The Evidence for Peer Support
Peer services are an evidence-based practice1. When working with professionals who are not used to working with peers, peer specialists may be in a position where they have an educational and transformational opportunity. Even many well-regarded and talented mental health professionals are unfamiliar with the ways in which peer support services have been demonstrated as effective.
Peer support services have been shown to:
- Reduce expensive inpatient service use
- Reduce recurrent psychiatric2,3,4 hospitalizations for patients at risk of readmission2,3,4
- Improve individuals’ relationships with their health care providers2,3,4
- Better engage individuals in care2,3,4
- Significantly increase individuals’ abilities to manage their symptoms and reduce their reliance on formal services while still achieving positive recovery outcomes5
Additionally, there are ways in which peer supporters and peer specialists can achieve outcomes and progress that are unique to the peer-to-peer relationship. Some of these are
- Use of personal experience―Peer support and peer specialists complement and increase effectiveness of traditional mental health service models (SAMSHA, 2012).
- Use of example—When provided with a peer role model, individuals show significant gains in expanding social networks and reducing isolation (Chinman, 2001), increasing physical activity, and promoting health-enhancing behaviors (Cook, 2009, Druss, 2010).
- Use of natural supports―Peer support group members experience significant decrease in family stress, improvement in interpersonal relationships, and increase in identified support persons (Thompson, Norman, 2008).
- Ownership of treatment and wellness—Individuals with access to peer support show greater gains in confidence and self-advocacy (Cook, 2009), knowledge and management of illness (Lucksted et al., 2009), and medication adherence and problem-solving (Druss, 2010), when compared to individuals receiving traditional services only.
- Use of mutual benefit―Peer specialists report personal gains from helping others, including greater interpersonal competence, social approval, professional growth, and self-management (Salzer, Liptzin-Shear, 2002).
- Understanding of mental health system—Peers are often more proficient with benefit acquisition and provide rapport to keep others engaged (Lupfer, 2012).
In September of 2014, The Hogg Foundation for Mental Health hosted the Robert Lee Sutherland Seminar XVIII: The State of Mental Health Recovery: Research, Training, and Practice. Dr. Larry Davidson presented “What Everyone Needs to Know About the Evidence Base for Mental Health Recovery”. Dr. Davidson’s presentation provides additional information and history to this important evidence.
1 Source: Centers for Medicare and Medicaid Services/CMS
2 Solomon P, Draine J, Delaney M. The working alliance and consumer case management. J Ment Health Admin. 1995;22:126–134.
3 Wexler B, Davidson L, Styron T. Severe and persistent mental illness. In: Jacobs S, Griffith EEH, editors. 40 years of academic public psychiatry. London: Wiley; 2008. pp. 1–20.
4 Davidson L, Stayner DA, Chinman MJ. Preventing relapse and readmission in psychosis: using patients’ subjective experience in designing clinical interventions. In: Martindale B, editor. Outcome studies in psychological treatments of psychotic conditions. London: Gaskell; 2000. pp. 134–156.
5 Sledge WH, Lawless M, Sells D. Effectiveness of peer support in reducing readmissions among people with multiple psychiatric hospitalizations. Psychiatr Serv. 2011;62:541–544