# Implementing Peer Support in Community Mental Health Nursing Teams: Qualitative Evaluation

## TL;DR

This study evaluates how peer support can be integrated into Swiss community mental health nursing teams, highlighting challenges and successful strategies.

## Contribution

The study provides new insights into the practical implementation of peer support in community mental health nursing in Switzerland.

## Key findings

- Peer support workers were well-received by clients and staff but faced challenges like unclear roles and limited training.
- Successful integration requires standardized training, financial recognition, and better team integration of peer support workers.
- Nursing teams observed positive effects on clients, including high satisfaction with outreach peer support.

## Abstract

Peer support (PS) is considered central in the recovery for people with mental health problems. While PS is established in the inpatient setting in Switzerland, it is rarely available in outpatient settings.

To evaluate the implementation of PS within Swiss community mental health nursing (CMHN) teams, focusing on its content and impact, as well as the factors contributing to its successful implementation and the potential barriers.

We conducted a qualitative, participatory study using implementation research principles in three CMHN teams. Data collection included interviews with managers, peer support workers (PSWs) and nurses, along with participant observations. Findings were analysed using qualitative content analysis. This article follows SRQR guidelines.

Clients and staff reported high satisfaction with PSWs but PS was only implemented at the client level. Challenges included unclear job descriptions, low PSW working hours, limited understanding of PS and financial constraints.

There was a lack of adequate training on PS and recovery. PSW were seen somewhat externally by the CMHN teams which weakened integration.

Aligning with best practice guidelines, our findings suggest that successful implementation of PS requires standardised PSW training, financial recognition, comprehensive team training and internal efforts on PSW team integration.

This study provides practice‐based insights into implementing peer support in Swiss community mental health nursing teams, a newly emerging area of practice. It highlights key factors influencing peer support worker integration, including role clarity, training gaps and nursing team preparation. The findings offer guidance for community mental health nurses to strengthen recovery‐oriented care through the effective implementation of peer support. By addressing practical barriers and facilitators, this study directly supports the advancement of mental health nursing in community settings.

What is known on the subject
○Peer support is crucial for mental health recovery, but in Switzerland, it is mostly used in inpatient settings.○In outpatient settings, and especially in community mental health nursing teams, peer support is not common.
Originality
○This study explores how peer support workers can be successfully integrated into community mental health nursing teams.○It examines the role and perception of peer support work by clients and nursing teams.○The study uses a participatory approach, involving service users at every stage of the research.
Significance
○Implementation strategies were adopted based on organisational needs and knowledge.○Challenges include low employment levels, billing issues within the Swiss health insurance system and limited knowledge on recovery principles.○Nursing teams generally welcomed peer support and saw positive effects on clients and high levels of client satisfaction with outreach peer support were noted.

What is known on the subject
○Peer support is crucial for mental health recovery, but in Switzerland, it is mostly used in inpatient settings.○In outpatient settings, and especially in community mental health nursing teams, peer support is not common.

Peer support is crucial for mental health recovery, but in Switzerland, it is mostly used in inpatient settings.

In outpatient settings, and especially in community mental health nursing teams, peer support is not common.

Originality
○This study explores how peer support workers can be successfully integrated into community mental health nursing teams.○It examines the role and perception of peer support work by clients and nursing teams.○The study uses a participatory approach, involving service users at every stage of the research.

This study explores how peer support workers can be successfully integrated into community mental health nursing teams.

It examines the role and perception of peer support work by clients and nursing teams.

The study uses a participatory approach, involving service users at every stage of the research.

Significance
○Implementation strategies were adopted based on organisational needs and knowledge.○Challenges include low employment levels, billing issues within the Swiss health insurance system and limited knowledge on recovery principles.○Nursing teams generally welcomed peer support and saw positive effects on clients and high levels of client satisfaction with outreach peer support were noted.

Implementation strategies were adopted based on organisational needs and knowledge.

Challenges include low employment levels, billing issues within the Swiss health insurance system and limited knowledge on recovery principles.

Nursing teams generally welcomed peer support and saw positive effects on clients and high levels of client satisfaction with outreach peer support were noted.