Peer support among individuals with severe mental illness: A review of the evidence
Larry Davidson2006, Clinical Psychology: Science and Practice
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Abstract
This article reviews the history and potential effectiveness of peer support among persons with severe mental illness. Following a historical overview, we describe the three primary forms of peer support that have been developed t o date by and for this population, and examine the existing empirical evidence of the feasibility, effectiveness, and utilization of each of these approaches in contributing t o the recovery of individuals with psychiatric disabiliies. These three forms are (1) naturally occumng mutual support groups, (2) consumer-run senices, and (3) the employment of consumers as providers within clinical and rehabilitative settings. Existing studies of mutual support groups suggest that they may improve symptoms, promote larger social networkr, and enhance quality of life. This research is largely from uncontrolled studies, however, and will need t o be evaluated further using prospective, controlled designs. Consumer-run services and the use of consumers as providers promise t o broaden the access of individuals with psychiatric disabilities t o peer support, but research on these more recent developments is only preliminary and largely limited t o demonstrations of their feasibility. We discuss issues entailed in participating in peer support for this population, and then close with a discussion of the implications for future policy, research, and practice.
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Revista de Psiquiatria Clínica, 2014
Background: Peer support is a mutual aid system based on the belief that someone who faced/overcome adversity can provide support, encouragement and guidance to those who experience similar situations. Objective: To conduct a systematic review that describes this concept and characterizes peer supporters, its practice and efficacy. Method: Research on ISI Web of Science, EBSCO Psychology and Behavioral Sciences Collection and Medline databases (from 2001 to December 2013) was conducted using as keywords "mental illness", "mental health", "psychiatric disability", "mental health services", combined with "peer support", "mutual support", "self-help groups", "consumers as providers", "peer-run services", "peer-run programs" and "social support". Results: We found 1,566 articles and the application of both the exclusion (studies with children, teenagers and elderly people; disease in comorbidity; peer support associated to physical illnesses or family members/caregivers) and the inclusion criteria (full text scientific papers, peer support or similar groups directed for schizophrenia, depression, bipolar or psychotic disorders) lead to 165 documents, where 22 were excluded due to repetition and 31 to incomplete text. We analyzed 112 documents, identifying as main peer support categories: characterization, peer supporter, practices and efficacy. Discussion: Despite an increasing interest about this topic, there is no consensus, suggesting realizing more studies.
Peer support among persons with severe mental illnesses: A review of evidence and experience
World Psychiatry, 2012
Peer support for people with psychiatric illness
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This chapter focuses on peer support: when individuals with lived experience of mental illness provide support to others with similar lived experiences. It specifically explores peer support in the behavioral health workforce. It offers a comprehensive overview of peer support by addressing what peer support is, why it is needed, and what it does to effect change. It also provides a review of the effectiveness research on peer support, specific roles of peer supporters in practice, and ways to more effectively partner with peer supporters in the behavioral health field. Last a case example is given to highlight the efforts and lessons learned implementing peer supporters in the US Department of Veterans Affairs.
Peer Support Among Adults With Serious Mental Illness: A Report From the Field
Schizophrenia Bulletin, 2005
Peer Support Services for Individuals With Serious Mental Illnesses: Assessing the Evidence
Psychiatric Services, 2014
Literature for outcome studies of peer support services from 1995 through 2012. They found 20 studies across three service types: peers added to traditional services, peers in existing clinical roles, and peers delivering structured curricula. Authors judged the methodological quality of the studies using three levels of evidence (high, moderate, and low). They also described the evidence of service effectiveness. Results: The level of evidence for each type of peer support service was moderate. Many studies had methodological shortcomings, and outcome measures varied. The effectiveness varied by service type. Across the range of methodological rigor, a majority of studies of two service typespeers added and peers delivering curricula-showed some improvement favoring peers. Compared with professional staff, peers were better able to reduce inpatient use and improve a range of recovery outcomes, although one study found a negative impact. Effectiveness of peers in existing clinical roles was mixed. Conclusions: Peer support services have demonstrated many notable outcomes. However, studies that better differentiate the contributions of the peer role and are conducted with greater specificity, consistency, and rigor would strengthen the evidence.
A Little Goes a Long Way: The Impact of Distal Social Support on Community Integration and Recovery of Individuals with Psychiatric Disabilities
2013
Although an extensive body of literature highlights the important role of social support for individuals with psychiatric disabilities, definitions of support tend to be restricted-focusing on intimate relationships such as friend and family networks and ignoring the role of casual relationships existing naturally in the community. This mixed-methods study of 300 consumers of mental health services in the Southeastern US aims to better understand the impact of community supports, termed distal supports, on community integration and recovery from mental illness. Qualitative content analysis, tests of group mean differences, and hierarchical linear regression analyses revealed the following: (1) participants primarily reported receiving tangible support (e.g., free medication/discounted goods) from distal supports rather than emotional support (e.g., displays of warmth/affection) or informational support (e.g., provision of advice); (2) women and older participants reported more distal supports than men or younger participants; and (3) distal supports played a unique role in predicting community integration and recovery even after accounting for the influence of traditional support networks. Results highlight the importance of considering diverse types of social support in naturally occurring settings when designing treatment plans and interventions aimed at encouraging community participation and adaptive functioning for individuals with psychiatric disabilities.
Peer Support for Youth and Young Adults who Experience Serious Mental Health Conditions: State of the Science
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Peer support is a quickly emerging workforce in mental health services generally (Cronise, Teixeira, Rogers, & Harrington, 2016; Lloyd-Evans et al., 2014; Myrick & del Vecchio, 2016), and increasing its availability has been advocated by service users, researchers, and government commissions (Faulkner & Bassett, 2012; Halvorson & Whitter, 2009; Myrick & del Vecchio, 2016; U.S. Department of Health and Human Services, 2004). Peer support is based on the idea that people who have experienced and overcome a particular type of adversity can serve as source of support, encouragement and hope to others experiencing similar situations, and may also be uniquely positioned to promote service engagement (Davidson, Chinman, Sells & Rowe, 2006; Myrick & del Vecchio, 2016; Lloyd-Evans, et al., 2014).
Self-Initiated Helping Behaviors and Recovery in Severe Mental Illness: Implications for Work, Volunteerism, and Peer Support
Psychiatric Rehabilitation Journal, 2015
Moran, G. S., Russinova, Z, Gidugu, V, Yim, JY, Sprauge, C. (2012). Benefits and mechanisms of peer providers with mental illnesses. First published on September, 7, 2011, doi: 10.1177/1049732311420578 Qualitative Health Research 22, 304-319.
Providing peer support to individuals with psychiatric disabilities has emerged as a promising modality of mental health services. These services are delivered by individuals who experience mental illnesses themselves. The purpose of this study was to explore how working as a peer provider can enhance personal recovery. The study was conducted with 31 peer providers employed in a variety of mental health agencies. Data were collected through face-to-face semistructured interviews and analyzed using a grounded theory approach. Qualitative analysis revealed a wide range of recovery benefits for the peer providers. The benefits span across five wellness domains: foundational, emotional, spiritual, social, and occupational. In addition, analysis revealed five role-related and five work-environment-related mechanisms of beneficial impact. The role of sharing one's personal story is highlighted as contributing to positively reauthoring one's self-narrative. Implications for peer training, job development, and workplace supports are discussed.
Predictors of Successful Participation in Peer Support Groups for Psychosis
Schizophrenia Research, 2010
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One-to-one peer support is a resource-oriented approach for patients with severe mental illness. Existing trials provided inconsistent results and commonly have methodological shortcomings, such as poor training and role definition of peer supporters, small sample sizes, and lack of blinded outcome assessments. This is a randomised controlled trial comparing one-to-one peer support with treatment as usual. Eligible were patients with severe mental illnesses: psychosis, major depression, bipolar disorder or borderline personality disorder of more than two years' duration. A total of 216 patients were recruited through in- and out-patient services from four hospitals in Hamburg, Germany, with 114 allocated to the intervention group and 102 to the control group. The intervention was one-to-one peer support, delivered by trained peers and according to a defined role specification, in addition to treatment as usual over the course of six months, as compared to treatment as usual alon...
Peer support in mental health services
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Considering international diversity in the implementation of mental health peer support and an increasing research interest in peer support work (PSW), this review focuses on priorities in current research and practice. With grassroots in informal services for people with mental health problems, peer support has been strengthened by the recovery paradigm in mental health policy, and there are steps towards integration in statutory services.
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Authors: Candelaria Mahlke (UKE Medical Center Hamburg) Ute Maria Krämer (King's College London and independent survivor researcher) Thomas Becker (University Ulm), Thomas Bock, UKE Medical Center Hamburg) Abstract Purpose of review: Considering international diversity in the implementation of mental health peer support and an increasing research interest in peer support work (PSW), this review focuses on priorities in current research and practice. With grassroots in informal services for people with mental health problems, peer support has been strengthened by the recovery paradigm in mental health policy, and there are steps towards integration in statutory services. Recent findings: Current issues include benefits of peer support, its efficacy and effectiveness. The value of peer support in formal and informal settings is discussed, and organizational change processes and the challenges in peer support implementation are discussed. Recent studies have identified the need for a clarification of roles, competencies and job structure and for adequate training and supervision. Along with reported benefits for consumer and PSW involvement in care revealed by mixed method studies, destigmatization at the personal and system level is a crucial PSW component. Summary: Various types of peer support merit further evaluation. Assessing the impact of peer support on service users, peer providers and organizations require complex intervention studies, using mixed methods designs with qualitative exploration of underlying processes and experiences to complement high-quality controlled trials.
The meaning of social support for persons with serious mental illness
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Aim-This study sought to better understand the population-specific types of social support relevant to adults living with serious mental illness (SMI). Our study was exploratory and used a qualitative approach that centered on uncovering the types of social support meaningful and relevant to persons with SMI. Method-The sample comprised of 52 adults receiving county mental health services in the San Francisco Bay Area. Data was gathered from six focus groups and analyzed using NVivo10 and Consensual Qualitative Research (CQR;. qualitative domains were identified: a) Supportive Conditions, b) Day-to-Day Living, c) Illness Management, d) Resources and Information, e) Guidance and Advice, and f) Community Participation Support. Discussion-While the six support domains share some broad-based conceptual underpinnings with traditional models of emotional and instrumental support, the domains emerging from our study represent supports uniquely tied to the stressors associated with living with an SMI, and therefore hold conceptual distinction from traditional types of support. Conclusions/Implications-Findings from this study offer a conceptual framework for understanding social support for persons living with SMI and lay the groundwork for the development of a SMI-specific measure of social support. In addition, our research permits future researchers to investigate the conditions under which social support buffers the impact of SMI
1 Effectiveness of one-toone peer support for patients with severe mental illness-a randomised controlled trial
2016
Background One-to-one peer support is a resource-oriented approach for patients with severe mental illness. Existing trials provided inconsistent results and commonly have methodological shortcomings, such as poor training and role definition of peer supporters, small sample sizes, and lack of blinded outcome assessments. Methods This is a randomised controlled trial comparing one-to-one peer support with treatment as usual. Eligible were patients with severe mental illnesses: psychosis, major depression, bipolar disorder or borderline personality disorder of more than two years’ duration. A total of 216 patients were recruited through inand out-patient services from four hospitals in Hamburg, Germany, with 114 allocated to the intervention group and 102 to the control group. The intervention was one-to-one peer support, delivered by trained peers and according to a defined role specification, in addition to treatment as usual over the course of six months, as compared to treatment ...
Service providers' views of psychiatric mutual support groups
Journal of Community Psychology, 2002
The effectiveness of peer support groups in psychosis: a randomized controlled trial
Acta Psychiatrica Scandinavica, 2008
Objective: To investigate the effect of a (minimally) guided peer support group (GPSG) for people with psychosis on social network, social support, self-efficacy, self-esteem, and quality of life, and to evaluate the intervention and its economic consequences.Method: In a multi-center randomized controlled trial with 56 patients in the peer support group and 50 patients in the control condition, patients were assessed at baseline and after the last meeting at 8 months.Results: The experimental group showed GPSG to have a positive effect on social network and social support compared with the control condition. In the experimental condition, high attenders favored over low attenders on increased social support, self-efficacy, and quality of life. Economic evaluation demonstrated groups to be without financial consequences. The GPSG-intervention was positively evaluated.Conclusion: Peer support groups are a useful intervention for people suffering from psychosis by improving their social network.
Benefits of support groups for families of adults with severe mental illness
American Journal of Orthopsychiatry, 1997
uring the past 15 years, support groups
Peer support in mental health services. COP review.
Curr Opin Psychiatry. 2014;27(4):276-81
Abstract PURPOSE OF REVIEW: Considering international diversity in the implementation of mental health peer support and an increasing research interest in peer support work (PSW), this review focuses on priorities in current research and practice. With grassroots in informal services for people with mental health problems, peer support has been strengthened by the recovery paradigm in mental health policy, and there are steps towards integration in statutory services. RECENT FINDINGS: Current issues include benefits of peer support, its efficacy and effectiveness. The value of peer support in formal and informal settings is discussed, and organizational change processes and the challenges in peer support implementation are discussed. Recent studies have identified the need for a clarification of roles, competencies and job structure and for adequate training and supervision. Along with reported benefits for consumer and PSW involvement in care revealed by mixed method studies, destigmatization at the personal and system level is a crucial PSW component. SUMMARY: Various types of peer support merit further evaluation. Assessing the impact of peer support on service users, peer providers and organizations require complex intervention studies, using mixed methods designs with qualitative exploration of underlying processes and experiences to complement high-quality controlled trials.
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