Abstract
BackgroundThe COVID-19 pandemic has led to a global mental health crisis, highlighting the need for a focus on community-wide mental health. Emotional CPR (eCPR) is a program and practice developed by persons with a lived experience of recovery from trauma or mental health challenges to train community members from diverse backgrounds to support others through mental health crises. eCPR trainers have found that eCPR may promote feelings of belonging by increasing supportive behaviors toward individuals with mental health problems. Thus, clinical outcomes related to positive and negative affect would improve along with feelings of loneliness.ObjectiveThis study examined the feasibility and preliminary effectiveness of eCPR.MethodsWe employed a pre-post design with 151 individuals, including peer support specialists, service users, clinicians, family members, and nonprofit leaders, who participated in virtual eCPR trainings between April 20, 2020, and July 31, 2020. Instruments were administered before and after training and included the Herth Hope Scale; Empowerment Scale; Flourishing Scale (perceived capacity to support individuals); Mindful Attention Awareness Scale; Active-Empathic Listening Scale (supportive behaviors toward individuals with mental health challenges); Social Connectedness Scale (feelings of belonging and connection with others); Positive and Negative Affect Schedule; and University of California, Los Angeles 3-item Loneliness Scale (symptoms and emotions). The eCPR fidelity scale was used to determine the feasibility of delivering eCPR with fidelity. We conducted 2-tailed paired t tests to examine posttraining improvements related to each scale. Additionally, data were stratified to identify pre-post differences by role.ResultsFindings indicate that it is feasible for people with a lived experience of a mental health condition to develop a program and train people to deliver eCPR with fidelity. Statistically significant pre-post changes were found related to one’s ability to identify emotions, support others in distress, communicate nonverbally, share emotions, and take care of oneself, as well as to one’s feelings of social connectedness, self-perceived flourishing, and positive affect (P≤.05). Findings indicated promising evidence of pre-post improvements (not statistically significant) related to loneliness, empowerment, active-empathetic listening, mindfulness awareness, and hope. Nonprofit leaders and workers demonstrated the greatest improvements related to loneliness, social connectedness, empathic listening, and flourishing. Peer support specialists demonstrated the greatest improvements related to positive affect, and clinicians demonstrated the greatest improvements related to mindfulness awareness.ConclusionsPromising evidence indicates that eCPR, a peer-developed and peer-delivered program, may increase feelings of belonging while increasing supportive behaviors toward individuals with mental health problems and improving clinical outcomes related to positive and negative affect and feelings of loneliness.
Highlights
To date, the United States has had over 22.8 million confirmed COVID-19 cases and over 500,000 associated deaths [1]
Data were stratified to identify pre-post differences by role. Findings indicate that it is feasible for people with a lived experience of a mental health condition to develop a program and train people to deliver Emotional CPR (eCPR) with fidelity
Promising evidence indicates that eCPR, a peer-developed and peer-delivered program, may increase feelings of belonging while increasing supportive behaviors toward individuals with mental health problems and improving clinical outcomes related to positive and negative affect and feelings of loneliness
Summary
The United States has had over 22.8 million confirmed COVID-19 cases and over 500,000 associated deaths [1]. The United Nations has called for widespread mental health psychoeducation to identify, understand, and support people outside of clinical environments [5]. Community mental health psychoeducation training programs have been disseminated internationally and have been shown to increase participants’ knowledge regarding mental health, decrease negative attitudes about mental health care, and increase supportive behaviors toward individuals with mental health problems among a diverse group of trainees (eg, adults, youth and teens, public safety officials, first responders, veterans, rural community members, students in higher education, and older adults) [6]. Advocates, provider organizations, policy makers, and researchers concur that widespread psychoeducation is essential for communities to identify, understand, and respond to signs of mental health conditions. ECPR trainers have found that eCPR may promote feelings of belonging by increasing supportive behaviors toward individuals with mental health problems. Clinical outcomes related to positive and negative affect would improve along with feelings of loneliness
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