Peer Specialists in Community Mental Health: Ongoing Challenges of Inclusion

Jones, Nev; Niu, Grace; Thomas, Marilyn; Riano, Nicholas S.; Hinshaw, Stephen P.; Mangurian, Christina

doi:10.1176/appi.ps.201800552

Cited by 22 publications

(13 citation statements)

References 9 publications

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“…Moreover, leaders were aware that sustaining PGLB required ongoing training and technical assistance not only on the intervention, but also on how to deliver and support peer-led services. Despite the growth of the peer specialist workforce in the USA, challenges on how to best recruit, train, supervise, and integrate this workforce into organizations continue to persist [23,24]. These findings are consistent with calls to develop better working environments for peer specialists in behavioral health organizations [24].…”

Section: Discussionsupporting

confidence: 53%

“…Despite the growth of the peer specialist workforce in the USA, challenges on how to best recruit, train, supervise, and integrate this workforce into organizations continue to persist [23,24]. These findings are consistent with calls to develop better working environments for peer specialists in behavioral health organizations [24]. In all, the function of strategies to build organizational capacity is to improve the fit between the intervention being sustained and the operations of the agency, thus creating a fertile context for the new intervention to develop stable programmatic roots so that it can grow and prosper within the agency.…”

Section: Discussionmentioning

confidence: 99%

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Organization leaders’ decisions to sustain a peer-led healthy lifestyle intervention for people with serious mental illness in supportive housing

Cabassa

Stefancic

Bochicchio

et al. 2020

Translational Behavioral Medicine

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Healthy lifestyle interventions that increase physical activity and healthy dietary habits can help improve the physical health of people with serious mental illness (SMI). Yet, these interventions are not implemented in routine practice settings. This mixed methods study examined the decisions that leaders from three supportive housing agencies made as they planned to sustain a peer-led healthy lifestyle intervention for people with SMI at the end of a clinical trial. A combination of implementation strategies that addressed cost concerns, generated local evidence of the intervention’s benefits, and provided ongoing training was identified as important for sustainability. A sustainability model illustrating implementation strategies and mechanisms for supporting three sustainability domains (funding, organizational capacity, and adaptation) was prioritized by participants. Study findings can inform future studies testing strategies and mechanisms to support the sustainability of interventions in routine practice settings to improve the physical health of people with SMI.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Organization leaders’ decisions to sustain a peer-led healthy lifestyle intervention for people with serious mental illness in supportive housing

Cabassa

Stefancic

Bochicchio

et al. 2020

Translational Behavioral Medicine

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“…Accordingly, implementation and dissemination of community-based EBIs for individuals with psychosis may benefit from including components that address the stigma surrounding severe mental illness (Agrest et al ., 2019 ). Our results are consistent with the broader mental health and stigma literature that interventions involving peers should also directly target internalized stigma among service users (Firmin et al ., 2017 ; Pyle et al ., 2018 ; Jones et al ., 2019 ). The findings further extend support for instituting specialized roles for the worker pair that may help in navigating the social hierarchies and enhancing acceptability among users.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a pilot community-based psychosocial intervention for patients with psychoses in Chile and Brazil: a comparative analysis of users' perspectives

et al. 2021

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Background Few studies provide clear rationale for and the reception of adaptations of evidence-based interventions. To address this gap, we describe the context-dependent adaptations in critical time intervention-task shifting (CTI-TS), a manualized recovery program for individuals with psychosis in Rio de Janeiro, Brazil and Santiago, Chile. Implications of the adaptations – incorporating a task-shifting approach and modifying the mode of community-based service delivery – are examined from users' perspectives. Methods A secondary analysis of in-depth interviews with CTI-TS users (n = 9 in Brazil; n = 15 in Chile) was conducted. Using the framework method, we thematically compared how participants from each site perceived the main adapted components of CTI-TS. Results Users of both sites appreciated the task-shifting worker pair to provide personalized, flexible, and relatable support. They wanted CTI-TS to be longer and experienced difficulty maintaining intervention benefits in the long-term. In Chile, stigma and a perceived professional hierarchy toward the task-shifting providers were more profound than in Brazil. Engagement with community-based services delivery in homes and neighborhoods (Chile), and at community mental health centers (Brazil) were influenced by various personal, familial, financial, and social factors. Uniquely, community violence was a significant barrier to engagement in Brazil. Conclusion CTI-TS’ major adaptations were informed by the distinct mental health systems and social context of Santiago and Rio. Evaluation of user experiences with these adaptations provides insights into implementing and scaling-up task-shifting and community-oriented interventions in the region through the creation of specialized roles for the worker pair, targeting sustained intervention effects, and addressing socio-cultural barriers.

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“…Overall, the peer consultants were distrusted. In many cases, worse wage conditions and equipment of workplace were noticed (Ahmed et al, 2015; Burke, 2019; Hurley et al, 2016; Jones, 2019; Kern et al, 2013; Lipfird, 2015; Moran et al, 2013; Watson, 2019; Wrobleski et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

“…The strongist positive side peer support is regular care provided to users contributes to the reduction of their social exclusion, poverty and deteriorating quality of life of their families. However, by sharing their experience, peer consultants risk becoming stigmatized within the community (Ahmed et al, 2015; Austin et al, 2014; Burke, 2019; Gillard et al, 2015; Jones, 2019; Lipfird, 2015; Moran et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Engaging peer consultants in mental health services: Narrative research

Balková

2021

Int J Soc Psychiatry

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Aims: The text deals with the specifics of the new job position of peer consultant in mental health services. The aim is to describe, through a literature search, the involvement of people with mental illness in the position of peer consultant in social services and to identify possible ethical aspects associated with this position. Theoretical background: The problem is viewed from the perspective of the service provider. The involvement of people with experience of mental illness (so-called peer consultants) in mental health services is still a little-known issue. These individuals use their experience of the disease to work with service users and can also act as intermediaries between users and professionals. The way a peer consultant works and his involvement in a team of experts can cause various ethical contradictions. Methods: To clarify the issue, a literature search was used, which was conducted for the period 2012 to 2020. Selected studies were analysed on the basis of focus and presented a connection with the practice, the results were compared. Findings were synthesized according to ethical attributes into categories and conclusions were drawn by subsequent logical deduction. Results: The results indicate a positive benefit of introducing the position to social services focused on mental health care. The positive impact is manifested in working with service user, in the functioning of the organization and also in the impact on the community. Successful implementation of the peer consultant position requires managers to prepare well and become familiar with the possible ethical aspects associated with the position.

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Peer Specialists in Community Mental Health: Ongoing Challenges of Inclusion

Cited by 22 publications

References 9 publications

Organization leaders’ decisions to sustain a peer-led healthy lifestyle intervention for people with serious mental illness in supportive housing

Organization leaders’ decisions to sustain a peer-led healthy lifestyle intervention for people with serious mental illness in supportive housing

Implementation of a pilot community-based psychosocial intervention for patients with psychoses in Chile and Brazil: a comparative analysis of users' perspectives

Engaging peer consultants in mental health services: Narrative research

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