Matthew Chinman1, Sharon McCarthy1, Rachel L Bachrach1, Chantele Mitchell-Miland1, Russell K Schutt1, Marsha Ellison1. 1. Dr. Chinman, Dr. McCarthy, Dr. Bachrach, and Ms. Mitchell-Miland are with the Center for Health Equity Research and Promotion and the Mental Illness Research, Education and Clinical Center, all at the U.S. Department of Veterans Affairs (VA) Pittsburgh Healthcare System, Pittsburgh. Dr. Chinman is also with RAND Corporation, Pittsburgh. Dr. Schutt is with the Department of Sociology, and Dr. Ellison is with the Department of Psychiatry, University of Massachusetts, Boston.
Abstract
OBJECTIVE: Peer specialists are individuals with mental illness and substance use disorders trained to use their experiences to help others with similar disorders. Evidence for the effectiveness of peer specialist services has been mixed in previous randomized trials using intent-to-treat analyses, possibly because of variation in the intensity of treatment delivered. This study, which was part of a larger randomized trial, assessed whether level of peer specialist engagement was associated with reliable positive change on measures of psychiatric symptoms and hope. METHODS: The Reliable Change Index was used to compute whether veterans (N=140) achieved reliable positive change on standardized baseline-to-posttest assessments of psychiatric symptoms and hope. Logistic regression analyses were conducted to predict positive change in symptoms and hope by level of peer specialist engagement, with controls for relevant demographic factors, several baseline mental health and substance abuse measures, and service use during the study. RESULTS: Logistic regression models showed that veterans with higher peer specialist engagement were more likely than those in a control group to show reliable positive change in psychiatric symptoms but not in hope. Compared with the control group, those with lower peer specialist engagement did not show positive change on either measure. White veterans were less likely than those from minority groups to exhibit positive change in psychiatric symptoms. CONCLUSIONS: Results suggest that peer specialists can benefit those with mental illnesses and substance use disorders who engage in more frequent interactions. Studies are needed to further assess the circumstances under which peer specialists can be effective.
RCT Entities:
OBJECTIVE: Peer specialists are individuals with mental illness and substance use disorders trained to use their experiences to help others with similar disorders. Evidence for the effectiveness of peer specialist services has been mixed in previous randomized trials using intent-to-treat analyses, possibly because of variation in the intensity of treatment delivered. This study, which was part of a larger randomized trial, assessed whether level of peer specialist engagement was associated with reliable positive change on measures of psychiatric symptoms and hope. METHODS: The Reliable Change Index was used to compute whether veterans (N=140) achieved reliable positive change on standardized baseline-to-posttest assessments of psychiatric symptoms and hope. Logistic regression analyses were conducted to predict positive change in symptoms and hope by level of peer specialist engagement, with controls for relevant demographic factors, several baseline mental health and substance abuse measures, and service use during the study. RESULTS: Logistic regression models showed that veterans with higher peer specialist engagement were more likely than those in a control group to show reliable positive change in psychiatric symptoms but not in hope. Compared with the control group, those with lower peer specialist engagement did not show positive change on either measure. White veterans were less likely than those from minority groups to exhibit positive change in psychiatric symptoms. CONCLUSIONS: Results suggest that peer specialists can benefit those with mental illnesses and substance use disorders who engage in more frequent interactions. Studies are needed to further assess the circumstances under which peer specialists can be effective.
Entities:
Keywords:
Recovery; Research/service delivery; peer specialist; peer support
Authors: Russell K Schutt; Mark Schultz; Chantele Mitchell-Miland; Sharon McCarthy; Matthew Chinman; Marsha Ellison Journal: Med Care Date: 2021-04-01 Impact factor: 2.983