What is peer support?
According to Schlichthorst et al. (2020), peer support is a “system of giving and receiving help, founded on key principles of respect, shared responsibility, and mutual agreement of what is helpful” (pp. 1-2). In the peer support system, two peers with shared experience of mental health or addiction issues focus on empathetically understanding one another’s situations.
This creates a deep, holistic understanding in which people can “be” with each other, avoiding the power structure of an expert-patient relationship (Schlichthorst et al., 2020).
Peer support Programs
Canadian Mental Health Association – Calgary’s School of Peer Support provides the opportunity to use one’s lived experience with mental health or addiction issues to support those in the community with similar journeys. Peers can connect those with lived experience to various available resources to support their recovery journey.
After applying to the School, undergoing an interview process, and being admitted, Peers receive 83-hours of free training and 50-hours of unpaid practicum experience. During their training, Peers learn basic peer support skills (active listening, self-disclosure, empathy, etc.); explore concepts of harm reduction, adverse childhood experiences, grief, trauma, and cultural humility; receive certification in non-violent crisis intervention; and learn about topics such as addictions, houselessness and self- care. The practicum experience is unique to each individual as they are matched with organizations that fit their unique skill set and lived experience.
Peer support in suicide prevention
Oftentimes, the treatment response for those with mental health challenges is primarily bio-medical in nature in which people may be guaranteed access to medication to help alleviate psychiatric symptoms, while other therapeutic support services are more difficult to access (Mental Health Commission of Canada, 2016).
As an alternative option of support in times of crisis, peer support programs have demonstrated to be effective in reaching to individuals who often “fall through the cracks” of traditional health services by not being connected to the proper supports (Schlichthorst et al., 2020). Research suggests that active listening, open-mindedness, and the promotion of self-empowerment, as is modeled in a peer support interaction, is linked to increased feelings of hopefulness reported by people in suicidal crisis (Gould et al., 2013). Furthermore, peer support can help address suicide risk by providing emotional support in which peers can share their own experience of recovery, thereby fostering perceived connectedness and reducing feelings of hopeless among those receiving support – two key factors against suicidal ideation (Bowersox et al., 2021; Centers for Disease Control and Prevention, 2012; McLean et al., 2008). Additionally, receiving support from peers may decrease stigma, promote personal growth and recovery, and encourage engagement in one’s own care journey (Bowersox et al., 2021).
From the literature
Studies by Chinman et al. (2015) and Druss et al. (2010) demonstrated that when peer support is integrated into case management services, people with severe or serious mental illness reported having a better quality of life, being more satisfied with their treatment, and becoming more engaged in their own health care practices (Shalaby & Agyapong, 2020). On the other hand, a systematic review of randomized controlled trials by Lloyd-Evans et al. (2014) analyzing the same demographic found some evidence of positive effects on patients’ reports of hope, recovery and empowerment while hospitalization, satisfaction, and overall symptoms did not show positive effects (Shalaby & Agyapong, 2020). More research is needed in this area to determine the effects of peer support for people with severe or serious mental illness.
Although data on the effectiveness of peer-based interventions is lacking, some studies suggest that peer-based services would be beneficial for support receivers, especially as a complement or alternative to more formal and traditional mental health services (Bowersox et al.; Shalaby & Agyapong, 2020; Schlichthorst et al., 2020). Furthermore, research has shown that peer-based interventions that target higher-risk subpopulations are linked to reductions in suicide risk within these subpopulations (Bowersox et al., 2021; Shalaby & Agyapong, 2020). Additionally, peer-based interventions can provide targeted outreach support to priority populations who may be reluctant or unable to access mental health services through more traditional and formal pathways (Bowersox et al., 2021; Shalaby & Agyapong, 2020).
The lived experiences of people who have experienced a suicide attempt can help save lives and foster hope for the millions of people experiencing suicide and mental health crises each year. Peer- based suicide interventions are highly accessible, low cost, available beyond regular business hours, and have enhanced privacy, contrasting with the barriers that often exist in traditional mental health care services (Bowersox et al., 2021). Although there are clear benefits of peer support, suicide prevention research has rarely utilized the first-person knowledge of suicidal ideation and behaviour that people who have experienced a suicide attempt can provide (National Actional Alliance for Suicide Prevention, 2014). However, data on the effectiveness of peer-based interventions is lacking and additional work must be done to evaluate its effectiveness in supporting those in suicidal crisis.
References
Bowersox, N. W., Jagusch, J., Garlick, J., Chen, J. I., & Pfeiffer, P. N. (2021). Peer-based interventions targeting suicide prevention: a scoping review. American Journal of Community Psychology, 68, 232-248. http://doi.org/10.1002/ajcp.12510
Canadian Mental Health Association – Calgary. (2022). Become a Peer.
https://cmha.calgary.ab.ca/education-training/become-a-peer/
Centers for Disease Control and Prevention. (2012). Preventing Suicide through Connectedness. https://www.cdc.gov/violenceprevention/pdf/asap_suicide_issue3-a.pdf
Gould, M., Coss, W., Pisani, A., Munfakh, J. & Kleinman, M. (2013). Impact of Applied Suicide Intervention Skills Training (ASIST) on national suicide prevention lifeline. Suicide and Life- Threatening Behavior, 43(6), 676-691. https://doi.org/10.1111/sltb.12049
McLean, J., Maxwell, M., Platt, S., Harris, F., & Jepson, R. (2008). Risk and Protective Factors for Suicide and Suicidal Behavior: A Literature Review. https://dspace.stir.ac.uk/bitstream/1893/2206/1/Suicide%20review1.pdf
Mental Health Commission of Canada. (2016). Making the Case for Peer Support. https://mentalhealthcommission.ca/wp- content/uploads/2021/08/MHCC_Making_the_Case_for_Peer_Support_2016_Eng.pdf
National Action Alliance for Suicide Prevention: Suicide Attempt Survivors Task Force. (2014). The Way Forward: Pathways to hope, recovery, and wellness with insights from lived experience. https://theactionalliance.org/sites/default/files/the-way-forward-final-2014-07-01.pdf
Schlichthorst, M., Ozols, I., Reifels, L., & Morgan, A. (2020). “Lived experience peer support programs for suicide prevention: a systematic scoping review.” International Journal of Mental Health Systems, 14(65), 1-12. https://doi.org/10.1186/s13033-020-00396-1
Shalaby, R. A., & Agyapong, V. I. (2020). “Peer Support in Mental Health: Literature Review.” JMIR Mental Health, 7(6), 1-14. https://dx.doi.org/10.2196%2F15572