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To examine the impact of one-to-one peer support on mothers’ personal breastfeeding goals.
Design:
Scoping review guided by Arksey and O’Malley’s five-stage framework and reported in accordance with PRISMA-ScR guidelines. Qualitative data were analysed using descriptive content analysis. Quantitative data were analysed by identifying numerical trends and recurring patterns, and a concise overview of key descriptive findings was provided using frequency counts and proportions.
Setting:
Studies conducted across 10 countries globally, identified through systematic searches of seven electronic databases and screening of reference lists.
Participants:
Thirty-eight studies were included: 20 quantitative, 7 qualitative, 6 mixed-methods, and three secondary analyses (drawing on two relevant primary sources). Participants were mothers who received one-to-one breastfeeding peer support, predominantly in community or home-based settings.
Results:
One primary outcome was assessed: The impact of one-to-one peer support on mothers’ personal breastfeeding goals. Two secondary outcomes were identified. The first examined the effect of one-to-one peer support on breastfeeding outcomes based on traditional measures of breastfeeding success. Of the included studies, 50% reported positive effects of one-to-one peer support on traditional measures of breastfeeding success, while 21% found no statistically significant differences. An additional secondary outcome reported in 34% of the included studies examined the impact of mother-centred breastfeeding peer support on maternal emotional well-being.
Conclusions:
One-to-one peer support enhances the mothers’ ability to achieve their personal breastfeeding goals and positively influences emotional well-being. These findings underscore the need to integrate structured one-to-one peer support into maternal health services in Ireland and globally.
The goal of this study was a re-analysis of a randomized controlled trial evaluating the effectiveness of Attachment and Biobehavioral Catchup (ABC), an early childhood parenting intervention. We compared the effectiveness of ABC for enhancing parental sensitivity and child behavior among 79 dyads who received the intervention as delivered by peer support specialists (n = 49 dyads) or master’s-level clinicians (n = 30 dyads). Peer support parent coaches were non-inferior at enhancing parental sensitivity and parental intrusiveness as parent coaches with a master’s degree. This research has important clinical implications for increasing access to ABC for parents involved in the child welfare system.
This study evaluated the effectiveness of a one-year smoking cessation intervention for people with severe mental illness compared with treatment as usual (TAU) in outpatient mental healthcare.
Methods
The KISMET study is a pragmatic cluster-randomized controlled trial conducted in 21 outpatient mental healthcare teams in the Netherlands. Eleven teams delivered the KISMET intervention comprising cognitive-behavioral and peer support, combined with optional pharmacological reatment. Ten teams participated in the TAU condition. We collected data between October 2022 and July 2024. The primary outcome was self-reported smoking cessation at 12 months, verified through exhaled carbon monoxide levels below 10 parts per million. Secondary outcomes included depression and anxiety (HADS), severity of psychotic symptoms (PANSS-6), quality of life (SF-12), disease self-management (PAM-13), lipid profile, blood pressure, body mass index, glucose level, and physical fitness. Crude and adjusted linear and multivariable logistic regression and mixed model analyses were performed.
Results
Eighty-nine participants were included in the KISMET intervention and 44 in TAU. Smoking cessation rates were significantly higher in the KISMET group at 3 months (OR 12.1, 95% CI 1.4 to 103.7) and at 12 months (OR 4.2, 95% CI 1.0 to 17.2) but not at 6 months (OR 1.9, 95% CI 0.5 to 6.9). No significant differences between groups were found for secondary outcomes. Dropout rates were 58% in the intervention and 32% in the TAU group.
Conclusions
The KISMET intervention shows potential without signs of physical or psychopathological complications. However, results must be interpreted with the high dropout rates in mind.
Youth in low- and middle-income countries (LMICs) bear a disproportionate burden of mental health conditions, alongside low health-seeking behaviours and limited access to services. These gaps underscore the need for accessible strategies such as youth peer-based mental health programmes and supports (Y-PBMHPS).
Aims
To examine whether Y-PBMHPS can help address the mental health needs of LMIC youth.
Method
We conducted a rapid review of peer-reviewed literature, searching Medline, PsycINFO, CINAHL, CAB Global Health, Science Citation Index and Social Sciences Citation Index for studies of Y-PBMHPS in LMICs published in English between 1 January 2002 and 19 September 2025. Two review authors performed title/abstract screening and full-text review. Study quality was assessed by one review author using Joanna Briggs Institute critical appraisal tools. The primary outcome was change in mental health status, expressed in standardised difference units.
Results
Of 6105 unique records identified, 329 studies were reviewed in full and 34 were included. All studies were conducted in Asia or Africa; 17 were quantitative studies (including randomised controlled trials), 9 were qualitative studies and 8 used quantitative designs with qualitative findings. Y-PBMHPS included counselling, psychotherapy, psychoeducation and self-help groups, with peers acting as leaders, facilitators, educators or service providers. Quantitative studies most frequently assessed anxiety and depression, reporting negligible to moderate effects. Qualitative findings indicated good fidelity, adherence and acceptability, alongside some feasibility challenges.
Conclusions
Y-PBMHPS can broaden youth mental health support and services in LMICs. Clearer guidelines on peer selection, training and supervision and further research in other LMICs, including cost-effectiveness evaluations, would strengthen the evidence base.
Although peer support is increasingly used in mental health services worldwide, service users’ experiences have been studied mostly in high-income countries. The current study examined service users’ experiences of peer support in the UPSIDES Trial, delivered across diverse cultural and resource contexts, including high, middle and low-income countries. Semi-structured interviews were conducted with 33 service users across six study sites (Germany [two sites], Uganda, Tanzania, Israel, and India) and analyzed using thematic analysis to identify patterns in participants’ experiences. To capture diverse perspectives, service users were purposively sampled based on pre–post changes in social inclusion and personal recovery, with participants randomly selected from the top and bottom 20% (‘high’ and ‘low’ responders). Four themes emerged: (1) adaptable settings and intervention flexibility; (2) ‘active ingredients’ such as mutuality, reciprocity, and role-modeling; (3) positive intra-personal, inter-personal, and behavioral outcomes; and (4) barriers, including mismatches, unmet expectations, unclear boundaries and challenges to continuity. The study highlights shared relational elements of peer support alongside context-specific adaptations. Findings reinforce its value as a complementary, person-centred service with global relevance, while pointing to challenges including improving matching, reducing dropout, and clarifying expectations. Site-specific aspects are discussed, offering insights for global implementation.
Edited by
Liz McDonald, East London NHS Foundation Trust,Roch Cantwell, Perinatal Mental Health Service and West of Scotland Mother & Baby Unit,Ian Jones, Cardiff University
There is a strong evidence base for the management of perinatal mental illness and all healthcare professionals should be aware of that; women can be offered hope of recovery with treatment.
NHS England and Scotland have published pathways of care for perinatal mental health care, but these do not deal with illness below the threshold of specialist care. Each area needs to develop effective local pathways of care that cover the full spectrum of disease and include all services.
The purpose of this chapter is to describe the building blocks that contribute to the rest of the pathway for women with perinatal mental illness. Although the chapter mainly covers the situation in England, it also gives information about the devolved nations, Scotland, Wales and Northern Ireland.
What follows covers principles of teamwork and stepped care.
Community-level interventions are a key part of suicide prevention. The effectiveness of these strategies vary and objective measurement of the efficacy of these interventions are often challenging. Evidence shows that preventing access to means of suicide in the community, and ongoing education and awareness among primary care healthcare professionals about mental illness and suicide, both are effective, universal-level preventive strategies. Increasing awareness and mental health literacy among young people in schools shows promise, though most evidence is from high-income countries. Trials have demonstrated that brief follow-up contact interventions (BCI), such as sending postcards, text messages or a follow-up phone call, are effective in reducing suicidal ideation and repetition of suicide attempts.
This chapter reviews the benefits of peer support for survivors of critical illness and their loved ones, which include psychological empowerment, the expression of shared experience, and fostering altruism and post traumatic growth. Peer support has also been shown to reduce social isolation and loneliness. Different modalities to deliver peer support are discussed, such as individual peer support delivered by a peer mentor. The chapter also provides an overview of structural support that should be in place to on-board, supervise, and partner with a peer volunteer. Mindfulness to power differentials and having access to a staff member that is qualified to supervise a peer volunteer are highlighted. The chapter reviews different models of peer support, including groups held in the ICU, community groups post-ICU, clinic-based groups, virtual groups, and asynchronous groups. Barriers and foundational knowledge, such as recruitment, logistics, facilitation, and sustainability, are reviewed.
Viewing disability as a form of social capital, this paper examines the unique contribution of volunteers with disabilities and the meaning that volunteering holds for them. Of the 35 volunteers with disabilities interviewed, all were volunteering in self-help organizations for people with disabilities, half of them in administrative and leadership roles. The interviews revealed rich and active stories. Their areas of activity were diverse and encompassed various organizations. The volunteers crossed over from the role of merely extending services to their beneficiaries to becoming activists for political and social change. Their practices suggest that the volunteers’ self-identity as individuals with disabilities has shaped their supportive approach. Therefore, understanding their unique resources as people with disabilities is key to developing an organizational culture that promotes integrative recruitment of volunteers.
Peer support approaches are gaining increasing importance within the mental health sector as an effective way to assist people with mental and addictive disorders. This article explores peer support volunteers’ motives for voluntary engagement in a model project in Germany. It aims to gain a deeper understanding of peer support approaches and their underlying motivations in an innovative context. Twenty-three qualitative interviews with peer support volunteers were analyzed according to Mayring’s qualitative content analysis. Results showed that voluntary engagement fulfills a heterogeneous range of functions for peer support volunteers. Alongside “typical” volunteers’ motives, there were peer-specific functions such as motivation due to own personal experiences and the objective of changing societal attitudes toward mental health. Furthermore, the context of employment promotion played a motivational role: Many interview partners aimed to transform counseling structures within the institutions they had experienced as clients themselves.
In many parts of the Western world, interventions for people with mental illness have radically changed in recent decades. In the deinstitutionalized system of today, the role for non-profit organizations is generally characterized by dual goals: political advocacy and service provision. Here, the role and function of the user movement in the Swedish mental health system is examined through a case study of all local branches of the largest non-profit organization within the Swedish mental health field. The empirical material consisted of annual reports from all local branches, and was analysed through two analytical schemes, concerning voice/service and conflict/consensus. The analysis pointed to a user movement that still retained the basic ideas of peer support and mutual aid, but were also increasingly being asked by formal service providers to represent the need of users. A hybrid organization category, a ‘Social Movement Peer Organization’, was identified that where social recreational activities are combined with local political advocacy.
Unpaid cancer caregivers (UCCs) are the primary caretakers of individuals with cancer, often shouldering caregiver responsibilities without prior preparation, which leads to a sense of isolation, particularly in remote and rural areas where healthcare access is challenging. Thus, this systematic review aimed to explore the perceived and/or received peer support needs of UCCs residing in rural and remote areas with a specific focus on informational, practical, and emotional needs.
Method
Seven databases (CINAHL, ScienceDirect, PUBMED/MEDLINE, PROQUEST, Web of Science, Scopus, and Informit) were searched from 2004 to 2024. Peer-reviewed qualitative, quantitative, and mixed-method studies published in English were considered for this review. Data were extracted using the Joanna Briggs Institute System for Unified Management, Assessment, and Review of Information and presented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram. Quality and bias were assessed with the Mixed Methods Appraisal Tool.
Results
In total, 8 primary studies were included: 4 qualitative, 2 mixed methods, 1 cross-sectional, and 1 prospective survey. Four themes were identified: (1) Emotional, practical, and informational unmet needs; (2) Lack of peer support on the physical and emotional well-being of UCCs in remote and rural areas; (3) Lack of supportive services in remote and rural areas; and (4) Access to flexible peer support.
Significance of results
This review revealed the unique unmet needs of UCCs in remote and rural areas, where a lack of reliable and accessible resources adversely leads to impaired UCCs’ overall well-being. Addressing these unmet needs is essential to enhance the support system for UCCs living in such regions. By identifying the gaps, the review underscores the need for developing a peer support model tailored to the specific needs of UCCs in rural and remote communities.
When do artists feel that first intense pull toward creation? Some artists know early in their lives what they want to do with their lives. Sometimes, artists feel like their specific art choice has always been a key part of their identities. Other times, there is a sudden jolt of insight in which they realize their life path, whether from a gift, a moment of creation, or working on an artistic project in tandem with a friend or sibling. Peer support and approval can be a powerful reinforcement to pursue one’s artistic passion.
Some adolescents can achieve academic success and maintain well-being despite their engagement in video gaming. Social factors may play a role in their vulnerability to mental health problems.
Aims
This study examined the role of perceived peer support and childhood experiences of optimal parenting in the association between video-gaming duration and depressive symptoms in adolescents.
Method
A sample of 1071 adolescents (mean age 13.62 years, s.d. = 0.95) completed a questionnaire on video-game usage. Their perceptions of parental care and support since childhood were assessed using the Parental Bonding Instrument, whereas their perceived peer friend support was assessed using the friend support subscale of the Multidimensional Scale of Perceived Social Support. Their depressive symptoms were measured using the depression subscale of the Depression Anxiety Stress Scales. Moderated mediation analysis was conducted to examine the associations of these variables. Family socioeconomic status and symptoms of attention-deficit hyperactivity disorder were included as covariates.
Results
Longer durations of video gaming were associated with higher levels of depressive symptoms. The role of perceived peer support in this association was moderated by childhood experiences of optimal parenting. Specifically, the mediating role of perceived friend support was significant only for adolescents who lacked optimal parenting.
Conclusions
The relationship between frequent video gaming and depressive symptoms in adolescents is complex and may depend on the levels of peer and parental support. Lacking support from both parents and peers can increase adolescents’ risk of depression associated with frequent video gaming.
To evaluate whether and how drafting psychiatric advance directives (PADs) with the support of a peer worker improves recovery outcomes for individuals with severe mental illness.
Methods:
A mixed-methods design was employed, combining quantitative data from a randomized trial with qualitative interviews. The trial included adults with schizophrenia, bipolar I disorder, or schizoaffective disorder who had experienced involuntary hospitalization in the past year. Participants either completed PADs with peer worker support or without specific facilitation. Recovery was assessed longitudinally using the Recovery Assessment Scale. Thematic analysis of interviews explored mechanisms underpinning the effectiveness of peer facilitation.
Results:
A total of 118 participants completed PADs, 84 with peer support. Mixed-effects regression analysis revealed significantly higher recovery scores for those supported by peer workers (coefficient = 4.77, p = 0.03). Qualitative findings highlighted two key mechanisms: peer workers’ boundary role fostering trust and relational symmetry and their facilitation practices promoting critical reflexivity and addressing past psychiatric trauma. Participants emphasized the flexibility and empathy of peer workers, which enabled deeper reflection and empowerment.
Conclusions:
Peer facilitation enhances the drafting of PADs, significantly contributing to recovery through trust, critical reflection, and trauma-informed approaches. These findings support the integration of peer workers into PAD frameworks and emphasize the need for tailored training and systemic reforms to maximize their impact.
Early Intervention Psychosis Services (EIPS) provide multimodal interventions for young people who are at risk of, or have experienced, a first episode of psychosis. Although recent studies have begun to examine this critical period in a young person’s personal recovery in more depth, little is known about how young people experience EIPS in general, and its influences on their clinical and psychosocial recovery in particular.
Aims
This study aimed to explore young people’s experience of EIPS, specifically the factors that have affected their (a) clinical and (b) psychosocial recovery.
Method
This study purposively sampled 27 young people from a range of backgrounds at 6 community-based EIPS in Australia. Audio-recorded, semi-structured interviews were conducted and reflexive thematic analysis was used to analyse this data-set.
Results
Four themes of how EIPS enabled recovery were identified. The first three - a safe space, unconditional support and active involvement – were foundational to a fourth theme of gradual self-management. In earlier-stage self-management, participants relied on practical supports to make connections and find education and employment opportunities. By later-stage self-management, they had developed the tools to do these things for themselves. Participants’ movement between earlier- and later-stage self-management was connected to their overall EIPS engagement and, for some, to their engagement with peer support.
Conclusions
Providing a safe space, unconditional support and active involvement for clients and their families created the foundational conditions for improved clinical and psychosocial recovery. Peer support programmes, increasing engagement when situational changes such as employment occur and the provision of culturally sensitive care appeared valuable to this process.
Peer Refugee Helpers (PRHs) support peers in humanitarian settings, which may influence their own mental health. This longitudinal study examined anxiety and depression trajectories among Afghan, Iranian and Syrian refugees and asylum seekers in Greece, focusing on how PRH status (paid/unpaid) and sense of coherence influence trajectory membership. The study included 176 adult, PRHs and non-helpers. The following scales were administered three times at ~4-month intervals: Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7), Social Provisions Scale (SPS-24), Sense of Coherence (SOC-13), Perceived Ability to Cope With Trauma (PACT) and Brief Trauma Questionnaire (BTQ). Using latent growth mixture modeling, we identified two depression (high and low) and three anxiety (high, moderate and low) trajectories. The adjusted logistic and multinomial regression models indicated that unpaid PRHs were significantly less likely to follow a low depression trajectory (odds ratio [OR] = 0.55, p = 0.037), while paid PRHs were more likely to follow a low anxiety trajectory (OR = 3.17, p = 0.009). Higher SOC was associated with low depression (OR = 1.03, p = 0.012) and low anxiety trajectories (OR = 1.06, p = 0.002). Our findings suggest PRH mental health may be associated with working conditions, including financial compensation.
Psychosocial interventions for people with mental illness are increasingly focusing on facilitating recovery and self-care. Despite evidence from Europe on the short-term effects of recovery self-planning programs for people discharged from crisis resolution teams, similar programs and supporting evidence in other countries or healthcare contexts are lacking, particularly regarding cultural adaptation and long-term assessment. This randomized controlled trial compared a 4-month peer-facilitated, recovery-focused self-illness management (Peer-RESIM) program for Chinese adults with first-episode psychosis with psychoeducation (PE) and treatment as usual (TAU).
Methods
Patients (N = 198) were recruited from four Integrated Community Centres for Mental Wellness in Hong Kong and randomly assigned to the Peer-RESIM, PE, or TAU group (66/group). The primary outcomes were recovery and functioning levels; the secondary outcomes were psychotic symptoms, problem-solving ability, rehospitalization rate, and service satisfaction. Assessments were conducted at baseline and immediate, 9, and 18 months postintervention.
Results
The generalized estimating equation test revealed that the Peer-RESIM group reported significantly greater improvements in recovery, functioning, problem-solving ability, psychotic symptoms, average duration of rehospitalizations, and service satisfaction (p = 0.01–0.04, small to large effect sizes) than the TAU group at all three posttests and the PE group at 18 months postintervention.
Conclusions
The Peer-RESIM can enhance long-term recovery and self-care in adults with early-stage psychosis.
Some trials have evaluated peer support for people with mental ill health in high-income, mainly English-speaking countries, but the quality of the evidence is weak.
Aims
To investigate the effectiveness of UPSIDES peer support in high-, middle- and low-income countries.
Method
This pragmatic multicentre parallel-group wait-list randomised controlled trial (registration: ISRCTN26008944) with three measurement points (baseline and 4 and 8 months) took place at six study sites: two in Germany, and one each in Uganda, Tanzania, Israel and India. Participants were adults with long-standing severe mental health conditions. Outcomes were improvements in social inclusion (primary) and empowerment, hope, recovery, health and social functioning (secondary). Participants allocated to the intervention group were offered UPSIDES peer support.
Results
Of the 615 participants (305 intervention group), 337 (54.8%) identified as women. The average age was 38.3 (s.d. = 11.2) years, and the mean illness duration was 14.9 (s.d. = 38.4) years. Those allocated to the intervention group received 6.9 (s.d. = 4.2) peer support sessions on average. Intention-to-treat analysis showed effects on two of the three subscales of the Social Inclusion Scale, Empowerment Scale and HOPE Scale. Per-protocol analysis with participants who had received three or more intervention sessions also showed an effect on the Social Inclusion Scale total score (β = 0.18, P = 0.031, 95% CI: 0.02–0.34).
Conclusions
Peer support has beneficial impacts on social inclusion, empowerment and hope among people with severe mental health conditions across diverse settings. As social isolation is a key driver of mental ill health, and empowerment and hope are both crucial for recovery, peer support can be recommended as an effective component of mental healthcare. Peer support has the potential to move global mental health closer towards a recovery- and rights-based orientation.
In the last ten years, the recovery movement has significantly influenced mental health services and workers, psychiatric reform, and the advocacy movement worldwide. Within Brazil’s public mental health care system, operates a cohesive, powerful advocacy coalition empowering recovery-oriented practices. This article aims to highlight successful initiatives spearheaded by individuals with lived experience in Brazil. We will also present some challenges, and discuss possible recovery strategies to strengthen mental health services by empowering people with lived experience and promoting social justice. Efforts and initiatives to implement recovery strategies in Brazil are underway, aiming to improve population mental health and substance misuse both within and outside mental health services. These initiatives include peer support, advocacy, testimonies and empowerment, employment, and social, cultural, and artistic initiatives. Some of the challenges to greater participation of individuals with lived experience in this ongoing process of Brazilian psychiatric reform include the following aspects: barriers to the autonomy and independence of lived experience organizations; the longstanding history of racism in Brazilian society; disparities in social indicators such as education and income, between professionals and people with lived experience in mental health and substance misuse. Although progress in Brazil’s psychiatric reform has advanced through recovery initiatives, challenges remain in ensuring leadership roles for people with lived experience. Ongoing success depends on their active involvement, alongside advocacy movements and involvement of broader society.