Paper short abstract:

This paper focuses on the recently institutionalised and relatively underexplored role of peer support workers in NHS community mental health care. Occupying a space of liminality between institution and service users, they creatively carve out spaces to engage in mutual caregiving practices.

Paper long abstract:

Recently institutionalised in NHS community mental health care, the role of peer support worker has subsequently gained traction in the largescale randomised controlled trial of Peer-supported Open Dialogue in the UK. Under this model, peer support workers both contribute to facilitating meetings with service users and their families alongside other clinicians during a crisis, while working more informally with service users on a one-to-one basis. While recruited by the NHS to channel their lived experience of mental illness, service use and recovery with existing service users, peer support workers often find themselves caught between the conflicting demands of service users and the wider institution. Facing inordinate personal and professional barriers in occupying this liminal space, peer support workers creatively carve out spaces at the crevice between institution and community, to engage in mutual caregiving practices.

Drawing on experiences from the author’s dual role as anthropologist and peer support worker in a community mental health team delivering Open Dialogue (an improvised research methodology carrying its own ethical dilemmas), this paper details alternative spaces for mutual caregiving ranging from swinging in the park, to ice skating, to gallery outings, to baking birthday cupcakes. Re-directing anthropological thought on friendship and hospitality toward mental health settings, this paper argues that through resisting the risk-averse institutional culture that posits strangers as a potential source of danger, genuine therapeutic relationships can be formed. Once peer support workers and service users alike share the same moral universe, a step towards recovery and social connectedness is made.