Peer Support in Primary Care: Australian Pilot Research and Findings
For most Australians experiencing mental health challenges, the GP clinic is the first place they go. It is familiar, accessible, and relatively affordable. But a ten to fifteen minute consultation was never designed to carry the weight of what people bring through that door: the isolation, the fear, the confusion about what support is even available, the exhaustion of telling their story again to someone who does not share it.
Lived Experience Australia has long advocated for peer support workers to be recognised as an integral part of Australia's mental health workforce, and we are pleased to be starting to see that shift. People who have navigated mental health challenges themselves, as consumers, carers, or kin, bring something to a support relationship that clinical training alone cannot replicate. The question this research set out to answer was specific and practical: could that kind of support work at the primary step in mental health care, inside a GP clinic?
This page brings together everything we know so far from an Australian pilot trial that attempted to find out. The research is honest about what worked, what did not, and what it would take to make this model genuinely viable at scale. We share it here because the findings belong to the people who made them possible, and because the conversation about what happens next needs as many voices in it as possible.
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About the Research
The Peer Support in Primary Care project, known as the PS-PC trial, was a mixed-methods pilot study funded through the Australian Government's Medical Research Future Fund Consumer-Led Round (Grant No. 2022527). It was led by Professor Sharon Lawn from Flinders University's College of Medicine and Public Health, with Lived Experience Australia as a key partner organisation, among several, throughout.
The trial ran from 2024 to 2025 across four general practice clinics in three Australian states and territories, three of these located in rural areas between 1.5 and 3.5 hours from a major metropolitan centre. This rural focus was deliberate. Premature mortality attributed to mental illness occurs at twice the rate in rural and remote settings compared to metropolitan areas, and access to specialist mental health services is considerably thinner on the ground.
The model was co-designed from the outset with people who have lived experience of mental health challenges, including consumers, carers, and peer workers, alongside service managers from primary care and community managed organisations. Peer support workers were linked with people referred by GPs at the participating GP clinics to provide up to twelve hours of individualised support to each referred person over two to three months. That support included goal setting, connection to community services and resources, emotional and practical assistance, and support to build self-management and recovery skills. For many people, this was their first time connecting with a Lived Experience (Peer) Worker.
Before the trial began, the research team conducted qualitative interviews with consumers, family carers, peer support workers, and GP clinic staff to understand their expectations, hopes, and concerns. That pre-trial study has since been published in the peer-reviewed journal Administration and Policy in Mental Health and Mental Health Services Research (Lawn et al., 2025). An outline of the project, the potential for peer work in primary care and brief summaries of post-trial findings from interviews with consumers, GP clinic staff, and peer workers are presented in the research summaries below.
For broader context about LEA's peer workforce research and advocacy, visit our peer research projects page.
What People Told Us: Research Findings
The findings below are drawn from post-trial qualitative interviews conducted across all four clinic sites. Consumers, GP practice staff, and peer workers were all interviewed. What emerges across the three summaries is a consistent picture: when the conditions were right, the model worked in ways that formal services rarely do. When they were not, it risked compounding the very disappointments it set out to address.
Each summary is available to view below and to download as a PDF.
Consumer Perspectives on
Peer Support in Primary Care
Most consumers came into the trial through a GP referral, though many reported receiving limited or unclear information about what they were signing up for. Staff at referring practices were often uncertain themselves about what the program involved, which created confusion before support had even begun. First impressions were largely positive. There was genuine curiosity and, for many people, relief at the idea of support from someone who understood from their own experience. That goodwill, however, depended heavily on what happened next.
Where peer workers listened well, adapted to each person's capacity, and met people in accessible and private settings, the outcomes were real. People reported feeling less isolated, more confident, clearer about their goals, and better connected to services they had not known existed, including NDIS navigation support. One consumer described gaining a more positive outlook and a renewed sense of self-efficacy that showed up in the small details of daily living.
Conversely, there were significant issues that would need to be considered carefully for any future models.
Inflexible scheduling caused disengagement at one site. Meetings held in public library spaces without private rooms left people feeling embarrassed and exposed. Some peer workers shared too much of their own experience, leaving consumers feeling unheard rather than understood. Others left the program without warning or adequate explanation, and the people they had been supporting were not told why. For some, this confirmed a familiar and painful expectation: that services will let you down. One consumer said plainly that the experience had made them feel they should stop expecting services to help at all.
These are not minor implementation issues. They are the difference between a model that earns trust and one that erodes it.
What We Learned from the Implementation
The implementation summary looks at the trial from the inside: what the research team, peer organisations, and clinic staff learned about the practical realities of running this model in a GP setting.
One finding stood out across all sites. The most effective recruitment approach by far was a dedicated nurse systematically reviewing patient lists for eligibility. Not posters. Not flyers in the waiting room. Not a mention in the local paper. None of those passive strategies generated meaningful patient interest without active GP endorsement. That single finding has significant implications for how any future rollout would need to be designed.
The full picture of what supported the model and what hindered it is set out below.
Enablers of Peer Support in Primary Care
Clinic Integration
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Dedicated nurse systematically reviewing patient lists, the most effective recruitment approach.
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Skilled Peer Coordinators who provided effective operational support to peer workers.
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Peer Service with well-established administrative systems that integrated the trial into those systems.
Communication
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GP champions actively discussing the program with teams sustained awareness and referrals.
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Regular communities of practice were highly valued because they provided peer workers with opportunities to raise concerns, share learning and information, and debrief about the peer role in the primary care context.
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Chief Investigator fortnightly contact with Practice Managers aided problem-solving.
Workforce & Support
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Flexible meeting options, including home visits and online supported consumer comfort, capacity, availability and access needs.
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Skilled peer workers who listened well, paced sharing appropriately and maintained clear boundaries were highly valued.
Consumer Experience
Barriers to Peer Support in Primary Care
Clinic Integration
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GP time pressures and using new and unfamiliar referral pathways impacted referrals.
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Peer support not embedded in clinic workflows, reliant on individual GP recall rather than systemic processes.
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Lack of co-location made GPs reluctant to refer to people they'd never met.
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Lived experience staff turnover/flux within peer services.
Promotion & Awareness
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Passive promotion strategies (posters, flyers, local paper) generated minimal patient interest without GP endorsement.
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Staff and consumer unfamiliarity with peer support as a concept created barriers to explaining and accepting the model.
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Peer worker shortages and unplanned exits left consumers feeling abandoned.
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Administrative burden from research protocol exceeded routine practice demands for staff and consumers.
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Trial funding did not cover true organisational costs for peer services.
Workforce & Resourcing
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Lack of private meeting space at some sites, libraries or public cafés without private rooms could feel embarrassing and impact engagement.
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Poor matching (e.g. limited shared lived experience, large age gaps, incompatible personality) led to early disengagement.
Consumer Experience
One barrier in the barriers list deserves particular emphasis. Trial funding did not cover the true cost of peer organisations' participation. Several organisations subsidised their involvement out of goodwill. That is not a foundation anything can be scaled on.
Staff and Service Provider Perspectives
Sixteen staff members across the four clinic sites were interviewed, including GPs, practice managers, nurses, and reception staff. Their views were mixed, and the research does not soften that.
Many found it difficult to articulate clear outcomes. GP time pressures within short consultations made it hard to discuss referrals in any depth. Unfamiliar referral pathways added friction. Several staff had limited understanding of what peer support actually involves, which made explaining the model to patients difficult. As one GP reflected, it is genuinely hard to recommend something you have not seen yourself, particularly when most referrals happen between people who already know each other.
At the same time, staff who worked alongside peer workers and saw the model operating well were largely convinced of its value. The concept of peer support available inside a GP practice, without an appointment, without a Mental Health Care Plan, and without the cost of a psychology session, resonated clearly. Several staff described it as a logical part of person-centred care, even without prior familiarity with the peer workforce or the evidence behind it.
Most staff and peer workers concluded that this is a model worth pursuing. The problems they identified were problems of implementation, not evidence that the idea itself is wrong.
Being Heard and Validated
From Expectation to Experience
Before the trial began, participants across all groups were interviewed about what they hoped peer support in a GP setting might offer. What the post-trial interviews revealed was more complicated, and considerably more instructive. The table below maps those two phases directly against each other. The gaps it reveals point to exactly where investment and design attention need to go next.
Pre-Pilot Hopes
Consumers and carers described wanting someone who could sit with them without a clinical agenda. Someone whose own experience meant they genuinely understood, not just professionally. Staff recognised this too, noting that time constraints in general practice rarely allowed for the kind of listening people needed. For many, the hope was simple: to feel less alone in the room.
Post-Pilot Experiences
Many consumers reported exactly this. People felt understood, less alone, and more capable. Where it broke down was when peer workers shared their own stories too frequently or too early, shifting the dynamic so that consumers felt less heard than before. Shared experience requires real skill to use well. When that skill was present, the difference was tangible. When it was not, the impact landed hard.
Navigating the System
Pre-Pilot Hopes
Across all groups, exhaustion with the mental health system came through clearly. Carers described not knowing what services existed. Consumers talked about leaving GP appointments with a referral and no real sense of what came next, or what to do during the weeks of waiting. The hope was for someone who had actually used those services and could speak to what they were really like from the inside.
Post-Pilot Experiences
This was one of the clearest areas of genuine impact. Consumers were connected to services they had not known existed, including NDIS navigation support. The practical, experienced knowledge of peer workers translated directly into the kind of guidance people had described wanting. The failure point was consistency. When peer workers left without handover, that navigational relationship simply ended, often without explanation to the people who had been relying on it.
Reducing Pressure on GPs
Pre-Pilot Hopes
Staff were largely enthusiastic about peer workers taking on the ongoing, conversational, practical support that GP appointments cannot accommodate. The vision was of a consistent person who could follow up between appointments and keep people engaged while they waited for other services to begin. Several staff described it as filling a gap they had long known existed but had no way to address within a standard consultation.
Post-Pilot Experiences
This potential was largely unrealised at most sites. Without peer support embedded in clinic workflows, referrals depended on individual GPs thinking to mention it during consultations already running over time. Where a GP champion actively promoted the model and the peer worker was a known presence in the clinic, the gap between vision and reality narrowed considerably. Those sites provided the proof of concept. The model worked. The conditions just were not consistently there.
Trust and Safety
Pre-Pilot Hopes
Consumers and carers spoke in detail about the barriers to honesty in clinical settings: fear of being misunderstood, of information being used against them, of losing control over their own care. The hope was that peer workers would come from a different place entirely, not there to diagnose or manage risk, but simply to understand. One participant described it as coming from a different power base, and that distinction mattered enormously to people who had learned to be careful about what they said in clinical rooms.
Post-Pilot Experiences
At its best, this was confirmed. Trust that developed with skilled, well-matched peer workers was real. People disclosed things they had not told their GPs and prepared for appointments differently. But when peer workers left without handover, the damage went beyond logistical. For people who had carefully opened up, an unexplained ending echoed past experiences of services withdrawing. Several said they would be reluctant to engage with peer support again. That is not a minor outcome. It is exactly the kind of harm a well-resourced model must be designed to prevent.
Practical and Interim Support
Pre-Pilot Hopes
All groups saw peer workers as valuable for the practical tasks that fall through the gaps: helping with forms, following up on referrals, supporting attendance at appointments, and providing a steady presence during the wait for other services. Staff were particularly clear on this point. Several described peer workers as a bridge, someone who could keep people engaged and supported in the space between a GP referral and actually seeing a professional.
Post-Pilot Experiences
Where peer workers were consistent and well-supported, this role was fulfilled. Consumers reported renewed motivation and tangible progress on goals. One described the shift in concrete terms: after each session, they came home and got things done. Where workforce instability or poor matching undermined the relationship, the support did not materialise, and some consumers were left feeling they had encountered yet another service that failed to follow through on its promise.
Power and Advocacy
Pre-Pilot Hopes
Consumers wanted someone in their corner during healthcare consultations. The idea of a peer worker as a witness, someone whose presence alone could shift the dynamic in the room, resonated strongly. Several described past experiences of feeling dismissed or unheard, and the hope that a peer worker could help them find their voice, or speak when they could not find it themselves. That is a different kind of support from anything a clinical role can offer.
Post-Pilot Experiences
This was one of the areas of clearest potential, though it was not consistently realised. Peer workers who understood their role well helped consumers prepare for appointments, articulate their needs, and engage with services on their own terms. Two peer support workers noted that their mere presence shifted the dynamic and language used in consultations. Workforce instability limited how often this depth of relationship could develop within the trial timeframe, but where it did, people noticed.
Fit within General Practice
Pre-Pilot Hopes
Staff and consumers alike described the GP setting as a logical home for peer support: accessible, familiar, and less stigmatising than specialist mental health services. The idea of support available inside a practice, without a Mental Health Care Plan or the cost of a psychology session, resonated clearly. One consumer described it as a no-brainer. Another used the phrase "one stop shop." The setting itself, they felt, lowered the threshold for asking for help.
Post-Pilot Experiences
The setting proved to be both the model's greatest asset and its most significant structural challenge. Consumers valued the accessibility and the reduced stigma. But embedding peer work into a setting not designed for it, without co-location, workflow integration, or adequate funding, meant the potential was only realised at sites where the conditions happened to be right. The GP setting works for this model. What it cannot do is compensate for under-resourcing.
What the comparison tells us
The pre-trial research captured a genuine, cross-sector aspiration. The post-trial findings show that aspiration is achievable, and they show precisely where it fails when the conditions are not in place. This is not a story of a promising idea that did not work. It is a story of a promising idea that worked when it was properly supported, and did not when it was not. The implementation requirements are known. The evidence base is growing. What remains is the question of whether the health system will invest in getting the conditions right.
The Published Research
The pre-trial qualitative study, exploring what consumers, carers, peer support workers, and GP staff hoped and expected peer support in primary care might offer, has been peer-reviewed and published in Administration and Policy in Mental Health and Mental Health Services Research.
Thirty-eight people across all four groups were interviewed before the trial commenced. Four themes emerged consistently. Peer support workers offer companionship, validation, and hope in ways that time-pressured clinical consultations often cannot. They can share practical knowledge and guide people through a system that most consumers and carers find confusing and exhausting. They can act as consistent, trusted connections between patients, GPs, and families. And they can help address real and perceived power imbalances in healthcare consultations, including by providing a witness presence and helping people find their voice when they feel unable to speak up for themselves.
Perhaps the most telling finding was that not one participant group, including GPs, nurses, and reception staff, raised concerns about power imbalances as a risk of the model. Practice staff were consistently open to peer support as a logical extension of person-centred care, even without strong prior awareness of the peer workforce.
What This Means in Practice
This was a pilot. That matters for how we read the findings. The trial demonstrated proof of concept under conditions that were deliberately supported: experienced research teams, engaged community partners, willing GP practices. It still encountered significant implementation challenges. That tells us something important about what a scaled model would genuinely require.
For general practice and Primary Health Networks, the message is structural. Peer support cannot be an add-on that depends on individual GPs remembering to mention it. It needs to be built into clinic workflows with the same intentionality as any other referral pathway, ideally supported by a nurse role to systematically identify eligible patients and a co-located peer worker whom clinic staff actually know. Without those foundations, referrals will be inconsistent and the model will underperform regardless of how skilled the peer workers themselves are.
For peer organisations, the funding question is not peripheral. Organisations that participated in this trial subsidised their involvement. That is not viable beyond a research context. Any commissioning model that does not account for the full cost of peer organisation participation, including management time, supervision, and administrative overhead, will deplete the very sector it depends on.
For policymakers and system designers, the unmet need is already quantified. A 2024 national report to the Australian Government estimated that 335,800 Australians aged 12 to 64 with severe mental illness are missing out on psychosocial support services, with a further 311,500 people with moderate mental illness also missing out (Health Policy Analysis, 2024). Peer support in primary care is not a solution to all of that. But for people whose first and sometimes only contact with the mental health system is their GP, it represents an accessible, less stigmatising, and potentially cost-effective form of support that currently does not exist in any systematic way.
For consumers, carers, families, and kin: your experiences shaped this research. The people who participated in interviews, before and after the trial, gave the evidence its texture and its honesty. This research would be thinner without them, and so would the argument for change.
Who This Research Is For
If you are a consumer or carer who has wondered why your GP does not seem to have much to offer beyond a referral and a wait, this research reflects that experience and makes a case for something better.
If you are a GP or practice nurse who has wanted to do more for patients experiencing mental health challenges but has not had the time, the tools, or the right connection to make it happen, the implementation findings speak directly to what would need to change for this to work in your clinic.
If you work in a peer organisation, you will recognise the workforce pressures named in this research. The argument for adequate and realistic funding is made here with evidence, not just advocacy.
If you are a PHN commissioning manager, a health service improvement lead, or anyone involved in designing how mental health support in primary care is structured and resourced, the barriers and enablers findings are where to start.
If you are a researcher, policymaker, or funder, the published article provides the peer-reviewed foundation, and the post-trial summaries show what implementation actually looked like on the ground.
A final report will be available at the conclusion of the project (December 2026).
We encourage everyone who finds this research useful to share it. The findings are only as valuable as the conversations they generate.
Get in Touch
Lived Experience Australia welcomes enquiries about this research and our broader peer workforce advocacy. If you would like to discuss the findings, explore how this work connects to your organisation's priorities, or learn more about LEA's research program, please email us.
For specific media and communications enquiries, contact us here.
You can also explore our broader peer workforce research at this page.
Acknowledgements
This research was funded by the Australian Government Medical Research Future Fund, Consumer-Led Round (Grant No. 2022527). The trial was led by Professor Sharon Lawn, Flinders University College of Medicine and Public Health, with Lived Experience Australia as a partner organisation.
The full research team and community partners are acknowledged in the published article and include contributors from Flinders University, Yale School of Medicine, James Cook University, Charles Sturt University, the Mental Health Coalition of South Australia, Community Mental Health Australia, TANDEM, Stride, Skylight Mental Health, Mental Illness Fellowship of Australia, Rural and Remote Mental Health, the Australian Psychological Society, the Australasian Society of Lifestyle Medicine, Riverland Mallee Coorong Local Health Network, and the participating general practice clinics.
We thank all consumers, carers, peer support workers, and practice staff who gave their time and experience to make this research possible.