support candidates completed the 80 hour training. Ten were hired as part-time PSS. The authors note the part-time designation was necessary to ensure the patients did not lose their social security benefits. Of the eight patients that were not hired, Three dropped out of the internship once they discovered it was not mandatory and five transitioned to supported employment. Three of the 10 patients that were hired had their conservatorships terminated after four months of working as a PSS.
Knowledge around peer support and recovery-oriented care improved both for PSS candidates (36% to 95%) and facility management (70% to 96%). PSS candidates also reported feeling a shift in identity from being a “mental patient” to being a “peer support specialist.” Some PSS candidates also reported feelings of “whiplash” in the transition from involuntary patient to the professional role as a PSS.
This study had three key limitations. The authors examined a single facility with a small sample size, limiting genralizability. The PSS candidate group was not compared to a control group. Four of six authors were employed by organizations that designed and secured funding for the Peer Support Learning Program. This means they were invested in a positive outcome for this program, which could have biased the results.
The Value, Impact, and Structural Tensions of Peer Support Work
A new study based in England and published in BMC Psychiatry details how peer support specialists approach their work, the underpinning values, the perceived impact, and the tensions involved in peer support work. This research, led by Ruth E. Cooper from King’s College London, reports that the non-clinical approach peer support specialists often employ is sometimes at odds with NHS services.
This study aimed to investigate the core values, defining features, and larger impact of peer support work in mental healthcare. The authors, including eight researchers with lived experience of mental health struggles, co-produced semi-structured interviews around peer support work. These interviews were coded and the authors identified larger themes from the initial codes. In total, the authors used interview data from 35 paid peer support workers throughout England.
The authors identified three overarching themes in the interview data: the peer support approach, underpinning values, and perceived impact and tensions. The peer support approach involved the prioritization of building deep connections with service users and patients, often involving sharing their own lived experience of mental health struggles. Peer support workers also reported advocating for service users outside the typical clinical boundaries.
The underpinning values of peer support work included recovery being possible with peer support workers serving as a role model, mutuality that involved sharing lived experiences to foster deep empathy, a person-centered approach that adapts services to the individual needs of each service user and patient, and empowering service users and patients to regain control rather than trying to “fix” them.
Participants reported the impact of peer support work as helping service users and patients feel understood and encouraging openness. Participants also said peer support work helped in their own recovery journey. However, there were some clashes between the approach employed by peer support workers and the clinical setting, and the emotionally demanding nature of peer support work could lead to burnout.
This study had two main limitations. The participants were all from England, limiting generalizability to other populations. The participants were self-selected, which could bias the results towards overly positive or negative experiences of peer support work.
Strong Organizational Support Important in Avoiding Peer Support Specialist Burnout
A new study published in the Community Mental Health Journal finds that supportive, well-resourced work environments are important in ensuring that peer support specialists do not burnout. This research, led by Danya K. Krueger from the University of North Carolina, reports that both personal resilience and supportive work environments were linked to increased job satisfaction and lower rates of burnout.
The goal of this study was to examine how job satisfaction, organizational support, satisfaction with management, and personal resilience affected burnout for US-based peer support specialists. The authors examined data from previous studies that used self-report surveys with validated measures of burnout, personal resilience, and organizational support to examine these relationships. In total, the authors examined data from 454 US based peer support specialists.
Higher rates of burnout were significantly linked to lower rates of job satisfaction. Higher rates of personal resilience and satisfaction with management were linked to less burnout and greater professional well-being and job satisfaction. Organizational support was also linked to higher rates of job satisfaction. Overall, the authors estimate that personal resilience, management and organizational support, and burnout explain 42% of the variance in reported job satisfaction. While personal resilience can explain some of the variance in job satisfaction, the authors report that “results highlighted the need for organizations, policymakers, and researchers to collaboratively develop and assess PRSS-centric interventions that foster supportive and well-resourced work environments.”
This research had two key limitations. The study’s design means this data can only speak to links, not causes, between the observed factors. The self-report nature of the data means it is susceptible to misremembering and reporting what is socially desirable rather than what is true.
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Ashcraft, L., Blum, P., Cronise, R., Martin, C., Johnson, G., & Karyczak, S. (2026). Peer Employment Learning Center (PELC) pilot project: From mental patient to peer support provider. Community Mental Health Journal. (Link)
Cooper, R. E., Lyons, N., Jeffreys, S., Jeynes, T., Nicholls, V., Foye, U., Shah, P., Mitchell, L., Machin, K., Chipp, B., Grundy, A., Pemovska, T., Ahmed, N., Appleton, R., Repper, J., Lloyd-Evans, B., Simpson, A., & Johnson, S. (2026). Understanding the roles and experiences of mental health peer support workers in England: A qualitative interview study. BMC Psychiatry, 26(1). (Link)
Krueger, D. K., Zerden, L. de, Jensen, T. M., & Lombardi, B. M. (2025). Burnout and job satisfaction among U.S. Peer Recovery Support Specialists: Personal Resilience and satisfaction with supervisor and organizational support as Mediating Mechanisms. Community Mental Health Journal, 62(2), 208–218. (Link)
