Feasibility and Preliminary Effectiveness of a Peer-Developed and Virtually Delivered Community Mental Health Training Program (Emotional CPR): Pre-Post Study

Abstract

Background The COVID-19 pandemic has led to a global mental health crisis, highlighting the need for a focus on community-wide mental health. Emotional CPR (eCPR) is a program and practice developed by persons with a lived experience of recovery from trauma or mental health challenges to train community members from diverse backgrounds to support others through mental health crises. eCPR trainers have found that eCPR may promote feelings of belonging by increasing supportive behaviors toward individuals with mental health problems. Thus, clinical outcomes related to positive and negative affect would improve along with feelings of loneliness. Objective This study examined the feasibility and preliminary effectiveness of eCPR. Methods We employed a pre-post design with 151 individuals, including peer support specialists, service users, clinicians, family members, and nonprofit leaders, who participated in virtual eCPR trainings between April 20, 2020, and July 31, 2020. Instruments were administered before and after training and included the Herth Hope Scale; Empowerment Scale; Flourishing Scale (perceived capacity to support individuals); Mindful Attention Awareness Scale; Active-Empathic Listening Scale (supportive behaviors toward individuals with mental health challenges); Social Connectedness Scale (feelings of belonging and connection with others); Positive and Negative Affect Schedule; and University of California, Los Angeles 3-item Loneliness Scale (symptoms and emotions). The eCPR fidelity scale was used to determine the feasibility of delivering eCPR with fidelity. We conducted 2-tailed paired t tests to examine posttraining improvements related to each scale. Additionally, data were stratified to identify pre-post differences by role. Results Findings indicate that it is feasible for people with a lived experience of a mental health condition to develop a program and train people to deliver eCPR with fidelity. Statistically significant pre-post changes were found related to one’s ability to identify emotions, support others in distress, communicate nonverbally, share emotions, and take care of oneself, as well as to one’s feelings of social connectedness, self-perceived flourishing, and positive affect (P≤.05). Findings indicated promising evidence of pre-post improvements (not statistically significant) related to loneliness, empowerment, active-empathetic listening, mindfulness awareness, and hope. Nonprofit leaders and workers demonstrated the greatest improvements related to loneliness, social connectedness, empathic listening, and flourishing. Peer support specialists demonstrated the greatest improvements related to positive affect, and clinicians demonstrated the greatest improvements related to mindfulness awareness. Conclusions Promising evidence indicates that eCPR, a peer-developed and peer-delivered program, may increase feelings of belonging while increasing supportive behaviors toward individuals with mental health problems and improving clinical outcomes related to positive and negative affect and feelings of loneliness.

Assessing the Feasibility, Acceptability, and Preliminary Effectiveness of a School-Aged Program that Supports Physical Activity and Wellness

“…eCPR is delivered by a lay professional (non-clinically trained) using a manualized workbook. Empirically eCPR is associated with increased empowerment, hope, and quality of life and decreased incidence of psychiatric symptoms and loneliness [ 16 ].…”

An Update of Peer Support/Peer Provided Services Underlying Processes, Benefits, and Critical Ingredients

“…Consequently, the service is more structured today, rather than primarily providing informal support, and may involve the delivery of evidence-based interventions, such as self-management programs including Wellness Recovery Action Planning [11], developed by a peer, and Illness Management and Recovery [12], which was developed by professionals and is delivered by both peers and non-peers [13]. Other programs provided have been developed by peers such as emotional CPR [14] or co-produced by peers and non-peer scientists such as PeerTECH [15,16]. These interventions offer important and practical information and skill teaching while still providing assistance in accessing needed resources and enhancing companionship by sharing experiences and knowledge.…”

A Digital Peer Support Platform to Translate Web-Based Peer Support for Emerging Adult Mental Well-being: Protocol for a Randomized Controlled Trial

“…Our review of the existing literature reveals a limited understanding of how dyadic emotional disclosure and support from friends can collectively function as a digital intervention in support of the mental well-being of emerging adults [ 8 , 22 - 24 ]. Before the pandemic, the administration of digital peer support to a college student population mediated the impact of various psychological and health outcomes [ 25 , 26 ].…”

“…With the onset of the global pandemic, the increase in social connections on the web underscores the potential effectiveness of digital peer emotional disclosure and support to positively affect the psychological well-being of college students [ 2 , 5 , 6 ]. Digital peer support platforms may address specific areas of well-being that include anxiety, depression, and suicidal ideation [ 24 , 27 ]. These findings have provided the impetus for researchers, education stakeholders, and health care professionals to understand the role of peer support on digital platforms in intervening in the psychological well-being of emerging adults, particularly college students.…”

“…Of note, most mHealth platforms on the market are not designed for a specific age group and, even of those used academically, only 13% are designed specifically for emerging adults. Second, despite preliminary literature that highlights the importance of digital intervention, particularly involving peer support, on emerging adults’ psychological well-being, there is a continued need to achieve effective implementation strategies and clinical outcomes [ 24 , 27 ]. The increasing mental health issues that stem from prolonged isolation and reduced social connections associated with the outbreak of COVID-19 further the impetus among researchers, policy makers, and other stakeholders to design effective interventions that consider the need for users to access support remotely.…”