Major review shows peer support can improve mental health

The review, published in BMC Medicine and commissioned by the Department of Health and Social Care, is one of the largest reviews of peer support in mental health to date.

Peer support is delivered by individuals who have lived experience of mental health difficulties. The review was led by King’s College London, and researchers analysed 35 existing reviews – including a total of 426 individual studies.

The review found evidence that peer support can aid mental health recovery, depression (particularly perinatal depression), and self-belief.

The findings showed that peer support is mutually beneficial for peer support workers 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.

However, the researchers also identified challenges to the role. Some peer support workers reported the ‘sick’ label stayed with them in the role, with non-peer staff at times concerned that their mental health would impact their work. A lack of clarity about the job description and low pay could lead peer support workers to feel the role was undervalued and tokenistic.

Good implementation of peer support was found to include 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.

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

Senior author Professor Sonia Johnson (UCL Division of Psychiatry) 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."

Joint first author Dr Ruth Cooper (King’s College London) 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.”

Related:

• Read the full paper in BMC Medicine
• Professor Sonia Johnson’s academic profile
• UCL Division of Psychiatry

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