The effectiveness, implementation, and experiences of peer support approaches for mental health: a systematic umbrella review
Abstract Background Peer 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. Methods We searched MEDLIN...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-02-01
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| Series: | BMC Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12916-024-03260-y |
| _version_ | 1827327220730822656 |
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| author | Ruth E. Cooper Katherine R. K. Saunders Anna Greenburgh Prisha Shah Rebecca Appleton Karen Machin Tamar Jeynes Phoebe Barnett Sophie M. Allan Jessica Griffiths Ruth Stuart Lizzie Mitchell Beverley Chipp Stephen Jeffreys Brynmor Lloyd-Evans Alan Simpson Sonia Johnson |
| author_facet | Ruth E. Cooper Katherine R. K. Saunders Anna Greenburgh Prisha Shah Rebecca Appleton Karen Machin Tamar Jeynes Phoebe Barnett Sophie M. Allan Jessica Griffiths Ruth Stuart Lizzie Mitchell Beverley Chipp Stephen Jeffreys Brynmor Lloyd-Evans Alan Simpson Sonia Johnson |
| author_sort | Ruth E. Cooper |
| collection | DOAJ |
| description | Abstract Background Peer 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. Methods We 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). Results We 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. Conclusions Peer 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. |
| first_indexed | 2024-03-07T14:57:57Z |
| format | Article |
| id | doaj.art-eb1a5e1de70148bc932d9f9d4a271c5e |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-03-07T14:57:57Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-eb1a5e1de70148bc932d9f9d4a271c5e2024-03-05T19:21:24ZengBMCBMC Medicine1741-70152024-02-0122114510.1186/s12916-024-03260-yThe effectiveness, implementation, and experiences of peer support approaches for mental health: a systematic umbrella reviewRuth E. Cooper0Katherine R. K. Saunders1Anna Greenburgh2Prisha Shah3Rebecca Appleton4Karen Machin5Tamar Jeynes6Phoebe Barnett7Sophie M. Allan8Jessica Griffiths9Ruth Stuart10Lizzie Mitchell11Beverley Chipp12Stephen Jeffreys13Brynmor Lloyd-Evans14Alan Simpson15Sonia Johnson16NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonNIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonNIHR Mental Health Policy Research Unit, Division of Psychiatry, University College LondonMHPRU Lived Experience Working GroupNIHR Mental Health Policy Research Unit, Division of Psychiatry, University College LondonMHPRU Lived Experience Working GroupMHPRU Lived Experience Working GroupNIHR Mental Health Policy Research Unit, Division of Psychiatry, University College LondonNIHR Mental Health Policy Research Unit, Division of Psychiatry, University College LondonNIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonNIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonMHPRU Lived Experience Working GroupMHPRU Lived Experience Working GroupMHPRU Lived Experience Working GroupNIHR Mental Health Policy Research Unit, Division of Psychiatry, University College LondonNIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonNIHR Mental Health Policy Research Unit, Division of Psychiatry, University College LondonAbstract Background Peer 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. Methods We 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). Results We 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. Conclusions Peer 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.https://doi.org/10.1186/s12916-024-03260-yPeer supportMental healthSystematic reviewUmbrella review |
| spellingShingle | Ruth E. Cooper Katherine R. K. Saunders Anna Greenburgh Prisha Shah Rebecca Appleton Karen Machin Tamar Jeynes Phoebe Barnett Sophie M. Allan Jessica Griffiths Ruth Stuart Lizzie Mitchell Beverley Chipp Stephen Jeffreys Brynmor Lloyd-Evans Alan Simpson Sonia Johnson The effectiveness, implementation, and experiences of peer support approaches for mental health: a systematic umbrella review BMC Medicine Peer support Mental health Systematic review Umbrella review |
| title | The effectiveness, implementation, and experiences of peer support approaches for mental health: a systematic umbrella review |
| title_full | The effectiveness, implementation, and experiences of peer support approaches for mental health: a systematic umbrella review |
| title_fullStr | The effectiveness, implementation, and experiences of peer support approaches for mental health: a systematic umbrella review |
| title_full_unstemmed | The effectiveness, implementation, and experiences of peer support approaches for mental health: a systematic umbrella review |
| title_short | The effectiveness, implementation, and experiences of peer support approaches for mental health: a systematic umbrella review |
| title_sort | effectiveness implementation and experiences of peer support approaches for mental health a systematic umbrella review |
| topic | Peer support Mental health Systematic review Umbrella review |
| url | https://doi.org/10.1186/s12916-024-03260-y |
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