A community-based peer support service for persons with severe mental illness in China

Abstract

BackgroundPeer support services for patients with severe mental illness (SMI) originated from Western countries and have become increasingly popular during the past twenty years. The aim of this paper is to describe a peer service model and its implementation in China, including the model’s feasibility and sustainability.MethodsA peer support service was developed in four Chinese communities. Implementation, feasibility and sustainability were assessed across five domains: Service process, service contents, peer training and supervision, service satisfaction, and service perceived benefit.ResultsService process: 214 peer support activities were held between July 2013 and June 2016. No adverse events occurred during three years. Each activity ranged from 40 to 120 min; most were conducted in a community rehabilitation center or community health care center. Service content: Activities focused on eight primary topics—daily life skills, social skills, knowledge of mental disorders, entertainment, fine motor skill practice, personal perceptions, healthy life style support, emotional support. Peer training and supervision: Intensive training was provided for all peers before they started to provide services. Regular supervision and continued training were provided thereafter; online supervision supplemented face to face meetings. Service satisfaction: Nineteen consumers (79.2%) (χ2(1) = 12.76, p < 0.001) were satisfied with the peers and 17 consumers (70.8%) (χ2(1) = 8.05, p = 0.005) expressed a strong desire to continue to participate in the service. Fourteen caregivers (93.3%) (χ2(1) = 11.27, p = 0.001) wanted the patients to continue to organize or participate in the service. Service perceived benefit: Six peers (85.7%) (χ2(1) = 3.57, p = 0.059) reported an improvement of working skills. Ten consumers (41.7%) (χ2(1) = 0.05, p = 0.827) reported better social communication skills. Six caregivers (40%) (χ2(1) = 1.67, p = 0.197) observed patients’ increase in social communication skills, five (33.3%) (χ2(1) = 1.67, p = 0.197) found their own mood had been improved.ConclusionsPeer support services for patients with SMI can be sustainably implemented within Chinese communities without adverse events that jeopardize safety and patient stability. Suggestions for future service development include having professionals give increased levels of support to peers at the beginning of a new program. A culturally consistent peer service manual, including peer role definition, peer training curriculum, and supervision methods, should be developed to help implement the service smoothly.

Barriers and Drivers to Service Delivery in Global Mental Health Projects

“…Using participatory approaches to harness peer support in project delivery can improve the level of engagement and participation with bene ciaries. While there is limited evidence for the mental health outcomes (32,33) and sustainability of peer support and family member involvement in service delivery, ndings from this qualitative analysis reinforce positive ndings from the existing literature in this area (34). Given the gaps in the existing evidence, more research is needed before conclusively recommending mechanisms for integrating more comprehensive peer support components in mental health care delivery.…”

A systematic review of influences on implementation of peer support work for adults with mental health problems

“…A stronger focus on grey literature, widening the inclusion criteria and a wider expert consultation, might have identified reports from lowerincome settings, e.g. China [40] and Uganda [41], or related studies such as the ReDeAmericas Program in Latin America (http://www.cugmh p.org/resea rch/redea meric as). Fourth, data extraction was conducted by two analysts on only 10% of included publications, whereas double data extraction is recommended on 100% of included publications [42].…”

Let us say what we need ourselves: report of the interview of mental health service users with schizophrenia in South-West Nigeria.

“…Rai et al (2018) also reported another benefit of mental health service users' involvement in rehabilitation by declaring that mental health service users co-facilitated training reduces the stigma of mental illness. A three-year peer support service among individuals with mental illness in China revealed the active participation of mental health service users serves, through therapeutic use of one another, as a role model for the new clients of recovery goal and rehabilitation service (Fan et al, 2018). This study was able to gather that the rehabilitation plan and choice of activities was directed by health professionals.…”