Multicultural experiences of UPSIDES peer support workers across HI/LMI-countries

Galia MORAN¹, Yael GOLDFARB¹, Inbar ADLER BEN-DOR¹, Shimri HADAS-GRUNDMAN¹, Maria HAUN¹, Silvia KRUMM¹

¹Ben-Gurion University in the Negev, Beer Sheva, Israel

Introduction: Peer support is gaining recognition as essential in recovery-oriented care worldwide and alleviating global burden on mental-health (MH). However, there is lack of research about peer support workers’ (PSW) experiences across varying income-level and cultures. This study aimed to assess the experiences of PSWs who engaged in UPSIDES intervention – a multi-country research project designed to empower and scale-up peer support in low-middle- and high-income (LMIC/HIC) countries.

Method: Nine focus groups totaling 38 PSWs were conducted 18 months after starting UPSIDES intervention at six study sites: Ulm and Hamburg (Germany), Butabika (Uganda), Dar es Salaam (Tanzania), Be’er Sheva (Israel), and Pune (India). Transcripts were analyzed using qualitative content analysis and MAXQDA software.

Results: Four general domains (2 sub-domains in each) were identified regarding PSWs’ experiences: (i) personal recovery, (ii) vocational/organizational aspects, (iii) PSWs’ relations with staff and MH systems, (iv) expanding influence to broader circles. Across sites, risks for successful assimilation of peer-support in MH were mentioned, specifically, lack of role-clarity, integration challenges with MH services and limitations in resources. In HIC self-disclosure and peer-vocational development were central issues. In LMIC, PSWs had meaningful interactions with stakeholders in the community (e.g. relatives, police, etc.) enticing social-educative and anti-stigma influence. PSWs in LMIC additionally experienced unique gains to their MH conditions and financial standing.

Discussion and Conclusions: This first multi-country study identifies PSWs’ subjective and tangible gains as well as challenges across varying income and cultural contexts. Findings suggest that along with supporting service users, PSW experience personal recovery, occupational and societal benefits, reflected differently across MH systems and HIC/LMIC contexts. In addition PSWs demonstrated their ability to act as change agents, impacting familial and social circles within and outside MH services - thus enhancing a recovery-culture across different income-level and cultural contexts.