Pass it on! Innovative approaches to making a difference in healthcare 

Peer support at the Centre for Addiction and Mental Health

by admin admin | Aug 18, 2010

Key Messages

Peer support workers as members of clinical teams bring a unique, non-traditional perspective that provides people with mental health and addiction problems with a sense of hope and practical help as they move toward recovery.

Integrating peer support workers into clinical teams requires careful preparation and training for all members of the team as well as the peer support worker.

Treatment teams benefit from the presence of a peer support worker on the team; his or her presence helps the team see things from the client's perspective.

Walk a mile in another person's shoes, so the proverb goes.

At the Centre for Addiction and Mental Health (CAMH), they're putting that proverb into practice through the Peer Support Worker Program.

CAMH is Canada's largest mental health and addiction teaching hospital. Located in Toronto, CAMH prides itself on its client-centred practice, recognizing the individual needs of each person it treats. And it recognizes that, sometimes, those needs are best met by someone who has walked that proverbial mile.

That's the intent behind the Peer Support Worker Program. The program connects "peers" – people who have experienced first-hand the mental health or addiction systems – with clinical teams, to work with clients. There are now 12 specially trained peer support workers bringing their unique experience to CAMH: 10 of them with the schizophrenia program, one with the mood and anxiety disorders program, and one with the addictions program.

Peers play a unique and non-traditional role, which may vary according to the patient's particular needs. They deal with clients individually and also lead group sessions on various topics. As part of the care team, they represent the client to the team and vice versa.

Thus, the peer support workers serve as educators, advocates, bridges to community resources and partners in facilitating recovery. They build on the client's strengths, resources and shared experiences to reshape the client's story from one of illness to one of recovery and ability. They offer empathy, compassion and experience. Above all, they offer themselves.

Shared benefits

Advanced Practice Clinician Carrie Clark says the treatment team sees the peer support workers as integral members whose points of view are valued and welcomed, which she believes is a significant aspect of the program. "Educating teams about a peer's lived experience helps teams to see things from the client's perspective," she explains.

Peer support workers themselves also benefit from participating in the program. Employment is one aspect. But their role also gives them a voice to make change, advocate and promote client rights.

Jeremiah Bach has been a peer support worker since August 2009. In addition to providing one-on-one support to clients, he runs a writer's collective and a current events group within the program. He says that the knowledge and skills that come from experience are just as valuable as "using a clinical gaze." "We have knowledge of the system, of being the person on the other end," he says. He adds that the peer support workers provide hope – they have successfully overcome the challenges their clients are facing.


My peer support worker is the genuine article who has walked the walk so she can talk the talk. [She] is an inspiration to me and provides me with hope.


Of paramount significance is that clients, both inpatients and outpatients, gain tremendously from being able to work with someone who has lived the same experience and who can understand what they are going through. Clients form close relationships with the peer support workers – relationships that are different from the clinical relationship a client might have with a therapist. "[The peer support worker] surpasses all expectations," says one client. "She listens actively to help me deal with issues that concern me … She encourages me and supports me in taking on new challenges … She is the genuine article who has walked the walk so she can talk the talk. [She] is an inspiration to me and provides me with hope."

A new way of thinking

The program began in 2007 and has continued to develop in partnership with CAMH's Empowerment Council and the Canadian Mental Health Association. While the program's roots go back much earlier – peers have frequently played a role in community-based treatment, particularly in the area of addictions – the CAMH program is unique in that it brings the concept into the hospital setting.

The traditional team structure is not accustomed to having clients, or previous clients, as members. Clark admits their inclusion caused some initial trepidation and necessitated a real paradigm shift for the organization. Ensuring the program's success required advocating for the new role, soliciting community and staff support, and developing an extensive training program. Despite the challenges, CAMH received more than 200 applications for the first eight peer support worker positions. To help bridge the transition, Clark says the organization took the time to prepare the teams to welcome the peers and help them overcome their concerns, many of which revolved around how to relate to clinicians in this different role.

The feedback on the program has been extremely positive. Clients are happy and peer support workers have started several innovative programs, among them a foster pets program, a word-of-the-month club and recovery groups. CAMH is in the process of evaluating the impact of the peer support worker program; the results of this evaluation should be available in fall 2010.

"It's been wonderful to see how staff have endorsed the peer support worker role," says Clark. "It's been powerful to see the advocacy, group programming, client support and community connecting that the peers have brought to the organization."


Carrie Clark
Advanced Practice Clinician
Centre for Addiction and Mental Health

This edition of Pass it on! highlights four Canadian healthcare organizations that are making the patient part of the healthcare team.

Other stories in this edition:


Pass it on! is a publication of the Canadian Health Services Research Foundation (CHSRF). Funded through an agreement with the Government of Canada, CHSRF is an independent, not-for-profit corporation with a mandate to promote the use of evidence to strengthen the delivery of services that improve the health of Canadians. The views expressed herein do not necessarily represent the views of the Government of Canada. © CHSRF 2010