Abstract
BackgroundPeer support services for patients with severe mental illness (SMI) originated from Western countries and have become increasingly popular during the past twenty years. The aim of this paper is to describe a peer service model and its implementation in China, including the model’s feasibility and sustainability.MethodsA peer support service was developed in four Chinese communities. Implementation, feasibility and sustainability were assessed across five domains: Service process, service contents, peer training and supervision, service satisfaction, and service perceived benefit.ResultsService process: 214 peer support activities were held between July 2013 and June 2016. No adverse events occurred during three years. Each activity ranged from 40 to 120 min; most were conducted in a community rehabilitation center or community health care center. Service content: Activities focused on eight primary topics—daily life skills, social skills, knowledge of mental disorders, entertainment, fine motor skill practice, personal perceptions, healthy life style support, emotional support. Peer training and supervision: Intensive training was provided for all peers before they started to provide services. Regular supervision and continued training were provided thereafter; online supervision supplemented face to face meetings. Service satisfaction: Nineteen consumers (79.2%) (χ2(1) = 12.76, p < 0.001) were satisfied with the peers and 17 consumers (70.8%) (χ2(1) = 8.05, p = 0.005) expressed a strong desire to continue to participate in the service. Fourteen caregivers (93.3%) (χ2(1) = 11.27, p = 0.001) wanted the patients to continue to organize or participate in the service. Service perceived benefit: Six peers (85.7%) (χ2(1) = 3.57, p = 0.059) reported an improvement of working skills. Ten consumers (41.7%) (χ2(1) = 0.05, p = 0.827) reported better social communication skills. Six caregivers (40%) (χ2(1) = 1.67, p = 0.197) observed patients’ increase in social communication skills, five (33.3%) (χ2(1) = 1.67, p = 0.197) found their own mood had been improved.ConclusionsPeer support services for patients with SMI can be sustainably implemented within Chinese communities without adverse events that jeopardize safety and patient stability. Suggestions for future service development include having professionals give increased levels of support to peers at the beginning of a new program. A culturally consistent peer service manual, including peer role definition, peer training curriculum, and supervision methods, should be developed to help implement the service smoothly.
Highlights
Peer support services for patients with severe mental illness (SMI) originated from Western countries and have become increasingly popular during the past twenty years
We described the implementation of a peer support service in China
Peers who agreed to participate in were subsequently utilized if they met the following inclusion criteria: Diagnosed with schizophrenia or bipolar disorder which was recoded from their medical record provided by community doctors; age between 18 and 60 years old; stable at least 6 months, being adherent with medications according to patients’ and family members’ report, and having insight about their disease which was assessed through individual interviews conducted by psychiatrists; no drug or alcohol abuse; no severe medical illness; and having good social functioning which was assessed by the personal and social performance scale (PSP), more than 50 scores in PSP is required [31]
Summary
Peer support services for patients with severe mental illness (SMI) originated from Western countries and have become increasingly popular during the past twenty years. Peer support services are designed to bring together people with similar life experiences, culture, living environments, social status, concerns, and daily challenges [1]. This commonality promotes mutual respect, and it enables sharing of information, practical strategies and ongoing support that are critical to sustained behavior change [1]. Providing peer support services can promote peers’ communication skills, improve emotional and verbal expression, and increase social functioning [9]. All of these benefits contribute directly to the recovery process. By demonstrating that people with SMI can recover and work, peer service providers are able to promote social understanding and acceptance, decrease social stigma and fear, and decrease patients’ feelings of shame and isolation [14]
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