Developing a change model for peer worker interventions in mental health services: a qualitative research study

Area of Science:

• Mental Health Services Research
• Qualitative Research Methods
• Intervention Science

Background:

• Peer worker roles are increasingly integrated into mental health services globally.
• Existing evidence for peer worker benefits is mixed, partly due to underdeveloped change models.
• Robust evaluation of peer support interventions requires a clear understanding of underlying change mechanisms.

Purpose of the Study:

• To develop an empirically and theoretically grounded model of change mechanisms for peer worker interventions.
• To identify core processes within the peer worker role that facilitate positive change for service users.
• To inform the development, evaluation, and planning of peer support initiatives.

Main Methods:

• A qualitative, comparative case study design.
• In-depth interviews with 71 peer workers, service users, staff, and managers across ten initiatives in England.
• Grounded Theory approach to identify core change processes.

Main Results:

• Key change mechanisms identified: building trust via shared lived experience, role-modeling recovery, and engaging service users with services and the community.
• Theoretical literature on role-modeling and relationships in mental health services supported these findings.
• A model of process and downstream outcomes associated with peer worker interventions was developed.

Conclusions:

• An empirically and theoretically grounded change model for peer worker interventions has been articulated.
• This model provides a valuable framework for the development and evaluation of peer support programs.
• The findings support the effective integration and planning of peer worker roles in mental health settings.