Abstract
BackgroundIn recent years the use of peer specialists in the delivery of mental health of care across the US has increased. Although data on the benefits of using peer specialists is limited and/or equivocal, states are making policy and funding decisions to support the expansion of peer specialist services. This data is even more limited in the state of Florida where no studies were found to document the effect of peer specialists on mental health care outcomes. The purpose of this study was to assess whether local decisions to use peer specialists can be supported through the measurement of outcomes of service utilization and mental health functioning when peer specialists are involved in the treatment of individuals living with serious mental illness.MethodsThe study was conducted using service data collected by South Florida Behavioral Health Network (SFBHN). SFBHN is the Managing Entity for publicly funded mental health and substance abuse services in Miami-Dade and Monroe Counties in Florida. We compared mental health outcomes and service utilization between individuals who received peer specialist services (n = 367) and a treatment as usual group (n = 1468) matched on gender, age and severity of diagnosis in the period July 2013 and June 2015. Multilevel models were used to evaluate the functioning outcomes between the groups. Service utilization was assessed using negative binomial regression.ResultsIndividuals in the treatment group receiving peer specialist services utilized more ambulatory/lower levels of care services and had more frequent crisis stabilization unit admissions. Those in the treatment group also displayed more functional difficulties with a variety of practical activities, employment and housing and violent temper, hostility, threatening behaviors.ConclusionsThe findings of the study further support existing evidence documenting the mixed benefits of using peer services compared to treatment as usual care. Policy makers and other stakeholders are encouraged to advance mental health recovery by examining outcomes more comprehensively. Future research should include examination of the subjective benefits of peer support for recipients, understanding the impact on service utilization and a better definition of the roles, supervision and expectations of peer support programs.
Highlights
In recent years the use of peer specialists in the delivery of mental health of care across the United States (US) has increased
Individuals in the treatment group were more likely to be admitted to high level of care services, crisis stabilization unit (CSU) (IRR = 1.3) and short term residential/short term residential treatment (SRT) (IRR = 1.3), this prediction was not statistically significant for SRT (Table 4)
As the time of treatment progressed, the average length of stay increased at a lower rate for individuals in the treatment group when compared with the treatment as usual (TAU) group
Summary
In recent years the use of peer specialists in the delivery of mental health of care across the US has increased. Data on the benefits of using peer specialists is limited and/or equivocal, states are making policy and funding decisions to support the expansion of peer specialist services. This data is even more limited in the state of Florida where no studies were found to document the effect of peer specialists on mental health care outcomes. Since 2003, this increase can be attributable in part to the recommendation of the President’s New Freedom Commission on Mental Health for the integration of peer support services into the continuum of community care [5]. Funders are increasingly demanding evidence that program models work
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