Peer Positive

From doing for, to doing with.

The Peer Positive initiative is dedicated to helping social service and mental health organizations to involve peers and community members in the design, delivery, and review of all services and supports.

We’re taking small steps towards a big goal

Peer Positive offers practical ways of preparing organizations for change by encouraging equitable processes of engagement that value lived experience.

When we say ‘peers,’ we mean people who have expertise to offer based on their own relevant lived experience.

Building on a strong foundation

The practical work of engaging peers in the design, delivery, and review of services is guided by deliberate efforts to re-balance relationships between peers and professionals. At the core of the Peer Positive approach is a commitment to developing strong personal and organizational understandings of how power, privilege, oppression, and equity shape every aspect of peer and professional relationships.



Within the mental health system, peers are historically disempowered and defined by labels associated with their mental health status. They experience paternalistic and sometimes harmful treatments, and by a system that often fails to provide social inclusion.

It is widely documented that meaningfully involving people with lived experience in the planning, delivery, and evaluation of mental health services is crucial to creating more responsive and empowering service experiences.

Creating meaningful opportunities for peers to contribute to a range of decision-making processes helps services better respond to service user needs. Peer experience is expertise; peers have a unique firsthand perspective about what works well and what needs improvement.


For peers to be meaningfully involved in decision-making processes regarding the design, delivery and review of services, organizations must establish supportive structures to promote an environment capable of addressing issues of power and equity.

Designating time and space for reflection on power and equity can help to embed a greater awareness of how these issues impact peer involvement in decision-making into the culture of the organization.


Seeking feedback is a key evaluation process that allows for the quality improvement of services. Giving the opportunity for service users to actively evaluate services, share their experience of them, and suggest improvements, allows services to solve problems, adapt to the needs of the populations served, and remain relevant and effective. Responding to feedback transparently and in a timely manner allows service users to build confidence while ensuring that services are held accountable to improving by applying the feedback.

In order to create equitable processes of feedback gathering, multiple mechanisms need to be available in order to meet folks who are harder to reach and make feedback processes accessible for all.


Peer Positive is an evidence-informed approach that has been developed by learning from the lessons found in traditional academic literature, less formal 'grey literature' like organizational or government reports, and the lived experience of professionals, service users, community members, and everyone in between.


Co-production involves creating equal partnerships between the people who provide services and the people who use them. It is also a major cornerstone of the Peer Positive approach.

Peer Positive has learned from the lessons of People Powered Health, a UK-based project that supported the design and delivery of innovative services for people living with long term health conditions. Their evaluations suggested that co-production of health services can:

  • Deliver better outcomes
  • Prevent problems
  • Leverage existing community capacity
  • Support better uses of scarce resources
  • Enhance social networks to support community resilience
  • Improve community wellbeing

Visit People Powered Health for their full series of reports.


Peer Positive works to increase levels of peer engagement in the decisions that shape mental health and social services. Research shows that young people who are engaged in services:

 Dyer, C. & Pereira, N. (2011). The Art of Youth Engagement. Ontario Centre for Excellence in Child and Youth Mental Health.

Dyer, C. & Pereira, N. (2011). The Art of Youth Engagement. Ontario Centre for Excellence in Child and Youth Mental Health.

  • Have stronger self-esteem
  • Feel a greater sense of belonging
  • Are more committed to programs
  • Report improved mental health

Family engagement is seen more and more as a best practice, but many organizations don't have the capacity to make it a meaningful reality.

Engagement helps organizations to:

  • Better address people's needs
  • Make decisions more effectively
  • Realize better health outcomes

Visit the Ontario Centre of Excellence in Child and Youth Mental Health for more information about the benefits of engagement.


The World Health Organization notes that the most important determinants of mental health include:

  • Social inclusion
  • Freedom from discrimination
  • Participation and control

The Wellesley Institute highlights that pervasive health inequities are one of the most critical problems facing Toronto, related in part to poverty and systemic racism. To support equitable outcomes from services, a targeted and integrated equity strategy is needed across all social services.

Find out more from the Wellesley Institute: Inner City Health (2010); Health Equity Road Map (2012).