No abstract

Purpose As peer support services have become increasingly used in mental health settings as a recovery-oriented practice, so has the body of published research on this approach to care. The purpose of this paper is to provide an update on the current evidence base for peer support for adults with mental illness in two domains: mental health and recovery, and physical health and wellness. Design/methodology/approach To provide a robust, non-redundant, and up-to-date review, first the authors searched for meta-analyses and systematic reviews. Second, the authors found individual studies not included in any of the reviews. Findings Peer services are generally equally effective to services provided by non-peer paraprofessionals on traditional clinical outcomes. Although some studies found peer services to be effective at reducing hospitalization rates and symptom severity, as a whole, the current evidence base is confounded by heterogeneity in programmatic characteristics and methodological shortcomings. On the other hand, the evidence is stronger for peer support services having more of a positive impact on levels of hope, empowerment, and quality of life. Research limitations/implications In addition to the need for further high-quality research on peer support in mental and physical health domains, the authors also question whether measures of hope, empowerment, and integration into the community are more relevant to recovery than traditional clinical outcomes. Originality/value This paper provides an original, robust, and up-to-date review of the evidence for peer services.

Citizenship is a multidimensional construct encompassing the degree to which individuals with different life experiences perceive inclusion or involvement across a variety of activities and concepts.

Peer support within mental health services has a growing evidence base and aligns with current policies of recovery-oriented care. Despite these advantages, widespread implementation of peer support remains limited, likely due to various methodological and implementation issues. Researchers have noted the importance of utilizing an implementation framework to understand best practices for implementation. Therefore, the purpose of the current study was to synthesize the existing literature on the implementation of peer support interventions and identify barriers and facilitators using an implementation framework. The Consolidated Framework for Implementation Research (CFIR) was used to organize the literature obtained in the systematic search and synthesize best practices for implementation. The systematic search identified 19 published articles that were coded for relevant information including implementation barriers and facilitators. The review highlighted a number of important elements for implementation within the CFIR domains, including clear role definition, a flexible organizational culture, and education for peer and nonpeer staff. Implementation barriers included an organizational culture without a recovery focus, allied practitioners' beliefs about peer support, and an unclear peer role. The results of this review provide a summary of best practices for the implementation of peer support in mental health services that can be used by researchers and service providers in future implementation. These practices should continue to be tested and reworked as the climate of recovery-oriented services within mental health organizations evolves. Impact StatementPeer support interventions have a growing evidence base within mental health services; however, a number of barriers have prevented widespread implementation. The current study systematically searched and synthesized the literature on the implementation of peer support interventions within mental health services. The results provide important information on the best practices of implementation that can be used by service providers in order to increase the uptake of peer support interventions.

With medications that improve cognition and advances in knowledge of successful rehabilitative approaches, adults with psychiatric disabilities are increasingly able to pursue desired personal and career goals in their communities. This article focuses on supported education (SEd)-one of the newest psychosocial rehabilitation (PSR) models for adults with mental illness. The mission, principles, and service components of SEd are presented, reflecting its basis in PSR practice. Evidence of the effectiveness of supported education, based on research and evaluation studies, is provided. The authors conclude with a discussion of why PSR and SEd are important to social work and how social workers can effectively use this evidence-based practice to maximize opportunities for consumers with a mental illness.

Of the outcomes, only decreased alcohol use was attributable to the experimental intervention. Although this may be a chance finding, peer- and community-oriented group support and learning may facilitate decreased alcohol use over time.

This study assessed the effectiveness of an intervention based on a theoretical framework of citizenship on reducing psychiatric symptoms, alcohol use, and drug use, and increasing quality of life for persons with serious mental illness (SMI) and criminal justice involvement. One-hundred fourteen adults with SMI and a history of criminal justice involvement participated in a 2 × 3 longitudinal randomized controlled trial of a four-month citizenship intervention versus usual services. Linear mixed model analyses were used to assess the intervention's impact on quality of life, symptoms, and substance use. After controlling for baseline covariates, participants in the experimental condition reported significantly increased quality of life, greater satisfaction with and amount of activity, higher satisfaction with work, and reduced alcohol and drug use over time. However, individuals in the experimental condition also reported increased anxiety/depression and agitation at 6 months (but not 12 months) and significantly increased negative symptoms at 12 months. Findings suggest that community-oriented, citizenship interventions for persons with SMI and criminal justice histories may facilitate improved clinical and community outcomes in some domains, but some negative clinical findings suggest the need for post-intervention support for intervention participants. Implications for practice and future research are discussed.

Fidelity criteria are increasingly used in program monitoring and evaluation, but are difficult to derive for emerging models (i.e., those not based on theory or a research demonstration project). We describe steps used to develop and operationalize fidelity criteria for consumer-run (CR) mental health services: articulating and operationalizing criteria based on published literature, then revising and validating the criteria through expert judgments using a modified Delphi method. Respondents rated highest those structural and process components emphasizing the value of consumerism: consumer control, consumer choices and opportunities for decision-making, voluntary participation (and the absence of coercion), and respect for members by staff.