Initial Training for Mental Health Peer Support Workers: Systematized Review and International Delphi Consultation

Abstract

Background Initial training is essential for the mental health peer support worker (PSW) role. Training needs to incorporate recent advances in digital peer support and the increase of peer support work roles internationally. There is a lack of evidence on training topics that are important for initial peer support work training and on which training topics can be provided on the internet. Objective The objective of this study is to establish consensus levels about the content of initial training for mental health PSWs and the extent to which each identified topic can be delivered over the internet. Methods A systematized review was conducted to identify a preliminary list of training topics from existing training manuals. Three rounds of Delphi consultation were then conducted to establish the importance and web-based deliverability of each topic. In round 1, participants were asked to rate the training topics for importance, and the topic list was refined. In rounds 2 and 3, participants were asked to rate each topic for importance and the extent to which they could be delivered over the internet. Results The systematized review identified 32 training manuals from 14 countries: Argentina, Australia, Brazil, Canada, Chile, Germany, Ireland, the Netherlands, Norway, Scotland, Sweden, Uganda, the United Kingdom, and the United States. These were synthesized to develop a preliminary list of 18 topics. The Delphi consultation involved 110 participants (49 PSWs, 36 managers, and 25 researchers) from 21 countries (14 high-income, 5 middle-income, and 2 low-income countries). After the Delphi consultation (round 1: n=110; round 2: n=89; and round 3: n=82), 20 training topics (18 universal and 2 context-specific) were identified. There was a strong consensus about the importance of five topics: lived experience as an asset, ethics, PSW well-being, and PSW role focus on recovery and communication, with a moderate consensus for all other topics apart from the knowledge of mental health. There was no clear pattern of differences among PSW, manager, and researcher ratings of importance or between responses from participants in countries with different resource levels. All training topics were identified with a strong consensus as being deliverable through blended web-based and face-to-face training (rating 1) or fully deliverable on the internet with moderation (rating 2), with none identified as only deliverable through face-to-face teaching (rating 0) or deliverable fully on the web as a stand-alone course without moderation (rating 3). Conclusions The 20 training topics identified can be recommended for inclusion in the curriculum of initial training programs for PSWs. Further research on web-based delivery of initial training is needed to understand the role of web-based moderation and whether web-based training better prepares recipients to deliver web-based peer support.

Training of Lived Experience Workforces: A Rapid Review of Content and Outcomes

“…Moreover, to ensure the sustainability of LLE work, content related to self-care and self-disclosure through meaningful and safely structured sharing of personal stories is key. Many of these content areas are consistent with prior literature noting the importance of their inclusion in initial training programs for peer support workers (Charles et al, 2021). Future trainings that include these components may optimise positive outcomes for trainees.…”

“…Future trainings that include these components may optimise positive outcomes for trainees. Ideally, adequate coverage of important topics and content areas would be ensured through the development of standardised processes for curriculum development and LLE workforce accreditation (Charles et al, 2021).…”

“…In light of the COVID-19 climate whereby online delivery of a variety of adult education and training and other types of interventions has become routine, online provision of training has become more acceptable and indeed an expected avenue for improved accessibility. A recent Delphi study examining the feasibility of online delivery of training topics for peer support workers found online delivery to be acceptable with the caveat that blended modalities were used, including some face-to-face learning or concurrent inperson support from a trainer (Charles et al, 2021). Greater availability of self-paced learning online and hybrid trainings may increase access otherwise limited by geographic or other constraints such as time constraints and ongoing life challenges faced by this workforce and provide opportunities for trainees to catch up on missed sessions (Colon et al, 2010;Deren et al, 2012;Treloar et al, 2012).…”

Experiences of peer support workers supporting individuals with substance use disorders in Egypt: phenomenological analysis

“…Participants described the high cost and limited access to PSW training, particularly with low pay and long working shifts of PSWs in Egypt, so not everyone can access it. Different training approaches employed in Egypt for PSWs warrants attention as essential elements in PSW training may be missing and a consensus should be reached to establish essential training components as the case in the Delphi study of Charles and colleagues [ 43 ]. Organizations which assist PSWs to combine the technical and competency-based aspect of the job through training with the reflexive, value-driven, and artistic aspect of PSW (lived experience) will enhance the professionalism of PSWs [ 50 ].…”

UPSIDES Mental Health Peer Support in Face of the COVID-19 Pandemic: Actions and Insights

“…The developed intervention was thus informed by multiple inputs including: (1) systematic reviews of PSW trainings and organizational influences on the implementation of peer interventions (Ibrahim et al, 2020 ); (2) previous experience of each consortium partner in delivering peer support trainings and interventions; (3) focus groups and expert panels informing current state and needs at each study site (Puschner et al, 2019 ); a pilot intervention study (Nixdorf et al, 2022 ). All of these combined together informed UPSIDES initial intervention and then its modifications (Charles et al, 2021 ; Nixdorf et al, 2022 ).…”