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Matthews EB, Rahman R, Schiefelbein F, Galis D, Clark C, Patel R. Identifying key roles and responsibilities of peer workers in behavioral health services: A scoping review. PATIENT EDUCATION AND COUNSELING 2023; 114:107858. [PMID: 37348313 DOI: 10.1016/j.pec.2023.107858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/18/2023] [Accepted: 06/15/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVE The roles and responsibilities of peer workers (PWs) are not well articulated. This scoping review aims to systematically identify and describe the roles of PWs in outpatient, community based mental health and substance use services, and compare their roles and responsibilities across these service settings METHODS: The scoping review was a priori developed and implemented according to the Joanna Briggs Institute methodology, which includes stating the review objectives, conducting a three-step search method, and charting the results. RESULTS Forty-four peer reviewed manuscripts were included in the review. PWs were used more often in mental health (n = 27) than substance use (n = 10) programs. Peers adopted a wide range of skills. Across program contexts, peers were frequently used as a source of informal support or mentorship and care coordination. Mental health programs often used peers to deliver manualized interventions, while substance use programs more frequently leveraged PWs to facilitate service linkage and engagement. CONCLUSION Roles of peers differed between substance use and mental health programs, reflecting significant diversity in how peers are being integrated into the behavioral health workforce. PRACTICE IMPLICATIONS Peer certification programs must balance consistency with the wide range of skills required of this workforce.
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Affiliation(s)
- Elizabeth B Matthews
- Fordham University, Graduate School of Social Service, 113W. 60th st., New York, NY 10023, USA.
| | - Rahbel Rahman
- Fordham University, Graduate School of Social Service, 113W. 60th st., New York, NY 10023, USA
| | - Faith Schiefelbein
- Fordham University, Graduate School of Social Service, 113W. 60th st., New York, NY 10023, USA
| | - Danielle Galis
- Fordham University, Graduate School of Social Service, 113W. 60th st., New York, NY 10023, USA
| | - Carson Clark
- Fordham University, Graduate School of Social Service, 113W. 60th st., New York, NY 10023, USA
| | - Rupal Patel
- Fordham University, Graduate School of Social Service, 113W. 60th st., New York, NY 10023, USA
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White S, Bhattacharya R, Bremner S, Faulkner A, Foster R, Gibson S, Goldsmith L, Harnett D, Lucock M, Patel A, Priebe S, Repper J, Rinaldi M, Salla A, Simpson A, Ussher M, Gillard S. Predictors of engagement with peer support: analysis of data from a randomised controlled trial of one-to-one peer support for discharge from inpatient psychiatric care. Int J Soc Psychiatry 2023:207640221148090. [PMID: 36645032 DOI: 10.1177/00207640221148090] [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: 01/17/2023]
Abstract
BACKGROUND A range of evidence for the effectiveness of one-to-one peer support in mental health services is emerging. Levels of engagement with peer support vary with limited studies showing few individual participant characteristics predicting engagement. Implementation factors that might predict engagement have not been considered. METHODS Data were analysed from the intervention arm of the ENRICH trial of one-to-one peer support for discharge from acute psychiatric inpatient care. Two outcomes were considered: (1) a measure of 'engaged with peer worker'; (2) number of face-to-face contacts with peer worker post-discharge. Two sets of independent variables were analysed against each outcome: (1) pre-randomisation participant characteristics; (2) implementation factors measured pre-discharge. Analyses used logistic and zero-inflated negative binomial regression models according to outcome structure. RESULTS Data were analysed for 265 participants randomised to peer support who had a known peer worker. Non-heterosexual participants had increased odds of engaging with peer support compared to heterosexual participants, OR = 4.38 (95% CI: 1.13, 16.9, p = .032). Longer duration of first contact with peer worker (OR = 1.03, 95% CI: 1.00, 1.04, p < .001) and more relationship building activities in the first contact (OR = 1.4, 95% CI: 1.13, 1.85, p = .004) were associated with greater odds of engaging with peer support. Analysis of number of contacts post-discharge showed consistent findings. CONCLUSIONS Implementation of peer support should include a focus on relationship building in the first session of peer support. The potential for peer support to break down barriers to accessing mental health services experienced by people from marginalised communities warrants further investigation.
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Affiliation(s)
| | | | - Stephen Bremner
- Brighton and Sussex Medical School, University of Sussex, UK
| | | | | | | | | | | | | | | | | | - Julie Repper
- Implementing Recovery through Organisational Change, Nottingham, UK
| | - Miles Rinaldi
- South West London & St George's Mental Health NHS Trust, UK
| | | | | | - Michael Ussher
- St George's, University of London, UK.,University of Stirling, UK
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Gillard S, Barlow S, Bremner S, Foster R, Gibson S, Goldsmith L, Healey A, Lucock M, Marks J, Patel A, Patel S, Priebe S, Rinaldi M, Simpson A, Ussher M, White S. Peer support for discharge from inpatient mental health care - Authors' reply. Lancet Psychiatry 2022; 9:542-543. [PMID: 35717962 DOI: 10.1016/s2215-0366(22)00205-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Steve Gillard
- School of Health and Psychological Sciences, City, University of London, London EC1V 0HB, UK.
| | - Sally Barlow
- School of Health and Psychological Sciences, City, University of London, London EC1V 0HB, UK
| | - Stephen Bremner
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Rhiannon Foster
- School of Health and Psychological Sciences, City, University of London, London EC1V 0HB, UK
| | - Sarah Gibson
- Joint Faculty of Health, Social Care and Education, Kingston University London and St George's, University of London, London, UK
| | - Lucy Goldsmith
- Population Health Research Institute, St George's, University of London, London, UK
| | - Andrew Healey
- King's Health Economics, King's College London, London, UK
| | - Mike Lucock
- Centre for Applied Research in Health, University of Huddersfield, Huddersfield, UK
| | - Jacqueline Marks
- Population Health Research Institute, St George's, University of London, London, UK
| | - Akshaykumar Patel
- Pragmatic Clinical Trials Unit, Queen Mary, University of London, London, UK
| | - Shalini Patel
- Adult Community Mental Health Team, South West London and St George's Mental Health NHS Trust, London, UK
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Miles Rinaldi
- Strategy and Transformation, South West London and St George's Mental Health NHS Trust, London, UK; Centre for Work and Mental Health, Nordland Hospital Trust, Bodø, Norway
| | - Alan Simpson
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Michael Ussher
- Population Health Research Institute, St George's, University of London, London, UK; Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Sarah White
- Population Health Research Institute, St George's, University of London, London, UK
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Gillard S, Foster R, White S, Barlow S, Bhattacharya R, Binfield P, Eborall R, Faulkner A, Gibson S, Goldsmith LP, Simpson A, Lucock M, Marks J, Morshead R, Patel S, Priebe S, Repper J, Rinaldi M, Ussher M, Worner J. The impact of working as a peer worker in mental health services: a longitudinal mixed methods study. BMC Psychiatry 2022; 22:373. [PMID: 35650562 PMCID: PMC9158348 DOI: 10.1186/s12888-022-03999-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/13/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Peer workers are increasingly employed in mental health services to use their own experiences of mental distress in supporting others with similar experiences. While evidence is emerging of the benefits of peer support for people using services, the impact on peer workers is less clear. There is a lack of research that takes a longitudinal approach to exploring impact on both employment outcomes for peer workers, and their experiences of working in the peer worker role. METHODS In a longitudinal mixed methods study, 32 peer workers providing peer support for discharge from inpatient to community mental health care - as part of a randomised controlled trial - undertook in-depth qualitative interviews conducted by service user researchers, and completed measures of wellbeing, burnout, job satisfaction and multi-disciplinary team working after completing training, and four and 12 months into the role. Questionnaire data were summarised and compared to outcomes for relevant population norms, and changes in outcomes were analysed using paired t-tests. Thematic analysis and interpretive workshops involving service user researchers were used to analysis interview transcripts. A critical interpretive synthesis approach was used to synthesise analyses of both datasets. RESULTS For the duration of the study, all questionnaire outcomes were comparable with population norms for health professionals or for the general population. There were small-to-medium decreases in wellbeing and aspects of job satisfaction, and increase in burnout after 4 months, but these changes were largely not maintained at 12 months. Peer workers felt valued, empowered and connected in the role, but could find it challenging to adjust to the demands of the job after initial optimism. Supervision and being part of a standalone peer worker team was supportive, although communication with clinical teams could be improved. CONCLUSIONS Peer workers seem no more likely to experience negative impacts of working than other healthcare professionals but should be well supported as they settle into post, provided with in-work training and support around job insecurity. Research is needed to optimise working arrangements for peer workers alongside clinical teams.
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Affiliation(s)
| | - Rhiannon Foster
- grid.28577.3f0000 0004 1936 8497City, University of London, London, UK
| | - Sarah White
- grid.264200.20000 0000 8546 682XSt George’s, University of London, London, UK
| | - Sally Barlow
- grid.28577.3f0000 0004 1936 8497City, University of London, London, UK
| | - Rahul Bhattacharya
- grid.450709.f0000 0004 0426 7183East London NHS Foundation Trust, London, UK
| | - Paul Binfield
- grid.450709.f0000 0004 0426 7183East London NHS Foundation Trust, London, UK
| | - Rachel Eborall
- grid.37640.360000 0000 9439 0839South London & Maudsley NHS Foundation Trust, London, UK
| | | | - Sarah Gibson
- grid.264200.20000 0000 8546 682XSt George’s, University of London, London, UK
| | - Lucy P. Goldsmith
- grid.264200.20000 0000 8546 682XSt George’s, University of London, London, UK
| | - Alan Simpson
- grid.13097.3c0000 0001 2322 6764King’s College London, London, UK
| | - Mike Lucock
- grid.15751.370000 0001 0719 6059University of Huddersfield, Huddersfield, UK
| | - Jacqui Marks
- grid.264200.20000 0000 8546 682XSt George’s, University of London, London, UK
| | - Rosaleen Morshead
- grid.264200.20000 0000 8546 682XSt George’s, University of London, London, UK
| | - Shalini Patel
- grid.439450.f0000 0001 0507 6811South West London & St George’s Mental Health NHS Trust, London, UK
| | - Stefan Priebe
- grid.4868.20000 0001 2171 1133Queen Mary, University of London, London, UK
| | - Julie Repper
- Implementing Recovery through Organisational Change, Nottingham, UK
| | - Miles Rinaldi
- grid.439450.f0000 0001 0507 6811South West London & St George’s Mental Health NHS Trust, London, UK
| | - Michael Ussher
- grid.264200.20000 0000 8546 682XSt George’s, University of London, London, UK ,grid.11918.300000 0001 2248 4331University of Stirling, Stirling, UK
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