Peer support: a force for social change?

Ubuntu is a powerful African concept which was fundamental to building post-Apartheid South Africa, and which has at its heart compassion, high regard for human life and shared humanity.

Leymah Roberta Gbowee (winner of the 2011 Nobel Peace Prize for her leadership of Liberia’s women’s peace movement) describes ubuntu as the belief that "I am what I am because of who we all are.”

Not that dissimilar to peer support, then. At its most basic, peer support is about a mutual relationship in which one person can say to another, “I’ve been there”.

"Peer support is about empathy, not sympathy. It’s about using shared experiences to help each other make sense of challenges, build resilience and find solutions. It relies and thrives on a deep sense of reciprocity."

Valerie Walsh is a mental health peer supporter who describes the contrast simply and yet so emotively: “Unlike mental health professionals #PeerSupport provides opportunities to give as a well as take. The people I support have given me so much”.

Like ubuntu, peer support is about forging communities based on shared experience. It’s about the healing process of giving and receiving, of coming to know another’s experiences as your own.

Peer support, like ubuntu, can be a powerful force for social change.

In a society in which people living with long term conditions report experiencing social stigma and discrimination, peer support offers the opportunity to build a new way of being which works for the very people whose experiences are delegitimised by dominant societal attitudes.

Recent EU Wise research found that only 50% of people with long term conditions consider their health care professionals as part of their self-management support network.

This statistic may not be surprising given that people living with long term conditions spend around 3-7 hours every year with their health and care professionals, leaving 8757 hours during which they manage their wellbeing in other ways.

This statistic shows that clinical input alone can’t tackle stigma and isolation. Clinical input can’t provide a listening ear when needed most; and it can’t enable people to know that there are others like them, feeling similar emotions and facing comparable challenges.

Thankfully, clinical input is far from the whole story. It’s no accident that peer support has grown up in some of the communities who face the most stigma and discrimination.

Give Stigma the Index Finger! (a community research project around the experiences of people living with HIV) found that 84% of people living with HIV have supported their peers. Similarly, there are a myriad of examples of peer support in mental health, including everything from self-help groups to peer brokerage.

Last week, I listened to a mental health service-user speak powerfully about how the mental health system legitimises the experiences of some, and de-legitimises the views and experiences of others, often - they argued - the most vulnerable and stigmatised.

If ubuntu is powerful enough to underpin peace-building processes, what could it do for our NHS? We know from research that the thing peer support really helps with – more than most other person centred interventions – is the confidence to make and sustain change in one’s life.

Desmond Tutu explains ubuntu simply: “My humanity is caught up, is inextricably bound up, in yours”. Could ubuntu be a crucial component of the new models of care our health and care system is searching for? And, if so, what can we do to make it happen?

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Thanks for this blog! I came across it via a MOOC on Dementia offered by the University of Birmingham. Coincidentally I had just posted a comment in the forum about the notion of ubuntu. I was wondering what might happen if we started to question the value of 'independence' that seems to be one of the cornerstones of Western society. We feel so proud to be able to 'do it alone' and 'do it MY way', and yet it's a complete myth! Not one of us is independent at any stage in life, yet we use this notion as a yardstick to evaluate and judge elders who can no longer live alone ... hell, MOST of us don't like living alone! So thank you for bringing this cultural wisdom from the South into conversation in (I assume) the North. Warmly, Alice (from Cape Town).
by Alice Ashwell
I am currently a patient in the Aston Ward at Lister Hospital's Mental Health facility. My "journey" to this place involved Law Enforcement as well as Clinical and Medical agencies such as the NHS and other Social Services. A week ago, I was given the option of Voluntary Self Referral to this unit, or remain in custody to answer to charges of bail contravention. I jumped at the chance to finally get in front of a team of top medical professionals, so, at around midnight on 26 June, I was transported to Lister Hospital in Stevenage and registered as a patient in Aston Ward, part of the Psychiatric Division of Mental Healthcare in this large regional hospital. I felt "at home" almost immediately, recognising familiar accents and body-language from the on-duty nursing team... "Most of you are from Zimbabwe..." ... They looked at each other, in a quizzical way, taken aback a little. "How do you know that?" The head-nurse asked. "I feel Ubuntu in this room," I said... "I am from South Africa, but was born in Zambia (Northern Rhodesia) and I have many, many friends who are Zimbabweans." The team looked at me, and then a little uneasily to each other. "There is Ubuntu here," said one, "and we try to live it as best we can..." A very noble and respectful attempt at upholding a faltering system, for there is little or no genuine Ubuntu here. There can never be... the bloated, jelly-like blob of an over-regulated and micro-managed social service such as the NHS is as far from Ubuntu as Stalinist Communism is to Human Rights. But I see some hope... By profession, I am a qualified Special Needs Teacher, who completed his education at the University of the Witwatersrand and Jhb College of Education in South Africa. I have the H.Dip.Ed in Remedial Teaching (here called "special needs") and have a background in Educational Psychology. I have worked with both children and adults in these areas, of "special educational needs" and "occupational therapies". I refrain from "boxing" or "pigeon-holing" that term - which is what our "system" likes us to do here... Now, as I enter my second full week here at Aston Ward, I see that the staff are as desperate as their patients for an opportunity to be "released" from their own "prisons of regulatory micro-management", and (it seems) to be "trusted" to afford us the Ubuntu we both so long to have. If anyone is interested in my personal "case", and would like to get in touch with me, it is a very, interesting and eye-opening account of a person's journey into mental "disorder", and how the Social Agencies of the State are not equipped to truly "care" for my welfare. Ubuntu - the great social welfare culture in Africa - cannot be "blended" into a culture that encourages suspicion, mistrust, top-down management, utterly confused lateral communications, and which prefers to "shield" the problems (of its own making) behind the thin veneers of "We Care..." bombast. But Ubuntu is here, in aston ward... It has to remain "secret", and is shared by those of us who know its true value - those of us who grew up with it in our common African Heartland.
by Grahame Palmer
I am more than willing to assist in any project(s) that are underway to improve the mutual "plight" of mental illness patients and their appointed carers. Here, in Aston Ward, I am encouraging my fellow patients to show "Ubuntu", firstly to each other, and now with the staff. Simple things like:- greeting each other, saying thanks for all the chores the staff have to do, helping clean up the dining room, setting places at the table before we eat. Showing genuine gratitude for the food (which is generally very tasty and wholesome)... Ubuntu is starting to show its warm glow here... I have confidence it will grow - but it will need "the space" to do so. "Trust" - it's core feature - is still not there in most respects. But I feel the Ubuntu has been seeded here. And that is worth some hope at least.
by Grahame Palmer
I taught at a school called St Martins - a Private, Anglican-Church, school in the south of Johannesburg. I went there as a pupil (1969-73) and returned to teach there in August 1979. I taught at the school for six years. The church played a significant role in school life, and Desmond Tutu was an occasional visitor (before he became Archbishops) to conduct church services. The staff (including myself) knew him well, on a personal basis that remained quite formal, but was nevertheless relaxed. So I have first-hand experience of this great man's compassion and faith. Ubuntu is a powerful force for good.
by Grahame Palmer
St Martins School - where I was both a student and teacher from 1969 to 1984 - was, prior to 1956, called "St Peter's". It was also known as "The Black Eton". When the Nationalist Party came to power in 1948, a systematic programme of dividing society along racial lines was (ass we all know) implemented with vigour and force (apartheid). Some of the more graphic projects include the destruction of the communiteis in Cape Town's "District 6" and in the Jhb equivalent - "Sophiatown", where the great Trevor Huddlestone fought in vain to salvage Ubuntu in it's most relevant forms. St Peter's - The Black Eton - then (and still) attached to the Community of the Resurrection - a "monastic" community of the Anglican Faith, was at last "mopped up" by the Apartheid regime in 1955/56. Many of South Africa's true leaders went to school there, including the great Oliver Tambo, amongst scores of others who would, a half-century later - emerge out of their darkness and lead the country. The buildings of St Peters were designed (in part) by Sir Herbert Baker, and that probably saved them from demolition. District Six in Cape town was razed to the ground - only churches were spared the bulldozers. So in 1956, St Peter's was re-branded "St Martin's" and became a Whites-only private school. Its first headmaster was Michael Stern, who, after several years at the helm and who tried to make the school multi-cultural - was under such threat from the apartheid regime that he feared for his personal safety - left South Africa and went on to found Waterford School in Swaziland. It became the educational "home" of many internal exiles in South Africa - including the children of the Mandela Family.... I met Michael Stern in the mid 1970,s, at his magnificent school, firstly to introduce myself as St Martonian, and secondly to see how Waterford worked. I was already into my 2nd year of university/college and liked the idea of working in schools such as Waterford. Michael Stern lost his life, many years later, in a car accident in the UK... How ironic... a man who was in constant mortal danger was to die a violent death in one of the world's most decent democracies... With him went much Ubuntu...
by Grahame Palmer
The "inmates" of Aston Ward are quickly seeing the value in each other and are excited by our new co-operative approach to looking after ourselves first, and to consider others' needs. I really like being here... and I mean that. And I get a genuine feeling that my fellow patients are much happier now than they were a week ago. Come visit and see us in action... You be the judge!
by Grahame Palmer


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