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Documented case studies and co-design and co-production research.
In 2021, the Victorian Mental Health and AOD sectors face their most significant inflection point since deinstitutionalisation in the 1990s. This moment, and the outcomes of this project, present the opportunity to establish a vibrant service system with well trained, supported, and thriving LLE workforces at its core.
This is a vital moment to establish solid foundations, ways of working and to crystalise and safeguard the unique capabilities, contributions and perspectives the LLE workforces bring - something that is vitally needed for the long-term structural reforms ahead.
The Rising Together study was a co-produced study funded by the Centre for Mental Health Learning (CMHL) and led by the University of Melbourne. The study sought to investigate the experiences of family/carer lived experience (LE) workers within the Victorian mental health system, with the aim of better understanding what is needed to ensure the safe and sustainable development of this workforce.
SUMMARY
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.
ABSTRACT
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
ABSTRACT
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.
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.