Peer Support Workers in Mental Health Care

Plural Positionings Beyond Transformation and Assimilation Dichotomy

Bibliographic Data

ID19508972
AuthorsLudovica Aquili (0000-0003-1467-6784, University of Padua, corresponding author), Michele Rocelli (0000-0001-5367-8067, University of Padua), Susanna Brunelli (National Institute for Astrophysics), Federica Mangione (Associazione Italiana Arbitri), Milena Negri (Associazione Italiana Arbitri), Giuseppe Salamina (0000-0003-3442-519X, Department of Public Health), Elena Faccio (0000-0002-1204-4866, University of Padua)
Year2026
Volume29
Issue1
Pagese70515-e70515
Publication date2026-02-01
Open AccessYes
TypeARTICLE
VenueHealth Expectations (JOURNAL)
Journal identifiersISSN: 1369-6513 • E-ISSN: 1369-7625
PublisherWiley (PUBLISHER • GB)
DOI10.1111/hex.70515
PMID41540680
OpenAlexW7124454436
LanguageEN
Citations received3
References cited37

INTRODUCTION: The role of the Peer Support Worker (PSW) has gained increasing prominence in mental health services, yet its institutionalisation raises questions about balancing autonomy and assimilation into service logics. This study examines the narrative positionings of three PSWs, focusing on how they construct professional identity in relation to mandate, collaboration with practitioners, and service organisation. METHODS: A qualitative design was adopted using semi-structured interviews with three PSWs. Data were analysed through Positioning Theory (Davies and Harré 1999) and Bamberg's three-level model (2022), which investigates positioning in relation to temporality, the other and agency. Particular attention was given to positions regarding the professional mandate, collaboration with practitioners, psychiatric and psychotherapeutic practices, and the services in which participants had placements or are currently engaged. RESULTS: PSW positioning emerged as dynamic and multifaceted, constantly negotiated between institutional mandates and fidelity to lived experience. Three configurations were identified: (1) a critical and independent stance, maintaining symbolic distance from services whilst collaborating with them; (2) an integrated stance, balancing institutional logics with attentiveness to user experience; and (3) a fluid stance, affirming the coexistence of PSW and service-user roles and challenging conventional boundaries between clinical and experiential knowledge. Across all narratives, PSWs located themselves in liminal spaces that foster transformative possibilities for mental health services. CONCLUSION: PSW identity is not fixed but articulated through multiple positionings, ranging from critical autonomy to institutional integration and fluid coexistence of service-user and professional roles. This plurality, rather than constituting ambiguity, represents an epistemic and ethical resource that extends the transformative potential of services beyond the dichotomy of transformation versus assimilation. Recognising this plurality means valuing PSW agency and fostering flexible, participatory practices responsive to the complexity of lived experience. INVOLVING THE PARTICIPANTS: The research team included both academics and PSWs in a co-participatory design initiated through voluntary applications. Only interviews with explicit consent were included. The first draft of the analyses was submitted for participant validation: each PSW reviewed their own transcript and related comments, with the option to modify or expand the analysis. Materials were then shared within the group to enable collective reflection and refinement of interpretation. Through this collective process, the group co-authored the present version of the article. CLINICAL TRIAL REGISTRATION: Does not fit

Assimilation (phonology) · Mental health · Peer support · Plural · Social support · Transformation (genetics) · Healthcare innovation and challenges · Mental Health and Patient Involvement · Social Work Education and Practice

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