Abstract

Background
Peer support workers (PSWs) provide support to others through their personal lived experiences of mental health. However, their work is often undervalued by their colleagues, and they frequently face challenges in the workplace, resulting in occupational stigma. Currently, there are limited insights into how PSWs experience and manage the stigma they face. Therefore, this study examines how PSWs in the UK National Health Service experience and navigate occupational stigma in their roles.

Methods
Seventy semi-structured interviews were conducted with PSWs and their colleagues. Interviews explored their experiences in the role, workplace interactions, and subsequently perceptions and experiences of stigma, and how they dealt with stigmatising experiences. The data were analysed using thematic analysis to identify how stigma manifested and how they navigated it.

Results
PSWs reported experiencing stigma both covertly and explicitly. Covert stigma included subtle devaluation of their knowledge and exclusion from decision-making, while explicit stigma involved direct questioning of competence and disrespectful behaviour from colleagues. In response, PSWs navigated stigma through three main strategies. First, they demonstrated commitment to their role via reliability, dedication, and consistent performance, reinforcing the value of their work. Second, PSWs leveraged experiential knowledge as expertise, emphasising practical skills and lived experience in patient care. Third, they used their roles to create reciprocal benefits, where they supported service-users, which in turn helped their own mental health and recovery.

Conclusion
Occupational stigma towards PSWs is pervasive, manifesting in both subtle and overt ways that can undermine their role. PSWs actively counter stigma through commitment, expertise, and reciprocal relationships, highlighting their resilience and adaptability. Addressing stigma in healthcare settings is critical for improving team dynamics and ensuring high-quality care. Going forward to support the role, policymakers and organisations that employ PSWs should focus on improving organisational culture, recognition of the role, and collaborative practices to reduce stigma, strengthen workforce sustainability and recognise the value of lived experience in the workforce.