Digital Peer Support Mental Health Interventions for People With a Lived Experience of a Serious Mental Illness: Systematic Review

Abstract

Background Peer support is recognized globally as an essential recovery service for people with mental health conditions. With the influx of digital mental health services changing the way mental health care is delivered, peer supporters are increasingly using technology to deliver peer support. In light of these technological advances, there is a need to review and synthesize the emergent evidence for peer-supported digital health interventions for adults with mental health conditions. Objective The aim of this study was to identify and review the evidence of digital peer support interventions for people with a lived experience of a serious mental illness. Methods This systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) procedures. The PubMed, Embase, Web of Science, Cochrane Central, CINAHL, and PsycINFO databases were searched for peer-reviewed articles published between 1946 and December 2018 that examined digital peer support interventions for people with a lived experience of a serious mental illness. Additional articles were found by searching the reference lists from the 27 articles that met the inclusion criteria and a Google Scholar search in June 2019. Participants, interventions, comparisons, outcomes, and study design (PICOS) criteria were used to assess study eligibility. Two authors independently screened titles and abstracts, and reviewed all full-text articles meeting the inclusion criteria. Discrepancies were discussed and resolved. All included studies were assessed for methodological quality using the Methodological Quality Rating Scale. Results Thirty studies (11 randomized controlled trials, 2 quasiexperimental, 15 pre-post designs, and 2 qualitative studies) were included that reported on 24 interventions. Most of the studies demonstrated feasibility, acceptability, and preliminary effectiveness of peer-to-peer networks, peer-delivered interventions supported with technology, and asynchronous and synchronous technologies. Conclusions Digital peer support interventions appear to be feasible and acceptable, with strong potential for clinical effectiveness. However, the field is in the early stages of development and requires well-powered efficacy and clinical effectiveness trials. Trial Registration PROSPERO CRD42020139037; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID= 139037

Strategies to Increase Peer Support Specialists’ Capacity to Use Digital Technology in the Era of COVID-19: Pre-Post Study

“…As people shelter in place and practice social distancing due to COVID-19, a peer support specialist workforce with proper training may play a powerful role in digitally supporting the needs of people in the community. Although the field of digital peer support is in its infancy [ 32 ], the expansion of digital peer support through wide-scale Medicaid reimbursements and standards training will potentially have applications in improving the health and wellness of service users during the COVID-19 pandemic. The Digital Peer Support Certification shows promising evidence of increasing the capacity of peer support specialists to use specific digital peer support technology features (eg, SMS text messaging, ecological momentary assessments on smartphone apps, and goal setting).…”

“…Digital peer support has potential to expand the reach of peer support services, improve the impact of peer support without the need for in-person sessions, and increase engagement among mental health service users [ 1 - 3 ]. Digital peer support is defined as live or automated peer support services delivered through technology mediums [ 4 ].…”

“…These training sessions are short in duration [ 6 ], build on already existing skill sets, and focus on rapid attainment of skills and concepts [ 6 ]. Digital peer support is quickly expanding worldwide in the wake of the COVID-19 pandemic [ 3 ]; therefore, telemental health training developed for peer support specialists is currently needed.…”

“…Using the framework for an Academic-Peer Partnership [ 11 ], we developed the Digital Peer Support Certification, which is designed specifically for peer support specialists (both Medicaid-billable peer specialists in traditional clinical services and peer specialists working for peer-run organizations) who deliver peer support via technology mediums in any country worldwide. This study examined the extent to which implementation of the Digital Peer Support Certification over three consecutive months impacted peer support specialists’ capacity to use a digital peer support smartphone app and care management dashboard, PeerTECH [ 1 - 3 ].…”

Primary Care Peer-Supported Internet-Mediated Psychological Treatment for Adults With Anxiety Disorders: Mixed Methods Study

“…The mental health sector has recently seen an increase in the use of peer support workers (PSWs) [ 17 , 18 ]. A peer support worker is a person with lived experience of mental health problems and rehabilitation who is employed in the mental health sector and becomes professionally active in recovery and support services for patients with mental health problems [ 19 - 21 ]. The PSW publicly identifies as a person who has received or is receiving mental health services [ 20 ] and has recovered enough from their mental illness to manage that illness and live a fulfilling life [ 19 ].…”