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Developing a change model for peer worker interventions in mental health services: a qualitative research study

Published online by Cambridge University Press:  03 July 2014

S. Gillard ,
S.L. Gibson ,
J. Holley  and
M. Lucock
S. Gillard*
Affiliation:
Institute of Population Health Research, St George's, University of London, London, UK
S.L. Gibson
Affiliation:
Institute of Population Health Research, St George's, University of London, London, UK
J. Holley
Affiliation:
Institute of Population Health Research, St George's, University of London, London, UK
M. Lucock
Affiliation:
Institute of Population Health Research, St George's, University of London, London, UK
*
*Address for correspondence: Dr S. Gillard, Social & Community Mental Health, Institute of Population Health Research, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK. (Email: [email protected])
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Abstract

Aims.

A range of peer worker roles are being introduced into mental health services internationally. There is some evidence that attests to the benefits of peer workers for the people they support but formal trial evidence in inconclusive, in part because the change model underpinning peer support-based interventions is underdeveloped. Complex intervention evaluation guidance suggests that understandings of how an intervention is associated with change in outcomes should be modelled, theoretically and empirically, before the intervention can be robustly evaluated. This paper aims to model the change mechanisms underlying peer worker interventions.

Methods.

In a qualitative, comparative case study of ten peer worker initiatives in statutory and voluntary sector mental health services in England in-depth interviews were carried out with 71 peer workers, service users, staff and managers, exploring their experiences of peer working. Using a Grounded Theory approach we identified core processes within the peer worker role that were productive of change for service users supported by peer workers.

Results.

Key change mechanisms were: (i) building trusting relationships based on shared lived experience; (ii) role-modelling individual recovery and living well with mental health problems; (iii) engaging service users with mental health services and the community. Mechanisms could be further explained by theoretical literature on role-modelling and relationship in mental health services. We were able to model process and downstream outcomes potentially associated with peer worker interventions.

Conclusions.

An empirically and theoretically grounded change model can be articulated that usefully informs the development, evaluation and planning of peer worker interventions.

Keywords

Change modelmental health researchpeer supportqualitative research
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 24 , Issue 5 , October 2015 , pp. 435 - 445
Copyright
Copyright © Cambridge University Press 2014 

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References

Bach, S, Della Rocca, G (2000). The management strategies of public service employers in Europe. Industrial Relations Journal 31, 82–96.Google Scholar
Bandura, A (1977). Social Learning Theory. Prentice-Hall: Englewood Cliffs, NJ.Google Scholar
Bandura, A (1997). Self-efficacy: The Exercise of Control. Freeman: New York.Google Scholar
Bordin, E (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy 16, 252–260.Google Scholar
Bowlby, J (1973). Attachment and Loss, Vol. 2: Separation. Basic Books: New York.Google Scholar
Bozeman, B, Feeney, MK (2007). Toward a useful theory of mentoring: a conceptual analysis and critique. Administration and Society 39, 719–739.CrossRefGoogle Scholar
Catty, J, Cowan, N, Poole, Z (2011). Attachment to the clinical team and its association with therapeutic relationships, social networks, and clinical well-being. Psychology and Psychotherapy 85, 17–35.Google Scholar
Coatsworth- Puspoky, R, Forchuk, C, Ward-Griffin, C (2006). Peer support relationships: an unexplored interpersonal process in mental health. Journal of Psychiatric and Mental Health Nursing 13, 490–497.CrossRefGoogle ScholarPubMed
Corrigan, P (2006). Impact of consumer-operated services on empowerment and recovery of people with psychiatric disabilities. Psychiatric Services 57, 1493–1496.CrossRefGoogle ScholarPubMed
Creswell, JW (2013). Qualitative Inquiry and Research Design: Choosing Among Five Approaches. Sage: Thousand Oaks, CA.Google Scholar
Daniels, A, Grant, E, Filson, B, Powell, I, Fricks, L, Goodale, L (2010). Pillars of Peer Support: Transforming Mental Health Systems of Care through Peer Support Services. The Carter Center: Atlanta.Google Scholar
Davidson, L, Chinman, M, Sells, D, Rowe, M (2006). Peer support among adults with serious mental illness: a report from the field. Schizophrenia Bulletin 32, 443–450.Google Scholar
Department of Health (2012). No Health without Mental Health: Implementation Framework. HMSO: London.Google Scholar
Festinger, L (1955). A theory of social comparison processes. Human Relations 7, 117–142.Google Scholar
Gillard, S, Simons, L, Turner, K, Lucock, M, Edwards, C (2012). Patient and public involvement in the coproduction of knowledge reflection on the analysis of qualitative data in a mental health study. Qualitative Health Research 22, 1126–1137.Google Scholar
Gillard, S, Edwards, C, Gibson, S, Owen, K, Wright, C (2013). Introducing peer worker roles into UK mental health service teams: a qualitative analysis of the organisational benefits and challenges. BMC Health Services Research 13, 188.Google Scholar
Gillard, S, Edwards, C, Gibson, S, Holley, J, Owen, K. (2014) New ways of working in mental health services: a qualitative, comparative case study assessing and informing the emergence of new peer worker roles in mental health services in England. Health Service Delivery Research.Google Scholar
Green, J, Thorogood, N (2004). Qualitative Methods for Health Research. Sage: London.Google Scholar
Griswold, KS, Pastore, PA, Homish, GG, Henke, A (2010). Access to primary care: are mental health peers effective in helping patients after a psychiatric emergency. Primary Psychiatry 17, 42–45.Google Scholar
Hustoft, K, Larsen, TK, Auestad, B, Joa, I, Johannessen, JO, Ruud, T (2013). Predictors of involuntary hospitalizations to acute psychiatry. International Journal of Law and Psychiatry 36, 136–143.Google Scholar
JCPMH (2012 a). Guidance for Commissioners of Acute Care – Inpatient and Crisis Home Treatment. Royal College of Psychiatry: London.Google Scholar
JCPMH (2012 b). Guidance for Commissioners of Community Specialist Mental Health Services. Royal College of Psychiatry: London.Google Scholar
Kaufman, L, Brooks, W, Steinley-Bumgarner, M, Stevens-Manser, S (2012). Peer Specialist Training and Certification Programs A National Overview. University of Texas: Austin, Texas.Google Scholar
Kelly, E, Fulginiti, A, Pahwa, R, Tallen, L, Duan, L, Brekke, JS (2013). A pilot test of a peer navigator intervention for improving the health of individuals with serious mental illness. Community Mental Health Journal 50, 435–446.Google Scholar
Killaspy, H, Banerjee, S, King, M, Lloyd, M (2000). Prospective controlled study of psychiatric out-patient non-attendance. Characteristics and outcome. British Journal of Psychiatry 176, 160–165.CrossRefGoogle Scholar
Lawn, S, Smith, A, Hunter, K (2008). Mental health peer support for hospital avoidance and early discharge: an Australian example of consumer driven and operated service. Journal of Mental Health 17, 498–508.Google Scholar
Martin, A, Buchheim, A, Berger, U, Strauss, B (2007). The impact of attachment organization on potential countertransference reactions. Psychotherapy Research 17, 46–58.Google Scholar
McCabe, R, Priebe, S (2004). The therapeutic relationship in the treatment of severe mental illness: a review of methods and findings. International Journal of Social Psychiatry 50, 115–128.Google Scholar
Mead, S (2006). Peer support: what makes it unique. International Journal of Psychosocial Rehabilitation 10, 29–37.Google Scholar
Mead, S, Hilton, D, Curtis, L (2001). Peer support: a theoretical perspective. Psychiatric Rehabilitation Journal 25, 134–141.CrossRefGoogle ScholarPubMed
Medical Research Council (2008). Developing and Evaluating Complex Interventions: New Guidance. Medical Research Council: London.Google Scholar
Mental Health Commission (2012). Blueprint II: Improving Mental Health and Wellbeing for All New Zealanders – Making Change Happen. Mental Health Commission: New Zealand.Google Scholar
Min, SY, Whitecraft, J, Rothbard, AB, Salzer, MS (2007). Peer support for persons with co-occurring disorders and community tenure: a survival analysis. Psychiatric Rehabilitation Journal 30, 207–213.CrossRefGoogle ScholarPubMed
Moran, GS, Russinova, Z, Gidugu, V, Yim, JY, Sprague, C (2012). Benefits and mechanisms of recovery among peer providers with psychiatric illnesses. Qualitative Health Research 22, 304–319.Google Scholar
Moran, GS, Russinova, Z, Gidugu, V, Gagne, C (2013). Challenges experienced by paid peer providers in mental health recovery: a qualitative study. Community Mental Health Journal 49, 281–291.Google Scholar
Mowbray, CT, Moxley, DP, Collins, ME (1998). Consumers as mental health providers: first-person accounts of benefits and limitations. Journal of Behavioral Health Services & Research 25, 397–411.Google Scholar
Muesser, KT, Corrigan, PW, Hilton, DW, Tanzman, B, Schuab, A, Gingerich, S, Essock, A, Tarrier, N, Morey, B, Vogel-Scibilia, S, Heerz, MI (2002). Illness management and recovery: a review of the research. Psychiatric Services 53, 1272–1284.Google Scholar
Nelson, G, Ochocka, J, Janzen, R, Trainor, J (2006). A longitudinal study of mental health consumer/survivor initiatives: part 1 – literature review and overview of the study. Journal of Community Psychology 34, 247–260.Google Scholar
Ochocka, J, Nelson, G, Janzen, R, Trainor, J (2006). A longitudinal study of mental health consumer/survivor initiatives: part 3 – a qualitative study of impacts of participation on new members. Journal of Community Psychology 34, 273–283.Google Scholar
Olfson, M, Haya Ascher-Svanum, MPH, Faries, DE, Marcus, SC (2011). Predicting psychiatric hospital admission among adults with schizophrenia. Psychiatric Services 62, 1138–1145.CrossRefGoogle ScholarPubMed
Patton, M (1990). Qualitative Evaluation and Research Methods. Sage: London.Google Scholar
Pitt, V, Lowe, D, Hill, S, Prictor, M, Hetrick, SE, Ryan, R (2013). Consumer-providers of care for adult clients of statutory mental health services. Cochrane Database of Systematic Reviews 3, 1–75.Google Scholar
Pollitt, A, Winpenny, E, Newbould, J, Celia, C, Ling, T, Scraggs, E (2012). Evaluation of the Peer Worker Programme at Cambridgeshire and Peterborough NHS Foundation Trust. RAND Europe: Cambridge.Google Scholar
Priebe, S, McCabe, R (2006). The therapeutic relationship in psychiatric settings. Acta Psychiatrica Scandinavica 113, 69–72.CrossRefGoogle Scholar
Repper, J, Carter, T (2011). A review of the literature on peer support in mental health services. Journal of Mental Health 20, 392–411.Google Scholar
Repper, J, Watson, E (2012). A year of peer support in Nottingham: the peer support workers and their work with individuals. Journal of Mental Health Training, Education and Practice 7, 79–84.Google Scholar
Resnick, SG, Rosenheck, RA (2008). Integrating peer-provided services: a quasi-experimental study of recovery orientation, confidence, and empowerment. Psychiatric Services 59, 1307–1314.CrossRefGoogle ScholarPubMed
Ruggeri, M, Lasalvia, A, Bonetto, C (2013). A new generation of pragmatic trials of psychosocial interventions is needed. Epidemiology and Psychiatric Sciences 22, 111–117.Google Scholar
Rüsch, N, Müller, M, Ajdacic-Gross, V, Rodgers, S, Corrigan, PW, Rössler, W (2014). Shame, perceived knowledge and satisfaction associated with mental health as predictors of attitude patterns towards help-seeking. Epidemiology and Psychiatric Sciences 23, 177–187.Google Scholar
Schrank, B, Riches, S, Bird, V, Murray, J, Tylee, A, Slade, M (2013). A conceptual framework for improving well-being in people with a diagnosis of psychosis. Epidemiology and Psychiatric Services 1–11. [Epub ahead of print].Google Scholar
Scott, A, Doughty, C, Kahi, H (2011). Peer Support Practice in Aotearoa New Zealand. Self-Commissioned: Christchurch.Google Scholar
Simpson, A, Quigley, J, Henry, SJ, Hall, C (2013). Evaluating the selection, training, and support of peer support workers in the United Kingdom. Journal of Psychosocial Nursing and Mental Health Services 52, 31–40.Google Scholar
Strauss, A, Corbin, J (1998). Basics of Qualitative Research. Techniques and Procedures for Developing Grounded Theory, 2nd edn. Sage: London.Google Scholar
Tennant, R, Hiller, L, Fishwick, R, Platt, P, Joseph, S, Weich, S, Parkinson, J, Secker, J, Stewart-Brown, S (2007). The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation. Health and Quality of Life Outcomes 5, 1477–1525.Google Scholar
Thompson, RA (2000). The legacy of early attachments. Child Development 71, 145–152.Google Scholar
Thornicroft, G (1991). Social deprivation and rates of treated mental disorder. Developing statistical models to predict psychiatric service utilisation. British Journal of Psychiatry 158, 475–484.Google Scholar
Trachtenberg, M, Parsonage, M, Shepherd, G (2013). Peer Support in Mental Health Care: Is It Good Value for Money? Centre for Mental health: London.Google Scholar
Van der Post, LF, Peen, J, Dekker, JJ (2013). A prediction model for the incidence of civil detention for crisis patients with psychiatric illnesses; the Amsterdam study of acute psychiatry VII. Social Psychiatry and Psychiatric Epidemiology 49, 283–290.CrossRefGoogle ScholarPubMed
Webber, M, Huxley, P (2004). Social exclusion and risk of emergency compulsory admission: a case-control study. Social Psychiatry and Psychiatric Epidemiology 39, 1000–1009.Google Scholar
Yanos, PT, Primavera, LH, Knight, EL (2001). Consumer-run service participation, recovery of social functioning, and the mediating role of psychological factors. Psychiatric Services 52, 493–500.Google Scholar
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