Monday, February 13, 2023

Life Outlook Improves When Patients Work With Peers, Meta-Analysis Suggests

Patients with mental illness who receive services delivered by individuals with lived experience of mental illness (peer support services) may experience greater personal recovery (for example, life satisfaction and hopefulness) than those patients who do not receive peer support services, a meta-analysis in Psychiatric Services in Advance has found.

“The effect of peer support on personal recovery was most pronounced in peer support delivered as an add-on to mental health hospital treatment,” wrote Cecilie Høgh Egmose, M.Sc., of the University of Copenhagen in Denmark and colleagues. “However, the evidence for the efficacy of peer support provided independently of hospital settings and online is promising and requires more high-quality [randomized, controlled trials] and attention from policy makers and funders.”

Høgh Egmose and colleagues compiled data from 49 randomized, controlled trials testing the effectiveness of peer support interventions that were delivered by peers only or by both mental health professionals and peers. Peers included individuals in paid and volunteer positions.

The combined data included 12,477 patients with a range of conditions including schizophrenia, bipolar disorder, depression, anxiety, and eating disorders. The peer support programs were divided into four categories, including those led by as follows:

  1. Peers working in hospital services (for example, recovery mentors delivered one-to-one peer support or group-based, peer-led self-management programs).
  2. Peers working in nonhospital settings, such as a university research center or a residential program.
  3. Peers working in established, paid service positions (for example, peers helped to facilitate conversations about requests for treatment, assertive community treatment, and occupational rehabilitation goals).
  4. Peers working with online support groups.

Overall, peer support was associated with a small positive effect on personal recovery compared with control interventions such as placement on a waitlist or receipt of usual care. Peer support was also associated with a slight decrease in anxiety and seemed to have a positive impact on patients’ hope and self-advocacy.

“We found that peers employed and trained in supporting roles in the mental health hospital treatment service had a small positive effect on personal recovery, had a small-to-moderate positive effect on self-efficacy, and were associated with a small reduction in overall psychiatric symptoms,” Høgh Egmose and colleagues wrote. “Nevertheless, before we can recommend implementation of peer support in specific health care settings, co-created high quality trials measuring the effectiveness, including potential adverse effects, and the cost-effectiveness of the intervention are needed.”

To read more on this topic, see the Psychiatric News articles “Peer Support Specialists Can Play Important Role in Patients’ Lives” and “Peer Specialists Can Aid in Suicide Prevention.”

(Image: iStock/FatCamera)

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