Consumer Enablement Guide

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Peer Support

Peer support is organised support provided by people with similar health conditions and experiences managing their health.

What is peer support?

Peer support is different to social support provided by family, friends, colleagues and communities, because it is based on a shared experience of a health condition and delivered specifically to help someone manage that condition.

There are peer support groups for nearly every serious medical condition and life circumstance, including:

  • mental health
  • substance abuse
  • weight loss
  • grief and trauma
  • perinatal health.1

The relationship can be one way, where one person supports the other, or mutual, where both people support each other. It is important to note that peer support is different to psychotherapy and professional counselling, so should complement and not replace these services.

Types of peer support

Peer support can be delivered in person, online or over the phone. It generally falls into one of the following categories.

Informal mutual support

This type of peer support does not use formal structures, trained group leaders or facilitators. It has limited or no involvement with health professionals and focuses on providing mutual support between people with shared experiences. Common types of information peer support include social media groups, blogs, community meet-ups, online forums and email or phone-based support.

Professional peer support

This is a type of peer support led by accredited or trained peer support leaders or health professionals. It includes peer support groups and self-management programs such as those run through disease-specific associations, local health districts and consumer groups.

Shared medical appointments are a type of peer-run support that is culturally appropriate for Aboriginal and Torres Strait Islander peoples and other groups that prefer to discuss health issues in a gender-specific environment. They are billable under the Medical Benefits Schedule.2

Peer-led support programs

Professional peer support workers are often employed to provide peer support to consumers. They are often further along the road to recovery or effective management than the people they support and must be willing to share information about their own experience.3

Peer support workers generally do not have health or medical training and do not provide healthcare services. They work in partnership with clinicians to improve communication and information sharing with consumers, with a focus on supporting the consumer rather than providing mutual support.

Why is it important?

Peer support can help people take control of their health and wellbeing. Research shows that peer support groups can help people:

  • feel accepted
  • compare experiences
  • find new coping strategies
  • increase knowledge
  • improve social skills
  • improve self-efficacy
  • self-manage their condition
  • improve their quality of life.3

It has shown to be particularly effective for people in vulnerable communities, such as those from culturally and linguistically diverse backgrounds.4 5 However, it is important to note that there is a lack of conclusive evidence about the impact of peer support on health outcomes.5

Other benefits of peer support

Improves social and psychological wellbeing

A person’s psychological, social and emotional state can have a significant impact on their ability to manage their condition. Some people struggle because they lack the necessary self-efficacy, confidence or motivation to work in partnership with their healthcare providers.

One of the essential benefits of peer support is hope, a belief in a better future, which occurs when they meet people who are successfully managing their condition. This shows them that there are people who have overcome difficulties and are living proof of what can be achieved.3 6

Reduces the burden on families and carers

When a person develops supportive peer relationships, some of the burden is reduced for families and carers. The person may develop a more positive attitude and make it easier for carers to support them.

Families and carers can also benefit from peer support groups with people who have had similar experiences as carers. This can lead to increased consumer enablement, by reducing carer burnout and making sure people are better supported at home.

Improves knowledge and healthy literacy

Peer support can help people develop problem-solving, decision-making, coping and stress management skills. They can provide advice about interacting with health professionals, accessing health and social services, and managing physical limitations. Peer groups also provide an opportunity to ask questions and discuss ideas and concerns with people who have had a similar experience.

Increases access to services

Peers can offer practical advice, support and encouragement that increases access to services. Models such as shared medical appointments and professional peer support can increase accountability for people who find health services intimidating or culturally unsafe.

How to practice peer support

Peer support is based on trust, equality, shared understanding, respect and mutual empowerment between people in similar situations.7 8

The most effective peer relationships are between people with other things in common, such as a shared cultural background, language, religion, age, location, personal values or gender.9

Before recommending peer support, it is important to:

  • talk to consumers, families and carers about the benefits of peer support
  • make sure consumers are aware of risks and can make an informed decision
  • encourage consumers to establish peer support relationships
  • consider barriers to participation, such as low literacy
  • build partnerships with peak bodies that have links to peer support groups
  • establish referral pathways for people who may benefit from peer support.6

Things to consider when choosing a group

Consider recommending peer support groups:

  • run by reputable associations or charities
  • with group leaders or facilitators who are accredited
  • with written ground rules about how the site or group may be used
  • that moderate online forums and emails
  • that provide safe spaces for face-to-face meetings
  • that maintain privacy of contact details and personal information.

What is missing from the evidence?

It is important to note that there is a lack of conclusive peer-reviewed evidence showing the benefits of peer support.5 Reviews of the literature have found various issues including poor research designs, inconsistent evaluation methods and problems with reporting of results.

While positive outcomes are often described in satisfaction surveys, they tend not to be specifically tied to health outcomes. Improved research design and evaluation is likely to show that peer support is an effective approach for improving patient experience and increasing self-management skills for chronic conditions.

References

  1. Davidson L, Chinman M, Kloos B, et al. Peer Support Among Individuals with Severe Mental Illness: A Review of the Evidence. Clinical Psychology: Science and Practice. 1999;6(2):165-87.
  2. Stevens J, Dixon J, Binns A, et al. Shared medical appointments for Aboriginal and Torres Strait Islander men. Australian Family Physician. 2016 Jun;45(No.6);425-429.
  3. Davidson L, Chinman M, Sells D et al. Peer support among adults with serious mental illness: a report from the field. Schizophrenia Bulletin. 2006;32(3):443-50.
  4. Batterham R, Osborne R, McPhee C et al. Consumer enablement: an Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Agency for Clinical Innovation. 2016.
  5. Chronic Illness Alliance. Peer Support for Chronic and Complex Conditions [Literature Review]. Camberwell, Vic: Chronic Illness Alliance; 2011 [updated 2011 Apr; cited 2017 Jun 30].
  6. Repper J, Carter T. A review of the literature on peer support in mental health services. Journal of Mental Health. 2011;20(4):362.
  7. Repper J. Peer Support Workers: theory and practice [Briefing]. London: Centre for Mental Health and Mental Health Network; 2013 [updated 2013 Jun; cited 2017 Aug 16].
  8. Faulkner A, Kalathil J. The Freedom to be, the Chance to Dream: Preserving User-led Peer Support in Mental Health. UK: Together; 2012 [updated 2012 Aug; cited 2017 Aug 23].
  9. Manderson B, McMurray J, Piraino E, et al. Navigation roles support chronically ill older adults through healthcare transitions: a systematic review of the literature. Health & Social Care in the Community. 2012;20(2):113-27.

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