Drift from Peer Support Values and Standards: A Position Statement and Call for Action

Abstract

In the past decade, peer support has been rapidly scaled and spread within mainstream healthcare settings without due concern and protection of its core values, contributing to a political, legal, and ethical problem referred to as “peer support drift” or co-optation. Over 2022-2024, PeerWorks consulted with peer supporters across the province of Ontario to develop a position statement and call to action on addressing this problem. This statement elaborates the conditions contributing to peer support drift, which include how many peer supporters are precariously employed in inhospitable workplace environments incongruent with peer support values (e.g., use of illness models, labeling, coercion); face workplace disrespect and exploitation as people who belong to equity-deserving groups; and have minimal access to equitable or adequate funding, resources, and opportunities for learning, as compared to other health disciplines. These workplace conditions can pressure peer supporters to deviate from their core values and towards inappropriate clinical (e.g., managing medications) or purely instrumental tasks (e.g., making coffee, driving clients to appointments). When values-based peer support is practiced with integrity, it has a unique ability to bridge gaps in the healthcare system, address the unmet needs of marginalized people, and reduce stigma and isolation through the rebuilding of relationships and community. However, when peer support drifts from its special role and duplicates conventional health services, we are deprived of these health equity-enhancing possibilities, harming health systems, society, and peer supporters. The position statement ends with 12 recommendations for collective, properly resourced prevention and intervention led by people with lived experience.