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. 2025 May 12;25(1):480.
doi: 10.1186/s12888-025-06850-z.

Understanding the barriers and facilitators to delivering peer support effectively in England: a qualitative interview study

Una Foye  1 , Natasha Lyons  2 , Prisha Shah  3 , Lizzie Mitchell  3 , Karen Machin  3 , Beverley Chipp  3 , Stephen Jeffreys  3 , Tamar Jeynes  3 , Karen Persaud  3 , Vicky Nicholls  2 , Ruth E Cooper  4 , Andrew Grundy  3 , Tamara Pemovska  2 , Nafiso Ahmed  2 , Rebecca Appleton  2 , Julie Repper  5 , Sonia Johnson  2   6 , Brynmor Lloyd-Evans  2 , Alan Simpson  4   7
Affiliations

Understanding the barriers and facilitators to delivering peer support effectively in England: a qualitative interview study

Una Foye et al. BMC Psychiatry. .

Abstract

Background: Peer support roles within mental health services are rapidly increasing in number and scope in the UK and internationally. This paper explores the facilitators and barriers to delivering peer support effectively, as experienced by Peer Support Workers (PSWs) in a range of services and settings.

Methods: We conducted semi-structured qualitative interviews with paid mental health PSWs working across a range of settings in England. We took a collaborative, participatory approach. Interviews were carried out by researchers with experience of living with and/or supporting others with mental health conditions, and for some having experience delivering peer support themselves, and data were analysed using methods guided by general principles of thematic analysis.

Results: We interviewed 35 PSWs with a range of roles that spanned a range of mental health areas, and regions. Overarching facilitators and barriers were identified including the need for roles to have flexibility with some structure and boundaries; the need for support, supervision and training to ensure PSWs are skilled in delivering the unique elements of their job; the importance of working with a strong team and leaders who support and value PSW; the complexity of working where there are tensions between the flexibility of PSW and the structures of existing healthcare systems, as well as the systemic factors such as funding, pay and progression can have an effect both on the personal experience of PSWs and on the value placed on PSWs in the wider organisation.

Conclusion: Our findings highlight the complexity of peer support work and PSW roles, with a variety both of facilitators allowing them to carry out roles effectively and the barriers to doing so. As PSWs numbers and the scope of their roles increase, awareness of barriers and facilitators needs to inform PSW job roles, support systems and integration into teams and systems.

Keywords: Peer support; Peer workers; Qualitative.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical. Ethical approval was granted by the University College London (UCL) Research Ethics Committee (REF: 19711/001, obtained 9th January 2023). All participants provided informed consent prior to enrolment in the study, including consent for publication of anonymised quotes. Consent for publication: Not Applicable. Competing interests: JR is the CEO of ImROC, a provider of peer support training nationally and internationally and is currently one of the organisations commissioned to provide peer support training by NHSE. KM is Director of With-You Consultancy, a provider of peer support training nationally and internationally and is currently one of the organisations commissioned to provide peer support training by NHSE. Clinical trial number: Not applicable.

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