CONCLUSIONES

This study has some real strengths, which have enabled us to add considerably to new knowledge:

1. It is ‘insider’ research. Two of the primary researchers, Dr. Anne Scott and Dr.

Carolyn Doughty, have practical experience in peer support. Robyn Priest, who helped us set up this study, is also a peer support practitioner. Tamehana Consultants, who did our data collection in the two Māori services, are Māori, and mental health ‘insiders’, as well. Hamuera Kahi is not active in the mental health sector, but is deeply immersed in Te Ao Māori. There are real benefits to research on peer support being done by people who have lived experience of mental distress, of Te Ao Māori, and of peer support:

a. Our collective experience of peer support has enabled us to recruit services to participate more easily. All ten of the organisations we approached about this research agreed to participate in the study. This involved a substantial commitment of time and enthusiasm on their part, and it meant that our sample was as diverse and comprehensive as was possible within the limits of our time and funding.

b. It gave us some insight into useful questions to ask, and some contextual experience with which to interpret the rich responses our participants gave.

It enabled the interviewers to more easily build rapport with participants.

c. It has allowed us to model what peer support is about, by carrying out peer-led and peer-controlpeer-led research, based in and answerable to the communities concerned.

2. This research has been conducted within a ‘decolonising methodology’ for which we owe the traditions forged in feminist, participatory and Kaupapa Māori research. It is

122 rooted in questions being asked by the peer support community, and is responsive to the peer support community. We have followed ethical processes that involve

‘taking back’ the results to the community. This report is part of that process.

3. Māori orientated services have been engaged with on their own terms, with a Māori analyst, and with the use of tikanga-based data collection processes, rather than being forced to work within an approach designed for mainstream services. The mixed methodology we have employed is a response to Treaty principles.

4. The process of conducting two in-depth interviews with most participants means that participants had sufficient time to expand on their ideas, and to think through what they wanted to say. Participants often thought about the first interview, and came to the second interview with a clearer idea of what they wanted to communicate. Because interviews can only be a partial insight into the thoughts, ideas and practice of peer supporters, it is important to create space for reflection within the interview process.

5. Peer supporters are specialists in communication and relationship, and this led to our participants being extraordinarily adept at articulating their ideas within the interviews. We have been humbled and enthused by the rich qualities and generous nature of the talk that was shared in this interview-based study.

In spite of its strengths, there are some limitations to this study. Some of these are:

1. This study doesn’t look systematically at the effectiveness of peer support. Some anecdotal evidence for peer support’s effectiveness did emerge in the interviews, but we didn’t go looking for such evidence, and thus doesn’t add to the effectiveness literature.

2. This study engaged with peer supporters and peer support managers. A major gap is that it didn’t look at the experiences of peers, or service users, except insofar as our

123 participants have also been service users, and this came up naturally in the interviews.

3. Peer support relating to addictions is not addressed in this study.

4. The mixed methodology meant that data collection with Māori services and mainstream services was at times different. In the Māori services, we had group interviews, while in the mainstream services we had individual interviews. These produced very different kinds of talk. In the Māori services, somewhat different questions were asked, in a different way, and in a generally different order. This means that the data we produced wasn’t always commensurable between the Māori and mainstream services. This was an issue when we wanted to look at proportions of people answering a particular question in a particular way. Due to the fact that questions were not asked in the same way, this wasn’t usually possible.

5. This study excluded Pacifica and Asian perspectives on peer support. This exclusion occurred in three ways. First, no specific Pacifica or Asian peer support services were included in the study. Secondly, as it happens, none of our interview participants were of Pacific or Asian ethnicity. Finally and as a result of the first two exclusions, we were not able to ask specific questions about the role of culture in peer support (outside of the Māori services where this was discussed extensively). This is a major gap in the report, and would be a good focus for future research.

6. There was no quantitative dimension to this research, and as a result we are not able to provide measurable results. For example, we didn’t measure the strength of people’s feelings about professionalisation, or about national peer support training.

7. This study has been conducted on minimal funding, which paid for interviewer travel expenses, our Māori consultants, and transcription. There was no researcher ‘time’

element in our funding.

124 8. Ethical constraints mean that some of what people have said can’t be directly

reported, due to concerns about confidentiality for peers.

9. Interviews do not provide unbiased access to what people actually do, in practice.

Instead, they provide a social situation in which talk can emerge which constructs, and sheds light on, ideas, insights, beliefs and practices. The nature of the occasion has a big impact on the type of talk which occurs. Thus, this research can only provide an exploratory introduction to some of the issues being addressed by peer supporters.

Possibilities for future research:

This study raises some questions that might be answered by future research. Some possibilities are:

1. An in-depth study looking at either Pacifica or Asian peer support, done with culturally appropriate researchers and methodologies. This could focus quite closely on the question of culture in peer support practice. A qualitative study would probably be most appropriate.

2. A quantitative study looking at the effectiveness of peer support in Aotearoa New Zealand. We believe it would be useful to incorporate consumer-assessed measures of outcomes, for example Taku Reo, Taku Mauri Ora, My Voice, My Life (Gordon et al 2009), as this has been developed with consumer input and from a consumer perspective. This would enable us to do a rigorous study of outcomes in peer support that focuses on the outcomes that consumers themselves feel are important.

3. A mixed methods – qualitative and quantitative – study looking at the ethical and practical effects of the implementation of PRIMHD (Programme for the Integration of Mental Health Data) across the peer support sector, and the issues that this type of data collection raises. Such a study could be done on minimal funding, through telephone interviews and an email questionnaire.

125 4. Cross-national comparative research looking at the way that ‘recovery’ is being implemented in different national context and the experiences of service users.

Culture could be a major element of such research which, once again, would ideally mix quantitative and qualitative methods. Such research would require an international research team and external funding.

5. An in-depth analysis of differing peer support training programmes across New Zealand, with an action research component looking at ways to create peer support training which is accessible, New Zealand focused and responsive to differing ways of doing peer support.

6. A study of New Zealand clinicians’ knowledge of, beliefs about, and concerns regarding peer support. Such a study could be accomplished through questionnaires.