Drift from Peer Support Values and Standards: A Position Statement and Call for Action
Bibliographic record
Abstract
In the past decade, peer support has been rapidly scaled and spread within mainstream healthcare settings without due concern and protection of its core values, contributing to a political, legal, and ethical problem referred to as “peer support drift” or co-optation. Over 2022-2024, PeerWorks consulted with peer supporters across the province of Ontario to develop a position statement and call to action on addressing this problem. This statement elaborates the conditions contributing to peer support drift, which include how many peer supporters are precariously employed in inhospitable workplace environments incongruent with peer support values (e.g., use of illness models, labeling, coercion); face workplace disrespect and exploitation as people who belong to equity-deserving groups; and have minimal access to equitable or adequate funding, resources, and opportunities for learning, as compared to other health disciplines. These workplace conditions can pressure peer supporters to deviate from their core values and towards inappropriate clinical (e.g., managing medications) or purely instrumental tasks (e.g., making coffee, driving clients to appointments). When values-based peer support is practiced with integrity, it has a unique ability to bridge gaps in the healthcare system, address the unmet needs of marginalized people, and reduce stigma and isolation through the rebuilding of relationships and community. However, when peer support drifts from its special role and duplicates conventional health services, we are deprived of these health equity-enhancing possibilities, harming health systems, society, and peer supporters. The position statement ends with 12 recommendations for collective, properly resourced prevention and intervention led by people with lived experience.
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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 | 0.087 | 0.112 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.024 | 0.025 |
| Scholarly communication | 0.030 | 0.031 |
| Open science | 0.011 | 0.022 |
| Research integrity | 0.085 | 0.088 |
| Insufficient payload (model declined to judge) | 0.018 | 0.014 |
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".