Abstract
INTRODUCTION: This study explored how youth with mental health issues, peer support workers, and primary care professionals perceive youth's needs while receiving support, key elements of peer support, and its integration into primary healthcare. METHOD: Twenty-eight semi-structured interviews were conducted and analyzed thematically to identify youth's needs, core components of peer support, and collaboration challenges between peer support services and primary care. RESULTS: All stakeholder groups recognized peer support as a valuable, low-threshold complement to traditional care, particularly for those awaiting treatment or lacking social support. Youth emphasized needs for knowledge, destigmatization, validation and connection - needs specifically addressed by the informal, empathetic, and non-hierarchical nature of peer support. Peer support workers and professionals emphasized the need to balance authenticity with safety and professional boundaries. Effective integration requires structured referral pathways, clear communication channels, confidentiality safeguards, and role clarity. Divergent expectations around responsibility for information sharing and formal requirements on lived experience highlight areas for improvement. Flexible peer support options that match youth's changing needs were seen as essential. DISCUSSION: While peer support services offer a valuable addition to youth mental healthcare, its integration with primary care remains complex and requires improved communication, role clarification, and adaptable support options.