Peer support in acute psychiatric inpatient settings: A scoping review

Peer support, grounded in lived experiences, plays an important role in advancing recovery-oriented mental healthcare. Although widely implemented in community settings, its adoption in acute psychiatric inpatient care remains limited because of structural and cultural factors that constrain recovery-oriented practices. This scoping review aimed to map existing evidence on peer support in acute psychiatric inpatient settings, focusing on (1) implementation formats, (2) peer roles, and (3) facilitators and challenges. Following the Arksey and O'Malley framework, we conducted a scoping review using the participants, concepts, and context framework. We systematically searched the PubMed, Scopus, MEDLINE, CINAHL, and ProQuest databases. We included studies that involved individuals with mental health conditions, described peer support provided by persons with lived experiences, and were conducted in acute psychiatric inpatient settings. Eleven studies, published between 1995 and 2024, met the inclusion criteria. Peer support was reported as being implemented through informal and structured formats that vary in frequency, continuity, and delivery contexts. Peer roles included emotional, practical, advocacy, and relational support. The reported benefits include increased activity participation, emotional reassurance, social engagement, and recovery-related gains for both patients and peer workers. Facilitators include training, supervision, leadership support, and collaborative relationships with staff. The reported challenges include unclear role boundaries, staff resistance, emotional strain, and structural limitations, including space, resources, and barriers to team integration. The findings suggest that peer support may help promote recovery-oriented practices in acute psychiatric settings, although further rigorous studies are needed to confirm its impact and inform sustainable integration.