What works within peer support for young people coping with complex mental health and substance use issues: A participatory-realist evaluation

University of Ottawa Institute of Mental Health Research

Peer support services follow the practice of involving “peers” or individuals who share key lived experiences with clients to promote positive outcomes. Although there is an expanding body of literature focused on youth peer support in mental health services, there continues to be a need to better understand what works for whom, why and in what circumstances. This presentation describes a hybrid realist and participatory evaluation designed to examine LOFT peer support services for transitional aged youth (TAY) with complex mental health and substance use challenges. These findings are an important foundation to bringing evidence-based practices to peer support, and the TAY peer program is an exemplar having been running for more that  years with more peers being hired every year.


Tanya Halsall
Tanya Halsall is a Postdoctoral Fellow at the Royal's Institute of Mental Health Research affiliated with the University of Ottawa and an Adjunct Research Professor in the Department of Neuroscience at Carleton University. Her primary research areas are in youth development, participatory evaluation and health promotion. Her specific interests are in ecological approaches and interventions that support behaviour change to enhance youth well-being. She has also been involved in evaluating system transformation initiatives in child and youth services at the regional, provincial, national and international level.

Mardi Daley
Mardi Daley, B.A. is an advocate, facilitator and Peer Specialist working in youth mental health and homelessness in Toronto. Working from the lens of lived experience, Mardi collaborates on research projects to support by-youth for-youth resources, training and engagement. Her interests include youth employment, peer support and ethical youth engagement.

Key takeaways

  • The participatory-realist evaluation comprises:
    • Youth participatory evaluation: young people are actively engaged in the research process
    • Realist evaluation: designed to answer the question: “what works, for whom, how, why and in what circumstances?”
  • Transition-aged youth (TAY) program serves 800 unique young people in the Toronto area through LOFT
    • Peer support workers are former clients of the TAY program
    • The majority of members are dealing with a mental health disorder along with substance use
    • Support youth in their desired path in life once they’ve moved on from the program
    • Found an overarching theme of recovery throughout patient participation
    • Some patients may not want to go through a route of recovery but would rather have a person they can talk to who understands what they’re going through
      • Peer support acts as a friend with boundaries

Key Learning Objectives (defined by presenters)

  1. Be introduced to the key mechanisms that support positive outcomes in youth peer support services and areas of peer engagement they may not have considered
  2. Learn how to implement a hybrid participatory-realist evaluation with strong co-design elements with youth peer staff
  3. Learn about the TAY program, it’s approach and evolution with peer support practices that support recovery not only for the client, but also the peers

Key Themes

  1. Peer support services

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