A Qualitative Exploration of mental health peer support provision for racially minoritised people in England

Background Peer support is being expanded at pace across mental health services in England. Limited research looks at peer support in relation to racially minoritised people in the UK, against a backdrop of longstanding racial inequities in mental health provision. The purpose of this research was to explore the main issues for peer support in responding to diverse populations, and to make recommendations relating to race equity considering the peers support’s integration into mental health services. Methods We conducted an exploratory qualitative study using semi-structured key informant interviews with 18 participants, including supported peers, peer workers and professionals. A lived experience advisory group ensured high levels of lived experience involvement in the conceptualisation, analysis and write up. Interviews were transcribed and analysed thematically. A hybrid approach was used in the data analysis. Results Data are presented below under four themes: peerness and connection, cultural awareness and peer support, cultural responsiveness and peer support, and organisational cultural competence. Important findings around racialised matching surfaced, reflecting various perspectives peer support must embrace. Peer support’s role as being tailored to addressing specific racial inequities was put forward. Themes looking at cultural awareness and responsiveness highlighted the dynamic inter-relation between peer support and race, ethnic and culture differences, and peer support’s agility to respond to diverse needs. Conclusions The introduction of peer support workers is a key part of NHS reform. The considerations in relation to race equity for this new mental health workforce have been unclear in practice and research. As the scope of PSW increases there is a need for greater awareness of the issues they will encounter to support system integration. Our findings highlight key approaches by PSW’s in responding to ethnic diversity. They also highlight the need for appropriate resourcing to help ensure race equity can be central to service delivery. Support for racialised peer support workforce to attend to vicarious racism should be provided, alongside opportunities for ongoing learning and coaching around culture and mental health. Improvements in how to monitor and to appropriately respond to inequities across access, experience and outcomes should also be a priority.