Peer support for adults with mental health issues:What components were adapted after implementation?

Introduction

In healthcare, adaptation refers to the alteration of an intervention's design or delivery to improve its fit or effectiveness based on the local context. Throughout the implementation process, a mental healthcare intervention might be modified, successfully or not, for several reasons. If these modifications are not fully recorded or understood, then their successful implementation, effectiveness evaluation and sustainment will likely be hindered. The exploration of the adaptation concept in relation to the implementation of mental health recovery-oriented interventions is nascent despite the proliferation of research on the implementation and evaluation of mental health recovery into services.



Methods

Following a multisite multiphase project on implementing mental health recovery guidelines in Canada, 19 staff members who were involved in implementing and sustaining peer support in housing services for people with mental illness participated in a mixed methods study. Participants completed questionnaires and were interviewed between 2022-2023. Data collection and analysis draw on the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) and the Program Sustainability Assessment Tool (PSAT).



Results

We will report on the adaptations made to peer support that emerged after initial implementation and its fidelity to the core principles of peer support and mental health recovery.



Discussion

Adaptation is a core component of sustainability. In terms of mental health recovery, the type and nature of adaptations will determine the level of sustainment of recovery-oriented interventions. Sustainment cannot be achieved if the adaptations compromise the core principles of mental health recovery, including self-determination of users of mental health services.



Conclusion

Findings from this research contribute to the uptake and sustainment of mental health recovery-oriented innovations since interventions are adapted throughout the implementation cycle.