Two approaches, one goal: How mental health registered nurses' perceive their role and the role of peer support workers in facilitating consumer decision-making

Abstract

Recovery-oriented principles underpin modern-day mental health care and are enhanced by consumer participation in decision-making. Understanding how consumer participation can be maximized is central to promoting recovery-oriented care. This study explored the key strategies used by mental health registered nurses and perceived by nurses to be used by peer support workers in facilitating consumer decision-making to determine similarities, differences, and possible tensions. A qualitative descriptive approach using semi-structured interviews was conducted with nine nurses employed in mental health care. Thematic analysis was conducted using open coding. Frequency of views expressed and prevalence of these amongst participants were noted to determine the most common strategies and challenges. Registered nurses use strategies aimed at empowerment, self-management, and managing expectations to facilitate decision-making but are challenged by entrenched coercion within the system. These same nurses view peer support workers as using their lived experience to build rapport, role model, and advocate for consumers. Tensions arise in how the peer support workers’ lived experience should be used and how this impacts on professional and therapeutic boundaries. Nurses expressed support for the role of peer support workers and viewed their inclusion in facilitating consumer decision-making positively. Their own role is perceived as being caught between modern-day service principles of empowerment and long-standing practices based on coercion.