Integrated initiatives

Many peer work initiatives work closely together with agencies.  They are organisationally linked or embedded in an agency.

Important factors for embedding peer support successfully in a professional organisation are that:

Agencies and peers have to work continuously  to develop forms of involvement that are recognised by both as genuinely meaningful.
Participation that leaves little actual responsibility in the hands of peers will sooner or later lead to their frustration and to the possibility that they will cease to participate.

The mission of the organisation is based on the concept of acceptance indicated, for example, by offering low threshold services without conditions such as stopping using drugs, etc

The professionals have an accepting, non-judgemental attitude towards their clients, the community and the peers members.




“Peer workers can give ‘person-based’,  ‘experience-based’ and ‘message-based’ credibility to health promotion in the context of intimate, illegal, and stigmatised behaviours such as illicit and injecting drug use.”

Annie Madden, The Australian Injecting and Illicit Drug Users League (AIVL)


Integrated initiatives have several benefits:

Better continuity of the projects.  Most self-organisations of drug users have had problems in sustaining themselves on a long-term basis.  The way of life related to illicit drug use   especially criminalisation  often appears to interfere with a continual commitment to steady involvement.

Better professional support for the involved drug users:
on a professional level (training - in knowledge, methods and attitudes - and supervision of the workers)
on an organisational level (team structure, etc.),
and on a personal level (personal problems, etc).

Peer expertise within the agency.  Information and experiences (about drug use techniques, social values, attitudes, etc) from peer workers are available to all the staff working in the agency.  Employing drug users also means acceptance and acknowledgement of them as competent members of society.

Peer workers within an agency have easier, workable contacts with other health and social service agencies than self-organisations, because they can use the existing network of the agency.  This is especially important to facilitate referrals when needed.

The agency can act as a firewall against negative actions by law enforcement agencies, neighbourhood initiatives, etc.  The agency will be supportive in building good relations with those who might otherwise hamper the development or work of the initiative.


The most significant limitation of integrated initiatives is that an embedded initiative relies heavily on the acceptance and willingness of agency (management and workers) on the one side and peers on the other side to build bridges, collaborations and learn from each other.  Agencies have to give up the concept of the traditional helper-client model as the only way to operate and need to open up to an alternative approach. And the other way round: peer workers may also need to learn to co-operate and deal with an agencies that might have (slightly) different ideas or approaches.