Establishing a Research Agenda for Understanding the Role and Impact of Mental Health Peer Specialists.

Mental health peer specialists are individuals with serious mental illnesses who receive training to use their lived experiences to help others with serious mental illnesses in clinical settings. This Open Forum discusses the state of the research for mental health peer specialists and suggests a research agenda to advance the field. Studies have suggested that peer specialists vary widely in their roles, settings, and theoretical orientations. Theories of action have been proposed, but none have been tested. Outcome studies have shown benefits of peer specialists; however, many studies have methodological shortcomings. Qualitative descriptions of peer specialists are plentiful but lack grounding in implementation science frameworks. A research agenda advancing the field could include empirically testing theoretical mechanisms of peer specialists, developing a measure of peer specialist fidelity, conducting more rigorous outcomes studies, involving peer specialists in executing the research, and assessing various factors that influence implementing peer specialist services and testing strategies that could address those factors.

Outcome of a randomized study of a mental health peer education and support group in the VA.

OBJECTIVES: Study objectives were to compare mental health outcomes of a peer-led recovery group, a clinician-led recovery group, and usual treatment and to examine the effect of group attendance on outcomes. METHODS: The study used a randomized design with three groups: a recovery-oriented peer-led group (Vet-to-Vet), a clinician-led recovery group, and usual treatment. The sample included 240 veterans. Recovery and mental health assessments were obtained at enrollment and three months later. Intention-to-treat analysis using mixed-model regression was performed to examine the effect of the intervention. "As treated" analysis was performed to examine the effect of group attendance. RESULTS: There were no statistically significant differences in improvement among the groups. Across groups, depression and functioning, psychotic symptoms, and overall mental health improved significantly. Better group attendance was associated with more improvement. CONCLUSIONS: This study adds to the evidence suggesting no short-term incremental benefit (or harm) from peer services beyond usual care.

Monitoring the dissemination of peer support in the VA Healthcare System.

This study illustrates a monitoring system for peer support programs, focusing on Vet-to-Vet, a program for veterans with chronic psychiatric disorders. The sample consisted of 1,847 anonymous surveys from 38 veteran peer support programs. Program satisfaction and recovery orientation were positively associated with duration and frequency of participation in peer support. Program satisfaction was also associated with the Vet-to-Vet model and location at a VA medical center (vs. other model & location types). Payment for peer facilitators was positively associated with recovery orientation, spirituality, and engagement in meaningful activity. Additional research using experimental design methods is needed to determine the impact of peer support on mental health outcomes.

A model of consumer-provider partnership: Vet-to-Vet.

Recently, there has been increased interest in consumer-provided mental health services. Two models have been proposed: One emphasizing full independence from professional services, and one in which consumers work within the mental health system. In this paper we describe Vet-to-Vet, a consumer-professional partnership model in which consumer services are embedded in a mental health system. We describe the advantages of this approach and barriers to implementation of other models. Vet-to-Vet has several unique elements, developed and implemented by consumers with professional consultation and supervision. We believe that consumer-partnership models of consumer-provided mental health services have potential for minimizing implementation barriers and for maximizing long-term sustainability.