An update on the growing evidence base for peer support
| DOI | https://doi.org/10.1108/MHSI-03-2017-0014 |
| Published date | 12 June 2017 |
| Pages | 161-167 |
| Date | 12 June 2017 |
| Author | Chyrell Bellamy,Timothy Schmutte,Larry Davidson |
| Subject Matter | Health & social care,Mental health,Social inclusion |
An update on the growing evidence
base for peer support
Chyrell Bellamy, Timothy Schmutte and Larry Davidson
Abstract
Purpose –As peer support services have become increasingly used in mental health settings as a
recovery-oriented practice, so has the body of published research on this approach to care. The purpose of
this paper is to provide an update on the current evidence base for peer support for adults with mental illness
in two domains: mental health and recovery, and physical health and wellness.
Design/methodology/approach –To provide a robust, non-redundant, and up-to-date review, first the
authors searched for meta-analyses and systematic reviews. Second, the authors found individual studies
not included in any of the reviews.
Findings –Peer services are generally equally effective to services provided by non-peer paraprofessionals
on traditional clinical outcomes. Although some studies found peer services to be effective at reducing
hospitalization rates and symptom severity, as a whole, the current evidence base is confounded by
heterogeneity in programmatic characteristics and methodological shortcomings. On the other hand, the
evidence is stronger for peer support services having more of a positive impact on levels of hope,
empowerment, and quality of life.
Research limitations/implications –Inaddition to the need for further high-qualityresearch on peersupport
in mental and physicalhealth domains, the authors alsoquestion whether measures of hope, empowerment,
and integration intothe community are more relevant to recovery thantraditional clinical outcomes.
Originality/value –This paper provides an original, robust, and up-to-date review of the evidence for
peer services.
Keywords Physical health, Serious mental illness, Consumer-provided, Peer services
Paper type Literature review
It has now been over 25 years since paid peer staff were first introduced into mental health care,
building on the successes of the mental health consumer/survivor movement and promising to
bring some of the healing aspects of mutual support into formal services for adults with mental
illness. While the growth of peer support both inside and outside of formal services has been
robust and global in nature, research evidence demonstrating the effectiveness of this new form
of service delivery has lagged behind. This is undoubtedly due to multiple factors, but is likely to
be at least in part due to the continued confusion or lack of clarity about what precisely
constitutes peer support that sets it apart from traditional mental health services, especially those
historically provided by paraprofessional staff; that is, other staff that do not have credentials in
psychology, social work, nursing, psychiatry, or rehabilitation. In fact, the first few studies of
peers who were hired to provide mental health services were feasibility studies of whether or not
these peers could provide traditional services, such as case management and residential
support, at least, as well as the non-peer staff who had been providing these services previously.
Those studies showed that the deployment of peers caused no harm and did not produce any
worse outcomes than traditional services provided by non-peers (Davidson et al., 1999); a
finding we will see below has been replicated numerous times since.
A second complication is whether peer staff should simply be added to existing programs, such
as assertive community treatment teams or inpatient units, or should rather be conceptualized as
offering new and separate services of a different nature with perhaps a different focus or aim.
It has taken some time for persons in recovery to develop new approaches that build explicitly
and directly on their shared experiences and the value of reciprocity characteristic of the mutual
Chyrell Bellamy is an Assistant
Professor of Psychiatry at the
Department of Psychiatry,
Yale University, New Haven,
Connecticut, USA.
Timothy Schmutte and
Larry Davidson are both based
at the Department of
Psychiatry, Yale University,
New Haven, Connecticut, USA.
DOI 10.1108/MHSI-03-2017-0014 VOL. 21 NO. 3 2017, pp. 161-167, © Emerald Publishing Limited, ISSN 2042-8308
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MENTALHEALTH AND SOCIAL INCLUSION
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