Lived Experience and Clinician Perspectives on the Priorities and Challenges of Integrating Peer Support in Acute Psychiatric Services for People With <scp>BPD</scp>
Bibliographic record
Abstract
People with borderline personality disorder (BPD) are high utilisers of acute psychiatric services (i.e., psychiatric emergency and inpatient services). Yet, people with BPD often encounter significant stigma in these settings, which can result in demoralisation and reluctance to seek further care. Peer support services are increasingly adopted to align mental health services with recovery-oriented principles. This study aimed to understand the perceived acceptability, opportunities and challenges of integrating peer support for people with BPD in acute psychiatric services. We invited people with lived experience (i.e., people with symptoms of BPD and their loved ones) and mental health professionals who provide care for people with BPD to participate in an online survey. We received 41 quantitative responses and 25 responses to open-ended questions. Peer support was rated as important by people with lived experience and providers. Themes extracted via thematic analysis from the open-text responses considered how peer support would (or would not) meet patients' needs, including: feeling seen, heard and understood; fostering a sense of connection and belonging; reducing negative or stigmatising experiences; accessing instrumental and informational support; experiencing a sense of psychological safety; and enhancing a sense of hope. Most responses saw peer support as well matched to these needs; however, some expressed possible implementation challenges, including staffing consistency, role confusion and incompatibility of crisis stabilisation versus recovery goals. Overall, results underscored the potential of peer support to enhance alignment with recovery-oriented practice, which is an organisational priority for many mental health services.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.024 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.007 | 0.007 |
| Scholarly communication | 0.006 | 0.004 |
| Open science | 0.001 | 0.008 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".