Effects of a peer-run course on recovery from serious mental illness: a randomized controlled trial.
ABSTRACT Research on the effectiveness of peer-run services on the recovery of people with major psychiatric problems has been limited and poorly controlled. This study evaluated the effects of a 12-week peer-run course on recovery, "Recovery Is Up to You."
Recruitment of people with major psychiatric problems took place in the Netherlands between 2006 and 2008, and the effects of the peer-run intervention were evaluated in a randomized controlled trial. A total of 333 people were randomly assigned to the experimental (N=168) or control (N=165) condition. Self-report instruments used were the Herth Hope Index, the Manchester Short Assessment of Quality of Life, the Mental Health Confidence Scale, the Dutch Empowerment Scale, and the Loneliness Scale. Assessments took place at baseline, after three months (at the end of the course), and after six months. Data were analyzed by using linear mixed modeling.
The intervention had a significant and positive effect on empowerment, hope, and self-efficacy beliefs but not on quality of life and loneliness. The effects of the intervention persisted three months after participants completed the course.
The results suggest that the peer-run course contributed to improvement in important domains of recovery. Peer-run services, such as "Recovery Is Up to You," add value to recovery-oriented mental health care because they offer participants an opportunity to make an active start on their recovery.
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ABSTRACT: To evaluate the effectiveness of peer-delivered interventions in improving clinical and psychosocial outcomes among individuals with severe mental illness (SMI) or depression. Systematic review and meta-analysis of randomised controlled trials comparing a peer-delivered intervention to treatment as usual or treatment delivered by a health professional. Random effect meta-analyses were performed separately for SMI and depression interventions. Fourteen studies (10 SMI studies, 4 depression studies), all from high-income countries, met the inclusion criteria. For SMI, evidence from three high-quality superiority trials showed small positive effects favouring peer-delivered interventions for quality of life (SMD 0.24, 95 % CI 0.08-0.40, p = 0.003, I (2) = 0 %, n = 639) and hope (SMD 0.24, 95 % CI 0.02-0.46, p = 0.03, I (2) = 65 %, n = 967). Results of two SMI equivalence trials indicated that peers may be equivalent to health professionals in improving clinical symptoms (SMD -0.14, 95 % CI -0.57 to 0.29, p = 0.51, I (2) = 0 %, n = 84) and quality of life (SMD -0.11, 95 % CI -0.42 to 0.20, p = 0.56, I (2) = 0 %, n = 164). No effect of peer-delivered interventions for depression was observed on any outcome. The limited evidence base suggests that peers may have a small additional impact on patient's outcomes, in comparison to standard psychiatric care in high-income settings. Future research should explore the use and applicability of peer-delivered interventions in resource poor settings where standard care is likely to be of lower quality and coverage. The positive findings of equivalence trials demand further research in this area to consolidate the relative value of peer-delivered vs. professional-delivered interventions.Social Psychiatry 03/2014; 49(11). DOI:10.1007/s00127-014-0857-5 · 2.05 Impact Factor
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ABSTRACT: Increasingly, people with diverse health conditions turn to social media to share their illness experiences or seek advice from others with similar health concerns. This unstructured medium may represent a platform on which individuals with severe mental illness naturally provide and receive peer support. Peer support includes a system of mutual giving and receiving where individuals with severe mental illness can offer hope, companionship, and encouragement to others facing similar challenges. In this study we explore the phenomenon of individuals with severe mental illness uploading videos to YouTube, and posting and responding to comments as a form of naturally occurring peer support. We also consider the potential risks and benefits of self-disclosure and interacting with others on YouTube. To address these questions, we used qualitative inquiry informed by emerging techniques in online ethnography. We analyzed n = 3,044 comments posted to 19 videos uploaded by individuals who self-identified as having schizophrenia, schizoaffective disorder, or bipolar disorder. We found peer support across four themes: minimizing a sense of isolation and providing hope; finding support through peer exchange and reciprocity; sharing strategies for coping with day-to-day challenges of severe mental illness; and learning from shared experiences of medication use and seeking mental health care. These broad themes are consistent with accepted notions of peer support in severe mental illness as a voluntary process aimed at inclusion and mutual advancement through shared experience and developing a sense of community. Our data suggest that the lack of anonymity and associated risks of being identified as an individual with severe mental illness on YouTube seem to be overlooked by those who posted comments or uploaded videos. Whether or not this platform can provide benefits for a wider community of individuals with severe mental illness remains uncertain.PLoS ONE 10/2014; 9(10):e110171. DOI:10.1371/journal.pone.0110171 · 3.53 Impact Factor
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ABSTRACT: Considering international diversity in the implementation of mental health peer support and an increasing research interest in peer support work (PSW), this review focuses on priorities in current research and practice. With grassroots in informal services for people with mental health problems, peer support has been strengthened by the recovery paradigm in mental health policy, and there are steps towards integration in statutory services.Current opinion in psychiatry 05/2014; DOI:10.1097/YCO.0000000000000074 · 3.55 Impact Factor