Effectiveness of peer support for adults with ill mental health in a civil society setting (RCT)

Chalotte HEINSVIG POULSEN1, Cecilie HØGH EGMOSE1, Bea KOLBE EBERSBACH1, Carsten HJORTHØJ1,2, Lene FALGAARD EPLOV1

1Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Hellerup, Denmark
2University of Copenhagen, Department of Public Health, Section of Epidemiology , Copenhagen, Denmark

Introduction: We aimed to investigate the effect of a co-created “Paths to Everyday Life” (PEER) group intervention led by volunteer peers added to service as usual (SAU) targeting adults with mental health difficulties compared to SAU alone in a Danish municipality civil society setting.

Methods: A two-armed, investigator-initiated, multi-municipal, parallel-group superiority trial. Participants were randomly assigned to receive PEER added to SAU from Dec 2019 to Oct 2022. Participants allocated to PEER received a 10-week manualized group course and an offer of individual companionship for up to 6 months. SAU received either other municipal offers or no service. Follow-up on self-assessed questionnaires at the end of the intervention was finalized Feb 2023. The primary outcome was the self-assessed Questionnaire about the Process of Recovery (QPR-15) at the end of the intervention. The secondary outcomes were the Empowerment Scale, the Manchester Short Assessment of Quality of Life (MANSA), and the Work and Social Adjustment Scale (WSAS). Exploratory outcomes were the State Hope Scale (SHS), the General Self-efficacy Scale (GSE), the Self-advocacy Scale (SAS), and the modified Copenhagen Social Relations Questionnaire (CSRQ).

ClinicalTrials.gov identifier: NCT04639167.

Results: Of the 296 included participants, 145 participants received PEER + SAU and 151 participants received SAU. Intention-to-treat analysis showed an effect on personal recovery, functioning, and quality of life at end of the intervention. Results of the explorative outcomes showed an effect on general self-efficacy and hope. There was no statistically significant difference between the groups in relation to measures of empowerment, self-advocacy, and social relations.

Discussion: The group-based peer support intervention delivered by volunteer peers in a municipality civil society setting beneficially impacts the personal recovery of people with mental health difficulties. Implementation of the peer support group course following the principles of the PEER manual is recommended.

Funding: VELUX FOUNDATION [Grant number: 26723, 2019].