Peer support worker training: Results of the evaluation of the Experienced Involvement training programme in Switzerland and Germany

A Qualitative Exploration of Peer Supporters' Experiences of Undertaking a Co-Produced Mental Health and Emotional Well-Being Training Programme

INTRODUCTION

Peer supporters play a crucial role in mental health and support services, but their own mental health and emotional well-being are often neglected by themselves, and, frequently, their organisations. Here, we report findings from a qualitative interview study of peer supporters who completed a co-produced emotional well-being training programme.

METHOD

Ten semi-structured interviews with peer supporters working in the North East of England were conducted to explore their experiences of the training programme.

RESULTS

Thematic analysis of the data produced three overarching themes. In Theme 1, 'Increasing psychological preparedness and identifying self-care and coping strategies', we found that peer supporters improved their knowledge of how to manage sensitive topics such as aggression and suicide and felt more confident in their peer support roles resultantly. In Theme 2, 'It's good to know you're not alone', peer supporters discussed their experience of loneliness in their roles, and as a consequence realised their own need for peer support to help maintain their well-being. Theme 3, 'Toward the future: next steps', encapsulated peer supporters' willingness to continue their role development and to create a peer support network to continue to obtain mutual support.

CONCLUSION

Our findings emphasise the perceived emotional well-being benefits of a co-produced peer supporter training programme. Participants highlighted the need for co-produced training programmes that are (1) emotion-focussed, (2) provide access to other peer supporters and (3) provide future avenues for a peer supporter network of mutual support and professional development activities and training opportunities.

PATIENT OR PUBLIC CONTRIBUTION

Individuals with lived experience of mental ill health and peer support were consulted in the development of interview questions and provided feedback on the finalised themes to ensure the analysis and interpretations were congruent with their experiences.

Experiences of Certified Peer Support Specialist Providing Formal Peer Support in Mental Health Services: A Systematic Review and Meta-Synthesis

Peer support specialists (PSSs) in mental healthcare services are individuals recovering from mental health conditions and providing formal peer support to clients with similar conditions. Despite evidence of the benefits of this modality and the increasing demand for it, little is known about the PSSs' experiences in mental healthcare services. This review systematically synthesises available qualitative data on the certified PSSs' experiences in providing formal peer support in mental healthcare services. A search was performed across six electronic databases and one grey literature database for all published and unpublished qualitative studies in English between 2014 and 2022. Mixed-methods studies were included if their qualitative data were extractable. This review included PSSs who provided formal peer support to clients with similar mental health conditions. The included studies were appraised through the Critical Appraisal Skills Program Qualitative checklist, while data extraction was done through a customised tool. Our meta-synthesis revealed an overarching theme on certified PSSs' journey in mental healthcare services, alongside four main themes: (i) emotional impacts of being PSSs, (ii) struggle to justify their roles, (iii) complex roles of PSSs and (iv) sources of support. The review has provided an insightful understanding of the PSSs' roles and needs, for which there is a need to cultivate a supportive working environment. Given the difficulties in adopting the PSSs' roles, as demonstrated by our findings, future research should explore how mental healthcare organisations can address their work-related challenges and cultivate a supportive working environment.

Towards an informed research agenda for the field of personality disorders by experts with lived and living experience and researchers

BACKGROUND

We describe a collection of themes for a research agenda for personality disorders that was originally formulated for the ESSPD Borderline Congress in 2022.

METHODS

Experts with lived and living experience (EE), researchers and clinicians met virtually, exchanged ideas and discussed research topics for the field of personality disorders. The experts - patients, relatives, significant others - named the topics they thought most relevant for further research in the field. These topics were presented at the ESPPD conference in October 2022.

RESULTS

The five top themes were: 1. Prevention, early detection and intervention, 2. Recovery beyond symptom improvement, 3. Involvement of relatives in treatment, 4. Gender dysphoria, and 5. Stigma.

CONCLUSIONS

In general, the topics reflect current issues and changes in societal values. Overarching aims of research on these topics are the improvement of social participation and integration in society, better dissemination of research, and better information of the general public and political stakeholders.

Training of Lived Experience Workforces: A Rapid Review of Content and Outcomes

Recently, the lived and living experience (LLE) workforce in mental health and alcohol and other drugs (AOD) sectors has expanded. Despite widespread benefit of this inclusion, some LLE practitioners have encountered personal and professional challenges in their workforce roles. An essential avenue to address these challenges is through provision of training to ensure adequate LLE role preparation, and to support integration of LLE workforces within mental health and AOD settings. We aim to understand the primary components applied in LLE training programs (i.e., content and methods), the outcomes from program participation, and to summarize observed patterns between training components and outcomes. This rapid review utilized a systematic methodology following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to synthesize existing literature on training programs for service users or carers/family in lived experience roles, in the mental health and AOD workforce. We searched CINAHL, PsycINFO, Medline, and Web of Science databases. We identified 36 relevant studies. Findings indicate short- and long-term impacts of training participation for this emerging workforce, with the most promising outcomes being increased professional knowledge and skills and improved personal psychosocial wellbeing and trauma recovery. Other positive training outcomes included high trainee satisfaction, increased application of training skills, and employment/education opportunities following training completion. Gaps and training limitations were noted in relation to the training content/delivery, trainee reservations, and personal barriers to training participation or completion. In response to program benefits and limitations investigated, we present recommendations for improving training processes for this workforce.

Effects of peer-delivered self-management, recovery education interventions for individuals with severe and enduring mental health challenges: A meta-analysis

WHAT IS KNOWN ON THE SUBJECT?: The paradigm shifts in the conceptualization of recovery have led to a wide adoption of peer-delivered self-management interventions among individuals with severe and enduring mental health challenges. Peers with experiential knowledge on managing their own mental health conditions act as role models for affected individuals. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The meta-analysis demonstrated significant small-to-medium effects favouring such interventions on symptom severity, self-perceived recovery, hopefulness and empowerment. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: With peer-delivered self-management interventions, individuals with severe and enduring mental health challenges could self-direct their care, thus reducing their reliance on service providers. Individuals with severe and enduring mental health challenges equipped to seek their recovery within the community beyond institutional care, regaining independence and gradually reintegrate into society. ABSTRACT: Introduction The shift in mindset within mental health care has led to the adoption of peer-delivered self-management interventions in promoting recovery among individuals with severe and enduring mental health challenges. However, no reviews have hitherto examined their effectiveness. Aim To determine the effectiveness of peer-delivered self-management interventions in improving symptom severity, self-perceived recovery, hopefulness and empowerment. Method A search was performed in nine English databases for published studies and grey literature from inception to the 5 January 2021. The methodological quality of the studies was graded with the Joanna Briggs Institute's critical appraisal tools. The overall effects were pooled through a meta-analysis with heterogeneity evaluated via the chi-square test and I-square statistics. This review was guided by the PRISMA 2020 statement on transparent reporting of systematic review and meta-analyses. Results Seventeen publications involving 3189 participants were included in this review, and ten were included for the meta-analysis and accounted for 2725 participants. The meta-analysis demonstrated significant small-to-medium effects favouring such interventions on symptom severity, self-perceived recovery, hopefulness and empowerment. Discussion Peer-delivered self-management interventions should be implemented as it is effective in promoting recovery among individuals with severe and enduring mental health challenges. Implications for practice With peer-delivered self-management interventions, individuals with severe and enduring mental health challenges could self-direct their care and reduce their reliance on service providers.

Psychometric assessment of the German version of the Questionnaire about the Process of Recovery

Personal recovery is important for mental health services and service users; moreover, valid and reliable assessment instruments are necessary for measuring personal recovery. Therefore, this study aimed to evaluate the unidimensional factor structure of the German version of the Questionnaire about the Process of Recovery. The study was conducted using a cross-sectional design with a convenience sample. The questionnaire was completed by 200 patients of outpatient services of two psychiatric hospitals in Switzerland. A confirmatory factor analysis was conducted to validate the unidimensional factor structure of the German version of the Questionnaire about the Process of Recovery. Cronbach's alpha was calculated to assess the internal consistency. The results showed an overall acceptable model fit (χ²  = 134.188, df = 90, P = 0.002; RMSEA = 0.050, 90% CI: 0.031-0.067; CFI = 0.937; TLI = 0.927) and excellent internal consistency (Cronbach's α = 0.91). These results are consistent with those of studies that have examined the Questionnaire about the Process of Recovery in other languages. This study provides preliminary evidence that the German version of the Questionnaire about the Process of Recovery is a reliable assessment instrument for measuring personal recovery among people with mental illness experiences. However, it is necessary to conduct further psychometric tests to verify the validity and reliability of the instrument. The German version of the Questionnaire about the Process of Recovery can be applied to both research and clinical practice, especially as a means of facilitating communication during the planning and evaluation of treatment goals.

Implementing the figure of peer support workers in mental health: an international perspective from the context of its implementation in Catalonia

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.

Implementation of peer-support services in Asia: A scoping review

WHAT IS KNOWN ON THE SUBJECT

Peer-support services was started in the 1970s psychiatric survivor movement in the United States of America (USA) due to the lack of transitional support for deinstitutionalized psychiatric patients. Delivered by peer-support workers (PSWs) with lived experiences of mental health conditions, peer-support workers use their experiential knowledge to help others with similar conditions. The paradigm shifts in mental health recovery has led to an increase in interest on peer-support services among the Asia countries. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The diversity political and cultural differences in Asia makes it a unique for people to understand the mental health ecosystem that exist within. This review is timely as it provides the insights into the current state of peer-support services for mental health consumers in Asia and the future research on them. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: First, this review provided a broad overview on the current types of peer-support services and their implementation in Asia. Second, emphasized the importance and value of peer-support services for individuals with mental health conditions in their journey towards recovery. Third, important to build a more positive image for peer-support workers by assigning more clarity to their roles and systematizing training to hone their skills in providing peer support.

ABSTRACT

Introduction The increasing recognition and need for recovery-oriented services led to the heightened interests of peer-support services globally, including Asia. However, little is known about the peer-support services in Asia as compared to the West, where peer-support services primarily originated from and are well established. Aim To examine available evidence on the implementation of peer-support services for such consumers in Asia. Method This scoping review was based on the Arksey & O'Malley's framework. A comprehensive search was performed across seven electronic databases. The grey literature was also searched through Open Grey and ProQuest Dissertation and Theses, alongside hand searching of the reference of the studies. Articles searched was from January 2000 to December 2021. Results Three main themes were identified to provide an overview on peer-support services for mental health consumers in Asia: the delivery of such services in Asia; Asian consumers' perceptions of them; and factors affecting their implementation. Discussion Given their relative novelty in Asia, findings from this review represent useful insights for organizations and policy administrators when formulating such services. Implications for Practice Future research should also focus on evaluating the effectiveness of such services in Asia and comparing their outcomes with other regions.