Nine-Month Longitudinal Impact of Peer Support Workers’ Recovery Attributes on Service Users’ Recovery in Hong Kong

AbstractThe current study seeks to determine how peer support roles change as peer support specialists’ positions within organizations and departments mature. We followed ten peer support specialists over the course of a year, interviewing them at three points, starting approximately three months after they began working as peer support specialists. We used an inductive process to analyze our data and followed guidelines on the structuring of longitudinal qualitative trajectories to divide the data into watershed moments. Our participants worked in a variety of departments in the hospital, and their service use experiences generally echo those of their service users. Participants appear to pass through four phases over the course of their employment as peers: early beginnings, establishing the role, role narrowing, and role sustainability. Services wishing to integrate new peers must be aware of the time required for integration. Having general job descriptions limited to specifying that peers are expected to use their lived experience to support current service users may lead to uncertainty amongst new and existing staff. Without role clarity, peers may struggle to find their place. Pairing new staff with mentors may limit this burden. As roles consolidate, boundaries may emerge. If these boundaries narrow the role of the PSS, they may no longer find the role appealing. They may then choose other caregiver roles with wider or different spheres of influence. Organizations may benefit by clearly indicating if they expect peer support positions to be static or transitionary.

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Experience of stigma among mental health service users in Hong Kong: Are there changes between 2001 and 2017?

International Journal of Social Psychiatry ◽

10.1177/0020764018815926 ◽

2018 ◽

Vol 65 (1) ◽

pp. 64-72 ◽

Cited By ~ 3

Author(s):

Ka-Fai Chung ◽

Samson Tse ◽

Chit-Tat Lee ◽

Michael Ming-Cheuk Wong ◽

Wing-Man Chan

Keyword(s):

Mental Health ◽

Hong Kong ◽

Mental Health Service ◽

Health Service ◽

Mental Health Problems ◽

Cross Sectional Study ◽

Baseline Survey ◽

Service Users ◽

Cross Sectional ◽

Over Time

Background: Public expenditure on mental health education has grown exponentially in the past two decades. Does the experience of stigma among people with mental health problems improve over time? Our study aims to compare the levels of perceived stigmatization, rejection experiences and stigma–coping among mental health service users in Hong Kong between 2001 and 2017 using longitudinal and repeated cross-sectional study design. Method: The baseline survey was completed by 193 psychiatric outpatients in 2001. They were traced for re-assessment in 2017. Another sample of 193 outpatients matched in age, gender and psychiatric diagnosis was recruited in 2017 for cross-sectional comparison. Participants completed a 39-item questionnaire on stigma experiences, Beck Depression Inventory and Disability Assessment Schedule at both time points. Results: In total, 109 of 193 participants (56.5%) of the 2001 survey were re-assessed. No significant change in perceived stigmatization, rejection experiences and stigma–coping was found among the 109 participants interviewed in 2001 and 2017. For cross-sectional comparison, significant differences in two perceived stigma items were observed upon Bonferroni correction (chi-square test, p < .005) and remained significant after controlling for confounding factors by regression analysis. Improvements in perceived stigmatization were on marriage and friendship, while viewpoints on trustworthiness, dangerousness, devaluation, avoidance and personal failure remained unchanged, and there was no improvement in rejection experiences and stigma–coping. Conclusion: Positive attitude changes over time are unlikely to occur if there is no targeted intervention on stigma. Our findings highlight that evidence-based antistigma interventions are urgently needed.

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Combining online and offline peer support groups in mental health care: A qualitative study of service users� experiences (Preprint)

10.2196/preprints.9804 ◽

2018 ◽

Author(s):

Monica Strand ◽

Deede Gammon ◽

Lillian Sofie Eng ◽

Cornelia Ruland

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Peer Support ◽

Support Groups ◽

Local Community ◽

Mental Health Problems ◽

Service Users ◽

Face To Face ◽

Individual Interviews

BACKGROUND Peer support groups for people with long-term mental health problems are at the heart of recovery-oriented approaches in mental health care. When conducted face-to-face (offline) or on the Internet (online), peer support groups have proven to have differing strengths and weaknesses. Little is known about the benefits and challenges of combining the two formats. OBJECTIVE The aim of this study was to gain insights into the benefits and challenges of combining online and offline peer support groups facilitated through an Internet intervention designed to support recovery processes. METHODS In this exploratory and descriptive study, an e-recovery portal called ReConnect was used by service users in two mental health communities in Norway for 6-12 months. The portal included an online peer support forum which also facilitated participation in local in-person ReConnect-cafés. Both formats of peer support were facilitated by an employed service user consultant with lived experience of mental health problems and with training in peer support. Qualitative data about service users’ experiences of using the portal were collected through focus groups and individual interviews and inductively analyzed thematically with focus on benefits and challenges of peer support online and offline. RESULTS A total of 14 service users 22-63 years of age with various diagnoses, receiving services at both primary and specialist levels of mental health care participated in three focus groups and 10 individual interviews. Two main themes were identified in the analysis: 1) balancing anonymity and openness, and 2) enabling connectedness. These themes are further illustrated with the subthemes: i) dilemmas of anonymity and confidentiality, ii) towards self-disclosure and openness, iii) new friendships, and iv) networks in the local community. Three of the subthemes mainly describe benefits. Challenges were more implicit and cut across the subthemes. Identified challenges were linked to transitions from anonymity to revealing one’s identity, how to protect confidentiality, or to participation at face-to-face meetings in the local community. CONCLUSIONS Our study suggests that online peer support groups and offline meetings complement each other, and the combination is mainly beneficial to users. The identified benefits appeared to arise from participants’ options of one format or the other, or that they could combine formats in ways that suited their individual values and comfort zones. We also identified challenges related to combination of formats, and both formats require appropriate facilitation of peer support. Combining online formats that enable anonymity, a non-judgmental atmosphere, and 24/7 accessibility regardless of location, with offline formats that foster local, in-person community ties, is a promising concept for facilitating recovery-oriented care, and warrants continued research.

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From surviving to thriving: how does that happen

The Journal of Mental Health Training Education and Practice ◽

10.1108/jmhtep-06-2015-0027 ◽

2015 ◽

Vol 10 (5) ◽

pp. 337-348 ◽

Cited By ~ 4

Author(s):

Mark Bertram ◽

Sarah McDonald

Keyword(s):

Lived Experience ◽

Peer Support ◽

Policy Development ◽

Well Being ◽

Service Users ◽

Content Type ◽

Employment Education ◽

Vocational Goals ◽

The Impact

Purpose – The purpose of this paper is to explore what helped seven people in contact with secondary mental health services achieve their vocational goals, such as: employment, education, training and volunteering. Design/methodology/approach – The authors used the practice of co-operative inquiry – staff and peer supporters co-designed an evaluation of vocational and peer support work with service users. Findings – Service users experienced invalidating living conditions that caused serious distress. These life struggles included: isolation, trauma events and stigma. The impact involved distressing emotions such as: despair, fear, pain and confusion. In contrast, when service users experienced supportive validating conditions (trusting relationships, engaging in valued activity and peer support) they reported being able to learn, change and grow – finding their own way forward, to improve well-being and quality of life. Research limitations/implications – Qualitative analysis from in-depth interviews revealed a range of consistent themes that enabled the authors to visually represent these and “begin” developing a model of change – grounded in lived experience. Further research is required to develop this model. Originality/value – The development of a model of change grounded in an invalidation/validation framework offers a different approach – in terms of how people are perceived and treated. This has relevance for Government policy development, clinical commissioning groups and practitioners.

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The uncut jade: Differing views of the potential of expert users on staff training and rehabilitation programmes for service users in Hong Kong

International Journal of Social Psychiatry ◽

10.1177/0020764011431540 ◽

2012 ◽

Vol 59 (2) ◽

pp. 176-187 ◽

Cited By ~ 6

Author(s):

Roger M. K. Ng ◽

Veronica Pearson ◽

Yin Wan Pang ◽

N. S. Wong ◽

N. C. Wong ◽

...

Keyword(s):

Hong Kong ◽

Staff Training ◽

Service Users

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Exploring Peer Support as a Strategy to Reduce Self-Stigma for Marginalised Children of Parents with Mental Illness (COPMI)

The British Journal of Social Work ◽

10.1093/bjsw/bcaa161 ◽

2020 ◽

Author(s):

Adele Parkinson ◽

Emily Keddell ◽

Peter Walker

Keyword(s):

Mental Illness ◽

Service Delivery ◽

Peer Relationships ◽

Peer Support ◽

Formative Evaluation ◽

Ecological Resilience ◽

Service Users ◽

Parental Mental Illness ◽

Youth Service ◽

Parents With Mental Illness

Abstract Many children of parents with mental illness (COPMI) experience stigma, resulting in detrimental effects and the need for support. Peer support programmes are widespread interventions, commonly providing relational, psychological and educational support. Some evidence suggests that these programmes result in positive changes to COPMI experiences of self, peers and their families. This article adds to the evidence base, presenting findings from a primarily qualitative, mixed-methods programme evaluation of a COPMI service in Aotearoa/New Zealand. Formative evaluation data were gathered from a COPMI service which supports families adversely affected by chronic and severe parental mental illness, via interviews (N = 10) and four age-differentiated focus groups (N = 24) of child/youth service-users aged eight to eighteen years, and mixed-method surveys of adult service-users (N = 32). This article reports data from child/youth service-users who participated. Findings indicate that many participants experienced stigma outside the service, and self-stigma was reduced for many due to supportive peer relationships formed during service delivery. Further understanding of the relationship between peer support and self-stigma in these programmes is needed, and how positive changes to self-perceptions might translate to other spheres. The application of socio-ecological resilience theory to findings implies that COPMI service delivery should address differential needs in relation to marginalisation and promote sustained peer relationships for those who are marginalised.

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Service users' experiences of residential alternatives to standard acute wards: qualitative study of similarities and differences

The British Journal of Psychiatry ◽

10.1192/bjp.bp.110.081075 ◽

2010 ◽

Vol 197 (S53) ◽

pp. s26-s31 ◽

Cited By ~ 36

Author(s):

Helen Gilburt ◽

Mike Slade ◽

Diana Rose ◽

Brynmor Lloyd-Evans ◽

Sonia Johnson ◽

...

Keyword(s):

Mental Illness ◽

Qualitative Study ◽

Peer Support ◽

Service Users ◽

Hospital Services ◽

Subjective Experiences ◽

People With Mental Illness ◽

Similarities And Differences ◽

Depth Interviews ◽

Acute Wards

BackgroundLittle is known about the preferences and experiences of people with mental illness in relation to residential alternatives to hospital.AimsTo explore patients' subjective experiences of traditional hospital services and residential alternatives to hospital.MethodIn-depth interviews were conducted with 40 purposively selected patients in residential alternative services who had previously experienced hospital in-patient stays. Transcripts were coded and analysed for thematic content.ResultsPatients reported an overall preference for residential alternatives. These were identified as treating patients with lower levels of disturbance, being safer, having more freedom and decreased coercion, and having less paternalistic staff compared with traditional in-patient services. However, patients identified no substantial difference between their relationships with staff overall and the care provided between the two types of services.ConclusionsFor patients who have acute mental illness but lower levels of disturbance, residential alternatives offer a preferable environment to traditional hospital services: they minimise coercion and maximise freedom, safety and opportunities for peer support.

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