Provision of peer support at the intersection of homelessness and problem substance use services

People who experience homelessness are often described as hard to reach and face marginalisation and exclusion.Peer support, which refers to the support provided by people who have lived experiences of a particular situation, has been recognised as an important way of working with vulnerable groups who have quite often struggled to access and have been stigmatised within healthcare.

This 'state of the art' review provides a systematic search and synthesis of literature examining the use of peer support models within services for people impacted by homelessness and problem substance use.

The review included 62 papers from across five countries and discusses the following overarching themes: the overall effectiveness and impact of peer-staffed or peer-led interventions; and challenges commonly faced in these roles.

Five themes relating to the challenges faced by peers were identified: vulnerability, authenticity, boundaries, stigma, and lack of recognition.

Suggested guidelines for the implementation of peer involvement in research studies and service delivery are presented.