(Apr. 18, 2018)Peer mentorship for individuals with serious mental illness who have multiple inpatient psychiatric hospitalizations and have a history of treatment non-engagement may be an effective support services tool, according to new research.
Since the 2003 President's New Freedom Commission on Mental Health, peer support services for individuals with serious mental illness has increased substantially, however the research supporting such interventions have been limited. Although evidence shows that people with histories of mental illness, or peers, can provide social services such as case management to individuals with serious mental illness, the effectiveness of these initiatives over other types of treatments is uncertain.
Recent evidence suggests, however, that peers may be able to develop more trusting relationships with individuals and result in higher treatment engagement for individuals classified as difficult to engage. This may be especially true for individuals caught in the revolving door of psychiatric hospitalizations, in which 40%-60% of individuals discharged from a psychiatric hospital are expected to return within a year of discharge.
Maria O'Connell and researchers from the Yale University School of Medicine conducted a randomized control trial of 93 individuals who had been hospitalized for psychiatric reasons at Yale New Haven Psychiatric Institute. After discharge from the hospital, half of study participants were linked to peer mentors who were trained in recovery-oriented treatment and were instructed to meet with individuals as they saw fit based on their own experiences. The other half of individuals who received the normal standard of care in the community after psychiatric hospital discharge.
Results of the trial
Individuals in the control arm of the study were rehospitalized at a rate of three times that of the peer mentorship group. In addition, individuals in the peer mentorship care group stayed out of the hospital twice as long as the standard care group.
The authors acknowledge that the findings are limited due to the small sample, however the findings warrant more research into the potential impact of peer support services during the critical period after inpatient psychiatric hospitalizations.
"Peer support services that build explicitly and directly on a peer's lived experiences of mental illness and recovery may offer more than simply adjunctive, nonspecific support," O'Connell writes. "In fact, these services may be a particularly effective, highly specific means of engaging reluctant persons in distress in supportive relationships that serve to decrease substance use and increase community tenure."
Elizabeth Sinclair
Director of Research
References:
- O'Connell, M. J. (April 2018). Outcomes of a peer mentorship intervention for persons with recurrent hospitalizations. Psychiatric Services.