How different are Consumer and Carer Roles?
Roennfeldt, H., Chapman, M., Runneboom, C., Wang, Y., & Byrne, L. (2023). Differences and similarities between Consumer- and Caregiver- or Family-Informed Peer Roles in mental health. Psychiatric Services, 74(10), 1037-1044. doi: 10.1176/appo.ps.20220386
How do consumer and carer peer workers differ in terms of values, goals, and work practices?
Take Home Messages
- This study explored the similarities and differences between consumer and carer peer workers in Australia.
- The results showed that most participants viewed consumer and carer roles as distinct. consumer and carer roles have different perspectives and have differences in values, goals, and work practices. However, there were also similarities in values between the two workforces.
- The study highlighted the potential risks and conflicts in positions where peer workers combine both consumer and carer perspectives in a single role.
Aim
To explore the similarities and differences between consumer peer workers and carer peer workers.
Background
Peer workers have mostly been people who are employed to use their own personal experience of mental distress and adversity (consumer peer workers) but more people with experience as a family member of someone who has experienced mental distress are being employed as carer peer workers.
We now know a lot about the factors that make the consumer peer workforce successful, including clear role descriptions and a supportive workplace. However, little research has been done with the carer workforce and little is known about the factors that make the carer workforce successful.
We noticed in a previous study that there were more Lived Experience workers who say they work from both a Consumer and Carer perspective and we were interested in people’s opinions about roles that combined both perspectives.
Method
The study used data from an Australian survey, which included responses from 882 people; 558 peer workers (including both consumer and carer peer workers), as well as 324 mental health staff who were not peer workers. The survey included multiple choice questions about the values and work practices of consumer and carer workers. The survey also included the following three questions and invited people to provide comments.
1. How similar or different are the values or goals of consumer and caregiver or family roles?
2. How similar or different are the work practices of consumer and caregiver or family roles?
3. In your opinion, is it appropriate for organizations to design roles that combine consumer and caregiver perspectives?
Results
Overall participants viewed consumer and carer roles as more different than similar in terms of values, goals and work practices.
The more experience people had in consumer roles, the more different they thought the roles were.
Themes from the interviews were:
Different perspectives
Different priorities
Different work practices
Similarities
Potential risks in combining consumer and carer roles
Possibility for combined roles in specific contexts
Different perspectives
Consumer and Carer roles were seen to have different perspectives. Perspectives refers to the individual and collective experience and knowledge people bring to their work role.
“The consumer is centered on emancipating other consumers and herself, as well as changing systemic inequalities from a consumer’s perspective. The carer is centered on emancipating other carers and herself, as well as changing systemic inequalities from a carer’s perspective.” (consumer peer participant)
Different priorities
Consumer and Carer roles were seen to have a different understanding and differences in how they valued and how they viewed safety and human rights.
“Today, I overheard my carer colleague advocating for a consumer to be treated against their will, because it was in the “best interests” of the family. As a consumer worker, I would NEVER advocate for something that would knowingly bring harm to someone else.” (consumer peer participant)
Different work practices
Consumer and Carer workers were thought to have different skills and expertise based on the differences in lived experience.
“As a consumer peer worker, I would not begin to understand the experiences of carers [or] family. If a carer contacted me, I would refer them to the carer peer worker(s) who can support them more effectively. I would expect the carer workers to refer the consumer in a family they are supporting to me as the consumer worker.” (consumer peer participant)
Similarities in consumer and carer roles
There were also some similarities in values between the two workforces.
“Both roles involve sharing lived experiences to build rapport, validation, and hope, while assisting the people they are working with to look at strengths, goals, and healthy coping strategies to enhance self-care, advocacy, and resilience.” (caregiver peer participant)
Potential risks in combining consumer and carer roles
Potential risks and conflicts were identified in combining consumer and carer perspectives within a single role. These risks were thought to occur because of the differences in Consumer and Carer roles and possible conflict in holding both perspectives.
“Potential for fundamental conflict regarding who is being supported or represented. Risk for consumers who have experienced trauma—why would they trust someone who identifies as a “carer,” when that word may have a negative meaning for them”. (consumer peer participant)
Possibility for combined roles in specific contexts
Although some people though combined roles may be useful in roles that do not work directly with people accessing support, such as in policy making.
“[Roles should be combined] only in certain contexts, where both consumers and carers are the subject of the service, policy, [or] research, . . . and where the role is focused on business functions or processes that are largely common. Many lived experience workers have experience of both and can apply their experience flexibly, depending on need.” (combined role peer participant)
Discussion
Consumer and Carer roles are distinct roles because the skills and knowledge are formed through different experiences- consumers through their own personal experience and carers through supporting someone. These different experiences mean that the perspectives of consumers and carers are different and the values, goals, work practices are more different than they are similar.
There is a need for greater understanding and research into the factors that support carer workforce to be successful in providing support to carers. Combined Consumer and Carer roles are not recommended.