Stakeholders' Perspectives on the Landscape of Peer Support in Swedish Mental Health Services: A Qualitative Study

Abstract

The integration of peer support workers (PSW) into the mental health services workforce has offered additional avenues to strengthen service provision. In Sweden, the availability of peer support workers has grown significantly over the past decade, yet there has been insufficient investigation into their organization and implementation. Consequently, there is a growing need for further research into the current state of peer support within the Swedish context. To examine stakeholders’ perspectives on the current state of peer support within the context of Swedish mental health services. In this qualitative study, a purposeful sampling method was employed in order to recruit 30 stakeholders, including peer support workers (n = 17) within mental health services, county council and municipal officials (n = 8), and representatives from user organizations (n = 5). The informants took part in focus groups or semi-structured individual interviews. The results highlight key factors from stakeholders for advancing peer support, providing PSWs with career paths and skill development, and advocating to top-level authorities. Organizational structures need to support sustainability, with Sweden's user organizations playing a crucial role to mitigate peer drifting. Long-term success relies on secure employment and a clear implementation strategy. The physical work environment shapes peer support implementation and requires clearly defined work roles. Navigating mental health services was viewed as challenging. According to the results, it requires stakeholders to balance perspectives and address feelings of inadequacy among PSWs, underscoring the need to legitimize the PSW profession in mental health care. To ensure genuine progress in the current organization of peer support, this work role must become a foundational aspect of service delivery, rather than merely an add-on, to foster the development of a more recovery-oriented mental health service in Sweden.