Yuri Hayashi,Mental health social worker,
Seseragi Nakano Ward Community Living Support Centre, Little Pocket NPO

1. Seseragi Nakano Ward Community Living Support Centre, run by Little Pocket NPO

Nakano Ward is an area located in the western part of Tokyo’s 23 wards, crossed by many railway lines running east to west, with the JR Chuo Line at their heart, and bordering Shinjuku and Shibuya Wards. The population is 333,000 (as of Nakano Ward’s Basic Resident Register of 1 March), and it is also used by many people commuting to universities or companies.

It was a small group of people, principally members of the public interest incorporated association Yadokari no Sato, which was active out of Saitama Prefecture, who started a leathercraft class in a private home in Higashi-Nakano, Nakano Ward in 1974. People who wanted to communicate the fun of leathercraft and people who hoped for a normal life all while living with a psychiatric disorder joined hands and started work. Nowadays, as the NPO Little Pocket (hereinafter, “our NPO”), we continue our activities aiming to bring about a society in which we can continue to live in the communities in which we choose, and providing advice and support, interaction through group work, and a place for daytime activities for people with “mental and emotional illnesses”. Our NPO also has offices in several places within the ward where we run a support for continuous employment type B workshop, advice and support offices, training projects to help people recovering from psychiatric disorders to adapt to life in society (public health centre daycares), a group home, and a support hub for community living.

Another of our NPO’s projects is the Seseragi Nakano Ward Community Living Support Centre (hereinafter, “Seseragi”). Seseragi’s predecessor was a sheltered workshop, Nakano Ward Smile Centre for Rehabilitation into Society, set up in 1995, and began its work as a community living support centre in 2001. Subsequently, in 2008, Seseragi’s operations were outsourced; our NPO received the commission, which we have held ever since.

There are currently 294 people registered with Seseragi, and the average number of those who use the facility each day is 25.9 (as of February 2023). Our work includes five areas: (1) “advice and counselling” by telephone and face-to-face, (2) “support with everyday living” through group work such as courses, programmes, an open space, and projects at the centre, (3) “housing support” assisting with the communications and coordination needed to move into or change accommodation, (4) “peer counselling” through programmes and in-person consultations with peer counsellors, and (5) “counselling” by a clinical psychologist for people with emotional concerns or their families. In addition, we run projects for support with moving to and continuing to live in the local community, assistance with living independently, and planning consultation support; these services are outside the scope of our commission.

2. The activities of the Seseragi Aozora Peer Group

The Aozora Peer Group currently carries out three programmes, each once a month.

1) Peer Café　

This programme is based on sharing with one another. The word “peer” first appeared in the Seseragi Newsletter which we publish in the March 2008 edition. Peer counselling was introduced as a new area of work when it was decided to outsource the management of the facility to the private sector, and the April edition that same year carried an announcement about the launch of “Group Peer”, a programme (group work) by peer support staff. According to an account by a person who knew Seseragi at that time, “Peer support staff originally came into the open space and talked and played games with us. This gradually evolved so that a time was set for getting together, and mental health social workers on the Seseragi staff also met with us in what became a Seseragi programme.”

2) Peer Study Group　

This programme is based on learning from one another. Peer support staff, facility users, and mental health social workers at Seseragi participated in in a course on setting up self-help groups run by Sudachikai Social Welfare Corporation in Mitaka City, which at that time ran groups drawing on JHC Itabashikai Social Welfare Corporation’s peer counselling seminars. What they learned there was reflected in the peer study group.

3) Peer Meetings

This programme is based on discussion with one another. Consideration of the group’s rules and planning and preparation for the annual peer counselling course are carried out here.

3. The role and effectiveness of peer staff

I joined the staff of Seseragi immediately after graduating from university. I wanted to deepen the interest in peer support which I had held ever since my student days through actual practice, and I am currently learning in my role as the member of staff responsible for supporting the running of the peer group.

In addition to the three programmes mentioned above, my work with Peer Group Aozora also involves giving talks to students of welfare and nursing at nearby universities. Moreover, I participate in meetings and gatherings related to peer support as a member of the Seseragi staff. In the course of these ongoing activities, I often receive questions about peer support from people in a variety of positions. I will answer some of the most frequently asked questions here in Q & A format.

Q1. What has been good about working with peer support staff?

A1. Even before being a member of peer support staff, Mr. Saito (peer support staff member at Seseragi) is my senior in the workplace. He taught me about the rules and way of working at Seseragi as my senior colleague. He is a person who has experienced psychiatric illness, but my role is not to support him in his daily life, so I feel that being overly careful about his condition or his illness might be rude. While at work, I talk about work with him, just like I do with other staff.

Q2. What is the role of peer support staff?

A2. I think that being someone with lived experience is the primary role. Mr. Saito has eyes to notice things precisely because he has this experience. Support staff are not Superman, and so in some cases, the support staff themselves can become a wall (barrier) in the way of making the life that the client hopes for become a reality. I feel that it is peer support staff who contribute towards realizing this life that the client wants by making a hole in this wall or changing its shape.

Q3. Are there difficulties when working with peer support staff?

A3. There is nothing particularly difficult purely because they are peer support staff. I think that peer support staff are simply professionals, so I have the same feelings when I consult with them as I do when consulting with other professionals such as doctors or nurses.

Q4. I would like to become a peer staff member or peer supporter – what should I do?

A4. It is unlikely that you will be given an unconditional opportunity for employment simply because you have experience of psychiatric illness. This is because the employer is not happy with just anyone with direct experience. In the same way as for any profession, your character is one of the decisive factors when hiring, I believe. And even before this, the reality of the situation is that you cannot freely choose where you are employed.

4. Conclusion

I feel that there has been a sudden increase in the number of people showing an interest in peer support over the last two or three years. However, there has been no change at all in terms of the importance which mental health social workers and many other supporters have long placed on their role in listening actively to the stories of those who have come to them for advice, building relationships of trust, looking for what they can do together, and returning them to society. This can be seen from the circumstances leading to the establishment of our NPO and of the peer group.

I hope that people will not be too worried about peer support and peer staff as “a new thing”, but will make use of the experience developed so far, and that the way of working represented by the new profession of peer support staff will come to be seen as something ordinary.

Edited and published by the Japanese Society for Rehabilitation of Persons with Disabilities.

Published on April 25th, 2023.