Exploring the Integration of Peer Support Workers and Their Experiential Knowledge in Mental Health Services: An Ethnographic Study from the Dual Perspectives of Peer Support Workers and Professionals in Trieste and its Region

Purpose Peer support, endorsed by the WHO and national guidelines, is increasingly recognised and promoted worldwide. However, innovative approaches are needed to evaluate the implementation of Peer Support Workers (PSWs) and their impact on mental health services. This study investigates the role of PSWs in Trieste and its region, a pivotal site of Italy’s psychiatric reform, where the deinstitutionalisation movement fostered the transition to a community-based care model. Methods The present study adopted an ethnographic methodology, encompassing a six-month field study involving participant observation and 22 semi-structured interviews with 12 PSWs and 10 mental health professionals. Results This study investigates the role, values, and benefits of peer support in mental health services within a specific Italian region, examining its impact on service users and its contributions to the humanisation and innovation of care. By analysing the perspectives of both PSWs and professionals, this research offers a comprehensive assessment of its significance. It also identifies the critical challenges related to the involvement and recognition of PSWs, employing an anthropological approach to identify operational difficulties and epistemological assumptions, which often constrain the full integration of PSWs. Moreover, the study proposes strategies for strengthening the role of PSWs and enhancing the consideration of experiential knowledge in mental health services. Conclusions In addition to their clinical effectiveness in supporting individuals' recovery, PSWs represent an opportunity for mental health services to critically reflect on their practices and the cultural assumptions underpinning them. These reflections have the potential to create meaningful innovation in psychiatric care