scholarly journals It helps to talk: A guiding framework (TRUST) for peer support in delivering mental health care for adolescents living with HIV

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248018
Author(s):  
Carol Wogrin ◽  
Nicola Willis ◽  
Abigail Mutsinze ◽  
Silindweyinkosi Chinoda ◽  
Ruth Verhey ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Peer Support ◽  
Viral Suppression ◽  
Age Groups ◽  
Sub Saharan Africa ◽  
Mental Health Support ◽  
Health Support ◽  
Living With Hiv

Introduction Adolescents living with HIV have poor treatment outcomes, including lower rates of viral suppression, than other age groups. Emerging evidence suggests a connection between improved mental health and increased adherence. Strengthening the focus on mental health could support increased rates of viral suppression. In sub-Saharan Africa clinical services for mental health care are extremely limited. Additional mechanisms are required to address the unmet mental health needs of this group. We consider the role that community-based peer supporters, a cadre operating at scale with adolescents, could play in the provision of lay-support for mental health. Methods We conducted qualitative research to explore the experiences of peer supporters involved in delivering a peer-led mental health intervention in Zimbabwe as part of a randomized control trial (Zvandiri-Friendship Bench trial). We conducted 2 focus group discussions towards the end of the trial with 20 peer supporters (aged 18–24) from across 10 intervention districts and audio recorded 200 of the peer supporters’ monthly case reviews. These data were thematically analysed to explore how peer supporters reflect on what was required of them given the problems that clients raised and what they themselves needed in delivering mental health support. Results A primary strength of the peer support model, reflected across the datasets, is that it enables adolescents to openly discuss their problems with peer supporters, confident that there is reciprocal trust and understanding derived from the similarity in their lived experiences with HIV. There are potential risks for peer supporters, including being overwhelmed by engaging with and feeling responsible for resolving relationally and structurally complex problems, which warrant considerable supervision. To support this cadre critical elements are needed: a clearly defined scope for the manageable provision of mental health support; a strong triage and referral system for complex cases; mechanisms to support the inclusion of caregivers; and sustained investment in training and ongoing supervision. Conclusion Extending peer support to explicitly include a focus on mental health has enormous potential. From this empirical study we have developed a framework of core considerations and principles (the TRUST Framework) to guide the implementation of adequate supportive infrastructure in place to enhance the opportunities and mitigate risks.

scholarly journals Long-term mental health support systems in the aftermath of disasters in Japan – Statistical data of the Miyagi Disaster Mental Health Care Center

2020 ◽  
Author(s):  
Naru Fukuchi ◽  
Shusaku Chiba
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Care Center ◽  
Disaster Mental Health ◽  
Health Care Center ◽  
Miyagi Prefecture ◽  
Mental Health Support ◽  
Health Support

Abstract Background A long-term mental health support system for the community is sometimes needed following massive natural disasters. Although the Disaster Mental Health Care Center (DMHCC) was established as a long-term mental health care center in Japan, its exact role and functioning are unclear. The Great East Japan Earthquake and Tsunami (GEJE) of 2011 affected thousands of residents. The Miyagi DMHCC was established in Miyagi prefecture in response to the GEJE and supported residents and communities as a long-term mental health care center. Methods The main purpose of this study was to clarify which population is psychologically at high risk and which methods are useful for residents’ mental health in each phase. The study used data collected by the Miyagi DMHCC that included personal information of residents who were supported by the center from 2013 to 2018. Chi-square tests of independence were conducted on the annual number of individuals supported by the center, sex, and the number of support methods used by the center according to years. A one-way analysis of variance was conducted on the annual mean age, followed by a post-hoc comparison of the functioning of the center. Results The number of residents who needed mental health support dramatically increased in Miyagi prefecture after the 2011 disaster. The Miyagi DMHCC supported 6,850 individuals who sought mental health services, which accounted for 22.9% of all cases reported to the health services between 2012 and 2017. Based on the results, in the first few years, the elderly residents who lived alone were declared as high-risk individuals by the health survey and supported through home visits. Several years later, as younger people started to seek mental health support by themselves, they underwent counseling at the Miyagi DMHCC. Conclusion Residents who need mental health support might change depending on recovery phases. Long-term mental health care centers should observe community recovery and provide appropriate support. We discuss the implications of this result and future research directions.

scholarly journals Who Are the Young People Choosing Web-based Mental Health Support? Findings From the Implementation of Australia's National Web-based Youth Mental Health Service, eheadspace

2016 ◽  
Vol 3 (3) ◽  
pp. e40 ◽  
Author(s):  
Debra Rickwood ◽  
Marianne Webb ◽  
Vanessa Kennedy ◽  
Nic Telford
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Young People ◽  
Mental Health Care ◽  
Clinical Presentation ◽  
Youth Mental Health ◽  
Rapid Expansion ◽  
Web Based ◽  
Mental Health Support ◽  
Health Support

Background The adolescent and early adult years are periods of peak prevalence and incidence for most mental disorders. Despite the rapid expansion of Web-based mental health care, and increasing evidence of its effectiveness, there is little research investigating the characteristics of young people who access Web-based mental health care. headspace, Australia’s national youth mental health foundation, is ideally placed to explore differences between young people who seek Web-based mental health care and in-person mental health care as it offers both service modes for young people, and collects corresponding data from each service type. Objective The objective of this study was to provide a comprehensive profile of young people seeking Web-based mental health care through eheadspace (the headspace Web-based counseling platform), and to compare this with the profile of those accessing help in-person through a headspace center. Methods Demographic and clinical presentation data were collected from all eheadspace clients aged 12 to 25 years (the headspace target age range) who received their first counseling session between November 1, 2014 and April 30, 2015 via online chat or email (n=3414). These Web-based clients were compared with all headspace clients aged 12 to 25 who received their first center-based counseling service between October 1, 2014 and March 31, 2015 (n=20,015). Results More eheadspace than headspace center clients were female (78.1% compared with 59.1%), and they tended to be older. A higher percentage of eheadspace clients presented with high or very high levels of psychological distress (86.6% compared with 73.2%), but they were at an earlier stage of illness on other indicators of clinical presentation compared with center clients. Conclusions The findings of this study suggest that eheadspace is reaching a unique client group who may not otherwise seek help or who might wait longer before seeking help if in-person mental health support was their only option. Web-based support can lead young people to seek help at an earlier stage of illness and appears to be an important component in a stepped continuum of mental health care.

The importance of peer support in the recovery process of persons with mental disorders

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Stimac Grbic ◽  
I Pavic Simetin ◽  
A Istvanovic
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Peer Support ◽  
Community Intervention ◽  
Recovery Process ◽  
Therapeutic Interventions ◽  
Hospital Treatment ◽  
Personal Recovery

Abstract Issue Care for people with severe mental disorders requires approach that is focused on a person's strengths, not his weaknesses, and is a shift from a deficit model that is often associated with mental illness. Care users and their family members play an important role in this approach. Description of the Problem Mental disorders are the leading group of diseases in Croatia, according to the number of days of hospital treatment. The number of hospitalizations is high, and the rate of hospitalization for depression has tripled in the last twenty years. Such indicators highlight the need for reorientation of mental health care, from hospital-based to community-based, by organizing mobile community intervention teams. Results In Croatia, psychosocial peer teams were established by the NGO Ludruga, financed by local government, to provide peer support to persons with mental disorders. The main activities are: development of a personal recovery plan, home visits and providing psychological support to persons with mental disorders, organizing support groups and education of peer workers. The teams consist of a peer worker, social worker, psychologist, and operate under the supervision of a psychiatrist. The teams have been operating for five years, have had over a hundred users so far and are a significant help to the healthcare system in preventing rehospitalizations. Lessons The goal of therapeutic interventions in mental health care should be recovery. Recovery involves empowering a person to take responsibility for themselves and their health. Peer workers play an important role in the recovery process, providing hope for recovery. Their role must also be recognized by the health system. Key messages People with mental disorders and their families should be co-creators of care and recovery-oriented interventions. Only by comprehensive interventions, tackling all determinants of health, therapeutic goal can be achieved.

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

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.

Unintentional participant observation: a research method to inform peer support in mental health?

2019 ◽  
Vol 23 (2) ◽  
pp. 81-85 ◽  
Author(s):  
Andrew Voyce
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Peer Support ◽  
Role Models ◽  
Participant Observation ◽  
Meta Analysis ◽  
Health Issues ◽  
Content Type ◽  
Mental Health Issues

Purpose The purpose of this paper is to validate peer support in mental health care. Design/methodology/approach Literature review and meta-analysis methodology are used. Findings The unintentional nature of peer support is a valid methodology for the understanding of mental health issues and mental health care. Research limitations/implications The limitation is that peer experience should be accepted as a valued method for research. Practical implications Professional domains may not keep a monopoly of research approaches in mental health. Social implications Peer support may mean more avenues for empowerment of mental health service users from peer role models who have unintentional acquaintance with mental health issues and care. Originality/value This research refers to ethnographic precedents to describe methodology relevant to twenty-first century peer support in mental health. It is original in valuing the unintentional participant observation acquired from experience of the mental health system.

scholarly journals Challenges to peer support in low- and middle-income countries during COVID-19

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Richard Mpango ◽  
Jasmine Kalha ◽  
Donat Shamba ◽  
Mary Ramesh ◽  
Fileuka Ngakongwa ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Peer Support ◽  
Global Mental Health ◽  
Health Conditions ◽  
Middle Income ◽  
Low Resource Settings ◽  
Mental Health Conditions ◽  
Middle Income Countries

Abstract Background A recent editorial urged those working in global mental health to “change the conversation” on coronavirus disease (Covid-19) by putting more focus on the needs of people with severe mental health conditions. UPSIDES (Using Peer Support In Developing Empowering mental health Services) is a six-country consortium carrying out implementation research on peer support for people with severe mental health conditions in high- (Germany, Israel), lower middle- (India) and low-income (Tanzania, Uganda) settings. This commentary briefly outlines some of the key challenges faced by UPSIDES sites in low- and middle-income countries as a result of Covid-19, sharing early lessons that may also apply to other services seeking to address the needs of people with severe mental health conditions in similar contexts. Challenges and lessons learned The key take-away from experiences in India, Tanzania and Uganda is that inequalities in terms of access to mobile technologies, as well as to secure employment and benefits, put peer support workers in particularly vulnerable situations precisely when they and their peers are also at their most isolated. Establishing more resilient peer support services requires attention to the already precarious situation of people with severe mental health conditions in low-resource settings, even before a crisis like Covid-19 occurs. While it is essential to maintain contact with peer support workers and peers to whatever extent is possible remotely, alternatives to face-to-face delivery of psychosocial interventions are not always straightforward to implement and can make it more difficult to observe individuals’ reactions, talk about emotional issues and offer appropriate support. Conclusions In environments where mental health care was already heavily medicalized and mostly limited to medications issued by psychiatric institutions, Covid-19 threatens burgeoning efforts to pursue a more holistic and person-centered model of care for people with severe mental health conditions. As countries emerge from lockdown, those working in global mental health will need to redouble their efforts not only to make up for lost time and help individuals cope with the added stressors of Covid-19 in their communities, but also to regain lost ground in mental health care reform and in broader conversations about mental health in low-resource settings.

scholarly journals Acceptance and Commitment Therapy in a Low-Income Country in Sub-Saharan Africa: A Call for Further Research

2021 ◽  
Vol 9 ◽  
Author(s):  
Yonas E. Geda ◽  
Janina Krell-Roesch ◽  
Yaphet Fisseha ◽  
Aida Tefera ◽  
Teferra Beyero ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Acceptance And Commitment Therapy ◽  
Mental Health Professionals ◽  
Sub Saharan Africa ◽  
Task Sharing ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Sub Saharan

A worsening trend of critical shortages in senior health care workers across low- and middle-income countries (LMICs) in sub-Saharan Africa has been documented for decades. This is especially the case in Ethiopia that has severe shortage of mental health professionals. Consistent with the WHO recommended approach of task sharing for mental health care in LMICs, Acceptance and Commitment Therapy (ACT), which is an empirically validated psychological intervention aimed at increasing psychological flexibility, may be delivered by trained laypersons who have a grassroots presence. In this paper, we discuss the need for and potential role of ACT to be delivered by health extension workers (HEWs) to address mental health care needs across Ethiopia. To this end, we also reviewed previous studies that have examined the effectiveness of ACT-based interventions in African countries including in Nigeria, Sierra Leone, Uganda, and South Africa. All studies revealed significant improvements of various mental health-related outcome measures such as decreased psychological distress and depressive symptoms, or increased subjective wellbeing and life satisfaction in the groups that received an ACT-based intervention. However, to date, there is no study that applied ACT in Ethiopia. Thus, more research is warranted to examine the effectiveness and, if proven successful, to scale up a task sharing approach of an ACT-based intervention being delivered by trained HEWs at a grassroots level, possibly paving the way for an innovative, sustainable mental health service in Ethiopia as well as other African LMICs.

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