The Canada-Norway Research Collaboration on Operationalizing Experience-Drive Innovation through Integration of Peer Support in Health Systems

Project Managers: Dr. Gillian Mulvale and Karl Johan Johansen

Research Team Members: Fiona Wilson, Dr. Ken Deal, Dr. Nick Kates, Shaleen Jones, Dr. Ian Arnold, Dr. Chuck Cunningham, Lee Purins, Anne B. Plathe, Ingvild Musdalslien Kvisle and Christina Kildal

Steering Committee Members: John Lee, Deborrah Sherman, Stella Ducklow, Frances Jewell, Patrick Mitchell, Eduardo Castro, Dagfinn Bjørgen, Torbjorn Mohn-haugen, Astrid Weber, Juni Høiseth and Ottar Ness

About the Research Collaboration

We have conducted an exploratory policy case study where the case is defined as the integration of formalized/intentional peer support services within clinical services located in hospital, primary care and community settings.

Formalized/intentional peer support refers to peer support services (either group or one-to-one) focusing on issues such as education, employment, mental health systems navigation, systemic/individual advocacy, supported housing, food security, internet, transportation, recovery education, and antidiscrimination work.

Sub-cases in Canada and Norway

We have examined two sub-cases: peer support in Norway and in Ontario, Canada. These jurisdictions were selected because they are comparable in terms of socioeconomic development, embrace a recovery orientation, and are actively seeking to expand peer support in mental health service delivery, yet differ in important contextual factors, such as the policy climate and levers adopted to support implementation.

Our data sources includes key informant interviews, surveys and published academic and grey literature. We have sampled the most common approaches to engagement of PSPs in adult mental health settings.


In Ontario, our recruitment strategy has focused on St. Joseph’s Healthcare Hamilton’s (SJHH) inpatient, Assertive Community Treatment Teams (ACTT) and outpatient clinic programs. In Norway, we have identified organizations that offer similar programs, including St. Olav’s Hospital Trondheim.

Using a combination of focus groups and individual interviews, we have engaged PSPs, and individuals and families receiving peer support, 5-10 front line staff (psychiatrists, nursing, allied health professionals) and supervisors associated with each program.

We have also conducted individual interviews with 2-3 policy makers in each jurisdiction (e.g. in Canada the Ministry of Health and Long-Term Care, the Hamilton Niagara Haldimand Brant Local Health Integration Network). We tailored the focus group and interview guides to capture the perspectives of each participant type, but have also explored common topics including: experience of providing/receiving peer support, barriers and facilitators to effective integration of PSPs (e.g. regulatory, funding, payment, organizational policies, team climate, information sharing, peer support and service delivery model) and change management approaches and implementation frameworks adopted.

The survey (approx. 30 participants per sub-case) has focused on the influence of team climate on integration and functioning of PSPs.

The data collection and analysis is finished, and we are currently working on summarize the findings and writing articles based on the findings. One article has been published in Healthcare Management Forum.