Social value of supported employment for psychosocial program participants

Strengths, weaknesses, opportunities and threats of peer support among disadvantaged groups: A rapid scoping review

Objective

To explore the current state of knowledge and evidence about peer support for various disadvantaged groups; to identify the strengths, weaknesses, opportunities, and threats of peer support to critically reflect on peer support within health and social services.

Methods

A rapid scoping review was conducted according to Arksey and O'Malley's framework, aiming to identify eligible studies in PubMed, APA PsychInfo, Education Resources Information Center, Cochrane Library, Academic Search Premier, ScienceDirect, Directory of Open Access Journals, ResearchGate, WorldCat, and Google Scholar. According to Rodgers' concept analysis steps and the SWOT model, data was reported using thematic synthesis.

Results

Forty-five studies were included, describing a variety of peer support initiatives among groups of young migrants and unsupervised minors, young adults with autism, people with (mental) health problems, foster/shelter families, vulnerable pregnant women, people outside the labour force, older adults, and homeless people. The strength of peer support is its positive effect on the quality of life among vulnerable people. The weakness is represented by peers both being too involved and focused on personal interest or by peers lacking expertise and knowledge. Opportunities for peer support are mutual learning, the anticipated long-term effects, and the potential to facilitate social inclusion. Culture, language barriers, drop-out rates, securing sustainability, and peers' lack of time and commitment are regarded as threats to peer support.

Conclusion

Although peer support offers good outcomes for various groups of vulnerable people, the weaknesses and threats need to be considered to provide and proliferate peer support.

Rural-urban differences in the mental health of perinatal women: a UK-based cross-sectional study

BACKGROUND

International data suggest that living in a rural area is associated with an increased risk of perinatal mental illness. This study tested the association between rurality and risk for two mental illnesses prevalent in perinatal women - depression and anxiety.

METHODS

Using a cross-sectional design, antenatal and postnatal women were approached by healthcare professionals and through other networks in a county in Northern England (UK). After providing informed consent, women completed a questionnaire where they indicated their postcode (used to determine rural-urban status) and completed three outcome measures: the Edinburgh Postnatal Depression Scale (EPDS), the Whooley questions (depression measure), and the Generalised Anxiety Disorder 2-item (GAD-2). Logistic regression models were developed, both unadjusted and adjusted for potential confounders, including socioeconomic status, social support and perinatal stage.

RESULTS

Two hundred ninety-five participants provided valid data. Women in rural areas (n = 130) were mostly comparable to their urban counterparts (n = 165). Risk for depression and/or anxiety was found to be higher in the rural group across all models: unadjusted OR 1.67 (0.42) 95% CI 1.03 to 2.72, p = .038. This difference though indicative did not reach statistical significance after adjusting for socioeconomic status and perinatal stage (OR 1.57 (0.40), 95% CI 0.95 to 2.58, p = .078), and for social support (OR 1.65 (0.46), 95% CI 0.96 to 2.84, p = .070).

CONCLUSIONS

Data suggested that women in rural areas were at higher risk of depression and anxiety than their urban counterparts. Further work should be undertaken to corroborate these findings and investigate the underlying factors. This will help inform future interventions and the allocation of perinatal services to where they are most needed.

Correlates of peer support in a clubhouse setting

The purpose of this study was to examine the social support characteristics and correlates of peer networks for Clubhouse members. A random sample of 126 members from one Clubhouse was requested to nominate social network members and asked a series of questions about characteristics of supports provided by each network member. Respondents with both peers and non-peers in their network, three fifths of the sample, had more frequent contacts with peers than with non-peers and were more satisfied with peer relationships than with non-peer relationships. Those respondents also reported that peers were less critical than non-peers. Among all respondents, being Caucasian and having better quality of social life were correlated with having a peer network while higher degree of reliance on others and more Clubhouse visits were correlated with having a Clubhouse network. Longitudinal studies are needed to further investigate the relationship between quality and benefits of peer support.

Who benefits from peer support in psychiatric institutions?

This study examines the influence of recovery-oriented peer events on participants' recovery attitudes and explores who benefits most from such events. Changes in participants' recovery attitudes were evaluated (pre, post, follow-up), and compared with changes of control groups. Distributions of recovery-related values in subgroups were analyzed descriptively. The results of non-parametric tests (Friedman) showed participants with significantly higher values in the dimension Recovery is possible directly after the interventions (P = 0.006), but not 6 months later, and not in comparison with members of control groups. On a descriptive level, women, participants with schizophrenia and with two or more episodes of the disorder showed higher recovery-related values compared to men, participants with an affective disorder and only one episode. Within their feedback, organizations and peers express a positive view of peer support, but evidence for a positive impact of the evaluated peer events on recovery attitude is limited.

A prospective investigation of work and nonvocational outcomes in adults with severe mental illness

This study assessed the impact of steady competitive or noncompetitive employment on nonvocational outcomes for clients with severe mental illness receiving employment services. We conducted a secondary analysis of 2-year data for 187 clients participating in a randomized controlled trial comparing two employment programs. Participants were classified according to 2-year employment outcomes into four groups: steady competitive work, steady noncompetitive work, minimal work, and no work. We compared these groups on 2-year outcomes including symptoms, hospitalizations, quality of life, and social networks. During follow-up, working clients had fewer days of hospitalization than the no-work group. The steady competitive group had greater reduction in negative symptoms than did the no-work group. The steady noncompetitive group showed greater improvement in social networks compared with the other groups. Extended periods of work are associated with improvements in nonvocational outcomes. Beneficial effects may vary according to the type of employment.