Documented case studies and co-design and co-production research.
Introduction: The importance of peer support workers in mental health care delivery has been extensively advocated for in mental health policy frameworks. However, there has been limited research examining the implementation of paid peer workers in clinical settings.
This study explores the experience of paid peer support workers integrated within a clinically-operated community-based residential rehabilitation service for people diagnosed with a mental health disorder experiencing challenges living independently in the community.
Methods: A general inductive approach was taken in the analysis of diaries completed by a newly employed peer workforce. These diaries focussed on what they viewed as significant interactions in fulfilling their role. Composite vignettes were generated to illustrate key themes.
Findings: Thirty-six diaries were provided; these reported unplanned and spontaneously occurring interactions. Peer workers emphasized the importance of connecting with people while they were engaging in everyday activities as an opportunity for personal growth of the residents. The diaries also focussed on the peer workers’ ability to connect and establish trust by sharing similar experiences with residents or family members. Peer workers also believed that they brought a different perspective than clinical staff and were able to refocus attention from clinical diagnoses and symptoms to other aspects of the resident’s lives.
Discussion: Peer support workers described their work as flexible, responsive, and adaptable to the resident’s needs. They believed that their roles brought a different lens to interactions on the unit and fostered a more inclusive and personal way of working for the team.
Conclusion: To ensure that peer workers can engage authentically with residents and family members, it is critical that the role and principles of peer work are valued and understood by all.
Background: Peer support is being introduced into mental health services internationally, often in response to workforce policy. Earlier systematic reviews incorporate different modalities of peer support (i.e. group and one-toone), offer inconsistent evidence of effectiveness, and also indicate substantial heterogeneity and issues of quality in the evidence base at that time.
An updated review, focussed on one-to-one peer support, is timely given current policy interest. This study aims to systematically review evidence for the effectiveness of one-to-one peer support interventions for adults using mental health services, and to explore heterogeneity in peer support interventions.
Method: We searched MEDLINE, PsycINFO, Embase, CINAHL and Cochrane databases from inception until 13 June 2019. Included studies were assessed for risk of bias, and meta-analyses conducted where multiple trials provided usable data. Results: Twenty-three studies reporting nineteen trials were eligible, providing data from 3329 participants. While seven trials were of low to moderate risk of bias, incomplete reporting of data in many studies suggested bias in the evidence base. Peer support interventions included peer workers in paraclinical roles (e.g. case manager), providing structured behavioural interventions, or more flexible support for recovery. Meta-analyses were conducted for eleven outcomes, with evidence that one-to-one peer support may have a modest positive impact on self-reported recovery and empowerment. There was no impact on clinical symptoms or service use. Analyses of heterogeneity suggest that peer support might improve social network support.
Conclusions: One-to-one peer support in mental health services might impact positively on psychosocial outcomes, but is unlikely to improve clinical outcomes. In order to better inform the introduction of peer support into mental health services, improvement of the evidence base requires complete reporting of outcome data, selection of outcomes that relate to intervention mechanisms, exploration of heterogeneity
Background: The employment of Peer Support Workers, who themselves have experience of significant emotional distress, can promote recovery at an individual and organisational level. While research examining the benefits of peer support within mental health services continues to grow, an understanding of how, and through what processes, these benefits are reached remains under-developed.
Aims: To review the published research literature relating to the process of peer support and its underpinning mechanisms to better understand how and why it works.
Method: A scoping review of published literature identified studies relating to peer support mechanisms, processes and relationships. Studies were summarised and findings analysed.
Results: Five mechanisms were found to underpin peer support relationships (lived experience, love labour, the liminal position of the peer worker, strengths-focussed social and practical support, and the helper role).
Conclusions: The identified mechanisms can underpin both the success and difficulties associated with peer support relationships. Further research should review a broader range of literature and clarify how these mechanisms contribute to peer support in different contexts.
In 2018, The Consumer Perspective Supervision Project (a partnership between the Victorian Mental Illness Awareness Council, Centre for Psychiatric Nursing, University of Melbourne and the Department of Health and Human Services) co-produced a framework on consumer perspective supervision: Consumer Perspective Supervision: A framework for supporting the consumer workforce.
This innovative framework provides a strong foundation for the development of consumer perspective supervision in Victoria. At two consultations conducted in 2018 by Inside Out & Associates Australia, participants were invited to bring favourite resources that they used in their work. Where applicable, these resources are incorporated into the annotated summary.
Background: Patient involvement in psychiatry education is required by policy and has many benefits for students. Little research has focused on the impact on expert patients (EPs).
Objective: This study aimed to explore the impact of involvement in psychiatry education on mental health patients.
Design: A qualitative descriptive study using semistructured interviews was conducted in a psychiatry teaching unit in the East Midlands, UK. A purposive sample of 20 EPs involved in teaching was interviewed about the social and psychological impacts of involvement. Transcripts were analysed thematically and a coding scheme was developed.
Results: Five themes were identified: shaping the doctors of the future-something worthwhile, challenging assumptions about mental health, recovery and transformation, vulnerability and support and expertise and power.
Conclusion: These EPs benefitted from their experience of teaching. Involvement in psychiatry teaching may require putting oneself in a vulnerable position, but a supportive and open faculty team may mitigate this challenge. The Expert Patient Programme was seen as a way of helping to reduce the power difference between patients and doctors in the future. There is a need to examine the language that we use to talk about patient involvement as this may have implications for this power dynamic. The context and mechanisms that lead to the benefits described by participants should be studied so that these benefits may be generalized to other contexts.
Patient contribution: An EP was involved in the planning and ethical approval application process of the project and the drafting and approval of this manuscript.
The National Mental Health Consumer and Carer Forum and the National Primary Health Network Mental Health Lived Experience Engagement Network acknowledge the Traditional Custodians of the lands and waters on which we work and live on across Australia. We recognise their continuing connection to land, waters, culture and community. We pay our respects to Elders past and present.
“A lived experience recognises the effects of ongoing negative historical impacts and or specific events on the social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples. It encompasses the cultural, spiritual, physical, emotional and mental wellbeing of the individual, family or community.
“People with lived or living experience of suicide are those who have experienced suicidal thoughts, survived a suicide attempt, cared for someone through a suicidal crisis, been bereaved by suicide or having a loved one who has died by suicide, acknowledging that this experience is significantly different and takes into consideration Aboriginal and Torres Strait Islander peoples ways of understanding social and emotional wellbeing.” - Aboriginal and Torres Strait Islander Lived Experience Centre
We welcome Aboriginal and Torres Strait Islander people to this site and invite them to provide any feedback or items for inclusion.
We also recognise people with lived and living experience of mental ill-health and recovery and the experience of people who are carers, families, kin, or supporters.