A Community-based, Peer-led Counseling Service: A Hybrid Type 3 Effectiveness-implementation Study

The goal of this observational study is to learn how a community-based peer counselling service works in everyday practice and whether it helps people who are going through a psychologically difficult time. Peer counsellors are trained people with their own lived experience of mental health problems. The service, Peerberatung St. Gallen, already exists in St. Gallen, Switzerland. It offers up to six one-hour counselling sessions per year per client. The study does not change the service or decide who receives it. The main questions this study aims to answer are: * Do clients report changes in their personal recovery, well-being and stress after using the service? * How do clients experience the counseling, and what do they find helpful? * How is the service put into practice, and how do peer counsellors and partner organizations view it? Clients who use the service will: * Fill out an anonymous questionnaire at the start of counseling and again after their last session * Be invited to take part in an interview about their experience Peer counsellors and staff of partner organizations will: \- Fill out a questionnaire about how acceptable, appropriate and practical they find the service Be invited to take part in group discussions (peers) or interviews (staff of organizations)

CLIENTS Inclusion Criteria (clients): * Age 18 to 65 years * Living in the canton of St. Gallen, Switzerland * Personally affected by a mental health problem or psychologically challenging situation * Admitted to counseling at Peerberatung St. Gallen through the regular intake process and received at least one counseling session during the 12-month data collection period * Informed consent Additional inclusion criterion for interviews (Aim 2): \- Completed counseling (single session up to the full course of six sessions) Exclusion Criteria (clients): * Not personally affected by a mental health problem (e.g. professionals or relatives/informal caregivers who use the service on behalf of others) * Not admitted to counseling at intake, i.e. persons who report suicidality, seek peer counseling as a substitute for clinical or psychiatric treatment, want to discuss treatment-specific questions such as medication, or seek support outside the scope of counseling (e.g. legal or financial assistance); these persons are referred to other services Inclusion Criteria (peers): * EX-IN-trained peer counselor actively delivering counseling at Peerberatung St. Gallen during the data collection period * Informed consent Exclusion Criteria (peers): \- Not actively delivering counseling at Peerberatung St. Gallen during the data collection period (e.g. extended leave or departure from the service) Inclusion Criteria (network partners): * Professional or organizational representative in the regional care network of Peerberatung St. Gallen, identified through the stakeholder analysis * Informed consent Exclusion Criteria (network partners): * Persons employed by or working for Peerberatung St. Gallen (peer counselors, project team, research team) * Persons without a professional or organizational role in the regional care network (e.g. private individuals) * Persons who use or have used the service as clients