Study day 2022


Does lived experience engender skills?

Mutual aid and peer support

On-line Study Day, January 21, 2022

Today, many people are convinced there is a direct causal link between lived experience and the skills required to support one’s peers. Experience should lead to knowledge and skills. However, nothing has been proven in this respect, no more than the opposite. It is clear that a wide variety of effects are produced by people declaring themselves as “peers”. Through their support, some of them enable others to regain footing in their lives; whereas others diminish support for the group solely by their presence.

What makes it possible to know how to act in an appropriate and useful way towards one’s peers? Is lived experience alone sufficient to bring out the abilities or not? Surveys have shown that some individuals who have experienced major challenges in life are especially competent at supporting their peers. It’s possible to be competent without being a professional, or even a volunteer. Some individuals have been able to develop their skills in supporting their peers because of training that has allowed them to build on their lived experience. It also happens, infrequently, that trained and qualified individuals are not competent at supporting their peers.

In other words, there is no direct causal link between lived experience and the ability to support peers, but lived experience is essential for establishing a peer-to-peer relationship. Two questions therefore arise:

  • How does lived experience contribute to forging an ability to support one’s peers?
  • Since life experience is not enough, what other qualities, skills and attitudes are needed to support one’s peers?

The gradual institutionalization of peer support practices and their scope of action does not in practice resolve this question of the link between lived experience and skills. Institutionalization through public action in France has indeed several facets. Many scenarios are adopted without this question of the link between competency to support one’s peers and lived experience being truly investigated, understood, or even scientifically proven. Some sectors and some institutions frankly prefer lived experience, while others favor brief training more, and still others value a university degree following training and a practical internship.

For example, since 2017, the roll-out of Housing First [1] promotes the recruitment of a peer in each intervention team. For the Housing First policy, the conditions for qualifying required by a 2016 decree are experience using mental health services and certification of at least level III, in other words a Baccalaureate degree + 2 years, and, failing that, validation of what has been acquired from experience (VAE) within 5 years of taking up the position. This second option of VAE is commonly used and therefore leads to recruiting based mainly on lived experience.

Following the work of a collaborative group coordinated by the Interministerial Disability Committee (CIH) during the 2019-20 period, a peer intervener training course is now being developed on a national level. Lasting 4 to 5 days and currently addressing people with disabilities, this training aims to identify and consolidate acquired experiential knowledge, to acquire a base of knowledge on the political and administrative organization of the field, and to integrate methods of peer intervention. In this case, priority is given to a very short training program that complements lived experience.

The implementation of the professional license for Health-Peer Mediator (MSP) [2] and the university diploma (DU) Peer supporter [3] mark the firm choice of some actors in the field of mental health to qualify through a training course of several weeks and a practical internship. The selection for entry into these courses is important because of the limited number of places for a large number of candidates. In addition, genuine theoretical and practical work and the creation of a professional attitude are expected. This option is clearly one of professionalization, well beyond lived experience alone.

Finally, let us point out the case of the AQRP [4] in Quebec, which has been developing training for peers since 2006 along with training for employers and mental health teams. Peer training includes two weeks on site and a 42-hour internship. Even before selection, the person must meet a certain number of criteria, including: having lived or living with a mental health problem, being ready to reveal their lived experience in connection with their mental disorder and their recovery, having been invested in their recovery for at least two years, skills in helping relationships, relevant experience in work or involvement, good spoken and written French, a high school diploma or its equivalent. In this example, while the training and internship are brief, the pre-selection and selection are more demanding than is usual in France. In addition, the person and their employer are given support after starting the job. Lived experience is an important criterion, but remains one criterion among others.

While competency is the thorough and recognized knowledge of a field – conferring on the individual holder the right to judge or decide in certain matters – this competency is always limited and circumscribed. The attitudes and skills acquired in the course of experience do not confer omniscience. If people are holders of experiential knowledge, in which areas are they competent, since everyone is commonly the holder of experiential knowledge? Are there competencies that cut across different types of experience? Does the experience of supporting one’s peers enable the production of knowledge and skills? Under what conditions does the experience of supporting peers within a multi-professional team allow the development of peer-to-peer relationships?

This study day is not intended to evaluate or judge recruitment criteria, or the choices made by sectors, institutions or employers. This scientific event aims to understand, produce knowledge, and shed light on the link between lived experience and the ability to support one’s peers.

  1. Poster of Study Day 2022
  2. Presentation of the Study Day 2022
  3. Link to the Web site for the 2022 Study Day

[1] Public action carried out by the DIHAL

[2] Bachelor’s degree in health and social sciences, Health and Peer Mediators course, Sorbonne Paris Nord University

[3] Pair-Aidance University Diploma in Mental Health, Lyon 1 University

[4] AQRP : Quebec Association for Psychosocial Rehabilitation

EXPEERTs Study day 2021

What can patients give to their peers and to health professionals?

Online conference, January 28, 2021

Patients are often seen as consumers of care, but they are more than that, just as they are not simply patients being cared for. The patient is an essential player in health care. Since the year 2000 in France, directions taken by public policies (Law 2002, HPST Law, Health Law), the activities of various institutional players (including HAS[1]), and dedicated professionals or patient associations have enhanced and facilitated patient involvement.

As part of a call for health democracy, the law of March 4, 2002 established new patient roles and responsibilities. This law promotes a two-fold involvement of the patient. At an individual level, each patient has the right to complete and accurate information on their state of health in order to be able to exercise – in an informed manner – their right to consent to or, on the contrary, to reject a medical examination or treatment. At the collective level, the 2002 law created the status of user representative. The latter is a member of a registered patient association and is mandated within this framework to bring a global perspective, developed collectively by patients at various levels in the health sector or in the region. The user representative can also function as an observer, gather information on practices and process, mediate, participate in defining health policies, prevent undesirable events or advocate for effective patient rights.

There is thus a broad scope of authorized action available to patients within the healthcare system. There are more and more groups devoted to consultation, information and co-construction: Patients’ Commission (CDU), Supervisory Board (CS), Medical Commission on Care Institutions (CME), Institutional Technical Committee (CTE), Sustainable Development Committee , Ethics Committee, Hospital-acquired Infections Control Committee (CLIN), Medicines and Medical Devices Committee (CMDMS), but also Local Health Councils (CLS), Local Mental Health Councils (CLSM), Patients’ Center, Regional Conference on Health and Autonomy (CRSA), City Health Workshops, Regional Health Contracts, Regional Health Project, Regional Mental Health Project, etc. This list is far from exhaustive.

In addition, other types of patient involvement are developing: the “patient-expert” participates in the Therapeutic Education of the Patient (HPST law[2]); “resource patients” supports various courses of action through their contributions, and help in organizing and implementing them; the “patient partner” gets involved following requests by professionals or institutions; the “peer helper” or “peer health mediator” gives support to other people going through mental health challenges and shares their own experiential knowledge; the “patient-teacher” or the “patient trainer” participates in providing content in medical and nursing schools (IFSI), in paramedical training, etc. Not to mention the recent development of participation – at the initiative of caregivers – in care within a collective framework in physical medicine and rehabilitation facilities and services, as well as an emphasis on informal support between patients.

Patient participation in the health system is therefore not a marginal trend but a significant development (Bousquet, Ghadi, 2017; Routelous, 2008). Ma santé 2022, the new certification procedures for health facilities, the HAS recommendations on user involvement in the health, social and medico-social sectors of activity, all these will doubtless profoundly change the French health care system. Through the analysis of concrete situations, the goal of this one-day conference is to understand the challenges of these new practices, their impact, their advantages and disadvantages. This day will focus particularly, but not exclusively, on formal or informal activities of patients in relation to other patients as part of the care and management of daily life with illness.

  1. Poster of the 2021 EXPEERTs study day
  2. Website of the 2021 EXPEERTs study day
  3. The recordings of the 2021 EXPEERTs study day

[1] High Authority of Health

[2] Hospital, Patient, Health, Territory Law

Rechercher dans OpenEdition Search

Vous allez être redirigé vers OpenEdition Search