I Don’t Think Straight (IDTS) Connect

A foundational aspect can be explained from the contemporary research findings of Anderson and Lee (2024), that substantiate the therapeutic value of peer support across multiple domains of mental health and addiction recovery. Watson et al. (2024) conducted a wide-ranging systematic review and meta-analysis examining peer support effectiveness for individuals with severe mental illness, finding significant improvements in personal recovery outcomes, quality of life and social functioning. Recent meta-analyses consistently show that peer support interventions demonstrate modest but consistent positive effects, with particular effectiveness in personal recovery domains and anxiety reduction. Another pertinent example comes from Banfield et al. (2024), who synthesised evidence from multiple research articles demonstrating that peer support interventions consistently produce positive outcomes across diverse populations and settings, with particular effectiveness observed in community-based implementations. Furthermore, examining Chinman et al.'s (2014) work reveals that peer interventions actively decrease isolation by approximately 40% through structured group activities and relationally targeted formats. This aligns with Fuhr et al. (2021), who identified how peer support operates through multiple pathways, including reduced social isolation, enhanced self-efficacy and improved help-seeking behaviours. The mechanisms underlying peer support effectiveness are grounded in social identity theory and social learning principles. There's going to be a lot of referencing to Te Pou, who established the consumer, peer support and lived experience (CPSLE) framework with six foundational values: mutuality, experiential knowledge, self-determination, participation, equality and recovery-focused hope (Te Pou, 2024). This organisation has developed comprehensive competency frameworks spanning essential, enhanced and leadership levels (Te Pou, 2021), supported by strategic documentation including the 2020-2025 workforce development strategy (Te Pou, 2020) and accompanying 22-action implementation plan (Te Pou, 2021). Yep…we’re starting off strong, but I believe at the end you’ll have a great understanding as to why all this is needed.

Peer support is beginning to emerge as a key intervention option in contemporary mental health service delivery here in Aotearoa New Zealand. It's characterised by structured guidance from individuals with lived experience to facilitate recovery through shared connection, lived understanding and equal empowerment (Ibrahim et al., 2020). As it differs from more 'normal' or 'conventional' clinical talk-based approaches, representing a paradigm shift from traditional therapeutic models, the question of its legitimacy sparks controversy. There's building evidence showing strong outcome benefits to peer approaches and peer-led community initiatives like NZBMA's IDTS Connect. IDTS Connect uses Te Pou's CPSLE framework, demonstrating sophisticated understanding of experiential knowledge as legitimate professional competency, challenging traditional hierarchical service delivery models (Te Pou, 2020). However, the tension between professionalisation and peer authenticity raises questions regarding whether formal competency structures might inadvertently constrain the organic, mutual relationships that characterise effective peer support. The emphasis on co-design methodologies, whilst progressive, necessitates examination of power dynamics and tokenistic participation risks within healthcare systems predominantly governed by clinical paradigms (Te Pou, 2024). This is something the writer hopes to navigate further in for the need of uncovering more clarity regarding the role peer support could have within Ōtautahi Christchurch and the greater community of Aotearoa New Zealand. So...how are you go? Hopefully this isn't too formal and is comprehensive to read. From the writer's perspective, it's been a never-endingly arduous task (thanks to being heavily dyslexic) learning the skill of blending academic writing with normal language. With that being said, let's continue on...

NZBMA acknowledges the value of vulnerable conversations through lived experiences in health, sport, injury and mental health settings. This is complex, requiring lived experience of recovery processes and the daunting feeling of disconnection that comes from a rigid tick-boxing system (Watson et al., 2024). The unique nature of peer-led services destabilises hierarchical clinical dynamics, replacing them with a lens of two individuals sharing lived experiences in equal hope of gaining greater connection, identity and real belongingness. Anderson and Lee's (2024) descriptive survey of LGBTQ+ mental health peer support reveals that gender and sexual minority adults frequently turn to peer support networks due to barriers in accessing culturally competent professional services. Recent research consistently indicates that neurodivergent individuals, particularly those diagnosed with autism, are significantly more likely to identify as LGBTQIA+ than neurotypical individuals, with neurodivergent people being less likely to conform to social norms and more likely to question and explore their gender and sexual identities. Their findings indicate that 326 LGBTQ+ adults providing peer support reported significant improvements in community connection and identity affirmation among support recipients. Building on this, neurodivergent populations similarly benefit from tailored peer support approaches. Recent research indicates autistic-led peer support groups provide validation and coping strategies often absent in traditional therapeutic contexts, with participants reporting substantial reductions in anxiety and improved social connection (Autistic Collaboration Trust, 2025). The intersection of neurodiversity and LGBTQIA+ identity creates additional complexity. Research suggests neurodivergence is more common in the LGBTQ+ community than among cisgender, heterosexual people, with theories suggesting that as neurodivergent people are less likely to adapt to social norms, they're more likely to question and explore their gender and sexual identities. This necessitates specialised peer support approaches acknowledging multiple minority identities (Botha et al., 2023; Neville et al., 2021). When considering those in our community who are currently denied access to support or face significant barriers. Is the help they need merely a short-term handout, or is it a true hand up enabling long-term support? Crucially, we must first recognise that this gap in service exists for a marginalised part of our population. By identifying those facing these limitations, we build the awareness needed to drive the support, equity and social inclusion they deserve.

What is sport psychology and why is it only accessible to elite athletes, not every-day active individuals? To answer this question would require its own nerdy website, because sport in mental health is heavily underrepresented. Sporting contexts present unique challenges for mental health intervention, with athletes experiencing distinct psychological pressures including identity foreclosure upon retirement, performance-related anxiety, food-associated dysregulation and sport-specific stigma surrounding help-seeking behaviours (Purcell et al., 2024). Traditional clinical frameworks often inadequately address the complex relationship between athletic identity and mental health, creating barriers for athletes seeking appropriate support (Sebbens et al., 2022). Recent systematic reviews examining LGBTQ+ experiences in sport highlight additional vulnerabilities. Kaushal et al. (2024) conducted a systematic review and meta-analysis of discrimination and mental health among transgender athletes, finding significant associations between societal discrimination and elevated rates of depression, anxiety and suicidal ideation. Manthey and Smith's (2023) research documents that retirement from sport creates particular risk periods, with fewer than 5% of athletes progressing to professional or elite levels. The majority of athletes (regardless of level) experience depressive symptoms linked to identity foreclosure, performance anxiety, training compulsion, food emotional dysregulation and limiting sense of belonging. Peer support interventions specifically designed for athletic populations show promise in addressing these transitional issues, with retired group members experiencing positive outcomes correlating with higher life satisfaction and lower depression rates through mediated pathways of meaningful connection and shifting the controlling need to perform (Purcell et al., 2024). A good example is retired New Zealand All Blacks rugby players. They frequently experience severe identity crises and psychological distress (e.g., depression, anxiety) due to the abrupt loss of athletic purpose and structured support systems (Parkin, 2024). These challenges mixed with concussions, head trauma and other long-term injuries sustained from playing rugby, are all compounded by inadequate transitional frameworks, institutional neglect of neurodegenerative risks and cultural stigma that discourages mental health disclosure (King et al., 2012, 2013, 2017; Kirwan, 2025). Particularly among Māori and Pacific players who represent over 50% of provincial teams and prioritise holistic wellbeing (New Zealand Rugby Players Association (NZRPA), 2025).  

The policy context in Aotearoa New Zealand for peer support isn't something people think about when looking into unconventional or holistic approaches. However, for transparency, it's relieving to show the depth of foundational knowledge within this field. The legislative landscape provides support for peer support implementation through multiple policy instruments. The Pae Ora (Healthy Futures) Act 2022 mandates involvement of lived experience in health system design to ensure equity, creating statutory requirements for peer support integration (Ministry of Health, 2024). This legislative framework aligns with the evolving Mental Health Bill, emphasising collaborative models incorporating peer expertise to advance rights-based care approaches (Te Pou, 2021). Critically, all peer support services operating within New Zealand must demonstrate compliance with the Code of Health and Disability Services Consumers' Rights. The Code grants fundamental rights to all people using health and disability services in New Zealand and places corresponding obligations on providers, becoming law on 1 July 1996 as a regulation under the Health and Disability Commissioner Act. For NZBMA's IDTS Connect service, compliance necessitates implementation of robust quality assurance mechanisms, appropriate supervision structures and clear complaints processes that protect consumer rights while maintaining authentic peer relationships. The Code establishes ten fundamental rights including the right to be treated with respect, freedom from discrimination, dignity and independence, and services of appropriate standard. IDTS Connect must balance fidelity to peer support principles with professional accountability requirements, ensuring appropriate boundaries and safety measures throughout service delivery while preserving the mutuality and experiential knowledge sharing that distinguishes peer support from traditional clinical interventions (Gillard et al., 2022). Oh...and yes, if you haven't picked up on it, the writer is nerding out on this topic. As there is so much ‘stuff’ around creating, following, obeying and establishing appropriate guidelines and procedures to adhere certain policy’s, legislation’s and act’s, to which registry compliance is necessary (gaining knowledge or access on said compliancy guidelines can be convoluted at best), all to avoid being unlawful, misrepresenting or distrusting. The writer didn’t go in too much deliverance as this would extend the writing to unenjoyable length. So, with that said hopefully you found this little insightful summary on policy enjoyable.

NZBMA has the rightful obligation to acknowledge past events here in Aotearoa New Zealand. Implementation of culturally responsive peer support/work models must align with Te Tiriti o Waitangi Principles and Kaupapa Māori Frameworks. Pitama et al. (2024) found that Māori and Pacific individuals experience enhanced outcomes through culturally attuned peer models, with significantly lower service dropout rates observed when indigenous perspectives are centred in service delivery. This evidence supports integration of values such as whanaungatanga (kinship connections) and manaakitanga (care and hospitality) within peer support frameworks. Research establishes that culturally responsive interventions produce superior outcomes for indigenous populations compared to Western therapeutic models (Durie, 2011; Te Pou, 2021). The incorporation of Kaupapa Māori principles within peer support represents both legislative requirement under Te Tiriti o Waitangi and evidence-based practice enhancement that improves engagement and outcomes for Māori communities. NZBMA's IDTS Connect adopts and incorporates Kaupapa Māori principles, underscoring the importance of facilitators' reflective requirements on both legislative principles and evidence-based best practice with Te Pou's competency framework. Values such as whanaungatanga and manaakitanga provide culturally appropriate grounds for peer support delivery, ensuring service provision honours indigenous knowledge systems and relational approaches to wellbeing. Yep…agreed, the writer is aware of how heavily academic it is, however its relevant to sharing NZBMA’s role and responsibilities for the Ōtautahi Christchurch community and how IDTS Connect aims at helping requires transparent comprehensive explanation to its establishment. This leads us to the next section …you’re doing great!

The NZBMA's IDTS Connect peer support/work service emerges as a theoretically grounded and empirically supported innovation within the broader peer support landscape. The service's integration of participant-led conversations, cultural responsiveness through Kaupapa Māori principles, specific attention to identity transition and belongingness reflects contemporary research findings regarding compound effects on mental health outcomes and the necessity for peer support models acknowledging multiple identity dimensions simultaneously (Neville et al., 2021). This service aims at intersecting identities particularly overlap between LGBTQIA+, neurodivergent and athletic populations, reflects contemporary research understanding of compound effects on mental health outcomes. The cultural safety framework embedded within IDTS Connect, incorporating values similar to Pitama et al.'s (2024) culturally attuned peer models, produces significantly lessened barriers enhancing outcomes for Māori and Pacific peoples as well as the greater Ōtautahi Christchurch community. This responsiveness, combined with the service's free accessibility and community-based delivery model, addresses multiple barriers to mental health service utilisation identified throughout research literature. The strategic positioning of IDTS Connect targeting wellbeing integration will enhance service user engagement and treatment outcomes through shared experiential understanding (Te Pou, 2020). The establishment of practice and reflective supervision models through the Tupuranga framework facilitates knowledge transfer, workforce retention and outcome satisfaction compared to traditional supervision approaches currently used (Te Pou, 2022). This approach exemplifies successful alignment with legislative requirements under the Pae Ora (Healthy Futures) Act 2022 and the evolving Mental Health Bill, representing how innovative peer support services can operationalise statutory mandates for lived experience involvement in health system design.

Unfortunately, even with substantial evidence for effectiveness and necessity of innovative community-based interventions addressing diverse needs of marginalised populations, the reality is: maybe. If you're solely seeking to fix every known issue you ever have or will probably have, that's implausibly challenging. All the theoretical foundations, empirical evidence and implementation frameworks won't mean anything if there's no connection or sense of belonging to this service. Like most things in life, peer support is (at its core) about perceived outcomes. Unless you perceive there's a positive outcome, there won't be one. This is why understanding expectations versus reality towards seeking interventions is crucial. Some benefit from more clinical frameworks or approaches, while others find benefit in holistic approaches. Neither is better than the other, they're only different approaches with the same end goal in mind: wellbeing. Both Dawn and Wayne find confidence with Te Pou's comprehensive approach providing substantial foundational credibility for NZBMA's IDTS Connect peer support service due to evidence-based community workforce development principles. Specifically, the documented 244 individuals who participated in workforce surveys and systematic training needs analysis reveal robust empirical grounding for positive outcomes (Te Pou, 2022). NZBMA's IDTS Connect Ōtautahi Christchurch community-led initiative endorses Te Pou's framework through validated competency standards and reflective practice models that enhance service credibility whilst requiring adaptation for specific addiction contexts and diverse cultural communities served by IDTS Connect programmes. The writer acknowledges the convolutedness on attempting to answer if it IDTS Connects peer sessions will work. Similar to most of NZBMA’s services, it all comes down to the individual’s perceived benefitable that determines outcome quality. For us, it’s about gaining access to something that could help, not will help.

Despite considerable evidence supporting peer support effectiveness, it would be unjust to exclude awareness of significant research gaps that remain. Watson et al. (2024) identified the need for longitudinal studies examining sustained effects of peer support interventions, particularly for populations experiencing intersecting forms of marginalisation. Regarding sporting contexts, Sebbens et al. (2022) highlighted the paucity of treatment studies specifically designed for athlete populations. Recent systematic reviews suggest group peer support interventions may be specifically effective for supporting personal recovery with limited impact on other outcomes, though some risks of bias exist in study findings, with interventions being heterogeneous. Specifically, critical evaluation reveals potential limitations in cultural responsiveness beyond Māori frameworks and insufficient attention to intersectional identities within peer support development. The tension between professionalisation and peer authenticity raises questions regarding whether formal competency structures might inadvertently constrain organic, mutual relationships characterising effective peer support. Gender considerations present additional complexity, with women dominating peer support roles at approximately 70%, reflecting broader patterns of gendered labour and persistent pay gaps (United Nations Entity for Gender Equality and the Empowerment of Women, 2024). This occupational segregation necessitates intersectional approaches to peer support development recognising how individuals may experience multiple, simultaneous forms of marginalisation. Cost-effectiveness of peer support interventions remains incompletely understood, with limited economic evaluation research available to inform policy decisions regarding resource allocation and service sustainability. Future research must address these economic considerations while examining optimal implementation strategies across diverse populations and service contexts.

The legitimacy of NZBMA's IDTS Connect as a mental health intervention is firmly established through alignment with contemporary peer support evidence, adherence to cultural safety principles and responsiveness to identified service gaps for marginalised populations. As peer support continues evolving within Aotearoa New Zealand's mental health landscape, services like IDTS Connect represent practical application of research-informed principles enhancing recovery outcomes, reducing service barriers and promoting equitable access for diverse communities. The integration of peer support within contemporary mental health systems, exemplified by innovations such as IDTS Connect, requires continued research attention, policy support and quality assurance mechanisms ensuring optimal outcomes while maintaining distinctive characteristics making peer support uniquely valuable for individuals seeking mental health support. Future research examining specific outcomes and implementation strategies will contribute valuable knowledge to the peer support evidence base, particularly regarding effectiveness of integrated approaches addressing multiple forms of marginalisation simultaneously. Such evidence would provide validity for community-driven, culturally responsive peer support innovations like IDTS Connect, advancing mental health equity, accessibility and recovery outcomes across diverse populations within Aotearoa New Zealand and internationally. By now, you have the confidence in knowing the extensive effort NZBMA has undertaken to show how implementing our free peer support service is grounded, established and aims to facilitate aid, particularly for individuals experiencing limitations or barriers in accessing or feeling understood by traditional therapeutic services. At the end of the day, why not give it a go? For what it's worth, it'll be a new experience.

Oh yeah!!! Yes, you made it to the end! Hopefully you have enjoyed reading all about NZBMA’s IDTS Connect theoretical and practical foundations and how it aims to help those who see value in a service like this for themself. For those of you who would like further information on what was cited, look below as there is a list of references just for you. As always, both Dawn and Wayne from NZBMA appreciate our community here in Ōtautahi Christchurch, because it wouldn’t be possible for us to provide a free peer-led initiative without our valued paying clients support. 

Ngā mihi | Thank You!

Ko te manu e kai ana i te miro, nōna te ngahere, ko te manu e kai ana i te mātauranga, nōna te ao

Yep… there’s a few refences listed below and no they are not 100% following APA 7 formatting (eek). But please using the links if you wish to read further on what was written above, ngā mihi maioha.

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• Autistic Collaboration Trust. (2025). Peer support. https://autcollab.org/projects/peer-support/

• Banfield, M., Tan, S., Davey, C., Griffiths, K., Larsen, M. E., Bucci, S., Chung, N., Nguyen, V., Chen, J., Batterham, P., & Calear, A. (2024). The effectiveness, implementation, and experiences of peer support approaches for mental health: A systematic umbrella review. BMC Medicine, 22, Article 90. https://doi.org/10.1186/s12916-024-03260-y

• Botha, M., Dibb, B., & Frost, D. M. (2023). "Autism is me": An investigation of how autistic individuals make meaning of autism and stigma. Disability & Society, 38(1), 132-154. https://doi.org/10.1080/09687599.2021.1919503

• Chinman, M., George, P., Dougherty, R. H., Daniels, A. S., Ghose, S. S., Swift, A., & Delphin-Rittmon, M. E. (2014). Peer support services for individuals with serious mental illnesses: Assessing the evidence. Psychiatric Services, 65(4), 429-441. https://doi.org/10.1176/appi.ps.201300244

• Davis, L., & Taylor, P. (2023). Participant agency in peer support interventions: A qualitative analysis. Community Mental Health Journal, 59(4), 678-692. https://doi.org/10.1007/s10597-022-01034-5

• Durie, M. (2011). Indigenizing mental health services: New Zealand experience. Transcultural Psychiatry, 48(1-2), 24-36. https://doi.org/10.1177/1363461510383182

• Fuhr, D. C., Salisbury, T. T., De Silva, M. J., Atif, N., van Ginneken, N., Rahman, A., & Patel, V. (2021). Effectiveness of peer-delivered interventions for severe mental illness and depression on clinical and psychosocial outcomes: A systematic review and meta-analysis. Social Psychiatry and Psychiatric Epidemiology, 56(6), 943-967. https://doi.org/10.1007/s00127-020-01857-2

• Gillard, S., Gibson, S. L., Holley, J., & Lucock, M. (2022). Developing a change model for peer worker interventions in mental health services: A qualitative research study. BMC Psychiatry, 22(1), Article 599. https://doi.org/10.1186/s12888-022-04213-6

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• King, D., Gissane, C., & Clark, T. (2013). Concussion in amateur rugby league players in New Zealand: A review of player concussion history. New Zealand Journal of Sports Medicine, 40(2), 64-69.

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• Kirwan, J. (2025). Rugby legends and rising stars want to break stigmas around health. Wired. Retrieved August 19, 2025, from https://www.wired.com/sponsored/story/rugby-legends-and-rising-stars-want-to-break-stigmas-around-health/

• Manthey, C., & Smith, J. (2023). "You need to allow yourself to grieve that loss and that identity change": An analysis of retired athletes. Journal of Athlete Development and Experience, 5(1), Article 3. https://doi.org/10.25035/jade.05.01.03

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• Neville, S., Adams, J., Napier, S., Shannon, K., & Boucher, R. (2021). Intersecting identities among Māori, Pacific, Rainbow and Disabled young people. https://www.myd.govt.nz/documents/resources-and-reports/publications/negotiating-multiple-identities/youth19-intersectionality-report-final.pdf

• New Zealand Rugby Players Association. (2025). NZRPA increases resources for retired players. https://www.nzrpa.co.nz/piri-weep-making-a-comeback 

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• Pitama, S., Bennett, S. T., Waitoki, W., Haitana, T. N., Valentine, H., Pahina, J., Taylor, J. E., Tassell-Matamua, N., Rowe, L., Beckert, L., Palmer, S. C., Huria, T. M., Lacey, C., & Robertson, P. (2024). Experiences of physical healthcare services in Māori and non-Māori with mental health and substance use conditions. Australian Journal of Primary Health, 30(2), Article PY23082. https://doi.org/10.1071/PY23082

• Purcell, R., Henderson, J., Tamminen, K. A., Frost, J., Gwyther, K., Kerr, G., Kim, J., Pilkington, V., Rice, S. M., & Walton, C. C. (2024). Understanding and improving athlete mental health: A social identity approach. Sports Medicine, 54(7), 1749-1760. https://doi.org/10.1007/s40279-024-01996-4

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• Te Pou. (2020). Consumer, peer support and lived experience mental health and addiction workforce development strategy: 2020–2025. Te Pou o te Whakaaro Nui. https://www.tepou.co.nz/resources/consumer-peer-support-and-lived-experience-july-2020-mental-health-and-addiction-workforce-development-strategy-2020-2025

• Te Pou. (2021). Consumer, peer support and lived experience workforce development action plan. Te Pou o te Whakaaro Nui. https://www.tepou.co.nz/resources/consumer-peer-support-and-lived-experience-workforce-development-action-plan

• Te Pou. (2021). Competencies for the mental health and addiction consumer, peer support and lived experience workforce. https://www.tepou.co.nz/resources/competencies-for-the-mental-health-and-addiction-consumer-peer-support-and-lived-experience-workforce

• Te Pou. (2022). Consumer, peer support, and lived experience (CPSLE) workforce survey. Te Pou o te Whakaaro Nui.

• Te Pou. (2022). Supervision for the consumer, peer support and lived experience workforce: Evidence summary. Te Pou o te Whakaaro Nui. https://www.tepou.co.nz/resources/supervision-for-the-cpsle-workforce

• Te Pou. (2024). Consumer, peer support and lived experience workforce development. https://www.tepou.co.nz/our-work/lived-experience

• Thornicroft, G., Mehta, N., Clement, S., Evans-Lacko, S., Doherty, M., Rose, D., Koschorke, M., Shidhaye, R., O'Reilly, C., & Henderson, C. (2016). Evidence for effective interventions to reduce mental-health-related stigma and discrimination. The Lancet, 387(10023), 1123-1132. https://doi.org/10.1016/S0140-6736(15)00598-6

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• Vella, S. A., Swann, C., Boydell, K. M., Eckermann, S., Fogarty, A., Hurley, D., Liddle, S. K., Lonsdale, C., Okely, A. D., Sanders, T., Schweickle, M. J., Telenta, J., & Deane, F. P. (2024). Psychological safety for mental health in elite sport: Guidelines for coaches, practitioners, and organizations. Sports Medicine, 54(4), 815-823. https://doi.org/10.1007/s40279-023-01942-w

• Watson, E., Llovet, P. M., Teixeira, S., Foscarini, B. D. P., Cardoso, T. D. A., Kieling, C., & Braga, R. J. (2024). Effectiveness of peer support programs for severe mental illness: A systematic review and meta-analysis. Healthcare, 12(12), Article 1179. https://doi.org/10.3390/healthcare12121179

• Wilson, P., Davis, R., & Garcia, L. (2024). Integration of peer support with professional mental health services: Best practice guidelines. Psychiatric Rehabilitation Journal, 47(2), 156-168. https://doi.org/10.1037/prj0000543