Peer workers' perceptions and experiences of barriers to implementation of peer worker roles in mental health services: A literature review

Int J Nurs Stud. 2016 Aug:60:234-50. doi: 10.1016/j.ijnurstu.2016.04.018. Epub 2016 May 11.


Objectives: To identify peer workers' perceptions and experiences of barriers to implementation of peer worker roles in mental health services.

Design: Review of qualitative and quantitative studies.

Data sources: A comprehensive electronic database search was conducted between October 2014 and December 2015 in PubMed, CINAHL, Web of Science, The Cochrane Library, and PsycARTICLES. Additional articles were identified through handsearch.

Review methods: All articles were assessed on quality. A thematic analysis informed by a multi-level approach was adopted to identify and discuss the main themes in the individual studies. Reporting was in line with the 'Enhancing transparency in reporting the synthesis of qualitative research' statement.

Results: Eighteen articles met the inclusion criteria. All studies adopted qualitative research methods, of which three studies used additional quantitative methods. Peer workers' perceptions and experiences cover a range of themes including the lack of credibility of peer worker roles, professionals' negative attitudes, tensions with service users, struggles with identity construction, cultural impediments, poor organizational arrangements, and inadequate overarching social and mental health policies.

Conclusions: This review can inform policy, practice and research from the unique perspective of peer workers. Mental health professionals and peer workers should enter into an alliance to address barriers in the integration of peer workers and to enhance quality of service delivery. Longitudinal research is needed to determine how to address barriers in the implementation of peer worker roles.

Keywords: Barriers; Experiences; Implementation; Mental health services; Patient involvement; Peer workers; Review.

Publication types

  • Review

MeSH terms

  • Humans
  • Mental Disorders / therapy
  • Mental Health Services / organization & administration*
  • Peer Group*
  • Professional Role*