Table 2.

Multilevel Factors Influencing Peer Support Worker Role Implementation

Levels of analysis	Themes in each level	Sub-themes/details	Inter (downward) & intra-level influences
Macro level Systems and broader structures level Source of role legitimacy & professional power dynamics	Macro socio-cultural factors	Discourses on medical model and recovery approach Professional power dynamics Training and certification	Macro: Regulatory and political factors Macro: Economic and financial factors Meso: All themes Micro: Relationships with team members
	Regulatory and political factors	Policy mandates Political commitment	Macro: Macro socio-cultural factors Macro: Economic and financial factors Meso: All themes Micro: Relationships with team members
	Economic and financial factors	Historical influence of voluntary work Financial structures in health systems (funding) Economic uncertainty	Meso: Human resource management policies
Meso level Organization level Arrangements affecting role implementation in mental health organizations	Organizational culture	More or less hierarchical culture Role clarity or ambiguity	Meso: Organizational leadership and supervision Meso: Human resource management policies Micro: Relationships with team members
	Organizational leadership and supervision	Commitment of organizational leadership Commitment of supervisors	Meso: Organizational culture Meso: Human resource management policies Micro: Relationships with team members
	Change management & workplace strategy	Change management model Consultation of various stakeholders Workplace integration strategy	Meso: Organizational culture Meso: Human resource management policies Micro: Relationships with team members
	Human resource management policies	Hiring criteria and procedures Remuneration of PSWs Training & socialization Retention Access to resources (self-care & education, network of PSWs, physical resources)	Meso: Organizational culture Micro: Relationships with team members Micro: PSW wellbeing
Micro level Integration to mental health teams Interactions of PSWs and staff in teams and the experiences of PSWs navigating their role in the teams	Relationships with team members	Stigma (various types) Readiness for the integration of PSWs in mental health teams) Role boundaries (disclosure of PSW mental illness information & disclosure of peers’ information to the team)	Micro: PSW wellbeing
	PSW wellbeing	Emotional involvement Self-care