Diverse elements comprising studies of peer support complicate evidence synthesis.

Area of Science:

• Mental Health
• Psychiatry
• Healthcare Services Research

Background:

• Serious mental illnesses like schizophrenia have unmet care needs.
• Peer support services are expanding but their effectiveness findings are mixed.
• Previous reviews overlooked the diverse elements within peer support studies.

Purpose of the Study:

• To highlight the diversity in intervention components and outcomes in peer support studies.
• To establish a foundation for more focused reviews on specific peer support components.
• To analyze the heterogeneity of peer support interventions for serious mental illness.

Main Methods:

• Conducted a realist review of the literature.
• Synthesized evidence focusing on intervention components and measured outcomes.
• Examined the diversity within 26 studies of peer support.

Main Results:

• Seven categories of outcomes were identified, including recovery, symptoms, functioning, and care utilization.
• Seven distinct intervention components were present: 'being there,' self-management, linkage, social support, ongoing support, shared experience, and systems advocacy.
• No single study included all components, and no component was universal across all studies.

Conclusions:

• Peer support services are too varied to be evaluated as a single intervention type.
• Components like self-management assistance, 'being there,' and utilizing shared lived experience warrant further focused research.
• Understanding the diversity of peer support is crucial for optimizing mental healthcare.