Member Showcase: Community in Action
On a Thursday morning in Brisbane’s West End, I found myself sitting on a well-worn couch in the front room of a post war cottage. The ceiling fan gave little reprieve from the late summer heat. Through the small leadlight window, sounds of an amateur musician strumming a guitar drifted through the air. Outside, choko vines coiled around the fence and butcher birds perched on the twisted branches of a poinciana tree. As I waited, an assortment of people – young and old and in-between, diverse genders and backgrounds – quietly filed into the tiny room, which was barely big enough to accommodate them all. The crowd sat patiently, expectantly. There was an air of anticipation difficult to ignore.
I had come to West End to observe a peer support meeting organised by GROW – the decades old community-based organisation that supports Australians with their recovery from mental illness. In my role at the Queensland Alliance for Mental Health, I had been invited by GROW’s regional manager, Sharon Friel, ostensibly to gain further understanding of the differences between peer support and peer work – an important distinction with far-reaching ramifications for funding models and referral processes. However, over those next two hours, as I witnessed the model firsthand, I started to ponder the complexities of peer support and where it fits into the larger mental health ecosystem.
In its broadest definition, peer support refers to “a process through which people who share common experiences or face similar challenges come together as equals to give and receive help based on the knowledge that comes through shared experience.” 1 Peer support groups have formed around a wide array of shared identities and personal circumstances – breast cancer survivors, victims of crime, and of course, people with a lived experience of mental distress.
In Australia, GROW has been offering peer support in every state and territory for 65 years. It’s also operating in New Zealand, Ireland and the USA. Founded in 1957 by a group of people with a lived experience it is based on a 12-step program of personal growth and mutual support. People who participate are called “Growers”. They follow a structured program, laid out in a guide called the “Blue Book” – an ever-evolving volume of the collective wisdom of lived experience. The Blue Book gives participants a common language to use when discussing how to respond to life’s challenges. During the two-hour meetings, which always follow the same structure, “Growers” discuss their recovery journey, disclose personal life challenges, read aloud from the Blue Book, receive practical tasks, report on progress, and offer mutual support.
There are many distinctive characteristics of GROW’s model, most importantly that it is mutual support being offered rather than a one-to-one client-professional relationship. In direct opposition to more traditional forms of mental health care, where wisdom tends to emanate from the mental health professional, GROW group leaders are viewed as equals who are learning along with everyone else, bringing their own problems and asking for advice. This dynamic means that Growers are not a recipient of a service, but rather a member of a community, offering empathy and support for people with shared experiences. Not surprisingly, this reciprocal relationship facilitates bonding, trust, and friendships among participants beyond the program – another hallmark of the GROW model.
Self-activation is another core feature of the GROW model, where participants are encouraged to step up and be responsible members of the community. In the GROW setting, this can mean taking on responsibility for being the meeting organiser or recorder, or being tasked with checking in with other participants through the week. The expectation to initiate a motivated behaviour contrasts with traditional mental health therapies where a participant passively receives a service.
Sitting on that old couch in West End, listening in to the conversation, I recognised the power of this model. As Growers slowly began sharing their stories of how they came to GROW and how they’re working on their own recovery journey, responding to each other with wisdom, empathy and humour, it became clear how the model fosters deep human connection. Rose* has been coming to GROW for over five years. “GROW is my lifeline. It has literally saved my life. It does so much for my mental health – not only support but it gives me a process for dealing with everyday life.” She admits that having doctors and other clinicians involved in people’s care is important, but reflects that “they’re not there weekly, and certainly never at the end of a phone when you need them most”. Listening to Rose tell me about her “GROW family” it has become clear to me that GROW not only provides a safe space for divulging personal challenges, it also allows Growers to realise their own value and strengths and empower others.
The available research into peer support backs up my observations and the testimonials from “Growers”. Several reviews and meta-analyses have assessed the effectiveness of peer support programs and found:
- Increased social integration, reduced feelings of isolation, reduced depression and improved quality of life2
- Enabling of participant connections and forging links with others in the community3
- Improving hope, empowerment and increasing self-activation4
- Decreased avoidance-based coping and an increased sense of belonging5
As we all grapple with an exponential rise in mental illness, a crisis of loneliness and isolation, and a health care system that is failing to improve the lives of people it was set up to help, there is no better time to consider alternative models of care. Following last year’s Parliamentary Inquiry into mental health, the Queensland Government introduced a mental health levy on big business. It will raise $1.65 billion over the next five years, but we already know that much of this will be invested in acute care – hospital beds, emergency departments and clinical workforces. While this is welcome, I wonder if we have the balance right? Is it time to challenge the stigma around peer support? There is a strong case to be made for recognising this model as an integral part of community mental health offerings. As a safe, effective, low-cost and evidence-based option for people experiencing mental distress, peer support needs to be viewed as a legitimate and valued pathway to recovery.
In a recent conversation, GROW’s regional manager Sharon summed it up by saying, “it’s just people helping each other”. Having witnessed the peer support meeting in action, I can see exactly what she means. But it’s also, much, much more than that.
- Penney, D. (2018). Defining Peer Support: Implications for Policy, Practice and Research, Massachusetts Association for Mental Health.
- Peersman, G. & Fletcher, G. (2019). ANZSOG Final Report – Peer Support Approaches, University NSW.
- Davy, L., Risher, K. R. & Wehbe, A. (2018). Peer Support Practice Review: Final Report of Stage 1A Findings, University NSW.
- Bender Simmons, M., Whitson, S., Bailey, A. & Brown, E. (2022). Research Square – The Effectiveness of Peer Support From a Person With Lived Experience of Mental Health Challenges for Young People With Anxiety and Depression: A Systematic Review, University of Melbourne.
- Suresh, R., Alam, A. & Karkossa, Z. (2021). Using Peer Support to Strengthen Mental Health During the COVID-19 Pandemic: A Review, Frontiers in Psychiatry.
*name has been changed to protect identity