Experiences Of Peer Support Research Articles

A realist change model for community-based perinatal mental health peer support from peer volunteers

ABSTRACT Aims To investigate what it is about community-based perinatal mental health peer support from trained volunteers that works, for whom, in what circumstances, in what respects, and why; and build a change model that includes positive and negative mechanisms and outcomes. Methods Realist evaluation methods based on semi-structured interviews were used to create a change model for a third sector programme in England. Results Mothers who received peer support (n = 20), peer support volunteers (n = 27), and programme staff (n = 9) were interviewed. Positive impact on mothers was primarily based on feeling understood and accepted, social comparison (including normalisation, hope, and gaining perspective) and sharing non-directive information from experiential knowledge. Negative impact on mothers was based on negative social comparison, or absence of key peer support mechanisms. Mothers were affected in different ways, depending on individual contexts: their backgrounds, personalities, social situations, resources, experiences, beliefs, and needs. Some different mechanisms were present in one-to-one and group situations. All participants considered the benefits of peer support to greatly outweigh the risks. Conclusion Individual contextual factors affect the multiple mechanisms through which mental health peer support can improve mothers’ emotional wellbeing and social participation. Peer support has potential risks as well as benefits, which can be mitigated. Programmes could use this understanding of how contexts and mechanisms interact to produce peer support outcomes to improve training for peer support volunteers and to design future evaluations that take into account diversity of peer support experience.

Peer support for eating disorders in Canada: program user perspectives

Evidence for the value of peer support for eating disorders (EDs) is growing. Peer support is not a replacement for treatment, but can provide hope for recovery, enhance motivation for treatment, and increase feelings of connectedness and belonging for those experiencing EDs. In this study, we explored peer mentees’ experiences of peer support for EDs to better understand the impact of peer support and its role in the Canadian treatment and support continuum. We conducted semi-structured interviews with 20 people who had received peer support (group, one-on-one, or chat) and conducted a reflexive thematic analysis through a critical realist lens. We developed four themes. Participants described the importance of connecting with others who had “been there,” which helped generate a sense of belonging and connectedness. They also highlighted aspects of the peer support “container” that needed to be in place, such as guidelines for groups and agreements for one-on-one mentoring. When peer support was delivered well, participants described how it helped them help themselves through increasing motivation, communication skills, and other coping skills. Finally, participants described the unique role of peer support within the treatment continuum, as a modality that was accessible, free, and delivered in a way that focused on the whole person. Together, our findings illustrate the value of peer support and considerations for enabling effective and safe peer support delivery.

Connected from Afar: Culturally Grounded Remote Peer Support During the COVID-19 Pandemic

In this article, two PhD students from separate Canadian universities, both sharing an immigrant background, engage in autobiographical narrative inquiry, highlighting the importance of peer-support experiences during the pandemic. They explore their journeys as immigrants and PhD students, recounting their experiences in a virtual support group. This narrative illustrates the exchange of academic, mental health and personal support rooted in shared culture, language and ethnicity. The study provides insights into the benefits of peer support on virtual platforms and adds immigrant perspectives. It suggests that university administrators can find innovative ways to support marginalized students, fostering mutual support among them, particularly in the remote-learning context of COVID. This article highlights the potential for authentic and effective support systems that address the unique challenges faced by immigrant and marginalized students, enhancing their academic and personal development.

The Construction of Peer Support Among Recently Diagnosed Breast Cancer Patients.

Breast cancer (BC) and its treatments decrease patients' psychological well-being. Peer support is one form of social support, but little is known about what gives rise to peer support. The purpose of this study was to examine how peer support is constructed among recently diagnosed BC patients. Eighteen women were randomly picked from 130 women who had received phone calls from a trained peer supporter and were invited to group interviews. In the interviews, patients discussed their cancer, peer support experiences, and social support. The transcribed data were analyzed using Braun and Clarke's thematic analysis approach. The construction of peer support among newly diagnosed BC patients was complex. It depended on the needs of the patient and the success of interactions. Once they had received a diagnosis, the lives of the patients changed suddenly, and patients dove into the I-we-others consideration and had a need to talk. Interaction with peer supporters gave them a chance to share their stories. At their best, interactions led to belonging, caring, and a sense of security. The need to be heard and seen is strong in a patient's changing health situation. Peer support plays an important role in high-standard care and in strengthening patients' self-determination. Hospitals should create chances for supportive communication, and the supportive communication should be easily accessible and successful. The training of peer supporters should ensure that they have reflected on their own BC process and know how to consider the needs of newly diagnosed patients.

Operational Mechanisms of Peer Support Groups and Support for Caregivers of People Living with Serious Mental Illness.

The challenges faced by caregivers of people living with serious mental illness in Canada are well documented in the literature including emotional distress, financial strain, social isolation, and concerns about their physical health following the impact of caregiving. Peer support programs (including peer support groups) emerged as a promising method to attempt to address these challenges. While there is evidence on the positive impacts of peer support groups in providing support for caregivers, the mechanisms by which peer support groups operate and influence support for caregivers of people living with serious mental illness are less understood. This qualitative study took on a co-designed participatory research approach. Fifteen adult caregivers of people living with serious mental illness across Canada were engaged through key informant interviews that lasted for 45-60min each. A thematic analysis was carried out to help understand the operational mechanisms of peer support groups in influencing support for caregivers. The key informant interviews allowed for the identification and description of the following operational mechanisms that influenced the support caregivers received from peer support groups: (1) Group dynamics; (2) Messaging/content; (3) Equity and inclusion, (4) Group philosophy; and (5) Privacy concerns. Findings from this study showed that caregivers identified a number of operational mechanisms of peer support groups that explained how they felt supported when they participated in peer support groups. Among other operational mechanisms, group dynamics in terms of the gathering of caregivers of different age brackets and varying caregiving experience negatively influenced the peer support experience of caregivers. This pointed to the need for group dynamics that consider close age ranges and similar caregiving experience during group meetings to enhance support for caregivers. Caregivers also identified a gap in equity and inclusion in peer support groups that could have otherwise enriched their experience and enhanced the support they looked to receive from the group. Practical examples to enhance equity and inclusion include promoting active listening, using inclusive language, encouraging diverse representation and asking for feedback from peer support group members. While peer support groups in Canada exist independently of one another, it may help to consolidate evidence-based recommendations in the operational mechanisms of these groups, for the benefit of caregivers who turn to these groups for support, having been left on their own by an otherwise fractured mental health system.

정신장애인 동료지원활동 경험에 대한 개념도 연구

The purpose of this study was to explore the peer support experiences of peer support for persons with mental illness using concept mapping methodology to derive key concepts in peer support for people with mental illness and to suggest directions for the expansion and development of peer support. To this end, interviews were conducted with 11 mental illness who had completed the peer support for persons with mental illness training educational program and had experience in peer support activities, and 79 core statements were derived. The research participants then sorted and rated the final derived statements, and the data were generated in a Group Similarity Matrix and Multidi- mensional Scaling and Hierarchical Cluster Analysis and Hierarchical Clustering Analysis (Ward method). As a result, the peer support practice experiences of peer supporters with mental illness were divided into practice efforts factors and practice effectiveness factors, and peer support practice direction factors and peer support practitioner factors, and were categorized into six clusters: “Perspectives on peers,” “Necessary competencies as experience experts,” “Continuous learning process,” “Promoting life recovery,” “Mutual growth of self and peers,” and “Positioning as a profession”. The study participants rated the sixth of the categorized groups, “Positioning as an Occupational Group,” as the most important. Based on these findings, recommends directions for promoting peer support, including institutionalizing peer support for persons with mental illness.

Mental health workers’ perspectives on the implementation of a peer support intervention in five countries: qualitative findings from the UPSIDES study

ObjectiveThe introduction of peer support in mental health teams creates opportunities and challenges for both peer and non-peer staff. However, the majority of research on mental health workers’ (MHWs) experiences...

Ways Rural Group Peer Support Experiences Support PTSD Care

Ways Rural Group Peer Support Experiences Support PTSD Care

The effectiveness, implementation, and experiences of peer support approaches for mental health: a systematic umbrella review

BackgroundPeer support for mental health is recommended across international policy guidance and provision. Our systematic umbrella review summarises evidence on the effectiveness, implementation, and experiences of paid peer support approaches for mental health.MethodsWe searched MEDLINE, EMBASE, PsycINFO, The Campbell Collaboration, and The Cochrane Database of Systematic Reviews (2012–2022) for reviews of paid peer support interventions for mental health. The AMSTAR2 assessed quality. Results were synthesised narratively, with implementation reported using the CFIR (Consolidated Framework for Implementation Research). The protocol was registered with PROSPERO (registration number: CRD42022362099).ResultsWe included 35 reviews (426 primary studies, n = 95–40,927 participants): systematic reviews with (n = 13) or without (n = 13) meta-analysis, or with qualitative synthesis (n = 3), scoping reviews (n = 6). Most reviews were low or critically low (97%) quality, one review was high quality. Effectiveness was investigated in 23 reviews. Results were mixed; there was some evidence from meta-analyses that peer support may improve depression symptoms (particularly perinatal depression), self-efficacy, and recovery. Factors promoting successful implementation, investigated in 9 reviews, included adequate training and supervision, a recovery-oriented workplace, strong leadership, and a supportive and trusting workplace culture with effective collaboration. Barriers included lack of time, resources and funding, and lack of recognised peer support worker (PSW) certification. Experiences of peer support were explored in 11 reviews, with 3 overarching themes: (i) what the PSW role can bring, including recovery and improved wellbeing for service users and PSWs; (ii) confusion over the PSW role, including role ambiguity and unclear boundaries; and (iii) organisational challenges and impact, including low pay, negative non-peer staff attitudes, and lack of support and training.ConclusionsPeer support may be effective at improving some clinical outcomes, self-efficacy, and recovery. Certain populations, e.g. perinatal populations, may especially benefit from peer support. Potential strategies to successfully implement PSWs include co-production, clearly defined PSW roles, a receptive hierarchical structure and staff, appropriate PSW and staff training with clinical and/or peer supervision alongside safeguarding. Services could benefit from clear, coproduced, setting specific implementation guidelines for PSW. PSW roles tend to be poorly defined and associations between PSW intervention content and impacts need further investigation. Future research should reflect the priorities of providers/service users involved in peer support.

Experiences of a peer group for people diagnosed with borderline personality disorder: A qualitative interview study.

There is a notable lack of literature evaluating peer support for people with a diagnosis of borderline personality disorder (BPD). Peer-led groups have been shown to positively impact outcomes related to empowerment, hope, and self-efficacy beliefs for consumers diagnosed with serious mental illness and may also be a helpful option for those experiencing personality disorder symptoms. We outline the coproduction of a peer group for people with a lived experience of BPD and a qualitative analysis of feedback post-group participation. Twenty-two consumers participated in post-group interviews and described their experiences of peer support. Interview transcripts were coded, and three main themes were identified: growth and change, connection and feeling understood, and creating safety. The findings suggested that participation in a coproduced peer support group for people with a diagnosis of BPD facilitated positive personal transformation as well as opportunities to develop connection through shared experiences in a safe environment grounded in mutuality. These themes were particularly powerful for participants because they countered previous experiences of not feeling safe, understood, or equal when seeking treatment. These findings support the acceptability of implementing a coproduced group for people diagnosed with BPD in a community mental health setting.

“Nowhere else to be found”: Drawing on peer support experiences among transgender and gender-diverse people to substantiate community-driven gender-affirming care

Increasingly, applied social scientists and clinicians recognize the value of engaging transgender and gender-diverse (TGD) people, particularly TGD individuals with lived experience as care recipients (peers), to inform the provision of gender-affirming care. Despite this trend, few researchers have systematically examined how this group can contribute to and enhance the development and delivery of interventions intended to affirm gender diversity. In this article, we address limitations in the literature by drawing on a secondary analysis of qualitative data – originally collected to examine the peer support experiences of TGD individuals – to explore the potential that TGD peers hold for elevating gender-affirming care. The study was informed methodologically by an abductive approach to grounded theory, and conceptually by critical resilience and intersectional scholarship. Data collection involved virtual, semi-structured interviews with 35 TGD individuals in two Canadian cities who indicated having experiences of seeking, receiving, and/or providing peer support. Data analysis comprised an iterative, abductive process of cross-referencing participant accounts with relevant scholarship to arrive at an account of how TGD peers may contribute to the growth of gender-affirming care. Our findings suggest, broadly, that TGD peers may enhance gender-affirming care by: (1) validating a growing diversity of embodiments and experiences in healthcare decision-making, (2) nurturing and diversifying relevant networks of safety, community support, and advocacy outside formal systems of care, and (3) strengthening possibilities for resisting and transforming existing healthcare systems. After outlining these findings, we briefly consider the implications of our analysis and leverage our inferences to substantiate the notion of community-driven gender-affirming care, meaning care that is intentional in its incorporation of relevant community stakeholders to shape governance and service provision. We conclude with reflections on the promise of community-driven care at a time of heightened volatility across systems serving TGD populations.

The Belo Horizonte’s harm reducers as a possible and effective peer support experience

PurposeThis article aims to analyze the incorporation of harm reduction health workers with lived experience in all services focused on the care for drug users in Belo Horizonte’s mental health network, one of the largest Brazilian Psychosocial Care Networks (Rede de Atenção Psicossocial [RAPS]), and reports the findings of a qualitative study on the life stories, recovery journeys and the professional practice of harm reducers in Belo Horizonte.Design/methodology/approachFor the development of this research, the authors chose the following methodological tools: documentary research; follow-up of harm reduction interventions; access to harm reducers’ field diaries; joint writing of the life stories of the harm reducers.FindingsIt indicates that these professionals, as harm reducers empowered by their life experience, have developed various elements and active ingredients of peer support. Their practices and the results of their actions have consolidated their inclusion as Belo Horizonte RAPS’ health workers and highlight that recovery-oriented care and peer support are a real possibility in Brazil.Originality/valueIn this research, harm reducers are coauthors and report their own life experience. In this article, they also talk about the impact of this experience on their work and on the lives of users of mental health services, emphasizing the protagonism and exercise of citizenship by harm reducers.

A qualitative exploration of the psychosocial needs of people living with long-term conditions and their perspectives on online peer support.

Approximately 20% of people with a long-term condition (LTC) experience depressive symptoms (subthreshold depression [SUBD]). People with SUBD experience depressive symptoms that do not meet the diagnostic criteria for major depressive disorder. However, there is currently no targeted psychological support for people with LTCs also experiencing SUBD. Online peer support is accessible, inexpensive and scalable, and might offer a way of bridging the gap in psychosocial care for LTC patients. This article explores the psychosocial needs of people living with LTCs and investigates their perspectives on online peer support interventions to inform their future design. Through a co-produced participatory approach, online focus groups were completed with people with lived experience of LTCs. Focus groups were audio recorded and transcribed verbatim. Reflexive thematic analysis (TA) was conducted adopting a critical-realist approach and an inductive analysis methodology that sought to follow participants' priorities and concerns. Ten people with a range of LTCs participated across three online focus groups, lasting an average of 95 (±10.1) min. The mean age was 57 (±11.4) years and 60% of participants identified as female. The three key emerging themes were: (1) relationship between self and outside world; (2) past experiences of peer support;and (3) philosophy and vision of peer support. Adults living with LTCs shared their past experiences of peer support and explored their perspectives on how future online peer support platforms may support their psychosocial needs. Despite the negative impact(s) of having a long-term physical health condition on mental health, physical and mental healthcare are often treated as separate entities. The need for an integrated approach for people with LTCs was clear. Implementation of online peer support to bridge this gap was supported, but there was a clear consensus that these interventions need to be co-produced and carefully designed to ensure they feel safe and not commercialised or prescriptive. Shared explorations of the potential benefits and concerns of these online spaces can shape the philosophy and vision of future platforms. This work is set within a wider project which is developing an online peer support platform for those living with LTCs. A participatory, co-produced approach is integral to this work. The initial vision was steered by the experiences of our Patient and Public Involvement (PPI) groups, who emphasised the therapeutic value of peer-to-peer interaction. The focus groups confirmed the importance and potential benefit of this project. This paper represents the perspectives of PPI members who collaborate on research and public engagement at the mental-physical interface. A separate, independent Research Advisory Group (RAG), formed of members also living with LTCs, co-produced study documents, topic guides, and informed key decision-making processes. Finally, our co-investigator with lived experience (E. A.F.) undertook the analysis and write-up alongside colleagues, further strengthening the interpretation and resonance of our work. She shares first joint authorship, and as a core member of the research team, ensures that the conduct of the study is firmly grounded in the experience of people living with LTCs.

Finding a safe space for learning and exploration: A qualitative study of recently diagnosed men's experiences of peer support for HIV in Sweden.

In Sweden men account for most new HIV cases, and little is known about the peer support needs of people living with HIV in Sweden. This qualitative study explored how recently diagnosed men perceive and experience peer support in Sweden. Purposively sampled from HIV patient organizations and infectious disease clinics throughout Sweden, data was collected through in-depth individual interviews with 10 men living with HIV, who have experience participating in peer support. Latent and manifest qualitative content analysis produced the overarching theme of Finding a safe space for learning and exploration. Participants used peer support to access key information and skills and as a space to safely explore life with HIV. Participants perceived successful peer support as having the right peer while also receiving support at the right location. Study recommendations include further research on how a peer is defined within the U = U era, further research on the peer support needs of young adults, and further research on the accessibility of peer support.

“It saves lives”: Peer support and resilience in transgender and gender diverse communities

Transgender (trans) and gender diverse (TGD) populations continue to experience significant inequities in social and health outcomes, often in connection with the systemic exposure of these groups to violence, stigma, and discrimination. Despite the promising role of peer support in mitigating adverse impacts of marginalization, this phenomenon remains under-examined. In this study, which is informed methodologically by an abductive approach to grounded theory and anchored theoretically in scholarship on critical resilience and intersectionality, we draw on individual semi-structured interviews with 35 TGD individuals located in two major cities in Canada (Toronto and Vancouver) to examine experiences of peer support. We also consider the role of peer support in building resilience among participants. Our findings are organized into four interrelated themes that both represent the constituent parts of peer support, and that explicate the connections between peer support and resilience. These include: (1) becoming visible to connect with similar others, (2) sharing embodiment, experience, and space, (3) constructing possibilities of being and collectivizing, and (4) surviving and thriving (at a cost). We leverage our findings to consider implications for research, policy, and practice, one of which includes the need for ongoing inquiry to substantiate the critical role of peer support in promoting health across diverse TGD communities.

“They make a difference”: a qualitative study of providers’ experiences of peer support in outpatient clinics for people living with HIV

BackgroundAlthough the life expectancy of people living with HIV has increased, they are still often disconnected from society through stigma and discrimination. Peer support has been found to increase social support. Given the limited research on peer support from the providers’ perspective, this study explored how peer supporters experience their roles and contributions in outpatient clinics (OPCs). Additionally, healthcare professionals’ perceptions of working with peer supporters in OPCs were examined. MethodsThis qualitative study included purposively selected peer supporters (n = 10) and healthcare professionals (n = 5) from five OPCs in Norway in 2020. In-depth interviews and focus group discussions were conducted in Norwegian or English, using interview guides. Interview transcripts were analysed in NVivo 12 using reflexive and collaborative thematic analysis.ResultsThe results show that peer supporters experience mutual support through emotional and honest interactions. Further, the peer supporters found it essential to negotiate with the service users about their preconception of HIV, confront their views through dialogue, and replicate positive experiences by being credible role models. The participants expressed that integrating peer support in the OPCs’ usual care processes increased the prospect of equitable services. Quality of peer support and role clarity were identified as critical components. The results demonstrate that emotional and honest conversations promote support between peers and that peer supporters identify a need for a reframed understanding of HIV by modelling plausible alternative interpretations and coping experiences.ConclusionsThis study contributes to knowledge on how peer support can meet the needs of people living with HIV. Incorporating people living with HIV in the co-production and distribution of healthcare services may improve the knowledge and perspectives in healthcare services. However, the skill standards of peer supporters should be addressed when implementing peer support in usual care.

‘It’s like there’s no staff here – we’re all a friendly bunch of people’ – Young service users’ experiences of peer support in a youth-friendly service

‘It’s like there’s no staff here – we’re all a friendly bunch of people’ – Young service users’ experiences of peer support in a youth-friendly service

Australian healthcare workers experiences of peer support during COVID-19: Hand-n-Hand peer support.

IntroductionFounded at the beginning of the COVID-19 pandemic, Hand-n-Hand Peer Support (HnH) offers free, confidential peer support to healthcare workers (HCWs) across Australia and New Zealand. This survey aimed to evaluate HCWs experiences of peer support and collect demographic data about what groups of HCWs were seeking support.MethodsAn online survey was conducted in November 2021 of HCWs who were either active or past HnH participants (n = 158). Questions included 5-point Likert scales, multiple choice and free text responses.ResultsWe received 66 responses (42% response rate). The median age range of respondents was 41–45 years and most were female (87.9%). Most respondents (57.4%) reported experiencing no barriers to accessing peer support. The vast majority (81.4%) of HCWs reported a ‘good’ or ‘very good’ peer support experience. Respondents felt peer support helped in multiple ways, particularly in feeling less alone and having a safe space to discuss issues.ConclusionAustralian HCWs accessing peer support tended to be female and more senior clinicians. Most HCWs engaged in HnH reported overall very positive experiences. Our survey helped to identify several areas for improvement in HnH, including clearer marketing about peer support and more targeted triage assessments.

Experiences of peer support amongst parents of children with neurodevelopmental disorders: A qualitative systematic review

ProblemPeer support is a form of social support that can address the complexities of support needs and challenges of parenting children with Neurodevelopmental Disorders (NDDs). However, there is paucity of research on the roles and influences of peer support experienced amongst parents of neurodivergent children. This qualitative systematic review therefore aimed to consolidate and synthesize the experiences of peer support amongst parents caring for neurodivergent children. Eligibility criteriaArticles were selected if they reported primary qualitative findings on the experiences of peer-support amongst parents of children diagnosed with at least one NDD as classified by DSM-5. SampleEleven articles were finalised and included in the review. ResultsFour themes emerged: (1) reasons for seeking peer support, (2) different roles of peer support, (3) contributing elements of successful peer support, and (4) barriers against facilitating peer support. The findings of this review revealed that peer support was a valuable social support resource that met the complex support needs of parents. It enabled parents to provide quality care for their children whilst living with quality of life for themselves. ConclusionsPeer support could be a valuable resource for parents of neurodivergent children as it could potentially enhance quality of life for parents while providing quality care for their children with complex needs. ImplicationsHealthcare providers should integrate peer support as an adjunct resource of social support to help ease caregiver burdens of parents with neurodivergent children.

A qualitative study of the impact of peer support on women’s mental health treatment experiences during the perinatal period

BackgroundPerinatal mental health problems are prevalent, affecting up to 20% of women However, only 17–25% receive formal support during the perinatal period. In this qualitative study, we sought to examine women’s experiences with peer support for mental health problems during the perinatal period.MethodsSemi-structured interviews and focus groups were conducted with twenty-five mothers from the UK who had utilised peer support for a perinatal mental health problem. Data was analysed using thematic analysis.ResultsSeven major themes were identified in women’s help seeking process and experience of peer support. These included; perinatal specific precipitating factors that contributed to their mental health problems, barriers in the form of unhelpful professional responses, feelings of isolation, acceptance of the problem and need to actively re-seek support, finding support either through luck or peer assistance.ConclusionPeer support showed promise as an effective means to reduce perinatal mental health difficulties; either as a form of formal support or as an adjunct to formal support. The results highlight ways to improve perinatal women’s access to mental health support through peer-based mechanisms.