'Walking the tightrope': The role of peer support workers in facilitating consumers' participation in decision-making

In adult mental health services, the participation of consumers is essential. The aimof this study was to explore the challenges faced by peer support workers when involving mentalhealth consumers in decision-making about their care and the strategies they employed toovercome these challenges so as to improve mental health consumers’ participation in decisionmakingand recovery. Semi-structured individual interviews were conducted with six peer supportworkers currently employed in psychiatric hospitals and/or community mental health systems.Thematic analysis identified challenges related to role definition, power imbalance, doctor-centricmedical approaches to care, and lack of resources. Strategies to overcome these challenges thatwere reported, included the following: facilitating meaningful involvement for service users,appropriate use of the lived experience, building relationships and communication, promotingrights and advocacy, and promoting professionalism of peer support workers (PSWs). Nursingstaff need ongoing support and education to understand and value the varied roles of PSWs andthereby empower PSWs to engage in enhancing consumer decision-making. The roles of the PSWsshould be viewed as complementary, and greater appreciation and understanding of roles wouldbetter support recovery-oriented car