Peer Support Research
A Promising New Approach
Peer support programs using consumers as service providers are an innovative and promising model to develop consumers’ self-management skills, restore participation in work and other social roles, and activate consumers to seek more effective care.
Consumer service providers are trained to work one-on-one with consumers to:
- motivate their peers to develop an expectation of recovery.
- encourage regular self-monitoring of symptoms.
- help their peers to develop self-management skills for symptom control and problem solving.
- activate consumers to be more informed partners in care and more effective self-advocates.
- motivate and assist consumers to reclaim work and other rewarding social roles.
- teach consumers how to communicate more effectively and efficiently with providers so that treatment plans reflect their unique wants and needs.
- enhance consumer commitment to medication and other treatment plans.
These programs typically incorporate cognitive and behavioral interventions to promote early recognition of symptoms, reduce exposure to triggers or precipitating stresses, promote commitment to treatment and develop effective self-management skills.
The President’s New Freedom Commission on Mental Health identified two principles to guide transformation of mental health services:
- Services and treatments must be consumer and family centered.
- Care must focus on increasing consumers’ ability to successfully cope with life’s challenges, on facilitating recovery, and on building resilience, not just on managing symptoms.
Peer Specialists focus on increasing consumer resiliency and coping mechanisms while enhancing communication with providers so that care can be customized to meet consumers’ needs.
Research shows peer support is effective.
Research on peer support programs has shown that participation in these services yields improvement in psychiatric symptoms and decreased hospitalization (Galanter, 1988); larger social support networks (Rappaport et al., 1992); enhanced self-esteem and social functioning (Markowtiz, DeMasi, Knight, & Solka, 1996); and decreased lengths of hospital stays, as well as lower services costs overall, (Dumont & Jones, 2002).
In Canada, the Consumer/Survivor Initiatives (CSI): Impact, Outcomes and Effectiveness report, developed in partnership with the Centre for Addiction and Mental Health, gathered research which demonstrates CSIs are vital to the mental health care system; they improve people’s health outcomes and support recovery, as well reducing the use of hospital, emergency, and other expensive services.
- One study demonstrates that the mean number of days in hospital for the participants dropped from 48.36 to 4.29 after becoming involved with a CSI.
- Another study showed that CSIs saved more than $12 million in reduced hospital stays for three hospitals over the course of one year.
- People with mental health problems who described themselves as lonely and were partnered with a peer mentor used an average of $20,300 less per person in hospital and emergency room services in the year after discharge.
A SAMHSA-funded 5-year random-assignment controlled study of eight sites, including 1,827 participants, is examining the efficacy of peer services as adjunct to traditional services. Preliminary findings reveal that participants showed greater improvement in well-being (a composite construct reflecting recovery, social inclusion, empowerment, quality of life, meaning of life, and hope) of adults with serious mental illness than participants randomly assigned to only traditional mental health services at those sites. (Campbell, COSP Preliminary Findings May 7, 2004).
Structured peer support programs are an innovative and promising approach to improve the availability, acceptability, and affordability of effective psychosocial treatments. They can offer unique benefits by re-orienting consumers and providers away from symptom management alone and toward recovery as the ultimate goal of treatment.
“Who then can so softly bind up the wound of another as he who has felt the same wound himself?”