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“Peer support saved my life”: The mental health service with a 7,000% return on investment

In Doncaster, peer-led mental health support is changing lives.

Members of PFG Doncaster in a room under a PFG sign
PFG Doncaster

When we read headlines about long waiting times for mental health services or impossible barriers to accessing benefits support, it can be hard to believe that there is help out there. But there is a service in South Yorkshire that anybody can walk into, without a referral, and get help the same day. Not only does this exist; it's entirely built around supporting people in a less than conventional way.

Run by others with mental health problems rather than trained professionals, PFG in Doncaster also provides a crisis service, educational support and meals. As a holistic community service, it believes in the people it works with and demonstrates that both giving and receiving support can be a positive, empowering experience. A recent report by the Sheffield-based citizen think tank Centre for Welfare Reform describes PFG as “one of the most powerful and inspirational versions of peer support in the world.”

Based at the Wellness Centre in Intake, the service began life as a way to get 'personalisation' to apply for adults with mental health problems as well as those with physical impairments. Personalisation is a form of social support where, instead of care being provided for a person by a local council, the funding for that support is given directly to a disabled person to control their own support needs. PFG soon expanded its outlook to cover wider mental health peer support.

The Wellness Centre
Google Street View

The organisation was set up by Kelly Hicks, a social worker who left her job to become independent. PFG has a different outlook to traditional mental health services. There is no hierarchy of 'knowing' professionals and 'lesser' patients. Everybody is equal and the person you support through a crisis now might be supporting you with a benefit application six months down the line.

People who would previously have been in touch with the NHS crisis team report no longer needing to contact them and in-patient stays can be reduced in length thanks to the support of others from PFG. By 2012, the group had provided 13,000 hours of practical support, with an estimated value of £250,000.

This support did not cost the £250,000 the NHS and social services would have spent on it, and this fact highlights another benefit of peer-led support. In 2015, 408 people were involved in PFG Doncaster, three of whom were paid. Yet the support offered was the equivalent of 45 full-time workers’ positions.

This is an efficient approach to mental health support, as well as an understanding and humane one. “What is perhaps most striking," the Centre for Welfare Reform notes, "is the enormous return on investment which comes from investing in PFG’s approach to peer support. The cost of PFG’s work to statutory service was only 1.5% of the value of that work. To put this another way statutory services see nearly £69 value created by spending £1. That is a return on investment of nearly 7,000%.”

Members of PFG Doncaster
PFG Doncaster

At the end of 2019, PFG launched Safe Space for people experiencing a mental health breakdown. Safe Space, like the wider PFG offer, is peer-led. As Covid hit soon afterwards and some statutory and voluntary services were closed down, Safe Space and PFG adapted the way they worked and continued to support people in need.

With discussions with commissioners only having begun in November 2019, the service was set up in a matter of weeks, with group members conscious of how difficult Christmas can be for many people with mental health problems. PFG sees a need, it works out how to address it, and it does what it needs to do.

Over 1,000 people were referred to Safe Space in its first year or so. Despite original estimates that there would be approximately 14 on-site visits and 80 phone calls a month, the reality was between 17 and 38 on-site visits and 747 calls a month.

According to the report, “The fundamental message of PFG Doncaster is that ‘you are enough.’ Everyone has sufficient life experience to qualify them to be a member of a peer support group and to support others: people helping people.”

Issues that bring people to PFG and Safe Space include addictions, depression and anxiety, domestic abuse, bereavement, self-harm, isolation and relationship problems. Many of the group members live in poverty and these structural disadvantages are not ignored by the service.

While the view of old-school psychiatry might be that peer support would be at best inadequate to the recipient of support and at worst damaging to the person delivering it, PFG proves this wrong. They have found that providing support is not only highly effective when two people can communicate on a more equal footing, but that it's also beneficial to both parties’ wellbeing. When somebody who has used mental health services takes on a role in an organisation like PFG, their strengths and confidence often develop considerably.

Simon Duffy, Director of the Centre for Welfare Reform, told Now Then that PFG’s support systems are not only cheaper and more grassroots in their approach - they are also more effective.

I think Kelly [Hicks] and the group who came together, going back to 2010, just really had this much more ambitious vision of what peer support could mean. They really, really believe - I guess as I do - that society is capable of much, much better. It starts with us. It starts with our ability to help each other and think differently about each other.

Both Kelly and I come from what I call the inclusion movement, so we just believe that everybody is gifted, whatever labels the system sticks on you. So when she started working initially, a lot of focus was on helping people who would be basically excluded from the mental health system and wanted some kind of personalised support that was unavailable to them.

This is what the theory of social work says, but it never happens in practice. She just did everything as an equal with everybody else, always asking that question, ‘Well, what can we do about it?’ And so instead of saying, ‘How am I going to rescue you?’, she just said, one human being to another, ‘Right well, we've got a problem. So how do we tackle that?’

In essence, when the attitude within an organisation is that everybody has potential and pretty much anything is possible, it becomes easier to believe that change can happen, and that that change can come from people like you.

The idea that “who you are is enough” is fundamental to PFG’s work, and Duffy hopes that the organisation’s success will inspire people across South Yorkshire to consider whether they too could come together with others to support their peers. It may not look the same as PFG Doncaster, but the principle of self-governing and meeting people with the help they need - not the help that someone else prescribes - is critical.

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