Peer support / counselling / mentoring is based on the assumption that individuals who have gone through the same types of experiences (and who are now living or coping successfully) may be best able to provide guidance and assistance to those more newly injured.
The relationship of the peer is first and foremost with the individual (with the disability) and the goals of the interaction are generally set by the desires and expectations of one or both of these individuals. These are areas where we use the Spinal Injuries Association (SIA) and the Back Up Trust’s services.
Closely related to the concept of peer mentor is the concept of patient navigator, a person who assists the individual in navigating the health care system and, where necessary, serves as a patient advocate.
The concept has its origins in the 1980s in cancer care and continues to gain support in addressing the health care needs of people with many other conditions including SCI in the USA.
Patient navigators, unlike peer counsellors, do not necessarily share the same health condition as the person they are assisting or have a disability themselves. Yet, like peer mentors, patient navigators receive training and supervision from a health care professional.
In recent years, the role of patient navigator has expanded to include health education and health behaviour change. We have not as yet begun to explore the role of patient navigator in SCI health management, but will follow the systems in the USA where they are piloting this approach.
In many ways, the use of peer mentors, patient navigators, patient advocates, and other forms of patient coaching underscores many of the health system’s underlying weaknesses with respect to access, usability, and responsiveness.
The use of third party agents, in one sense, represents a work-around solution to barriers in the health system that stop the individual themselves feeling confident to work alone with the service.
This issue needs to be addressed, and the SPIN (Spinal Patient INvolvement) sessions we hold are one way we aim to review this.
We also wish to pursue studies which show that patient coaching strategies can improve adherence with medical recommendations, performance within an organization,and cognitive functioning, so watch this space…!