The majority of the participants spoke about the tensions that arose between their own aims as a PSW and those of the service. It seems that this was challenging, and
although the PSWs gave some indication that they were able to adjust to this, it continued to add a sense of frustration to the role. This adjustment appears to be related to a realisation that their expectations of the role were not quite as they expected.
Richard described the struggle he had with being a service provider rather than a service user:
“It’s quite an eye opener, it was um … I still really really struggle to step away from the patient side of it as it were, or the service user side of it. Because it gets me quite emotive, I want people to be able to access help now here, there, whenever … and it’s just not doable (…)
potentially I could at some point come back into the system. And as much as I hope that would never happen as well, if it were to happen I’d want to know that the services there were …” (Richard, 226-230)
Richard referred to the experience of working within mental health services as an “eye opener”, which implies that he became aware of some aspects of the service that he had not been previously aware of, and conveys surprise. This suggests that he had not realised the limitations to the resources when he was using the service. He spoke about the strong emotions he felt in relation to this problem, and from his description,
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it seems that these emotions felt difficult to contain. In addition, it gets him thinking about his own situation and what would happen if he needed services in the future. Having this “inside knowledge” of how stretched services can be could potentially leave someone feeling more hopeless if they became unwell and needed help themselves.
The discomfort of service limitations was also raised by Fran, and she described it as a tension between the values of peer support, where you want to support people to move forward at their own pace, and the service aims, which may be to move someone forward and discharge them as quickly as possible:
“I think there’s … and there’s a tension between like the personal work that you do with someone and the issue of well can you move someone forward fast enough to be discharged because there’s not a very you know … there’s a tension between like the peer value of taking as long as it takes and giving people the time they need.” (Fran, 202-206)
Service limitations and funding issues also meant that PSWs were not always
employed in specific PSW roles. Sandra highlights the lack of available funding as an issue for her role as a PSW. She said that she agrees with the view that it is possible to use your lived experience in any role; however, from her account, it seems that this results in her doing a watered-down version of what she had initially hoped to be doing:
“Unfortunately, I can’t do the role to the best … to the way I want it, because the only way they would employ us, due to the lack of funds, was by giving us health care support worker duties as well. Cos they believe you can do peer support … and to a certain extent I agree … no matter what you’re doing. When I went into it first I envisaged myself running all these groups, like recovery groups, groups about hope, gratitude groups … Mindfulness groups … I have achieved that, I do run that. Drop-in sessions, all that, but there is no time for that
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Sandra’s account indicates the tension between what she would like to do and the reality of the role. Although she believed it is possible to offer peer support no matter what the role, within her account is the suggestion that the PSW role is limited by the addition of duties other than peer support. Although she has achieved some of what she wanted, she has not been able to offer everything she perhaps views as beneficial to peer support.
The impact that additional duties could have on the role of a PSW is evident in Celia’s account:
“I think there’s too much similarity between peer support worker and support worker roles, or when you’re a peer support worker on an acute ward – you still have to do everything a support worker does - and then you will hopefully bring in your peer support as an additional benefit to the ward.” (Celia, 141-144)
For Celia, it seems that it was difficult for her to define her role as separate from other roles on the ward. The use of the word “hopefully” suggests that from her experience, the peer support role is viewed as less important than the support worker role, because it implies that a person could be employed as a PSW but focus on the practical support and not necessarily bring in the values of offering true peer support. This is similar to Sandra’s account in that the role of a PSW can perhaps be viewed as being diluted by additional tasks, or the role can become too similar to other roles, potentially creating confusion for the role for both PSWs and for other staff.