Recovery Coaches, Support Workers and Peer Workers: Who Does What

Ask any five people working in the mental health sector what the difference is between a psychosocial recovery coach, a mental health support worker and a peer worker, and you get five similar but slightly different responses. The confusion is worse for participants and families, and the consequences of it are real. Plans are wasted on the wrong person, referrals are lost because no one knows where to turn to for help, and people find themselves with a recovery coach who is doing their shopping or a support worker who is being asked to tell them what to do.

Being able to explain these roles in plain terms is one of the most useful skills in psychosocial work, for the practitioner who is likely to be the one the participant asks. Here is the map.

The psychosocial recovery coach

The role of recovery coach is a specific role funded by the NDIS that has been developed for people with psychosocial disability. The essential components are recovery-oriented navigation: the facilitation of a recovery plan with the participant, orchestration of the moving parts of supports, facilitating capacity building to manage their life and supports, and staying connected through the ups and downs associated with psychosocial disability. Recovery coaches should have mental health knowledge that is gained through lived experience, work experience or qualifications, with the role being more about coordination and coaching than providing hands on daily support.

Shorthand for participants: the recovery coach helps you steer.

The mental health support worker

The support worker provides the practical, every day support, the support that goes with getting to appointments, establishing and maintaining routines, shopping, cooking, getting out of the house, connecting with community, and gently supports the strategies developed with the clinician and the person. The art of support work in psychosocial work is engagement, reliably turning up, keeping pace with the participant, and being a low-pressure presence on the bad days, as well as the good. Support workers are not coaches and are not clinicians. Their power is that they are in the participant's actual week, hour-by-hour, in which recovery occurs or does not occur.

Shorthand: the support worker helps you do.

The peer worker

Peer work isn't about what they're doing, it's about their perspective. A peer worker is hired for their lived experience of mental ill-health and recovery and trained to use this lived experience intentionally: giving hope from the 'other side' of an experience; modelling a reality of recovery; and having a credibility that no qualification can give. Peer workers can be found in settings such as community programs, hospital teams, and in the context of the NDIS peer support can be provided in a range of funded supports. The role is not a "support worker with a diagnosis"; peer work is its own job, with its own ethics and disclosure rules.

Shorthand: the peer worker helps you believe it is possible, because they have been there.

How the roles fit together, and where they blur

In a well-done set up, the three roles complement, rather than compete. The recovery coach holds the map, the support worker walks the road, and the peer worker reminds the person the destination is there. Not everyone will have all three, and funding is not always available for all three at full capacity, which is why the distinction matters: fund the functions the person needs, rather than three plans for the sake of it.

Here are the two directions of the common blurring. When a daily need is in front of them, recovery coaches tend to burn up coordination hours on daily support that a support worker could provide at a different rate. Support workers enter quasi-clinical or quasi-coaching space when the participant trusts them, and that's as much a compliment as a risk to the worker. Practitioners are in a great position to observe drift, and to gently name it at review points.

One boundary sits above all three roles: none of them is a substitute for clinical care. Treatment from psychiatrists, psychologists, GPs and community mental health teams is complemented by the work of coaches, support workers and peer workers. Any arrangement that quietly works around clinical care, rather than encouraging engagement with it, should be reconsidered.

How this plays out in practice

Take a typical scenario: a man in his thirties with schizophrenia, who has a recovery coach who he enjoys but doesn't use much, and an ageing mother who continues to drive him to all appointments and do his shopping. A review can reframe the mix, not the budget, the recovery coach refocuses on plan navigation and expands his capacity to navigate services, core funding engages a support worker three mornings a week for routines, shopping and appointment travel. And the change that matters most to families in this situation: his mum becomes his mum again, rather than his roster. No additional funding has been added. It has been targeted on the correct functions.

Working with all three roles as a practitioner

The principles of working together are the same regardless of the roles that surround your client, information is shared willingly and with consent, there is a course of escalation for any changes that arouse concern, and the role each person can carry is respected. Do not share the file, share the recovery goals. The three shorthands listed above are a two-minute conversation you can have with a participant who asks you which role they need.

Next steps

When a psychosocial participant's supports seem to be failing the next time, review the functions before the hours: who is helping them steer, who is helping them do, and who is helping them believe. Typically one of the three is the difference.