What is the system challenge?

Within the mental health and substance use systems, many peers have historically felt disempowered and defined by stigmatizing labels associated with their mental health status. By “peers,” we mean people who expect that their experience of mental health and substance use issues will be valued when supporting others and working to improve services. Many areas—like HIV/AIDS, violence against women, or chronic illness—benefit from the expertise of peers.

Peer experience is expertise; Peers have a unique perspective about what works and what needs improvement, but often experience tokenistic, paternalistic, and even harmful treatments from systems that, despite the best of intentions, can fail to involve peers in decisions that affect them.

What are we doing about it?

Peer Positive was implemented by the Northwest Toronto Service Collaborative with help from the Provincial System Support Program at the Centre for Addiction and Mental Health.

The Peer Positive approach is committed to developing strong personal and organizational understandings of how power, privilege, oppression, and equity strongly influence all peer and professional relationships. Creating meaningful opportunities for peers to contribute to a range of decision-making processes helps organizations better respond to service user needs. Engaging peers in the design, delivery, and review of services is guided by deliberate efforts to re-balance power relationships between peers and professionals.

Peer Positive is based on three key components:

  • Peer Involvement: Meaningfully involving people with lived experience in the planning, delivery, and evaluation of mental health, addictions, and other health and human services is crucial to creating more responsive and empowering service experiences.
  • Spaces to Reflect on Power and Equity: Designating time and space for reflection on power and equity can help to create a greater awareness within the culture of the organization of how these issues impact peer involvement in decision-making.
  • Accountable Mechanisms of Feedback and Response: When peers can actively evaluate services through a variety of avenues, services are more likely to remain relevant and effective. Timely and transparent responses to service user feedback ensure that services are held accountable to improvement and build user confidence in the service.
?What's this?

Full Implementation

Now at full implementation, involved peers reported that they learned new skills and knowledge, and felt a sense of participation and influence.

These experiences led to the development of the Peer Positive Toolbook as a preparatory guide for shifting the culture, values, and practices of their organization to better meet the needs of the populations being served.

How do we know it works?

“Being able to connect with peers and to opportunities. Through being part of this group I learned a lot more about the system than I had known before. I have now that perspective to add to everything I’ve learned. Being part of a group and say something that can be taken serious.”

— Peer Participant

services providers, peers, and community members were trained in the concepts and practice approaches of the Peer Positive initiative.

It was so enriching to see people who identified as peers step into new and different roles, no matter what they were. I have seen many people change positively because they were supported to take risks and challenge themselves.

— Interview with a Service Provider

organizations pilot-tested the Peer Positive initiative.

“Peer Positive allows a dynamic shift where those community and individuals within the communities are thought of as experts.”

— Service Provider Participant

Next steps

Responsibility for the Peer Positive initiative has been handed over to an independent Steering Committee to explore future funding options.