Abstract

Background:Peers are people with lived experience of mental illness. Peer support is an established intervention in which peers offer support to others with mental illness. A large proportion of people living with severe mental illness receive no care. The care gap is largest in low- and middle-income countries, with detrimental effects on individuals and societies. The global shortage of human resources for mental health is an important driver of the care gap. Peers are an under-used resource in global mental health.Objectives:To describe rationale and methodology of an international multicentre study which will scale-up peer support for people with severe mental illness in high-, middle-, and low-income countries through mixed-methods implementation research.Methods:UPSIDES is an international community of research and practice for peer support, including peer support workers, mental health researchers, and other relevant stakeholders in eight study sites across six countries in Europe, Africa, and Asia. During the first two years of UPSIDES, a series of qualitative studies and systematic reviews will explore stakeholders’ perceptions and the current state of peer support at each site. Findings will be incorporated into a conceptual framework to guide the development of a culturally appropriate peer support intervention to be piloted across all study sites. All intervention and study materials will be translated according to internationally recognised guidelines.Expected Impact:UPSIDES: will leverage the unique expertise of people with lived experience of mental illness to strengthen mental health systems in high-, middle- and low-income countries. UPSIDES will actively involve and empower service users and embed patient-centeredness, recovery orientation, human rights approaches, and community participation into services. The focus on capacity-building of peers may prove particularly valuable in low-resource settings in which shortages of human capital are most severe.

Highlights

  • Peer support has been defined as “a direct service that is delivered by a person with a serious mental illness to a person with a serious mental disorder

  • UPSIDES is a collaboration of researchers at eight study sites in six countries: Ulm University, Germany; University of Nottingham, UK; Implementing Recovery through Organisational Change (ImROC), UK; University Hospital Hamburg-Eppendorf, Germany; Butabika National Referral Hospital, Uganda; London School of Hygiene and Tropical Medicine, UK; Ifakara Health Institute, Dar es Salaam, Tanzania; Ben-Gurion University of the Negev, Beer Sheva, Israel; and Centre for Mental Health Law and Policy, Pune, India

  • UPSIDES will: (1) Draw upon the knowledge of people with a lived experience of mental illness which is an untapped resource in global mental health

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Summary

Introduction

Peer support has been defined as “a direct service that is delivered by a person with a serious mental illness to a person with a serious mental disorder. Peer support can be provided in different settings as an alternative to an independent service within or an integral part of professional care [7] As such, it provides mechanisms for people with lived experience of mental illness to engage with those whose need for support is high, but who are often alienated from traditional health services [6]. Objectives: To describe rationale and methodology of an international multicentre study which will scaleup peer support for people with severe mental illness in high-, middle-, and low-income countries through mixed-methods implementation research. Expected Impact: UPSIDES: will leverage the unique expertise of people with lived experience of mental illness to strengthen mental health systems in high-, middle- and low-income countries. The focus on capacity-building of peers may prove valuable in low-resource settings in which shortages of human capital are most severe

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