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BMC Psychiatry
Published in: BMC Psychiatry 1/2014

Open Access 01-12-2014 | Research article

A systematic review and meta-analysis of randomised controlled trials of peer support for people with severe mental illness

Authors: Brynmor Lloyd-Evans, Evan Mayo-Wilson, Bronwyn Harrison, Hannah Istead, Ellie Brown, Stephen Pilling, Sonia Johnson, Tim Kendall

Published in: BMC Psychiatry | Issue 1/2014

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Abstract

Background

Little is known about whether peer support improves outcomes for people with severe mental illness.

Method

A systematic review and meta-analysis was conducted. Cochrane CENTRAL Register, Medline, Embase, PsycINFO, and CINAHL were searched to July 2013 without restriction by publication status. Randomised trials of non-residential peer support interventions were included. Trial interventions were categorised and analysed separately as: mutual peer support, peer support services, or peer delivered mental health services. Meta-analyses were performed where possible, and studies were assessed for bias and the quality of evidence described.

Results

Eighteen trials including 5597 participants were included. These comprised four trials of mutual support programmes, eleven trials of peer support services, and three trials of peer-delivered services. There was substantial variation between trials in participants’ characteristics and programme content. Outcomes were incompletely reported; there was high risk of bias. From small numbers of studies in the analyses it was possible to conduct, there was little or no evidence that peer support was associated with positive effects on hospitalisation, overall symptoms or satisfaction with services. There was some evidence that peer support was associated with positive effects on measures of hope, recovery and empowerment at and beyond the end of the intervention, although this was not consistent within or across different types of peer support.

Conclusions

Despite the promotion and uptake of peer support internationally, there is little evidence from current trials about the effects of peer support for people with severe mental illness. Although there are few positive findings, this review has important implications for policy and practice: current evidence does not support recommendations or mandatory requirements from policy makers for mental health services to provide peer support programmes. Further peer support programmes should be implemented within the context of high quality research projects wherever possible. Deficiencies in the conduct and reporting of existing trials exemplify difficulties in the evaluation of complex interventions.
Appendix
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Literature
1.
Davidson L, Chinman M, Sells D, Rowe M: Peer support among adults with serious mental illness: a report from the field. Schizophr Bull. 2006, 32 (3): 443-450.CrossRefPubMedPubMedCentral
2.
3.
Salzer M, Shear S: Identifying consumer-provider benefits in evaluations of consumer-delivered services. Psychiatr Rehabil J. 2002, 25 (3): 281-288.CrossRefPubMed
4.
Bandura A, McClelland DC: Social learning theory. 1977, Englewood Cliffs New Jersey: Prentice-Hall
5.
Festinger L: A theory of social comparison processes. Hum Relat. 1954, 7 (2): 117-140. 10.1177/001872675400700202.CrossRef
6.
Deegan P: Recovery as a journey of the heart. Psychiatr Rehabil J. 1996, 19 (3): 91-97.CrossRef
7.
Clay S, Schell S, Corrigan P, Ralph R: On Our Own, Together. Peer Programs for People with Mental Illness. 2005, Nashville, TN: Vanderbilt University Press
8.
Faulkner A, Basset T: A helping hand: taking peer support into the 21st century. Ment Health Soc Incl. 2012, 16 (1): 41-10.1108/20428301211205892.CrossRef
9.
Halvorson A, Whitter M: Approaches to Recovery-Oriented Systems of Care at the State and Local Levels: Three Case Studies. 2009, Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration
10.
The Royal College of Psychiatrists Social Inclusion Scoping Group: Mental Health and Social Inclusion: Making Psychiatry and Mental Health Services Fit for the 21st Century. 2009, London: Royal College of Psychiatrists
11.
Bradstreet S, Pratt R: Developing peer support worker roles: reflecting on experiences in Scotland. Ment Health Soc Incl. 2010, 14 (3): 36-41. 10.5042/mhsi.2010.0443.CrossRef
12.
Armstrong N, Steffen JJ: The recovery promotion fidelity scale: assessing the organizational promotion of recovery. Community Ment Health J. 2009, 45 (3): 163-170. 10.1007/s10597-008-9176-1.CrossRefPubMed
13.
Slade M: 100 ways to support recovery: a guide for mental health professionals. 2009, London: RethinkCrossRef
14.
Scottish Recovery Network: The role and potential development of peer support services. 2005, Glasgow: Scottish Recovery Network
15.
16.
Repper J: Peer support workers: theory and practice. 2013, London: Centre for Mental Health
17.
Davidson L, Chinman M, Kloos B, Weingarten R, Stayner D, Tebes J: Peer support among individuals with severe mental illness: a review of the evidence. Clin Psychol-Sci Pr. 1999, 6 (2): 165-187. 10.1093/clipsy.6.2.165.CrossRef
18.
Solomon P, Draine J: The state of knowledge of the effectiveness of consumer provided services. Psychiatr Rehabil J. 2001, 25 (1): 20-27.CrossRefPubMed
19.
Solomon P: Peer support/peer provided services underlying processes, benefits, and critical ingredients. Psychiatr Rehabil J. 2004, 27 (4): 392-401.CrossRefPubMed
20.
Pistrang N, Barker C, Humphreys K: Mutual help groups for mental health problems: a review of effectiveness studies. Am J Community Psychol. 2008, 42 (1–2): 110-121.CrossRefPubMed
21.
Repper J, Carter T: A review of the literature on peer support in mental health services. J Ment Health. 2011, 20 (4): 392-411. 10.3109/09638237.2011.583947.CrossRefPubMed
22.
Pitt V, Lowe D, Hill S, Prictor M, Hetrick SE, Ryan R, et al: Consumer-providers of care for adult clients of statutory mental health services. Cochrane Database Syst Rev. 2013, 3: CD004807-PubMed
23.
Pfeiffer P, Heisler M, Piette J, Rogers M, Valenstein M: Efficacy of peer support interventions for depression: a meta-analysis. Gen Hosp Psychiat. 2011, 33 (1): 29-36. 10.1016/j.genhosppsych.2010.10.002.CrossRef
24.
Simpson E, House AO: Involving users in the delivery and evaluation of mental health services: systematic review. Br Med J. 2002, 325 (7375): 1265-1268. 10.1136/bmj.325.7375.1265.CrossRef
25.
NCCMH: Schizophrenia: Core Interventions in the Treatment and Management of Schizophrenia in Adults in Primary and Secondary Care. Updated ed. Leicester and London: The British Psychological Society and the Royal College of Psychiatrists, In press
26.
Atkins D, Best D, Briss P, Eccles M, Falck-Ytter Y, Flottorp S, et al: Grading quality of evidence and strength of recommendations. Br Med J. 2004, 328 (7454): 1490-CrossRef
27.
Simon G, Ludman E, Goodale L, Dykstra D, Stone E, Cutsogeorge D, et al: An online recovery plan program: can peer coaching increase participation?. Psychiatr Serv. 2011, 62 (6): 666-669. 10.1176/appi.ps.62.6.666.CrossRefPubMedPubMedCentral
28.
Solomon P, Draine J: One-year outcomes of a randomized trial of consumer case management. Eval Program Plann. 1995, 18 (2): 135-146.CrossRef
29.
Castelein S, Bruggeman R, van-Busschbach J, van-der Gaag M, Stant A, Knegtering H, et al: The effectiveness of peer support groups in psychosis: a randomized controlled trial. Acta Psychiatr Scand. 2008, 118: 64-72. 10.1111/j.1600-0447.2008.01216.x.CrossRefPubMed
30.
O’Donnell M, Parker G, Proberts M, Matthews R, Fisher D, Johnson B, et al: A study of client-focused case management and consumer advocacy: the Community and Consumer Service Project. Aust N Z J Psychiatry. 1999, 33 (5): 684-693. 10.1080/j.1440-1614.1999.00629.x.CrossRefPubMed
31.
Salyers M, McGuire A, Rollins A, Bond G, Mueser K, Macy V: Integrating assertive community treatment and illness management and recovery for consumers with severe mental illness. Community Ment Health J. 2010, 46 (4): 319-329. 10.1007/s10597-009-9284-6.CrossRefPubMed
32.
Druss B, Zhao L, von Esenwein S, Bona J, Fricks L, Jenkins-Tucker S, et al: The Health and Recovery Peer (HARP) Program: a peer-led intervention to improve medical self-management for persons with serious mental illness. Schizophr Res. 2010, 118 (1–3): 264-270.CrossRefPubMedPubMedCentral
33.
Kaufmann C: The self-help-employment-center - some outcomes from the first year. Psychosoc Rehabil J. 1995, 18 (4): 145-162.CrossRef
34.
Rowe M, Bellamy C, Baranoski M, Wieland M, O’Connell M, Benedict P, et al: A peer-support, group intervention to reduce substance use and criminality among persons with severe mental illness. Psychiatr Serv. 2007, 58: 955-961. 10.1176/appi.ps.58.7.955.CrossRefPubMed
35.
Forchuk C, Martin M, Chan Y, Jensen E: Therapeutic relationships: from psychiatric hospital to community. J Psychiatr Ment Health Nurs. 2005, 12: 556-564. 10.1111/j.1365-2850.2005.00873.x.CrossRefPubMed
36.
Chinman M, Oberman RS, Hanusa BH, Cohen AN, Salyers MP, Twamley EW, et al: A cluster randomized trial of adding peer specialists to intensive case management teams in the veterans health administration. J Behav Health Serv Res. 2013, 1-13. DOI: 10.1007/s11414-013-9343-1
37.
Proudfoot J, Parker G, Manicavasagar V, Hadzi-Pavlovic D, Whitton A, Nicholas J, et al: Effects of adjunctive peer support on perceptions of illness control and understanding in an online psychoeducation program for bipolar disorder: a randomised controlled trial. J Affect Disord. 2012, 142 (1–3): 98-105.CrossRefPubMed
38.
Craig T, Doherty I, Jamieson-Craig R, Boocock A, Attafua G: The consumer-employee as a member of a mental health assertive outreach team. I. Clinical and social outcomes. J Ment Health. 2004, 13 (1): 59-69. 10.1080/09638230410001654567.CrossRef
39.
Barbic S, Krupa T, Armstrong I: A randomized controlled trial of the effectiveness of a modified recovery workbook program: preliminary findings. Psychiatr Serv. 2009, 60 (4): 491-497.CrossRefPubMed
40.
Clarke G, Herinckx H, Kinney R, Paulson R, Cutler D, Lewis K, et al: Psychiatric hospitalizations, arrests, emergency room visits, and homelessness of clients with serious and persistent mental illness: findings from a randomized trial of two ACT programs vs. usual care. Ment Health Serv Res. 2000, 2 (3): 155-164. 10.1023/A:1010141826867.CrossRefPubMed
41.
Davidson L, Shahar G, Stayner DA, Chinman MJ, Rakfeldt J, Tebes JK: Supported socialization for people with psychiatric disabilities: lessons from a randomized controlled trial. J Community Psychol. 2004, 32 (4): 453-10.1002/jcop.20013.CrossRef
42.
Rogers E, Teague GB, Lichenstein C, Campbell J, Lyass A, Chen R, Banks S: Effects of participation in consumer-operated service programs on both personal and organizationally mediated empowerment: results of multisite study. J Rehabil Res Dev. 2007, 44 (6): 785-800. 10.1682/JRRD.2006.10.0125.CrossRefPubMed
43.
Sells D, Davidson L, Jewell C, Falzer P, Rowe M: The treatment relationship in peer-based and regular case management for clients with severe mental illness. Psychiatr Serv. 2006, 57: 1179-1184. 10.1176/appi.ps.57.8.1179.CrossRefPubMed
44.
Sledge W, Lawless M, Sells D, Wieland M, O’Connell M, Davidson L: Effectiveness of peer support in reducing readmissions of persons with multiple psychiatric hospitalizations. Psychiatr Serv. 2011, 62 (5): 541-544. 10.1176/appi.ps.62.5.541.CrossRefPubMed
45.
Cook J, Copeland M, Jonikas J, Hamilton M, Razzano L, Grey D, et al: Results of a randomized controlled trial of mental illness self-management using wellness recovery action planning. Schizophr Bull. 2011, 34: 214-222.
46.
Cook J, Steigman P, Pickett S, Diehl S, Fox A, Shipley P, et al: Randomized controlled trial of peer-led recovery education using Building Recovery of Individual Dreams and Goals through Education and Support (BRIDGES). Schizophr Res. 2012, 136 (1–3): 36-42.CrossRefPubMed
47.
Kaplan K, Salzer M, Solomon P, Brusilovskiy E, Cousounis P: Internet peer support for individuals with psychiatric disabilities: a randomized controlled trial. Soc Sci Med. 2011, 72: 54-62. 10.1016/j.socscimed.2010.09.037.CrossRefPubMed
48.
Rivera J, Sullivan AM, Valenti SS: Adding consumer-providers to intensive case management: does it improve outcome?. Psychiatr Serv. 2007, 58: 802-809. 10.1176/appi.ps.58.6.802.CrossRefPubMed
49.
Segal S, Silverman CJ, Temkin TL: Outcomes from consumer-operated and community mental health services: a randomized controlled trial. Psychiatr Serv. 2011, 62 (8): 915-921.CrossRefPubMed
50.
Van Gestel-Timmermans H, Brouwers E, Van Assen M, Van Nieuwenhuizen C: Effects of a peer-run course on recovery from serious mental illness: a randomized controlled trial. Psychiatr Serv. 2012, 63 (1): 54-60.CrossRefPubMed
51.
Edmundson E, Bedell J, Archer R, Gordon R: Intergrating skill building and peer support in mental health treatment. Community mental health and behavioural ecology. Edited by: Jeger A, Slotnick R. 1982, New York: Plenum, 127-139.CrossRef
52.
Higgins J, Altman DG, Gøtzsche PC, Cochrane Bias Methods Group: The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. Br Med J. 2011, 343: d5928-10.1136/bmj.d5928.CrossRef
53.
Leamy M, Bird V, Le Boutillier C, Williams J, Slade M: Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. Br J Psychiatry. 2011, 199 (6): 445-452. 10.1192/bjp.bp.110.083733.CrossRefPubMed
54.
Reeves BD, Higgins J, Wells J, Wells G: Chapter 13: including non-randomised studies. Cochrane Handbook for Systematic reviews of Interventions v.5.1.0. Edited by: Higgins J, Green S. 2011, Cochrane Collaboration, Web resource: http://​www.​cochrane-handbook.​org
55.
Deeks JJ, Dinnes J, D’amico R, Sowden A, Sakarovitch C, Song F, et al: Evaluating non-randomised intervention studies. Health Tech Assess. 2003, 7 (27): 1-179.CrossRef
56.
Oakley A, Strange V, Bonell C, Allen E, Stephenson J: Health services research: process evaluation in randomised controlled trials of complex interventions. Br Med J. 2006, 332 (7538): 413-10.1136/bmj.332.7538.413.CrossRef
57.
Altman D: Better reporting of randomised controlled trials: the CONSORT statement. Br Med J. 1996, 313 (7057): 570-571. 10.1136/bmj.313.7057.570.CrossRef
58.
Mayo-Wilson E: Reporting implementation in randomized trials: proposed additions to the consolidated standards of reporting trials statement. Am J Public Health. 2007, 97 (4): 630-633. 10.2105/AJPH.2006.094169.CrossRefPubMedPubMedCentral
59.
Schulz K, Altman DG, Moher D: CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. J Clin Epidemiol. 2010, 63 (8): 834-840. 10.1016/j.jclinepi.2010.02.005.CrossRefPubMed
60.
Grant SP, Mayo-Wilson E, Melendez-Torres G, Montgomery P: Reporting quality of social and psychological intervention trials: a systematic review of reporting guidelines and trial publications. PLoS One. 2013, 8 (5): e65442-10.1371/journal.pone.0065442.CrossRefPubMedPubMedCentral
61.
Harrison B, Mayo-Wilson E: Trial registration: understanding and preventing reporting bias in social work research. Res Soc Work Pract. In press
62.
Finn L, Bishop B, Sparrow N: Capturing dynamic processes of change in GROW mutual help groups for mental health. Am J Community Psychol. 2009, 44 (3–4): 302-315.CrossRefPubMed
63.
New Freedom Commission on Mental Health: Achieving the promise: transforming mental health care in America. Final report. 2003, MD: Department of Health and Human Services, DHHS pub no SMA-03-3832
64.
Perkins R, Repper J, Rinaldi M, Brown H: Recovery Colleges: Implementing Recovery through Organisational Change (ImROC) briefing paper. 2012, London: Centre for Mental Health
65.
Coatsworth-Puspoky R, Forchuk C, Ward-Griffin C: Peer support relationships: an unexplored interpersonal process in mental health. J Psychiatr Ment Health Nurs. 2006, 13 (5): 490-497. 10.1111/j.1365-2850.2006.00970.x.CrossRefPubMed
66.
Smith-Merry J, Freeman R, Sturdy S: Implementing recovery: an analysis of the key technologies in Scotland. Int J Ment Health Syst. 2011, 5 (1): 11-10.1186/1752-4458-5-11.CrossRefPubMedPubMedCentral
67.
Repper J: A year of peer support in Nottingham: lessons learned. J Ment Health Train Pract. 2012, 7 (2): 70-10.1108/17556221211236466.CrossRef
Metadata
Title
A systematic review and meta-analysis of randomised controlled trials of peer support for people with severe mental illness
Authors
Brynmor Lloyd-Evans
Evan Mayo-Wilson
Bronwyn Harrison
Hannah Istead
Ellie Brown
Stephen Pilling
Sonia Johnson
Tim Kendall
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2014
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-14-39

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