Tensions & Possibilities: The Role of Peers across Social Work Contexts

With task shifting across domains of social work and medical practice, as well as consumer/survivor activism surrounding "nothing about us without us" the category of "people with lived experience" has become increasingly invoked. Recently, peers are called upon as "trusted messengers" to engage service users, in varied institutional contexts such as mental health and criminal-legal settings. Yet, this hailing comes with inherent tensions and challenges: people with lived experience are asked to represent a cohesive communal and professionalized identity, thereby obscuring important social differences, histories and politics (Voronka, 2016). Despite efforts to codify peer work across domains of social work practice, the historical emergence and thus, the distinct subjectivities produced, vary substantially across geographic and service contexts. Peer work in mental health, for example, emerged in defiance to medical authority. Meanwhile, peer-led grassroots organizations and activists developed harm reduction amidst state abandonment of drug users. In many ways, the commodification of peer work has situated it within the very regimes of power which it developed in reaction to.

This roundtable session focuses on the following questions: How do people with lived experience enact, negotiate with, and resist the professionalized forms of peer work and identity? How might social work and medical institutions respond? Would their responses entrench the marginalization of these groups or create new possibilities of participatory governance? What formal and informal rules govern the work of peers and with what consequences? To what extent are peers understood as knowledge producers, and how is that knowledge incorporated into institutions? What tensions arise when peer work is commodified?

Discussion will take place among a group of researchers and activists, including those who have worked as peers. With attention to the distinct genealogies of peer work, we discuss the following questions across of domains of social work drawing on (1) The work of an academic, social worker and former peer specialist who considers current trends in "peer work" and its intersections with democratic ethics, epistemology, and political economy. (1) an ethnography of the 2020 census count and the use of "trusted messengers" to speak on behalf of the state and the Census. (2) A phenomenological life histories study of mental health peer specialists with incarceration histories, showing that many, but not all, peers approach their work from an activist stance, resisting efforts for cooptation despite institutional pressures. (3) An ethnographic study on a peer mentoring program for persons who became blind as adults in China, discussing how persons with disabilities may use peer work to claim expertise in independent living amidst the dominance of professional services, and how the identity of peers elide diversity, intersectionality, and trauma in experiences of disability and disablement. (4) The final panelst draws on over a decade of work that has explored the possibilities, conditions, and consequences of peer work, most recently as a member of a qualitative research project focused on four intersecting communities often engaged in peer research: mental health service user/consumer/survivor, people who use drugs, racialized, and trans/non-binary communities.non-binary communities.