Exploring the Experiences of Peer Counsellors Providing Remote Behavioural Activation Therapy for Antenatal Depression: A Qualitative Study

Purpose Growing evidence shows that peer-support and peer-led counselling is beneficial for people with antenatal depression, however, little is known about the experiences of peer counsellors (PCs) in providing support. Understanding PCs’ experiences is essential for determining whether a peer-led model of care is appropriate for improving access to mental health support in pregnancy. This qualitative research aimed to capture the personal impact and experiences of PCs while offering peer support in a randomized trial of remote peer-delivered Behavioral Activation Therapy for Antenatal Depression, the P3 PAAD Trial. Methods Data were collected through qualitative semi-structured interviews with PCs involved in the P3 PAAD Trial. Guided by an experience-based framework, inductive thematic analysis was employed to explore the perceptions and experiences of peer counsellors with training and delivering peer counselling to pregnant Albertans. Results Five themes emerged, 1. Positive Fulfillment 2. Personal Growth and Learning, 3. Fostering Dialogue on Maternal Mental Health, 4. Connection and 5. Support. PCs found fulfillment in providing support, witnessing personal growth in mentees, and expressing a desire to continue their involvement. PCs experienced mutual learning with mentees, benefitted from applying learned skills to their own daily lives, and in some cases, recognized a need to further their own treatment. PCs confronted stigma and facilitated open discussions about maternal mental health while finding solidarity and support through meaningful connections with mentees and fellow counsellors. PCs felt emotionally supported, with resources and guidance readily available. Conclusions Providing peer-led counselling was perceived as largely beneficial, and the results indicate that peer-led antenatal mental health support can be beneficial to those providing the support in addition to those receiving it. These findings also support further exploration of a peer-led model of care as a potential approach for improving access to antenatal mental health support.