Peer work in Australian mental health policy: What 'problems' are we solving and to what effect(s)?

Points Of InterestIndividuals with lived experience of distress are increasingly included within mental health systems through employment as peer workers.The inclusion of peer workers has both the potential to challenge, and to reinforce, existing ways of thinking and relating within the mental health system.This article looks at the ways that peer workers are included in Australian mental health policy, and the potential consequences for peer workers and peer work practice.We suggest that attention needs to be paid to both the liberating and troubling aspects of inclusion, to ensure that peer work continues to challenge unhelpful ways of thinking and relating regarding mental health. The inclusion of peer work within mental health policy offers potential for lived experience expertise to shape the construction of, and subsequent responses to, mental health 'problems'. However, increasingly, scholars and activists are highlighting limits to such inclusionary practices. We explore these tensions through a critical analysis of problem representations including peer workers within Australian mental health policy. Drawing on Mad studies and user/survivor scholarship, we suggest that despite popular conceptions of inclusion as having universally positive effects, the inclusion of peer workers within policy has both liberating and troubling effects. Such effects include positioning peer workers as complicit in managing 'problems' that reinforce psy-regimes of governance and limiting the political subjectivities available to promote alternative representations. By highlighting such complexity, we endeavour to create opportunities for re-imagining peer work and inclusion in ways that bring such practices closer to achieving self-determination and social justice.