Providing mental health peer support 1: A Delphi study to develop consensus on the essential components, costs, benefits, barriers and facilitators

Abstract

Background: While formalised mental health peer support is on the increase, there continues to be a lack of consensus regarding the peer supporter role. Aim: The aim was to develop consensus on the essential components, personal costs, personal benefits, barriers and facilitators involved in providing mental health peer support. Methods: The Delphi method was used. In the first round, an exhaustive list of statements pertaining to peer support was generated from literature review and consultation with experienced peer supporters. In the second round, 147 UK peer supporters rated statements online or via post, and completed a questionnaire about experiences of providing peer support. Criteria for consensus were applied. Where there was uncertainty, statements were re-rated. Descriptive statistics and group comparisons were calculated. The final statements were grouped thematically. Results: Consensus was reached on statements pertaining to essential components (n = 67), personal benefits (n = 21), barriers (n = 1) and facilitators (n = 35). Formal peer support involves many skills and competencies. Most participants agreed that a wide range of personal benefits come with the role. Organisations may facilitate peer support through their values, actions and oversight. Approximately half of the sample worked in public services and were more likely to have concerns regarding pay and career progression. Conclusion and Implications for Practice: Results define the peer supporter role and add to the knowledge base about optimal conditions for it to thrive. Recommendations are made regarding role development and career progression, and future research to better understand personal costs and benefits.

Peer Support in Mental Health: Literature Review

“…Through an initiative undertaken by SAMHSA via its “Bringing Recovery Supports to Scale Technical Assistance Center Strategy,” a successful identification of abilities and critical knowledge necessarily required for PSWs who provide help and support for those recovering from mental health and substance abuse was noted [ 76 ]. At present, peer support is seen as a growing paradigm in many countries, including the United Kingdom, Canada, New Zealand, France, and the Netherlands [ 103 , 119 ]. As an evolving culture, peer support has the opportunity to forge not just mental health system change but social change as well [ 37 ].…”

“…Organizations may facilitate peer support through their values, actions, and oversight [ 119 ] and through a robust supervision system with available educational access, which could be the adequate path for creating a positive and risk-free environment for PSWs throughout their complex workloads [ 126 ]. On the other hand, ethics committees play essential roles in the inclusion of PSWs in applied research studies by avoiding repetition of the work of other trusted agencies and considering the ethical validity of consent procedures for peer support interventions [ 127 ].…”

Hospital workforce mental reaction to the pandemic in a low COVID-19 burden setting: a cross-sectional clinical study

“…The detected inverse association between age and anxiety is in line with past reports [ 17 , 41 , 42 ] and may be explained by more efficient use of problem-solving-, cognitive restructuring- and express emotion coping strategies with advancing age [ 43 ]. This advantage of advancing age might be useful in implementing and fostering (one-to-one) peer support interventions, which are on the increase worldwide [ 44 – 46 ], to enhance efficacy of hospital workforces in coping with the COVID-19 crisis, although even such interventions are not immune to the detrimental effects of the pandemic crisis and the difficulties related to its management (e.g. social distancing, reliance on communication via internet) [ 47 ].…”

“…shortened shifts, staff involvement in organisational decisions), effective (online) listening and communication [54], easily accessible professional support (e.g. web-or telephone based hotlines, hospital-based teams providing counselling on handling stress) [39] and models such as the structured forum Schwartz rounds [55] and (one-to-one) peer support [44][45][46][47] may contribute to the alleviation of the distress of hospital workforces due to the COVID-19 crisis.…”

Challenges to peer support in low- and middle-income countries during COVID-19

“…In Uganda, where peer support has been available since 2011, the country’s “total lockdown” resulted in a ban on public and private transport, severely restricted outpatient mental health care and closure of rehabilitative and other essential services. As in many countries around the world [ 7 ], Uganda’s PSWs are not salaried employees and instead combine small incentives such as meal and transport allowances with income-generating activities such as farming or petty-trading to make ends meet. Lockdown has put their livelihoods under threat, while also restricting access to the services upon which many PSWs rely to support their own recovery.…”