Peer Workforce Research

The majority of research has focused primarily on the peer workforce component and more so on ‘Consumer’ peer work than ‘Carer’ peer work.  HealthWorkforce Australia undertook a Literature Scan in 2014 and draws on national and international literature reviews and studies undertaken by others.

A summary of key findings is included below:

  • The employment of peer workers is often seen as a key component of transforming mental health services to a recovery orientation (Sledge et al 2011)
  • People who have faced, endured and overcome adversity can offer useful support, encouragement, hope, and perhaps mentorship to others facing similar situations (Davidson et al, 2006)
  • Seven key functions of the mental health consumer workforce has been identified
  1. Individual advocacy (support individuals to understand and navigate the system/service needs)
  2. Peer support (giving and receiving held founded on key principles of respect, shared responsibility and mutual agreement)
  3. Systemic advocacy and representation (participation at all levels individual through national)
  4. Health promotion (improving mental and physical health, recovery and other areas)
  5. Education and training (of other mental health service providers, peer educators)
  6. Quality and research and
  7. Coordination and management (NSW Consumer Advisory Group 2013)
  • National Practice Standards for Mental Health Workforce (2002) stresses the importance of involving both consumers and carers in the education of the workforce.

HealthWorkforce Australia conclude by stating that “the literature suggestions that peer workers can provide an important and useful complement to the traditional teams delivering mental health services … particular benefits can include improving the recovery orientation of services, better engagement with people using services, reduction in hospital admissions and reduced load on other practitioners … offers an improved experience of treatment (HWA )

 

Benefits for Consumers

Admission Rates and Community Tenure

  • People engaging in peer support tend to show reduced admission rates and longer community tenure (Repper and Carter 2011)
  • 50% reduction in readmissions with peer support outpatients program compared to traditional general outpatients population (Chinman et al 2001)
  • A South Australian study of a mental health peer support service providing hospital avoidance and early discharge support to consumers over a three-month period found savings of 300 bed days (Lawn et al 2008)
  • Using peer support as a part of discharge process significantly reduced readmission rates and increased discharge rates (Forchuk 2005)

Empowerment

  • Several studies of peer support report raised empowerment scores by consumers (Repper and Carter 2011)
  • Increased sense of independence which may have related to increased stability in work, education and training (Ochocka 2006)

Social Inclusion

  • Allow people to create relationships and practice a new identity in a safe and supportive environment (Mead et al 2001)
  • Higher level of community engagement (Repper & Carter 2011)
  • Improved social support, enhanced social skills and improved social functioning (Forchuk et al 2005)

Reduced Stigma

  • Peer workers embody the possibility of acceptance and success, so they can challenge the barriers created by self-stigmatisation (Repper et al 2012)
  • Engaging in peer support can alter attitudes to mental illness, and break down stigma as well as fostering hope (Mowbray et al 1998)

 

Benefits for Peer Workers

Mental Health and Wellbeing

  • Increased levels of self-esteem and levels of hope (Razlaff et al 2006)
  • Peer work employment can provide an identity shift from patient/consumer/client to that of valued worker and contributing citizen (Hutchison et al 2006)
  • Discovery of personal strengths and sense of self as a capable being (Moran et al 2012)

Acceptance

  • Instead of trying to hide or ignore a mental illness, peer providers were able to embrace the notion of having a psychiatric condition and at the same time, pursue a fuller life beyond the illness (Moran et al 2012)

Skills and Employment

  • Increase an individual’s skill base, which makes them more employable and opens up other opportunities (Raxlaff et al 2006)

 

Benefits for Carers

  • Can offer hope to families, can share the vulnerabilities experienced and help ease the burden for familiies, can empower families and staff to improve communication and collaboration (Geraghty et al 2011)
  • Involvement in Mutual support groups reported greater improvement in functioning and less burden (Chien et al 2006)
  • Gaining a sense that one is not alone and we’re all in the same boat was perceived as most helpful group therapeutic factor (Stephens et al 2011)

 

Benefits for Mental Health Services

Engagement of Consumers

  • Peer support workers highly skilled and effective at engaging and communicating acceptance, Able to increase treatment participation by hard to reach or disengaged (Sells et al 2006)
  • Acting as a bridge between clients and other staff and complements existing services (Davidson et al (2012)

Organisational Culture

  • Enhances commitment to recovery, staff more aware of their use of language and being more reflective (Bradstreet et al 2010)
  • Created culture change through role modelling, informal dialogue, education and creating conditions where some professionals felt safe to ‘come out’ as consumers/suvivors (O’Hagan 2011)
  • Staff develop increased empathy and understanding toward people in recovery as a result of working with peer support workers (Walker & Bryant 2013)

Cost Effectiveness

  • By increasing trained peer personnel, can increase number of people served (Hutchison et al 2006)
  • When well-trained and supervised, peer staff can lessen the load carried by other practitioners, enriching consumers lives while allowing other staff to concentrate on their respective roles (Davidson et al 2012)
  • A review of eleven randomised controlled trials found that the outcomes for clients were no better or worse than those achieved by professionals employed in similar roles, delivering the same functions and activities, peer support workers produced outcomes comparable with their non-peer colleagues (Pitt et al 2013)
  • Peer support workers bring about significant reductions in bed-use among the patients they support leading to financial savings which are well in excess of additional pay costs (for the peer workers (Trachtenberg et al 2013)

Responding to Crisis and Reducing Coercive Practices

  • Recovery Innovations in Arizona found by adding peers to the staff team was an important element in changing staff attitudes toward recovery and reducing acceptance of seclusion and restraint in two crisis services (Ashcraft and Anthony 2008). 

If you would like to get more involved in Peer related research go to the following links:

Center of Excellence in Peer Support 

http://www.peersupportvic.org/index.php

This is funded by the Victorian Government and is compiling a database of research about peer support from Australia and internationally. You can be added to their mailing list, and encourage your organisations to sign their charter of co-operation

Consumer-Led Research Network

http://www.cmhdaresearchnetwork.com.au/home/

This is sponsored by the NSW Mental Health Commission and auspiced by NADA and MHCC. They are going through some changes as support of the network shifts to NADA. However, you can still join their mailing list, and they hope to run a webinar later in the year to re-connect all the researchers.

They have some YouTube videos that captured the forum I attended last year. The first one is available here

There are three in all.

Our Consumer Place

http://www.ourconsumerplace.com.au/consumer/index

Griffith University, School of Human Services and Social Work

https://www.griffith.edu.au/health/mental-health