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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: sgillard@sgul.ac.uk)
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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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