Peer support in mental health services: where is the research taking us, and do we want to go there?

Gillard, Steve

doi:10.1080/09638237.2019.1608935

Cited by 100 publications

(101 citation statements)

References 34 publications

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“…They also highlight significant methodological limitations in the existing literature, including: the inability to distinguish the effects of peer recovery support from other recovery support activities; the heterogeneous nature of these populations, inconsistency in the definitions of peer workers and recovery coaches; and the lack of any, or appropriate, comparison groups [83]. Similarly, findings to date regarding the effectiveness of peer support in mental health arena remain mixed [18].…”

Section: Discussionmentioning

confidence: 99%

“…People who understood themselves as psychiatric survivors sought reform on, for example, hospital procedures for those in crisis, as well as greater acknowledgement of the social factors that contribute to distress, and the value of lived experience [12]. Research into peer support in mental health services is increasing [17], with recent reviews suggesting that evidence for effectiveness is mixed [18]. This is partially due to a lack of uniform understanding, definitions, and clearly specified job roles for peers in this arena [18].…”

Section: Introductionmentioning

confidence: 99%

“…Research into peer support in mental health services is increasing [17], with recent reviews suggesting that evidence for effectiveness is mixed [18]. This is partially due to a lack of uniform understanding, definitions, and clearly specified job roles for peers in this arena [18].…”

Section: Introductionmentioning

confidence: 99%

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Provision of peer support at the intersection of homelessness and problem substance use services: a systematic ‘state of the art’ review

et al. 2020

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Background: Peer support refers to a process whereby individuals with lived experience of a particular phenomenon provide support to others by explicitly drawing on their personal experience. It has been adopted in a variety of service contexts including homelessness, substance use, mental and physical health. Those who experience homelessness have some of the most complex intersecting health and social challenges. This 'state of the art' review provides a systematic search and synthesis of literature examining use of peer support models within services for people impacted by homelessness and problem substance use. Methods: A systematic search using six databases (CINAHL, SocINDEX, PsycINFO, MEDLINE, Scopus and Web of Knowledge) was conducted in August 2019 and identified 2248 papers published in English after the year 2000. After de-duplication and scanning titles/abstracts, 61 papers were deemed relevant. Three more papers (including one grey literature report) were identified via references, but two papers were later excluded due to relevance. The final 62 papers included studies conducted in five countries. A thematic analysis approach was used to compare and contrast the study findings and provide a synthesis of the main learning points. Results: In recent years there has been a substantial increase in research examining the utility of peer support yet there is significant variation across this field. Alongside profiling the range of settings, aims, populations, and main outcomes of these studies, this paper also provides an overview of overarching themes: the overall effectiveness and impact of peer-staffed or peer-led interventions; and challenges commonly faced in these roles. Five themes relating to the challenges faced by peers were identified: vulnerability, authenticity, boundaries, stigma, and lack of recognition. Conclusions: While our findings provide support for current efforts to involve individuals with lived experience in providing peer support to those experiencing concurrent problem substance use and homelessness, they also urge caution because of common pitfalls that can leave those providing the support vulnerable. We conclude that peers should be respected, valued, supported, and compensated for their work which is often profoundly challenging. Suggested guidelines for the implementation of peer involvement in research studies and service delivery are presented.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Provision of peer support at the intersection of homelessness and problem substance use services: a systematic ‘state of the art’ review

et al. 2020

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“…This study addresses several knowledge gaps and limitations in previous RCT designs and is in line with calls to continue to research and improve the quality of studies on peer support in mental health [6,58]. First, evaluating the development of an effective peer intervention using a longitudinal design combining both quantitative and qualitative methods has been previously recommended [59].…”

Section: Discussionmentioning

confidence: 52%

“…Further, it will focus on social inclusion as the primary outcome, alongside other outcomes directly related to personal recovery, in line with established definitions of mental health peer support [8,59,61]. In addition, the study will include mental health and economic outcomes reported to be missing from many studies of peer support, according to previous reviews [6,58].…”

Section: Discussionmentioning

confidence: 99%

Peer support for people with severe mental illness versus usual care in high-, middle- and low-income countries: study protocol for a pragmatic multicentre randomised controlled trial (UPSIDES-RCT)

Moran

Kalha

Mueller-Stierlin³

et al. 2020

Preprint

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Background: Peer support is an established intervention involving a person recovering from mental illness to support others with mental illness.. Peers are an under-used resource in global mental health. Building upon comprehensive formative research, this study will rigorously evaluate the impact of peer support at multiple levels, including: service user outcomes (psychosocial and clinical); peer support worker outcomes (work role, empowerment); service outcomes (cost-effectiveness, return on investment); and implementation outcomes (adoption, sustainability, organisational change). Methods: UPSIDES-RCT is a pragmatic parallel-group multi-centre randomised controlled trial assessing the effectiveness of UPSIDES at four measurement points over one year (baseline, 4-, 8-, and 12-month follow-up), with embedded process evaluation and cost-effectiveness analysis. Research will take place in a range of high-, middle- and low-income countries (Germany, United Kingdom, Israel, India, Uganda, Tanzania). The primary outcome is social inclusion of service users with severe mental illness (N= 558; N = 93 per site) at 8-month follow-up, measured with the Social Inclusion Scale. Secondary outcomes include empowerment (Empowerment Scale), hope (HOPE scale), recovery (Stages of Recovery), and health and social functioning (Health of the Nations Outcome Scales). Mixed-methods process evaluation will investigate mediators and moderators of effect, and implementation experiences of four UPSIDES stakeholder groups (service users, peer support workers, mental health workers, policy makers). A cost-effectiveness analysis examining cost-utility and health budget impact will estimate the value for money of UPSIDES peer support. Discussion: The UPSIDES-RCT will explore the essential components necessary to create a peer support model in mental health care, while providing the evidence required to sustain and eventually scale-up the intervention in different cultural, organisational and resource settings. By actively involving and empowering service users, UPSIDES will move mental health systems toward a recovery orientation, emphasising user-centeredness, community participation, and the realisation of mental health as a human right.

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A systematic scoping review of peer support interventions in integrated primary youth mental health care

Murphy,

Huggard,

Fitzgerald

et al. 2023

Journal Community Psychology

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Peer support, defined as the social and emotional support offered and received by individuals with a shared experience of mental health difficulties, is gaining popularity in youth mental health settings. This systematic scoping review aimed to collate and synthesise the evidence on key aspects of peer support interventions within integrated youth services and educational settings. Specifically, it synthesised evidence on the (1) assessed mental health outcomes in peer support interventions, (2) key characteristics and associated roles of peer support workers (PSWs) and (3) barriers and facilitators to implementation. A search of peer reviewed articles from January 2005 to June 2022 across five electronic databases (PsychINFO, Pubmed, Scopus, ERIC and CINAHL) was conducted. A total of 15 studies retrieved in the search met the inclusion criteria and were included in the review. This review supports previous research indicating that peer support has potential for improving recovery related outcomes. While a variety of interventions and PSW roles were reported, studies could be strengthened by providing more in‐depth information on intervention content. Examples of barriers to implementation included staff concerns around confidentiality of peer support relationships as well as PSWs' confidence in their roles. Facilitators included positive support from staff members and role clarity.

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Peer support in mental health services: where is the research taking us, and do we want to go there?

Cited by 100 publications

References 34 publications

Provision of peer support at the intersection of homelessness and problem substance use services: a systematic ‘state of the art’ review

Provision of peer support at the intersection of homelessness and problem substance use services: a systematic ‘state of the art’ review

Peer support for people with severe mental illness versus usual care in high-, middle- and low-income countries: study protocol for a pragmatic multicentre randomised controlled trial (UPSIDES-RCT)

A systematic scoping review of peer support interventions in integrated primary youth mental health care

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