Peer support helps people recover from mental illness, study finds

Peer support can help people with mental health problems, particularly depression, to recover, a large-scale review of research has found.

The systematic review, carried out by researchers at King’s College London and University College London and published in BMC Medicine, analysed 35 existing reviews, covering a total of 426 studies. The individual studies ranged from 95 to 41,000 participants.

Numerous reviews highlighted the benefits of peer support, the researchers found. Peer support was beneficial for peer support workers (PSWs) and service users, with both experiencing improved wellbeing and recovery from delivering or receiving peer support. Service users also reported that peer support normalised and de-medicalised their experiences, reducing feelings of self-stigma.

The results on the effectiveness of peer support were mixed. The researchers found evidence that it was particularly good at helping people recover from perinatal depression and improving self-belief. But they also found that most evidence regarding mental health symptom severity among adults and adolescents with mental health diagnoses or who were using mental health services “suggested no effect”.

Route back into employment

Peer supporter workers themselves “benefited in a variety of ways,” the authors write. For example, they add: “The role provided a route back into employment, improving functioning and social inclusion, and allowed them to learn more about their own mental health. PSWs also reported increased self-acceptance as they no longer had to hide their mental health issues.”

As a result of working with PSWs, other staff “developed increased empathy towards service users and a belief in recovery,” the authors write.

The researchers also identified challenges with the peer support role. Some peer support workers said that the “sick” label stayed with them, and that other staff were concerned that their mental health problems might affect their ability to do their job. A lack of clarity about the job description and low pay could lead peer support workers to feel the role was undervalued and tokenistic. This could affect their own recovery and led to uncertainty in their responsibilities with service users.

Good implementation of peer support included co-design with people with lived experience, clear job descriptions, a recovery-oriented, supportive, and trusting workplace culture, and appropriate training for peer support workers and non-peer staff, the research found.

Lack of time and resources are barriers

Barriers to peer support being implemented successfully included a lack of time, resources and appropriate funding, and a lack of recognised peer support worker certification.

Sonia Johnson, professor of social and community psychiatry at UCL, and senior author on the study, said: “It’s widely acknowledged that paid peer support is an important approach to mental health care, now and in the future. However, there is still a lot of uncertainty about the best way to do it right. Our review offers valuable pointers to help service providers deliver peer support that is beneficial to both service users and the staff providing it. Moving forward, we hope to see more research that is co-produced with service users so we can better understand which types of peer support work for who, and in what settings.”

Dr Ruth Cooper, a research associate at King’s and joint first author, said: “Despite peer support interventions being recommended internationally, research into its effectiveness has produced mixed results. Our review, which is one of the largest to date, found that peer support can help mental health recovery, but there are structural and cultural barriers to successful implementation that must be overcome. Understanding how best to implement these interventions is essential to building effective mental health care systems that deliver the best possible care for people.”

The study was funded by the NIHR Policy Research Programme.