Comparative Effectiveness of Integrated Peer Support and Clinical Staffing Models for Community-Based Residential Mental Health Rehabilitation: A Prospective Observational Study

Abstract

This observational study compared the outcomes of consumers receiving community-based residential mental health rehabilitation support in Australia under a clinical staffing model and an integrated staffing model where Peer Support Workers are the majority component of the staffing profile. Reliable and clinically significant (RCS) change between admission and discharge in functional and clinical assessment measures were compared for consumers receiving care under the clinical (n = 52) and integrated (n = 93) staffing models. Covariate analyses examined the impact of known confounders on the outcomes of the staffing model groups. No statistically significant differences in RCS improvement were identified between the staffing models. However, logistic regression modelling showed that consumers admitted under the integrated staffing model were more likely to experience reliable improvement in general psychiatric symptoms and social functioning. The findings support the clinical and integrated staffing models achieving at least equivalent outcomes for community-based residential rehabilitation services consumers.

Co-Production of a Flexibly Delivered Relapse Prevention Tool to Support the Self-Management of Long-Term Mental Health Conditions: Co-Design and User Testing Study

“…Although this may be explained by the fact that many of the participants were peer workers or consumer advocates themselves, this finding mirrors the current movement within mental health services toward the holistic inclusion of lived experience expertise [ 39 ]. Further, integrated staffing models may also be associated with better recovery, including better social functioning [ 40 ]. Taken together, implementation-focused research is needed to determine how MyPREP is actually delivered and how it can be optimized once it is introduced in real-world settings.…”

Riding the tides: Directions in mental health rehabilitation in NSW

“…There is developing literature investigating the benefits of peer-led programs and novel staffing models with integrated peer support workers and clinicians working in a unified team suggesting genuinely improved outcomes. 15 Recent guidelines on rehabilitation for adults with psychosis recognised the need for interventions to be provided by multidisciplinary teams. 11 Collectively, the provision of evidence-based psychosocial interventions requires a re-design of the system that emphasises the value of rehabilitation skills, provided by a specialist workforce that may deviate from traditional professional models, and who are enabled to focus on rehabilitation strategies.…”

Community-based models of care facilitating the recovery of people living with persistent and complex mental health needs: a systematic review and narrative synthesis

“…Furthermore, there is a need for systematic reviews of the evidence for improving individuals' clinical, functional, and personal recovery through specific models of care. Using a whole system perspective, such a review should encompass models of care across both clinical and NGO sectors, as well as blended models of care [e.g., ( 19 , 20 )].…”

“…However, the conditions for recovery are increasingly recognized, including empowerment, choice, and meaningful social engagement free of stigma and discrimination. These conditions may, in turn, foster enhanced participation in treatment and support (17).…”