Reference: Murphy, R., Huggard, L., Fitzgerald, A., Hennessy, E., & Booth, A. (2023). A systematic scoping review of peer support interventions in integrated primary youth mental health care. Journal of Community Psychology.
Summarized by Ellen Parry Luff
About the Study:
In today’s world, young people often struggle to access appropriate mental health support. In response to this issue, there has been a growing international movement to provide youth-specific mental health services. Integrated primary youth mental health (YMH) care models, in particular, have been developed to address the complex psychological and social challenges faced by young people with specialist integrated youth services, school, and university mental health services serving as two main sites. Within these and other settings peer support interventions (PSI) are being recognized for their potential to improve mental health outcomes and to help empower young people to seek help when they may originally be hesitant to speak to a professional. However, there is a need for more comprehensive research to understand the role of PSIs and how they are implemented. This study reviews the existing literature on PSIs in integrated primary YMH care settings to examine the reported mental health outcomes, the core characteristics of peer support workers (PWS), and the barriers and facilitators in implementing PSIs.
- Mental Health Outcomes: There were varied outcomes for more general mental health difficulties, with mixed but generally positive results in reducing anxiety and depression, with 4 out of 5 studies seeing improvements in well-being. There were also positive findings in more specific well-being measures such as recovery-related and psychosocial outcomes, as well as body dissatisfaction and social anxiety which saw moderate to significant changes. It’s important to note that peer support was provided within a clinician-led intervention.
- Characteristics of PSWs: PSWs in the sample covered a wide range of ages though all PSWs were in the same age range as the young people they supported. Several studies also required PSWs to have a lived experience of mental health difficulties, however, several studies did not report information on lived experience.
- PSW Training and Roles: Training was consistently discussed but discussion of specific frameworks and models was generally missing. Additionally, the role of supervision was mentioned in over half of the studies and came from a variety of sources. The roles of PSWs varied across interventions, ranging from providing one-to-one support to working with self-help and online support groups.
- Facilitators: Comprehensive training, particularly around workplace skills and interpersonal skills, as well as support and supervision from experienced peer support staff and clinicians, was very important. Additionally, general support for the addition of peer support from clinical staff was vital for success.
- Barriers: A lack of clear communication from clinical staff and their uncertainty on how to interact with PSWs led to role confusion among PSWs as well as feeling “less valued” than the clinical staff.
Implications for Mentoring:
Given how interest in peer support programs is increasing rapidly, the authors stress the need for more detailed reporting of peer support interventions (e.g., which participants are attending the interventions, what the intervention content is, how the clinicians are involved, and what the training for PSWs looks like). Specifically, there is a need for more research that examines the development and feasibility of these programs, not just evaluating their effectiveness. Overall, this study highlights the need for more work contributing to the development of evidence-based practices. Additionally, the authors highlight the need for more qualitative work to understand the perspectives of clinicians, PSWs, and young people more generally to ensure that programs address the needs of young people while still being possible to implement within existing service structures.
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