TY  - JOUR
TI  - The effectiveness, implementation, and experiences of peer support approaches for mental health: a systematic umbrella review
N1  - This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
ID  - discovery10188660
Y1  - 2024/02/29/
UR  - https://doi.org/10.1186/s12916-024-03260-y
JF  - BMC Medicine
VL  - 22
SN  - 1741-7015
A1  - Cooper, Ruth E
A1  - Saunders, Katherine RK
A1  - Greenburgh, Anna
A1  - Shah, Prisha
A1  - Appleton, Rebecca
A1  - Machin, Karen
A1  - Jeynes, Tamar
A1  - Barnett, Phoebe
A1  - Allan, Sophie M
A1  - Griffiths, Jessica
A1  - Stuart, Ruth
A1  - Mitchell, Lizzie
A1  - Chipp, Beverley
A1  - Jeffreys, Stephen
A1  - Lloyd-Evans, Brynmor
A1  - Simpson, Alan
A1  - Johnson, Sonia
N2  - BACKGROUND: Peer support for mental health is recommended across international policy guidance and provision. Our systematic umbrella review summarises evidence on the effectiveness, implementation, and experiences of paid peer support approaches for mental health. METHODS: We searched MEDLINE, EMBASE, PsycINFO, The Campbell Collaboration, and The Cochrane Database of Systematic Reviews (2012-2022) for reviews of paid peer support interventions for mental health. The AMSTAR2 assessed quality. Results were synthesised narratively, with implementation reported using the CFIR (Consolidated Framework for Implementation Research). The protocol was registered with PROSPERO (registration number: CRD42022362099). RESULTS: We included 35 reviews (426 primary studies, n?=?95-40,927 participants): systematic reviews with (n?=?13) or without (n?=?13) meta-analysis, or with qualitative synthesis (n?=?3), scoping reviews (n?=?6). Most reviews were low or critically low (97%) quality, one review was high quality. Effectiveness was investigated in 23 reviews. Results were mixed; there was some evidence from meta-analyses that peer support may improve depression symptoms (particularly perinatal depression), self-efficacy, and recovery. Factors promoting successful implementation, investigated in 9 reviews, included adequate training and supervision, a recovery-oriented workplace, strong leadership, and a supportive and trusting workplace culture with effective collaboration. Barriers included lack of time, resources and funding, and lack of recognised peer support worker (PSW) certification. Experiences of peer support were explored in 11 reviews, with 3 overarching themes: (i) what the PSW role can bring, including recovery and improved wellbeing for service users and PSWs; (ii) confusion over the PSW role, including role ambiguity and unclear boundaries; and (iii) organisational challenges and impact, including low pay, negative non-peer staff attitudes, and lack of support and training. CONCLUSIONS: Peer support may be effective at improving some clinical outcomes, self-efficacy, and recovery. Certain populations, e.g. perinatal populations, may especially benefit from peer support. Potential strategies to successfully implement PSWs include co-production, clearly defined PSW roles, a receptive hierarchical structure and staff, appropriate PSW and staff training with clinical and/or peer supervision alongside safeguarding. Services could benefit from clear, coproduced, setting specific implementation guidelines for PSW. PSW roles tend to be poorly defined and associations between PSW intervention content and impacts need further investigation. Future research should reflect the priorities of providers/service users involved in peer support.
KW  - Mental health
KW  -  Peer support
KW  -  Systematic review
KW  -  Umbrella review
KW  -  Pregnancy
KW  -  Female
KW  -  Humans
KW  -  Mental Health
KW  -  Systematic Reviews as Topic
KW  -  Workplace
AV  - public
ER  -