Open Letter on Peer Support Worker Apprenticeships

You can read more about the letter and the apprenticeship scheme here.

If you would like to sign the letter, please email us with your name as you would like it published, and your affiliation (group, organisation etc), if any.

To the Institute of Apprenticeships and Technical Education and the Peer Support Worker Apprenticeship Development Group,

A Request for Collaboration: Nothing About Us Without Us

As a group of peer supporters and our allies, we are pleased to see the development of an apprenticeship that would enable peer support workers to formalise their skills and abilities in this important role. We acknowledge and appreciate the developers’ attempts to recognise the value of peer support across communities and mental health systems in England. However, we feel that this particular apprenticeship proposal falls short of delivering an apprenticeship that will enable peer support to be diverse, flexible and valuable to a range of organisations and employers who might seek to employ peer support apprentices across the nation.

The roots of peer support in mental health are in social justice, human rights and community action. Throughout the history of survivor/service user advocacy groups like the Alleged Lunatics Friend Society (1840s), Mental Patients Union (1970s), Scottish Union of Mental Patients (1970s), people who have experience of psychiatric systems have gathered and organised to advocate for our rights and improved care. Through those groups, and others who developed around self-help and mutual aid, we have taken solace in each other, found learning and healing in our relationships and developed peer networks that exist to this day through organisations such as NSUN and the Hearing Voices Network.

The impact of organic community-based peer support for our communities has been noted and peer support worker roles have been developed by various health and community employers across England. There is a wide breadth of peer support and associated roles that have been implemented nationally, from grass roots, peer-led organisations through to the NHS. Core values and competencies vary, as do the tasks peer support workers undertake, due to the broad range of roles and requirements of different employers. The key underpinning criteria is that role is undertaken by someone with experience of mental health challenges, and that they share these experiences as part of the role.

Fidelity standards for peer support have not been identified in England, and the core values and principles have not been nationally agreed. Where core concepts in peer support are defined, they must allow for flexibility from self-determinist, non-health perspectives to peer support roles designed for clinical environments in order to allow for the breadth of variation in practice, perspective and context.

It is the opinion of the undersigned that the peer support worker apprenticeship is not fit for purpose across potential employers in England as (primarily but not exhaustively):

1. The peer support worker apprenticeship proposal has too narrow a definition of peer support to effectively prepare a workforce for the variety of roles they may encounter in England. Core concepts of grass-roots peer support that are absent in the role include:

· Social action/justice, human rights approach

· Importance of community

· Focus on relationships (rather than intervention)

· Expertise by experience (not intervention) is the core knowledge base

· Trauma informed/human experience approaches

· Learning together

· Non-coercive

· Moving towards mutually negotiated futures

· A focus on possibilities that emerge from a mutual relationship rather than focus on recovery goals

2. The principles of “mutual, reciprocal, strengths focused, inclusive, progressive, non-directive, recovery focused and safe” are not all universal and, by general definition, are not reflective in the duty descriptors for the apprenticeship.

3. The duty “Maintain a focus on their own personal self-care and well-being engaging in self- management strategies” is discriminatory in that it perpetuates the perspective that peer staff have a greater need and responsibility for managing their own wellbeing than other non-peer staff, and makes their own wellbeing a duty of the role in a way that is not required by their non-peer colleagues.

4. Peer support is about allowing for possibilities which arise from connecting through relationships rather than goals and ‘techniques’.

5. Record-keeping should be kept to a minimum and co-produced with the service user.

6. There is no evidence in the proposal that peer led grassroots (or larger) organisations have been an integral part of the apprenticeship design.

7. Not all peer support roles require the post holder to have accessed psychiatric services or have a psychiatric diagnosis.

8. We cannot forget the fundamental principle from which peer support developed: that peer supporters have experiences of the losses, oppression and marginalisation that diagnosis and treatment can cause, and an understand the wider impact of intersectionality that affect the complexity of ‘othering’ across our society.

It is proposed that the peer support worker apprenticeship proposal be paused and revisited with a wider group of peer collaborators from a range of approaches.

1. Peer support is a lived experience concept. Thorough coproduction with grass roots peer supporters, peer-led groups and organisations must be undertaken, if not a user-led approach to developing the apprenticeship with involvement from non-peer employers to ensure the apprenticeship is fit for purpose.

2. The identification of core fidelity standards must be clearly defined and enable a flexible approach to peer support around core values and principles.

3. The peer support worker apprenticeship must be relevant to the wide range of peer support roles in the UK, and not restrictive to a particular peer support model.

Beyond our concerns about this particular proposal, we believe we also need to ask an even more fundamental question: whether a peer support worker apprenticeship scheme is in fact necessary or beneficial. Due to the important ramifications of apprenticeships and associated fidelity standards, there needs to be a thorough, open and inclusive conversation which examines the benefits and drawbacks of any such scheme. This cannot be a rushed process and should involve all stakeholders, in particular user-led groups and peer support workers from both grassroots settings and statutory services. We urge the group who have developed this proposal to pause this process and invite a transparent and open discussion.

In many ways, a common principle in peer support applies to this proposal: if it’s not working for one of us, it’s not working for all of us. We request seats at the table to develop a proposal that works for peer support across all sectors and perspectives.

We write this letter to open the conversation and offer our views and guidance in collaboration. We offer our support in identifying a group of peer supporters who can work in the development team to submit a revised proposal which can be flexibly applied across England.

Signatories 

1. NSUN (National Survivor User Network)
2. Tori Otero, Lived Experience Lead, Beyond Barriers CIC
3. Beth Ingram, Director of Hearts & Minds Peer Support
4. Mark Allan, Hearing Voices Network, England and Mad Studies North East
5. Lisa Archibald, PeerZone/Intentional Peer Support, Aotearoa, New Zealand
6. Vikki Price, Intentional Peer Support Trainer and Peer Training Developer
7. Hollie Berrigan
8. Tony Roberts, Director, Fostering Change Ltd
9. Keir Harding, Clinical Lead, Beam Consultancy
10. Jen Anderson, NHS Strategic Expert by Experience
11. Ginny Allende Cullen – Independent Occupational Therapist – Headspace Bolton C.I.C.
12. Tamar Jeynes, LXP Consultant, Pink Sky Thinking
13. Julie Fay RMN, RNLD
14. Nina Bradshaw, Mental Health Professional and person with lived experience
15. Sal Smith, Expert By Experience, NHS trust
16. Len Demetriou, King’s College London
17. Alison Faulkner, Survivor Researcher
18. Sue Sibbald, Peer Worker, Sheffield
19. Angela Newton, Founder, Lived Experience Matters
20. Stephanie de la Haye, Chair, Survivors of Depression in Transition (peer led- peer support charity)
21. Wendy Micklewright
22. Jane Chevous, Founder and Director, Reshapers CIC; Co-Founder and Director, Survivors Voices (peer run)
23. Chester Cornford, Clubber2Clubber
24. Dr Timothy Buescher, Lecturer, mental health nursing, University of Hull
25. Dr Sarah Carr FRSA, Senior Fellow in Mental Health Policy, University of Birmingham
26. Fiona Naylor
27. Katy Stepanian, Research Assistant
28. Karen Machin, Independent survivor researcher
29. Helen Leigh-Phippard, Service User Consultant
30. Peter Beresford, Shaping Our Lives
31. Dina Poursanidou
32. Bristol Reclaiming Independent Living (BRIL)
33. Rachel Yates, Person Centred Counsellor
34. Kim Laidler, Lived Experience
35. Nikki Mattocks, Award winning Mental health / Human rights advocate/Time to change ambassador/ young minds campaigner/ evolve peer support group leader/ amnesty international speaker
36. Karen Passmore on behalf of DPAC Bristol & SouthWest
37. Rosina Falla-smith
38. Emma Hickey, Clinical Psychologist
39. Diana Harvey, Peer Support Worker, Norfolk and Suffolk Financial Trust
40. Cathy Scoines
41. Neil Caton, peer group facilitator
42. Sophie Robinson, peer support worker and engagement worker
43. Patrick Wood, Co-ordinator, SUST (Sheffield User Survivor Trainers)
44. H Cobb, Bibliotherapy peer facilitator, Kirklees
45. Hearing Voices Network England
46. Steve Flatt, Director, “Working Conversations”
47. The Side by Side Network
48. Shery Mead, Intentional Peer Support
49. Chris Hansen, Intentional Peer Support
50. Kay Weatherley, Expert By Experience, NHS Trust
51. John McGowan, Social Workers Union
52. Carol Reid, National Organiser, Social Workers Union
53. Bec John, Peer Mentor NHS Wales
54. Alison Cameron, Citizen Engagement Advisor
55. Stephanie Allan, Glasgow University PhD student
56. Simon Hough, Peer Supporter and Service User
57. Katrina Squires, Peer Support Worker, Norfolk and Suffolk Foundation Trust
58. Bethan Edwards, Service user researcher & activist
59. Joanne Bailey, Peer Support Worker, Together UK
60. Craig Frederick Clark, Support Worker, Nottinghamshire Care NHS Foundation Trust
61. Rachel Waddingham, Survivor Practitioner/Researcher; Hearing Voices Network, England; ISPS UK
62. Isa Sallinen
63. Sue Wedge, Peer Support Worker, Mind in Haringey
64. June Sadd, Independent survivor consultant, researcher and trainer
65. South West Region SWAN (Social Work Action Network)
66. Zoe Rivers, Clinical Lead, Beyond Barriers
67. Lucy Gameson, Lived Experience Practitioner and Intentional Peer Support Trainer
68. Polly Johnson
69. Lisa Morrison (Lead Peer Trainer, SHSCT, Northern Ireland)
70. Jess Worner, Interim Lived Experience Leadership Manager, Together
71. Michael C Ashman, Independent Survivor Researcher/Educator
72. Valerie Christina White
73. Julie Woollacott, Service User, Mid Devon Community Mental Health Team
74. Fiona Moore, Head of Service User and Carer Involvement and Experience, Midlands Partnership NHS Foundation Trust
75. Sue Kilminster, Faculty lead for Health Professionals’ Education Research, Faculty of Medicine and Health, University of Leeds
76. F.E.E.L. – Friends of East End Loonies
77. Colin King
78. Carol Jacques, Intentional Peer Support Manager & Community Lead
79. Paul Baker, Hearing Voices Network Cymru
80. Hearing Voices Network Cymru
81. Akriti Mehta, King’s College London
82. Elizabeth Thacker, Peer Support Worker, City Anchorage
83. Mirabai Swingler, Only Us Campaign
84. Dr Brigit McWade, Lecturer in Medical Sociology, Lead for Widening Participation, Lancaster Medical School
85. Clare Ockwell. lived experience trainer/consultant
86. Robin Barker, Director, Healthy Teen Minds, Registered Nurse – Mental Health
87. Dr Stan Papoulias, Assistant Director Service User Research Enterprise, King’s College London
88. Alan Ford
89. Kirsty Wilson
90. Dr Samantha Hartley, clinical psychologist
91. Dr Glorianne Said, clinical psychologist
92. Dr Sally Morgan, clinical psychologist
93. Dr Natalie Tobert, medical anthropologist
94. Jen Kilyon, Soteria UK, ISPS UK, ISPS Int
95. Professor Paula Reavey, London South Bank University
96. Satyin Taylor, Lived Experience/ ELFT Spiritual Care / NELFT Dialogue First / Trustee Buddhist Healthcare Chaplaincy Trust / Trustee National Spirituality and Mental Health Forum / Founder London group of Spiritual Crisis Network
97. Daniel Pini Neis, Intentional Peer Support Trainer
98. Frederick Craig Clark
99. Dr Caroline Yeo, survivor researcher, University of Nottingham
100. Leigh Bell
101. Clare Shaw
102. Diane Wright
103. Karen McNeil, service user
104. Joanna Landeryou
105. Laura J Welti, Bristol Disability Equality Forum
106. Emma Hindmarch, expert by experience and former peer mentor
107. Mohammed Zaman
108. Daisy Abraham
109. Dr Laura Wood
110. Professor Diana Rose, Professor of User-Led Research, Co-Director Service User Research Enterprise, King’s College London
111. Laura J Welti, Bristol Disability Equality Forum
112. Alan Gurbutt (RMN), Lincolnshire