Just a Tick Box: A Qualitative Study of Peer Workers' Experiences Driving System Change in Mental Health Services

Peer workers in public mental health settings engage in direct support to service users and system change advocacy. Yet, peer workers' experiences of driving system change are often under-researched. To address this gap, this qualitative study examined the experiences of eight peer workers engaged in system change via committees and working groups in an Australian mental health service. Findings are captured in the four themes: I'm just there as a tick box, which describes experiences of tokenistic engagement; They held the power, which points to the privileging of clinical perspectives; You've got to be assertive and proactive, which shows the considerable labour exercised by peer workers to navigate system inequity; and It's just kind of burnt me out, which describes the psychosocial impacts of navigating entrenched power dynamics. Findings indicate an urgent need for structural and cultural reforms to ensure peer workers have genuine influence in shaping mental health system change.