Development and pilot study of a suicide prevention intervention delivered by peer support specialists.

Abstract

Suicide rates in the United States have been increasing in recent years, and the period after an inpatient psychiatric hospitalization is one of especially high risk for death by suicide. Peer support specialists may play an important role in addressing recommendations that suicide prevention activities focus on protective factors by improving hope and connectedness. The present study developed a peer specialist intervention titled Peers for Valued Living (PREVAIL) to reduce suicide risk, incorporating components of motivational interviewing and psychotherapies targeting suicide risk into recovery-based peer support. A randomized controlled pilot study was conducted to assess the acceptability, feasibility, and fidelity of the intervention. A total of 70 adult psychiatric inpatients at high risk for suicide were enrolled into the study. Participants were randomized to usual care (n = 36) or to the 12-week PREVAIL peer support intervention (n = 34). Those in the PREVAIL arm completed an average of 6.1 (SD = 5.0) peer sessions over the course of 12 weeks. Fidelity was rated for 20 peer support sessions, and 85% of the peer specialist sessions demonstrated adequate fidelity to administering a conversation tool regarding hope, belongingness, or safety, and 72.5% of general support skills (e.g., validation) were performed with adequate fidelity. Participants’ qualitative responses (n = 23) were highly positive regarding peer specialists’ ability to relate, listen, and advise and to provide support specifically during discussions about suicide. Findings demonstrate that a peer support specialist suicide prevention intervention is feasible and acceptable for patients at high risk for suicide.

Preventing suicide, promoting resilience: Is this achievable from a global perspective?

“…The recent PREVAIL US pilot study that examined the role of peer support for people who are suicidal showed that peers can instill hope to allow people to know that recovery is possible. All peer support workers who took part in this pilot received training in motivational interviewing, how to listen, how to advise, and how to provide psychosocial support, and the intervention was feasible, acceptable to patients, and effective with a recommendation that there should be fidelity to the peer training program (Pfeiffer, King, Ilgen, et al, ).…”

Peer support programs for people experiencing suicidality – A systematic scoping review of current literature

“…These described seven programs that were from four different countries: USA (3), Germany (2), China (1), and Australia (1), and which varied in setting and design (see Table 1). Of the seven programs, four included an evaluation component (23)(24)(25)(26)(27) and three provided descriptive accounts of a program (28)(29)(30). Four peer support programs provided group support (23)(24)(25)(26)29), two were designed to deliver one-on-one support (27,28) and one program included mixed modes of support (30).…”

“…Of the seven programs, four included an evaluation component (23)(24)(25)(26)(27) and three provided descriptive accounts of a program (28)(29)(30). Four peer support programs provided group support (23)(24)(25)(26)29), two were designed to deliver one-on-one support (27,28) and one program included mixed modes of support (30). Regarding the program settings, two programs were delivered in clinical settings (27,30), two in the community (23,28), two online (24)(25)(26) and one in schools (29).…”

“…Four peer support programs provided group support (23)(24)(25)(26)29), two were designed to deliver one-on-one support (27,28) and one program included mixed modes of support (30). Regarding the program settings, two programs were delivered in clinical settings (27,30), two in the community (23,28), two online (24)(25)(26) and one in schools (29). Salvatore (2010) presented a mixed mode peer support program within a psychiatric hospital (30).…”

“…While this program has been implemented as part of the Montgomery County Emergency Service, evaluation data on its effectiveness has yet to be published. The second program designed for patients in clinical settings was the Peers for Valued Life (PREVAIL) program (27). This program is a one-on-one support service for people who had attempted suicide and were patients of a psychiatric Two programs were set online using data from online messaging boards (24)(25)(26).…”