Capturing the value of peer support: measuring recovery-oriented services
| Date | 05 September 2019 |
| DOI | https://doi.org/10.1108/JPMH-02-2019-0022 |
| Pages | 180-187 |
| Published date | 05 September 2019 |
| Author | Stacey L. Barrenger,Victoria Stanhope,Emma Miller |
| Subject Matter | Health & social care,Mental health,Public mental health |
Capturing the value of peer support:
measuring recovery-oriented services
Stacey L. Barrenger, Victoria Stanhope and Emma Miller
Abstract
Purpose –The purpose of this paper is to examine the gap between recovery-oriented processes and
clinical outcomes in peer support, an exemplar of recovery-oriented services, and offer suggestions for
bridging this gap.
Design/methodology/approach –This viewpoint is a brief review of literature on peer support services and
gaps in outcome measurement towards building an evidence base for recovery-oriented services.
Findings –Clinical outcomes like hospitalizations or symptoms remain a focus of research, practice and
policy in recovery-oriented services and contribute to a mixed evidence base for peer support services, in
which recovery-oriented outcomes like empowerment, self-efficacy and hopefulness have more evidentiary
support. One approach is to identify the theoretical underpinnings of peer support services and the
corresponding change mechanisms in models that would make these recovery-oriented outcomes
mediators or process outcomes. A better starting point is to consider which outcomes are valued by the
people who use services and develop an evaluation approach according to those stated goals. User driven
measurement approaches and more participatory types of research canimprove both the quality and impact
of health and mental health services.
Originality/value –This viewpoint provides a brief review of peer support services and the challenges of
outcome measurement in establishing an evidence base and recommends user driven measurement as a
starting point in evaluation of recovery-oriented services.
Keywords Measurement, Peer support, Mental health, Integrated health, Recovery-oriented services
Paper type Viewpoint
Historically, recovery in mental health has been conceptualized as the absence of psychiatric
symptoms and functional impairments, but more recently has shifted to being understood as a
process allowing for a range of experiencesrelating to symptoms of mental illness and its impact
on one’s life (Davidson et al., 2005). Recovery involves changes in attitudes, values, feelings and
goals in order to develop meaning and purpose in life (Anthony, 1993). These changes in the
conceptualization of recovery were drivenby the mental health consumer/survivormovement that
highlighted the value of knowledge derived from people’s own narratives and challenged mental
health services to empower people in their recovery journey (Peebles et al.,2007).Further,the
recovery movement seeks to promote cultural change in mental health services toward full
citizenshiprather than continuation of pessimistic diagnoses(Davidson et al., 2010). Mor e recently,
and in alignment with the goal of citizenship, concepts of hope and agency are increasingly
referenced in literature about recovery, as well as a focus on the need to address material,
economic and social realities, as well as treatment of illness (Tang, 2018).
As policy makers and providers have embraced a recovery-oriented approach to mental health
services (Daniels et al., 2012), more interventions based on recovery principles, such as Illness
Management Recovery and Person-Centered Care Planning, are being developed and
implemented. As services are increasingly intended to reflect more closely the interests of service
users, questions arise on the extent to which the outcomes used to evaluate services within
health care systems also align with the outcomes valued by services users. This matters because
what is measured in services influences activity and practice. Challenges are encountered in
navigating from policy to practice, where a variety of imperatives and interests compete in
influencing what is to be measured.
Received 10 February 2019
Revised 22 March 2019
Accepted 27 March 2019
Stacey L. Barrenger and
Victoria Stanhope are both
based at the Silver School of
Social Work, New York
University, New York,
New York, USA.
Emma Miller is based at the
School of Social Work and
Social Policy, University of
Strathclyde, Glasgow, UK.
PAGE180
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JOURNAL OF PUBLIC MENTAL HEALTH
j
VOL. 18 NO. 3 2019, pp. 180-187, © Emerald Publishing Limited, ISSN 1746-5729 DOI 10.1108/JPMH-02-2019-0022
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