“Confronted with paperwork”: Information and documentation in peer support

Abstract

Background

Peer support has a unique philosophy of practice, which is reflected in the way information is handled.

Aims

To describe the way peer supporters use documentation in their work and explore tensions this generates.

Methods

Qualitative study based on two individual or group interviews with each of 37 peer supporters and peer-support managers in Aotearoa New Zealand.

Results

Peer supporters challenged disciplinary uses of documentation by either keeping minimal information about their interactions with peers, or keeping notes in a collaborative, empowering and transparent manner. This generated tensions with regard to the wider mental health system, particularly in relation to an emerging national database of mental health service use.

Conclusions

Funders and planners need to be aware of the reasons for some peer-support services' reluctance to participate in mental health information strategies. Peer-support documentation approaches might usefully be adopted across the mental health sector.

Keywords:

• mental health
• documentation
• Foucault
• sociology
• peer support
• evidence

Acknowledgements

We would like to express our appreciation to Frank Bristol and Leo McIntyre for their advice on earlier drafts of this paper, and to Hamuera Kahi, Egan Bidois and Waiatamai Tamehana for their contributions to data collection. We would also like to express our gratitude towards this journal's anonymous reviewers for their helpful comments at the review stage. Finally, we would like to express our deepest appreciation to our participants, without whom this paper would not have been possible.

Declaration of Interest: The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.

Notes

1 The Panoptican was a prison that was designed so that prisoners faced the constant possibility of surveillance by guards they could not see. It was used by Michel Foucault as a metaphor for systems of control in modern society (Foucault, 1979).

2 The DHBs are public bodies which own and manage most public hospitals within a region, and fund private and NGO provided services. There are currently 20 DHBs in Aotearoa New Zealand. Information on peer-support services they fund came directly from the DHBs.

3 A kaupapa Māori service is a service based on Māori empowerment and principles.

4 A tikanga-based practice is a practice based on Māori protocols.

5 A whakatau is a welcome, while mihi are introductions which combine personal introductions with connections on the basis of whakapapa (geneology) and other connections.

6 A kaumatua is a Māori elder who acts as a guide to the organisation.

7 Particularly as the PRIMHD database groups all peer-support activities into one code, which does not allow its users to differentiate different types of peer support.

8 HoNOS is “Health of the Nation Outcome Scales”. It is a 12-item assessment of the service user, measuring behaviour, impairment, symptoms and social functioning. They are completed after clinical assessments.