1
|
Egmose CH, Poulsen CH, Bjørkedal STB, Eplov LF. The 'Paths to everyday life' (PEER) trial - a qualitative study of mechanisms of change from the perspectives of individuals with mental health difficulties participating in peer support groups led by volunteer peers. BMC Psychiatry 2024; 24:555. [PMID: 39138435 DOI: 10.1186/s12888-024-05992-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 07/29/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Worldwide, peers support has been shown to play a crucial role in supporting people with mental illness in their personal recovery process and return to everyday life. Qualitiative studies underpinning the mechanisms of change in peer support has been reviewed. However, the findings are primeraly based on the perspectives of peer support workers employed in mental health services. Thus, qualitiative studies elucidating the mechanisms of change from the recipient perspective in mental health service independent civil society settings are higly needed to further contribute to the evidence of peer support. The 'Paths to every day life' (PEER) is evaluated in a randomized trial and is substantiated by qualitative studies investigating the experiences of PEER from the perspectives of the recipients and the facilitators of peer support. The purpose of this qualitative study underpinned by critical realism was to substantiate the PEER intervention program theory by gaining deeper insight into the change mechanisms and elaborate how, when, and under what circumstances the peer support groups potentially had or did not have an impact on personal recovery from the perspectives of the recipients of peer support. METHODS Eleven individuals were interviewed at the end of the ten-week group course. The semi-structured realist-inspired interviews were audio recorded and transcribed verbatim. The analysis was guided by reflective thematic analysis and through an abductive framework based on the program theory. Data were coded and analysed in Nvivo software. RESULTS Four overarching themes were identified that informed and nuanced the program theory: 1) Connectedness as a prerequisite for engagement; 2) A sense of hope by working out new paths to recovery; 3) Seeing new sides of oneself; and 4) Sprout for change. CONCLUSIONS This study substantiates the program theory and the quantitative results of the PEER trial by elaborating on mechanisms that were felt to be essential for the personal recovery process from the perspectives of the recipients of the group-based peer support. In addition, the study points out that the opportunities to act in everyday life depended on individual context and where the group participants were on their recovery journey. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT04639167.
Collapse
Affiliation(s)
- Cecilie Høgh Egmose
- Copenhagen Research Unit for Recovery, Mental Health Centre Amager, Hans Bogbinders Allé 3, 3. Floor, Copenhagen S, 2300, Denmark
| | - Chalotte Heinsvig Poulsen
- Copenhagen Research Unit for Recovery, Mental Health Centre Amager, Hans Bogbinders Allé 3, 3. Floor, Copenhagen S, 2300, Denmark.
| | - Siv-Therese Bogevik Bjørkedal
- Copenhagen Research Unit for Recovery, Mental Health Centre Amager, Hans Bogbinders Allé 3, 3. Floor, Copenhagen S, 2300, Denmark
| | - Lene Falgaard Eplov
- Copenhagen Research Unit for Recovery, Mental Health Centre Amager, Hans Bogbinders Allé 3, 3. Floor, Copenhagen S, 2300, Denmark
| |
Collapse
|
2
|
Leah P, Riewpaiboon W, Sirirungruang I, Visuttipun P. Feasibility of online psychosocial interventions to promote mental health recovery and well-being. Int J Soc Psychiatry 2024:207640241264656. [PMID: 39104060 DOI: 10.1177/00207640241264656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
BACKGROUND Amid the increasing trend and huge impact of mental illness, psychosocial support (PSS) has been asserted to support individuals' recovery. Unfortunately, about 80% of affected people cannot access care as needed. Meanwhile, digital technology has a considerable role in closing service gaps. AIMS This convergent parallel mixed methods study examines existing mental health service utilization, users' needs for PSS, and feasibility of online PSS development. METHODS A cross-sectional interview survey was conducted using a semi-structured questionnaire at a super tertiary psychiatric hospital in Thailand from March to May 2023, with three groups of service users, having self-perceived conditions/diagnosis of schizophrenia (n = 100), mood disorders (n = 84), and others including alcohol and substance use, anxiety and personality disorders (n = 52). Four focus group discussions with three user groups (n = 16) and one multidisciplinary provider group (n = 7) were parallelly executed. Quantitative and qualitative data were convergently analyzed using descriptive and inferential statistics, and thematic and content analysis. RESULTS Critical shortcomings of PSS were indicated by 75.8% of user participants. Six common types of self-determined PSS were psychoeducational program, support group, skills training, counseling, supported employment, and complimentary therapy. While psychoeducational program was feasible, support group, and counseling were possibly featured within the 'all-at-once' online intervention development. CONCLUSIONS PSS development based on users' needs can promote clinical and personal recovery outcomes, and close the service gaps. Users with mood disorders have the potential for online interventions. Peer-provider formalization, co-production approach, community engagement, digital literacy, infrastructures, and equal access factors are crucial for sustainable development.
Collapse
Affiliation(s)
- Peanchanan Leah
- Faculty of Medicine Ramathibodi Hospital, Ratchasuda Institute, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | - Wachara Riewpaiboon
- Faculty of Medicine Ramathibodi Hospital, Ratchasuda Institute, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | - Issavara Sirirungruang
- Faculty of Medicine Ramathibodi Hospital, Ratchasuda Institute, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | - Paranee Visuttipun
- Faculty of Medicine Ramathibodi Hospital, Ratchasuda Institute, Mahidol University, Salaya, Nakhon Pathom, Thailand
| |
Collapse
|
3
|
Obegu P, Nicholls K, Alberti M. Operational Mechanisms of Peer Support Groups and Support for Caregivers of People Living with Serious Mental Illness. Community Ment Health J 2024:10.1007/s10597-024-01326-y. [PMID: 39093458 DOI: 10.1007/s10597-024-01326-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Accepted: 07/13/2024] [Indexed: 08/04/2024]
Abstract
The challenges faced by caregivers of people living with serious mental illness in Canada are well documented in the literature including emotional distress, financial strain, social isolation, and concerns about their physical health following the impact of caregiving. Peer support programs (including peer support groups) emerged as a promising method to attempt to address these challenges. While there is evidence on the positive impacts of peer support groups in providing support for caregivers, the mechanisms by which peer support groups operate and influence support for caregivers of people living with serious mental illness are less understood. This qualitative study took on a co-designed participatory research approach. Fifteen adult caregivers of people living with serious mental illness across Canada were engaged through key informant interviews that lasted for 45 - 60 min each. A thematic analysis was carried out to help understand the operational mechanisms of peer support groups in influencing support for caregivers. The key informant interviews allowed for the identification and description of the following operational mechanisms that influenced the support caregivers received from peer support groups: (1) Group dynamics; (2) Messaging/content; (3) Equity and inclusion, (4) Group philosophy; and (5) Privacy concerns. Findings from this study showed that caregivers identified a number of operational mechanisms of peer support groups that explained how they felt supported when they participated in peer support groups. Among other operational mechanisms, group dynamics in terms of the gathering of caregivers of different age brackets and varying caregiving experience negatively influenced the peer support experience of caregivers. This pointed to the need for group dynamics that consider close age ranges and similar caregiving experience during group meetings to enhance support for caregivers. Caregivers also identified a gap in equity and inclusion in peer support groups that could have otherwise enriched their experience and enhanced the support they looked to receive from the group. Practical examples to enhance equity and inclusion include promoting active listening, using inclusive language, encouraging diverse representation and asking for feedback from peer support group members. While peer support groups in Canada exist independently of one another, it may help to consolidate evidence-based recommendations in the operational mechanisms of these groups, for the benefit of caregivers who turn to these groups for support, having been left on their own by an otherwise fractured mental health system.
Collapse
Affiliation(s)
- Pamela Obegu
- Canadian Institute for Advancements in Mental Health, Toronto, Canada.
| | - Kayla Nicholls
- Canadian Institute for Advancements in Mental Health, Toronto, Canada
| | - Mary Alberti
- Canadian Institute for Advancements in Mental Health, Toronto, Canada
| |
Collapse
|
4
|
Goh HQ, Nelson LE, Teo WZ, Aidoo-Frimpong G, Ramos SR, Shorey S. Perspectives and thoughts of pregnant women and new mothers living with HIV receiving peer support: A mixed studies systematic review. J Adv Nurs 2024; 80:2715-2727. [PMID: 38093472 DOI: 10.1111/jan.16014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/31/2023] [Accepted: 11/26/2023] [Indexed: 06/13/2024]
Abstract
AIM The aim of this study was to systematically consolidate evidence on perspectives and thoughts of women living with HIV regarding the peer support they have encountered during pregnancy and after childbirth. DESIGN Mixed studies systematic review. DATA SOURCES PubMed, EMBASE, Cochrane, PsycINFO, CINAHL, Scopus and ProQuest were sourced from 1981 to January 2022. METHODS A convergent qualitative synthesis approach was used to analyse the data. Quality appraisal was performed using the Mixed Methods Appraisal Tool. RESULTS A total of 12 studies were included, involving 1596 pregnant women and 1856 new mothers living with HIV. An overarching theme, 'From One Mother to Another: The Supportive Journey of Pregnant Women and New Mothers Living with HIV', and two themes were identified: (1) Emotional support buddies and extended networks and (2) Link bridge to healthcare support and self-empowerment. CONCLUSION Peer support played an indispensable role in the lives of women living with HIV and served as a complementary support system to professional and family support. IMPACT What problem did the study address? Pregnant women and new mothers living with HIV face preconceived stigma and discrimination. What were the main findings? Peer support was perceived to be beneficial in enhancing emotional support among women living with HIV and was well-accepted by them. Where and on whom will the research have an impact? Healthcare providers and community social workers could develop or enhance peer support educational programmes tailored to pregnant women and new mothers living with HIV. Policymakers and administrators can leverage public awareness, advocacy and political will to formulate and implement policies and campaigns aimed at fostering awareness and receptivity towards peer support interventions. REPORTING METHOD Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
Collapse
Affiliation(s)
- Huang Qi Goh
- National Kidney Foundation, Singapore, Singapore
| | - LaRon E Nelson
- Yale School of Nursing, Yale University, New Haven, Connecticut, USA
| | - Wei Zhou Teo
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Gloria Aidoo-Frimpong
- Yale AIDS Prevention Training Program, School of Public Health, Yale University, New Haven, Connecticut, USA
| | - S Raquel Ramos
- School of Nursing, Yale University, Orange, Connecticut, USA
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| |
Collapse
|
5
|
Hölzle L, Schöch P, Hörtnagl C, Buchheim A, Lampe A, Zechmeister-Koss I, Paul JL. Identifying and synthesizing components of perinatal mental health peer support - a systematic review. Front Psychiatry 2024; 15:1389545. [PMID: 38966189 PMCID: PMC11223205 DOI: 10.3389/fpsyt.2024.1389545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/29/2024] [Indexed: 07/06/2024] Open
Abstract
Background Becoming a parent, while often perceived as a joyous event, can also be a vulnerable life transition, with approximately one in five mothers experiencing perinatal mental illness. Peer support is recommended for its preventive and therapeutic benefits. However, relevant program components of perinatal mental health peer support remain to be identified. Objectives This review aims to (1) identify peer support programs in perinatal mental health through existing reviews and to (2) synthesize the components of these programs. Methods A systematic literature review guided by PRISMA was conducted searching four databases, supplemented by hand searches. The Template for Intervention Description and Replication (TIDieR) checklist facilitated the systematic extraction and synthesis of program components. Results Eleven peer support programs were identified from three reviews, largely conducted in English-speaking countries. The identified reviews highlight the benefits of peer support in perinatal mental health. Key components of individual programs were contextual background, materials, provider training and support, delivery modes and locations, and evaluation. Sharing lived experience and providing flexible support were central to all programs. Conclusion Aspects of flexibility, authenticity and the challenges of program evaluation in peer support must be considered. Findings can now inform future planning and implementation efforts of peer support programs in periantal mental health.
Collapse
Affiliation(s)
- Laura Hölzle
- Department of Psychiatry, Medical University Innsbruck, Psychotherapy, Psychosomatics, and Medical Psychology, Division of Psychiatry I, Innsbruck, Austria
- University of Innsbruck, Institute of Psychology, Innsbruck, Austria
| | - Philipp Schöch
- Department of Psychiatry, Medical University Innsbruck, Psychotherapy, Psychosomatics, and Medical Psychology, Division of Psychiatry I, Innsbruck, Austria
- University of Innsbruck, Institute of Psychology, Innsbruck, Austria
| | - Christine Hörtnagl
- Department of Psychiatry, Medical University Innsbruck, Psychotherapy, Psychosomatics, and Medical Psychology, Division of Psychiatry I, Innsbruck, Austria
| | - Anna Buchheim
- University of Innsbruck, Institute of Psychology, Innsbruck, Austria
| | - Astrid Lampe
- Ludwig Boltzmann Gesellschaft Institute for Rehabilitation, Vienna, Austria
| | | | - Jean Lillian Paul
- Department of Psychiatry, Medical University Innsbruck, Psychotherapy, Psychosomatics, and Medical Psychology, Division of Psychiatry I, Innsbruck, Austria
| |
Collapse
|
6
|
Ahlstrand A, Mishina K, Elomaa-Krapu M, Joronen K. Consumer involvement and guiding frameworks in mental healthcare: An integrative literature review. Int J Ment Health Nurs 2024. [PMID: 38706160 DOI: 10.1111/inm.13343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/26/2024] [Accepted: 04/14/2024] [Indexed: 05/07/2024]
Abstract
Perspectives of healthcare have, in past decades, focused more on active citizenship, human rights and empowerment. Healthcare consumer involvement as a concept is still unstructured and consumers have no apparent opportunities to participate in their care processes. The focus is often on the expertise of professionals, even if mental health consumers are willing to become involved and have sufficient decisional capacity. The aim of this integrative literature review was to construct an understanding of consumer perceptions and guiding frameworks of consumer involvement. There was no previous synthesis of mental health consumer perceptions combined with guiding frameworks. An integrative review methodology was employed, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of the 18 studies included was analysed with the Whittemore and Knafl approach. By following Braun and Clarke's guidelines, an inductive thematic analysis was conducted to collate the themes from the selected papers. Mental health consumers' perceptions of involvement included expectations of person-centred care, such as respect, dignity, equal interaction, supportive environments and being part of a community. This research did not find any single established framework to give clear guidelines for consumer involvement in mental healthcare, but similar determinants describing various frameworks were uncovered. This review also shows how the terminology has changed throughout the years. The perceptions of mental health consumers need to be considered to enable the implementation of person-centredness from guidelines through to practice. Paying more attention to the education of professional mental health caregivers and the involvement of mental health consumers in their care provides better opportunities to co-develop successful mental health services and recovery processes.
Collapse
Affiliation(s)
- Anita Ahlstrand
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
- Metropolia University of Applied Sciences, Helsinki, Finland
| | - Kaisa Mishina
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
| | - Minna Elomaa-Krapu
- Metropolia University of Applied Sciences, Helsinki, Finland
- Faculty of Social Sciences, Nursing Science, Tampere University, Tampere, Finland
| | - Katja Joronen
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
| |
Collapse
|
7
|
Oostermeijer S, Morgan A, Cheesmond N, Green R, Reavley N. The Effects of Australia's First Residential Peer-Support Suicide Prevention and Recovery Centre (SPARC). CRISIS 2024; 45:217-224. [PMID: 38375762 DOI: 10.1027/0227-5910/a000939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
Aim: This paper reports preliminary evidence of the impacts of Australia's first residential peer-support service for people at risk of suicide. Methods: Psychological distress was measured preintervention, postintervention, and after 3 months and analyzed using paired t tests. Interviews were held postintervention and were analyzed using thematic analysis. Results: Psychological distress significantly improved from preintervention to postintervention (n = 16, d = 1.77) and at follow-up (n = 5, d = 1.12). Interviews (n = 10) indicated that participants experienced improvements in mental well-being and feelings of connectedness, respite, and confidence to engage with other services. The peer-support workers were key. Some participants felt that the location was too remote, too little information was given, and a longer stay would have been preferable. Limitations: The study did not include a control group, the sample was relatively small, and participants may have been subject to socially desirable answers. Conclusions: These findings indicate that residential peer-support services potentially offer a valuable alternative to conventional inpatient treatment for people at risk of suicide.
Collapse
Affiliation(s)
- Sanne Oostermeijer
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Amy Morgan
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | | | - Rachel Green
- Independent Community Living Australia, Surry Hills, NSW, Australia
| | - Nicola Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| |
Collapse
|
8
|
Vita A, Barlati S, Porcellana M, Sala E, Lisoni J, Brogonzoli L, Percudani ME, Iardino R. The patient journey project in Italian mental health services: results from a co-designed survey on clinical interventions and current barriers to improve the care of people living with schizophrenia. Front Psychiatry 2024; 15:1382326. [PMID: 38606407 PMCID: PMC11007707 DOI: 10.3389/fpsyt.2024.1382326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/04/2024] [Indexed: 04/13/2024] Open
Abstract
Introduction The Patient Journey Project aimed to analyze the scenario among Italian Mental Health Services (MHS) to understand the clinical interventions that are properly implemented and the ones deserving further implementation to design an effective treatment plan for patients living with schizophrenia (PLWS). Methods The 60-items survey was co-designed with all the stakeholders (clinicians, expert patients and caregivers) involved in the Patient Journey and focused on three phases of schizophrenia course: early detection and management, acute phase management, long-term management/continuity of care. Respondents were Heads of the Mental Health Departments and Addiction Services (MHDAS) or facilities directors throughout Italian MHS. For each statement, respondents expressed the consensus on the importance and the degree of implementation in clinical practice. Results Considering the importance of the statement, strong consensus was reached for most of the statements. Good levels of implementation were found on 2/17 statements of early detection and management, on 3/16 statements for acute phase management and on 1/27 statements of long-term management/continuity of care. Poor levels of implementation were found on 1/17 statements of early detection and management, none of acute phase management, and 4/27 statements for long-term management/continuity of care. Moderate levels of implementation were found on 14/17 statements for early detection and management, on 13/16 statements of acute phase management, and on 22/27 statements of long-term management/continuity of care. Thus, among Italian MHDAS, most interventions for PLWS were moderately implemented in clinical practice. Discussion Italian MHS have to provide new strategies and structural actions to overcome these current limitations and barriers to effectively improve the journey of PLWS. The areas that deserve most implementation include interventions during the early stage (especially the continuity of care between Child and Adolescent Mental Health Services and Adult Mental Health Services), the evidence-based psychosocial interventions during the chronic stages of the disorder, and the continuity of care after acute hospitalization.
Collapse
Affiliation(s)
- Antonio Vita
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Stefano Barlati
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Matteo Porcellana
- Department of Mental Health and Addiction Services, Niguarda Hospital, Milan, Italy
| | - Elisa Sala
- Department of Political and Social Sciences, University of Pavia, Pavia, Italy
| | - Jacopo Lisoni
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | | | | | | |
Collapse
|
9
|
Reeves V, McIntyre H, Loughhead M, Halpin MA, Procter N. Actions targeting the integration of peer workforces in mental health organisations: a mixed-methods systematic review. BMC Psychiatry 2024; 24:211. [PMID: 38500086 PMCID: PMC10949677 DOI: 10.1186/s12888-024-05664-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/06/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Lived experience workforces are one of the fastest growing emerging disciplines in Australian mental health service settings. Individuals with lived and living experience of mental distress employed in mental health services, often referred to as peer or lived experience workers, are widely considered essential for mental health recovery and reform. Despite vast growth of this workforce, concerns remain over the widespread integration of peer workforces to align with recommended movement of healthcare services toward greater recovery-orientated and person-centered practices. Previous research has identified barriers for peer work integration including a lack of clear role definition, inadequate training, and poor supportive organisational culture. Stigma, discrimination and a lack of acceptance by colleagues are also common themes. This systematic review seeks to identify organisational actions to support integration of peer workforces for improved mental health service delivery. METHOD A systematic search was conducted through online databases (n = 8) between January 1980 to November 2023. Additional data were sourced from conference proceedings, hand searching grey literature and scanning reference lists. Qualitative data was extracted and synthesised utilising narrative synthesis to identify key themes and findings reported adhere to PRISMA guidelines. The review protocol was registered with Prospero (CRD: 42,021,257,013). RESULTS Four key actions were identified: education and training, organisational readiness, Structural adjustments, resourcing and support and, demonstrated commitment to peer integration and recovery practice. CONCLUSIONS The study identifies actions for mental health service organisations and system leaders to adopt in support of integrating peer and lived experience workforces in service delivery.
Collapse
Affiliation(s)
- Verity Reeves
- The University of South Australia, 5001, Adelaide, GPO Box 2471, South Australia.
| | - Heather McIntyre
- The University of South Australia, 5001, Adelaide, GPO Box 2471, South Australia
| | - Mark Loughhead
- The University of South Australia, 5001, Adelaide, GPO Box 2471, South Australia
| | | | - Nicholas Procter
- The University of South Australia, 5001, Adelaide, GPO Box 2471, South Australia
| |
Collapse
|
10
|
von Peter S, Kraemer UM, Cubellis L, Fehler G, Ruiz‐Pérez G, Schmidt D, Ziegenhagen J, Kuesel M, Ackers S, Mahlke C, Nugent L, Heuer I. Implementing peer support work in mental health care in Germany: The methodological framework of the collaborative, participatory, mixed-methods study (ImpPeer-Psy5). Health Expect 2024; 27:e13938. [PMID: 39102703 PMCID: PMC10729536 DOI: 10.1111/hex.13938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 11/24/2023] [Accepted: 12/01/2023] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Starting in the 1990s in the United States, individuals with lived experience of mental health crises and recovery have been employed as peer support workers (PSWs) internationally. However, the implementation of PSW in clinical contexts remains challenging. METHODS This manuscript presents and discusses the methodological framework of the ImpPeer-Psy5 study on the PSW implementation in the German mental healthcare sector. This study used a mixed-methods and collaborative research approach, as well as participatory research strategies. After describing the study design, populations, teamwork and assessments, the epistemic challenges of its methodological framework will be critically discussed and how it has iteratively shaped the object of study. DISCUSSION AND PRACTICAL IMPLICATIONS The healthcare, policy and funding context of PSW implementation as well as the study's methodological framework have differently influenced the ways in which the implementation of PSW has been conceived in this study. The choice of a collaborative or participatory methodological framework is advised to better align research questions and procedures to the specific needs and challenges of PSWs and other stakeholders concerned with PSW implementation. PATIENT AND PUBLIC CONTRIBUTION The research team of the ImpPeer-Psy5 study was collaboratively staffed by a portion of researchers who also identify as users or survivors of psychiatric services. A nonprofit organization for the training of PSWs served as a practice partner throughout the research process. Different participatory formats involve a significant number of diverse stakeholders relevant to PSW implementation.
Collapse
Affiliation(s)
- Sebastian von Peter
- Brandenburg Medical School, Centre of Mental HealtPsychiatry and PsychotherapyImmanuel Klinik RüdersdorfNeuruppinGermany
| | - Ute Maria Kraemer
- Brandenburg Medical School, Centre of Mental HealtPsychiatry and PsychotherapyImmanuel Klinik RüdersdorfNeuruppinGermany
| | - Lauren Cubellis
- Brandenburg Medical School, Centre of Mental HealtPsychiatry and PsychotherapyImmanuel Klinik RüdersdorfNeuruppinGermany
| | - Georgia Fehler
- Brandenburg Medical School, Centre of Mental HealtPsychiatry and PsychotherapyImmanuel Klinik RüdersdorfNeuruppinGermany
| | - Guillermo Ruiz‐Pérez
- Brandenburg Medical School, Centre of Mental HealtPsychiatry and PsychotherapyImmanuel Klinik RüdersdorfNeuruppinGermany
| | - Daniela Schmidt
- Brandenburg Medical School, Centre of Mental HealtPsychiatry and PsychotherapyImmanuel Klinik RüdersdorfNeuruppinGermany
| | - Jenny Ziegenhagen
- Brandenburg Medical School, Centre of Mental HealtPsychiatry and PsychotherapyImmanuel Klinik RüdersdorfNeuruppinGermany
| | - Madeleine Kuesel
- Brandenburg Medical School, Centre of Mental HealtPsychiatry and PsychotherapyImmanuel Klinik RüdersdorfNeuruppinGermany
| | | | - Candelaria Mahlke
- Department of PsychiatryUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Lena Nugent
- Department of PsychiatryUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Imke Heuer
- Department of PsychiatryUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| |
Collapse
|
11
|
Wedema D, Wardenaar KJ, Alma MA, van Asselt ADI, Korevaar EL, Schoevers RA. A blended module (STAIRS) to promote functional and personal recovery in patients with a major depressive disorder in remission: study protocol of a concurrent mixed methods randomized controlled trial. BMC Psychiatry 2023; 23:727. [PMID: 37805486 PMCID: PMC10560411 DOI: 10.1186/s12888-023-05213-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 09/22/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Despite the availability of a wide variety of evidence-based treatments for major depressive disorder (MDD), many patients still experience impairments in their lives after remission. Programs are needed that effectively support patients in coping with these impairments. The program Storytelling and Training to Advance Individual Recovery Skills (STAIRS) was developed to address this need and combines the use of peer contact, expert-by-experience guidance, family support and professional blended care. The aim of the planned study is (1) to assess the efficacy of the STAIRS program in patients with remitted MDD, (2) to investigate patients' subjective experiences with STAIRS, and (3) to evaluate the program's cost-effectiveness. METHODS A concurrent mixed-methods randomized controlled trial design will be used. Patients aged between 18 and 65 years with remitted MDD (N = 140) will be randomized to either a group receiving care as usual (CAU) + the STAIRS-program or a control group receiving CAU + some basic psychoeducation. Quantitative efficacy data on functional and personal recovery and associated aspects will be collected using self-report questionnaires at the start of the intervention, immediately following the intervention, and at the six-month follow-up. Insights into patients' experiences on perceived effects and the way in which different program elements contribute to this effect, as well as the usability and acceptability of the program, will be gained by conducting qualitative interviews with patients from the experimental group, who are selected using maximum variation sampling. Finally, data on healthcare resource use, productivity loss and quality of life will be collected and analysed to assess the cost-effectiveness and cost-utility of the STAIRS-program. DISCUSSION Well-designed recovery-oriented programs for patients suffering from MDD are scarce. If efficacy and cost-effectiveness are demonstrated with this study and patients experience the STAIRS program as usable and acceptable, this program can be a valuable addition to CAU. The qualitative interviews may give insights into what works for whom, which can be used to promote implementation. TRIAL REGISTRATION This trial was registered at ClinicalTrials.gov on 1 July 2021, registration number NCT05440812.
Collapse
Affiliation(s)
- David Wedema
- Research and Innovation Centre for Rehabilitation, Hanze University of Applied Sciences, Groningen, The Netherlands.
| | - Klaas J Wardenaar
- Department of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Manna A Alma
- Department of Health Sciences, Applied Health Research, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Antoinette D I van Asselt
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Eliza L Korevaar
- Research and Innovation Centre for Rehabilitation, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Robert A Schoevers
- Department of Psychiatry, Research School of Behavioural and Cognitive Neurosciences (BCN), University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| |
Collapse
|
12
|
Tolmeijer E, Waite F, Isham L, Bringmann L, Timmers R, van den Berg A, Schuurmans H, Staring ABP, de Bont P, van Grunsven R, Stulp G, Wijnen B, van der Gaag M, Freeman D, van den Berg D. Testing the combination of Feeling Safe and peer counselling against formulation-based cognitive behaviour therapy to promote psychological wellbeing in people with persecutory delusions: study protocol for a randomized controlled trial (the Feeling Safe-NL Trial). Trials 2023; 24:644. [PMID: 37798792 PMCID: PMC10557156 DOI: 10.1186/s13063-023-07661-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/19/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Persecutory delusions are strong threat beliefs about others' negative intentions. They can have a major impact on patients' day-to-day life. The Feeling Safe Programme is a new translational cognitive-behaviour therapy that helps patients modify threat beliefs and relearn safety by targeting key psychological causal factors. A different intervention approach, with growing international interest, is peer counselling to facilitate personal recovery. Combining these two approaches is a potential avenue to maximize patient outcomes. This combination of two different treatments will be tested as the Feeling Safe-NL Programme, which aims to promote psychological wellbeing. We will test whether Feeling Safe-NL is more effective and more cost-effective in improving mental wellbeing and reducing persecutory delusions than the current guideline intervention of formulation-based CBT for psychosis (CBTp). METHODS A single-blind parallel-group randomized controlled trial for 190 out-patients who experience persecutory delusions and low mental wellbeing. Patients will be randomized (1:1) to Feeling Safe-NL (Feeling Safe and peer counselling) or to formulation-based CBTp, both provided over a period of 6 months. Participants in both conditions are offered the possibility to self-monitor their recovery process. Blinded assessments will be conducted at 0, 6 (post-treatment), 12, and 18 months. The primary outcome is mental wellbeing. The overall effect over time (baseline to 18-month follow-up) and the effects at each timepoint will be determined. Secondary outcomes include the severity of the persecutory delusion, general paranoid ideation, patient-chosen therapy outcomes, and activity. Service use data and quality of life data will be collected for the health-economic evaluation. DISCUSSION The Feeling Safe-NL Trial is the first to evaluate a treatment for people with persecutory delusions, while using mental wellbeing as the primary outcome. It will also provide the first evaluation of the combination of a peer counselling intervention and a CBT-based program for recovery from persecutory delusions. TRIAL REGISTRATION Current Controlled Trials ISRCTN25766661 (retrospectively registered 7 July 2022).
Collapse
Affiliation(s)
- Eva Tolmeijer
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research, Amsterdam, The Netherlands.
- Department of Psychosis, Parnassia Psychiatric Institute, The Hague, The Netherlands.
| | - Felicity Waite
- Department of Experimental Psychology, University of Oxford and Oxford Health NHS Foundation Trust, Oxford, UK
| | - Louise Isham
- Department of Experimental Psychology, University of Oxford and Oxford Health NHS Foundation Trust, Oxford, UK
| | - Laura Bringmann
- Department of Psychometrics and Statistics, University of Groningen, Groningen, The Netherlands
| | - Robin Timmers
- Voice-Hearing Support and Recovery-Team, RIBW Nijmegen and Rivierenland, Nijmegen, The Netherlands
- University of Applied Sciences Nijmegen, Nijmegen, The Netherlands
| | - Arjan van den Berg
- Department of Health, Wellbeing and Sport, Zadkine College Rotterdam, Rotterdam, The Netherlands
| | | | - Anton B P Staring
- ABC Department for First Episode Psychosis, Altrecht Psychiatric Institute, Utrecht, The Netherlands
| | - Paul de Bont
- Mental Health Organizations Oost Brabant, Boekel, The Netherlands
| | - Rob van Grunsven
- Department of Psychosis, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Gert Stulp
- Department of Sociology, University of Groningen, Groningen, The Netherlands
| | - Ben Wijnen
- Centre of Economic Evaluation and Machine Learning, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
| | - Mark van der Gaag
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research, Amsterdam, The Netherlands
| | - Daniel Freeman
- Department of Experimental Psychology, University of Oxford and Oxford Health NHS Foundation Trust, Oxford, UK
| | - David van den Berg
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research, Amsterdam, The Netherlands
- Department of Psychosis, Parnassia Psychiatric Institute, The Hague, The Netherlands
| |
Collapse
|
13
|
Eiroa-Orosa FJ. Beyond recovery: toward rights-based mental health care - A cluster randomized wait-list controlled trial of a recovery and rights training for mental health professionals with or without first person accounts. Front Psychol 2023; 14:1152581. [PMID: 37780153 PMCID: PMC10539929 DOI: 10.3389/fpsyg.2023.1152581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 08/31/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction Mental health models grounded in Recovery and Rights are driving the advancement of transformative care systems through multifaceted actions, which encompass Continuing Professional Development. The objective of this work is to evaluate a training activity developed through a participatory process that included people with lived experience of psychosocial distress, their relatives, and mental health professionals. Methods The training focused on alternatives to diagnosis, recovery principles, rights-based care, and peer support. The evaluation followed a cluster randomized wait-list controlled design. Four hundred eighty-eight health professionals from eight care centers were randomized to three experimental conditions: a wait list control, which underwent a one-month interval between the baseline assessment and the training activity, and two experimental groups, with or without first-person accounts, which accessed the training immediately after completing the baseline assessment. The dependent variables measured at all follow-ups were beliefs and attitudes toward mental health service users' rights. One hundred ninety-two professionals completed at least one follow-up and were included in the analyses. Results We observed different evolutions of experimental and control groups with statistically significant differences for tolerance to coercion and total beliefs and attitudes scores. No differences were observed between the groups with or who attended training activities with or without first person accounts. Upon receiving the training activity, the control group had an evolution equivalent to the experimental groups. Discussion The results of this evaluation project provide compelling evidence for the need to expand recovery and rights training activities to reach a larger audience of mental health professionals These training activities hold the potential to positively influence the beliefs and attitudes of mental health professionals, ultimately contributing toward a better future for individuals with lived experience of psychosocial distress.
Collapse
Affiliation(s)
- Francisco José Eiroa-Orosa
- Section of Personality, Assessment and Psychological Treatment, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- First-Person Research Group, Veus, Catalan Federation of 1st Person Mental Health Organisations, Barcelona, Spain
- Yale Program for Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT, United States
| |
Collapse
|
14
|
Rayland A, Andrews J. From Social Network to Peer Support Network: Opportunities to Explore Mechanisms of Online Peer Support for Mental Health. JMIR Ment Health 2023; 10:e41855. [PMID: 36853738 PMCID: PMC10015351 DOI: 10.2196/41855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 12/14/2022] [Accepted: 01/02/2023] [Indexed: 03/01/2023] Open
Abstract
An increasing number of psychological interventions are shifting to online modes of delivery. One such intervention is peer-to-peer support, which in this context may provide internet users living with mental health disorders an opportunity to connect with and support others living with similar conditions. This paper presents a call for further research into how platforms such as Facebook could be used as channels for peer support and the mechanisms that may underlie their effectiveness. We discuss the background of peer support, how it has transitioned online, and consider theories and models that may have relevance. We also consider the importance of moderation within online peer support and the development of specific social network-based online interventions. We conclude that for social network sites to be used as peer-to-peer support interventions, more research is needed to understand their effectiveness, the role of moderation in these communities, and the mechanisms that produce the benefits experienced by users.
Collapse
Affiliation(s)
- Amy Rayland
- Academic Unit of Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Jacob Andrews
- Academic Unit of Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,National Institute for Health and Care Research Mindtech Medtech Co-operative, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom.,National Institute for Health and Care Research Nottingham Biomedical Research Centre, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| |
Collapse
|
15
|
Eiroa-Orosa FJ, Sánchez-Moscona C. Implementing the figure of peer support workers in mental health: an international perspective from the context of its implementation in Catalonia. Salud Colect 2023; 19:e4252. [PMID: 37311138 DOI: 10.18294/sc.2023.4252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/29/2022] [Indexed: 01/24/2023] Open
Abstract
In the context of debates surrounding the training of mental health peer support workers and their incorporation into the Catalan Health System, this article presents a literature review complemented by interviews carried out between 2020 and 2021 with both international and Spanish experts. Based on the information obtained, content analysis of elements of their training and integration within the health system was performed. German-speaking countries offer the most homogeneous training and recruitment programs. In the case of English- and French-speaking countries, non-profit or third sector organizations are usually in charge of training programs and recruitment. Various experiences with training programs exist in the Ibero-American world, although they are not recognized as professional qualifications. Recommendations are offered for the development of this figure in Catalonia, which include advancing towards professional training with recognition as health care providers, as well as contracting options from both socio-health or health care providers or from third sector entities.
Collapse
Affiliation(s)
- Francisco José Eiroa-Orosa
- Doctor en Psicología Clínica y Psiquiatría. Investigador Ramón y Cajal, Sección de Personalidad, Evaluación y Tratamiento Psicológico, Departamento de Psicología Clínica y Psicobiología, Universidad de Barcelona. Integrante, Grupo de Investigación en Salud Mental en Primera Persona, Federación Veus, Barcelona, España
| | - Cecilia Sánchez-Moscona
- Magíster en Psicología General Sanitaria. Sección de Personalidad, Evaluación y Tratamiento Psicológico; Departamento de Psicología Clínica y Psicobiología, Universidad de Barcelona. Integrante, Grupo de Investigación en Salud Mental en Primera Persona, Federación Veus, Barcelona, España
| |
Collapse
|