Emerging Voices From the Frontline: Perspectives of Advanced Practice Nurses and Peer‐Helpers in French Mental Health Settings

Background Globally, the emergence of advanced practice nurses (APNs) and Peer‐Helpers is transforming mental health systems by addressing workforce shortages and user‐centred care. In France, where mental health has recently been designated a national priority, the lived experiences and perceptions of these emerging professionals remain underexplored. This study investigates how APNs and Peer‐Helpers construct their professional identities and navigate the tensions and power dynamics surrounding their integration within mental healthcare settings. Aim To comparatively explore the professional identities, lived experiences, and integration challenges of APNs and Peer‐Helpers within France’s mental healthcare system. Design Descriptive qualitative research using in‐depth data collection. Method Semistructured interviews were conducted with six APNs and six Peer‐Helpers from diverse mental healthcare settings across France. Data were analysed using reflexive thematic analysis, identifying themes and patterns in participants’ perspectives and lived experiences. Results Participants described persistent barriers to legitimacy, including unclear scopes of practice, institutional resistance, and epistemic asymmetries within clinical teams. While APNs struggled with medical hierarchies, Peer‐Helpers faced symbolic inclusion coupled with structural marginalization. Despite these tensions, both roles developed forms of adaptive boundary work to assert relevance in team collaborations. Conclusion The study reveals that professional integration is not a linear or neutral process but marked by role conflict, emotional labour and jurisdictional negotiation. These findings challenge normative assumptions about role innovation as purely technical solution and invite a more nuanced, practice‐based understanding of systemic change. Implications for the Profession and/or Patient Care To our knowledge, this is the first comparative study of APNs and Peer‐Helpers in France. It shows that their complementary contributions, clinical expertise and experiential knowledge, remain underleveraged due to institutional inertia and entrenched hierarchies. Internationally, these findings urge policymakers and health leaders to reconsider professional integration not as a rigid implementation, but as contested labour that demands interpersonal trust, structural support and epistemic equity. Patient or Public Contribution None.