Poster #64 - Peer Support and Mental Health: What Circumstances, With Whom, and How Is Peer Support Most Effective? A Review and Meta-Analysis

• In Event: Poster Session 04

Abstract

Peer support has gained burgeoning interest among mental health professionals, policy makers, and researchers as a mental health resource and protective factor (Mahlke et al., 2014). An extensive body of observational studies examined peer support in everyday context that is drawn from one’s close social relations (with peers). Beyond regular and routine peer support that is based on ones’ social network, peer support interventions are concerned with active engagement and solicitation of peer support from three sources: informal naturally occurring (peers with common lived experiences of health and/or social care services), formal unpaid (peers participating in consumer or peer-run program/self-help groups), and formal paid (therapists, clinicians, and psychologists as peer supporters).

Research has yet to evaluate the relationship of peer support in everyday context and effectiveness of interventional peer support with mental health functioning. The current gaps about peer support and mental health need to be addressed: what do we know and do not know; where/how, for who and for what purpose/circumstances is peer support most effective (essence of peer support); the long term implications of peer support (Pfeiffer et al., 2011). The aims of our systematic review and meta-analysis are to evaluate whether and how peer support relates to and impacts mental health functioning--in what circumstances, with whom and how, and peer support’s prospective relations with and sustained effects on mental health functioning.

Using mixed-effects modelling, which included 56 and 88 effect sizes from 36 observational studies and 54 randomized controlled trials, respectively, our findings with the observation studies revealed a low positive relation between peer support in everyday context and mental health, r = 0.22, p < 0.001; [95% CI: 0.18 to 0.26]. With RCTs that compared pre-post peer support interventions, peer support interventions to control and to other forms of intervention (e.g., Cognitive Behavioural Therapy), we found a moderate effect of peer support in enhancing mental health functioning, with pooled effect size of standardized mean difference (SMD) = 0.45, p < 0.001 [95% CI: 0.37 to 0.52].

Forms (emotional, social, connectedness) and modes of peer support (traditional face-to-face, online/digital, and a combination of offline and online) did not moderate the association between everyday peer support and mental health functioning for observational studies, Qbetween = 1.52, p = 0.68 and Qbetween = 0.06, p = 0.81, respectively. Comparing different forms of peer support interventions in RCTs, Qbetween = 13.90, p = 0.001; informal naturally occurring peer support intervention demonstrated the greatest effectiveness in increasing mental health functioning with high effect size. The duration of peer support intervention did not affect its effectiveness, Qbetween = 0.88, p = 0.35.

Our review and meta-analysis demonstrated that peer support is related to and results in positive mental health functioning. We discussed the importance of our findings for theory building, specifically in forming a primary model of peer support. For practical implications, our findings can aid policy makers, mental health professionals and community leaders in identifying and establishing features of high performing peer support for mental health in the community.

Authors

• Geckhong Yeo, National University of Singapore
  Presenting Author

• Cameron Tan, National University of Singapore

• Dean Ho, National University of Singapore

• B. Bradford Brown, University of Wisconsin-Madison

• Mitchell J Prinstein, University of North Carolina at Chapel Hill