Paving the Road While Walking - Perspectives from Flexible Assertive Community Treatment Managers on Preparing the Implementation of Peer Support Work (PSW) in Outpatient Services.

This qualitative study explored the perspectives of Flexible Assertive Community Treatment managers on preparation and employment of peer support workers. The study was based on semi-structured interviews with managers ( n  = 5) in Outpatient Services in the North Denmark Region. The analysis was based on an inductive approach to content analysis which led to three themes: (1) An exploratory but energy-loaded process-deciding to employ peer support workers, (2) Paving the road while walking-preparing employment of peer support workers, and (3) Uncertainty about the "how" and the "what"-preparing mental health professionals for collaborating with peer support workers. Together these themes describe an exploratory and unstructured implementation process, revealing a lack of structure during implementation. Such circumstances are known to potentially compromise staff wellbeing, feeling insecure about own professional role, and lack of readiness to embrace peer support workers as colleagues. Applying an implementation framework and addressing the literature on barriers and facilitators may promote successful implementation of peer support worker employment.