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Peer support in mental health has gained much attention especially in high income countries (HICs). Peer support can be delivered informally or formally. Both informal peer support and formal peer support work in mental health (PSW-MH) hold promise for service users’ recovery and increasingly delivered in low- and middle-income countries (LMICs) too, to overcome large treatment gaps between mental health care needs and limitations in services. 37 semi-structured interviews and 3 focus groups with 14 service users, 12 service providers and 12 carers of service users at three tertiary psychiatric hospitals in the Western Cape, South Africa, were conducted. Data were analysed using reflexive thematic analysis. Support as facilitator to recovery was generated as a theme, including peer support; described as beneficial for both service users and peer support workers. The benefits lead to the exploration of the opportunities and challenges for PSW-MH in the study context. While there is still a long way to go to the successful inclusion of formal peer support within health care services in South African contexts, we have discussed the possible ways in which such inclusion can be beneficial on various levels, if the challenges to PSW-MH are heeded.

Opportunities and challenges: a case for formal peer support work in mental health in a South African context